BACKGROUND: Herpes zoster is an important and troublesome disease. OBJECTIVE: The purpose of this study was the elucidation of the epidemiological and clinical characteristics of herpes zoster through patient assessrnent. METHODS: During a 5- Year period, January 1990 to December 1994, 215 patients with herpes zoster were assessed with regard to annual and monthly frequency in occurrence, age and gender incidence. Associated conditions, dermatomic distributions, the relationship of onset of pain and skin lesions, Multi-CMI test and complications were also evaluated. RESULTS: 1. The annual freguency of herpes zoster ranged from 0.88% to 1.78% (mean 1.23%) during the 5-year period. The highest number of herpes zoster patients was observed in winter (p<0.001) especially in January. 2. Herpes zoster was found to most frequently afflict persons aged 50-59 (27.9%). 71% of the patients were over 40 years of age. 3. In 76 patients (41.8%), neuralgia occurred several days (4 days mean) before the development of skin lesions. In 92 patients (50.5%), pain and skin lesions developed simultaneously while skin lesion development occurred before the onset of pain in 14 patients (7.7%). 4. Among the patients, 42.8% had associated conditions such as diabetes mellitus, hypertension, pulmonary tuberculosis, liver diseases, peptic ulcer, hypothyroidism, pharyngitis, fracture, etc. 5. The dermatomic invclvement of herpes zoster patients having one dermatome was most frequent in thoracic dermatome ca. es (52.6%). Others included cervical (16.7%), trigeminal (11.6%), sacral (6. 0%), lumbar (4.2%), facial (0.5%). Cases having two different dermatomes constituted 8.4%. 6. The most common complication of herpes zoster was postherpetic neuralgia although instance of ophthalmologic compiications, secondary bacterial infection, scar formation, Ramsay-Hunt syndrome, keloid formation, and urinary difficulty were also documented. 7. Multi-CMI (Cell-mediated immunity) tests were done on 88 herpes zoster patients. Thirteen of them (14.8%) were found to have comparatively depressed scores. Ten of the 79 single dermatome involvement patients (12.7%) and three of the 9 two dermatome involvement patients (33.3%) exhibited similar scores. CONCLUSION: These results are in accordance with those of previous reports with the exception of the higher incidence ot two different dermatome involvements and seasonal variation.
Bacterial Infections ; Cicatrix ; Diabetes Mellitus ; Herpes Zoster* ; Humans ; Hypertension, Pulmonary ; Hypothyroidism ; Incidence ; Keloid ; Liver Diseases ; Neuralgia ; Neuralgia, Postherpetic ; Peptic Ulcer ; Pharyngitis ; Seasons ; Skin ; Tuberculosis

No abstract available.
Anus, Imperforate*

BACKGROUND: Congenital aortic stenosis in children is characterized by "excessive" left ventricular hypertrophy with reduced left ventricular systolic wall stress that allows for supernormal ejection performance. We hypothesized that left ventricular wall stress was decreased immediately after surgical correction of pure congenital aortic stenosis. Also measuring postoperative left ventricular wall stress was a useful noninvasive measurement that allowed direct assessment for oxygen consumption of myocardium than measuring the peak systolic pressure gradient between ascending aorta and left ventricle for the assessment of surgical results. MATERIAL AND METHOD: Between September 1993 and August 1999, 8 patients with isolated congenital aortic stenosis who underwent surgical correction at Yonsei cardiovascular center were evaluated. There were 6 male and 2 female patients ranging in age from 2 to 11 years(mean age, 10 years). Combined Hemodynamic-Ultrasonic method was used for studying left ventricular wall stress. We compared the wall stress peak systolic pressure gradient and ejection fraction preoperatively and postoperatively. RESULT: After surgical correction peak aortic gradient fell from 58.4+/-17.6, to 23.7+/-17.7 mmHg(p=0.018) and left ventricular ejection fraction decreased but it is not statistically significant. In the consideration of some factors that influence left ventricular end-systolic wall stress excluding one patient who underwent reoperation for restenosis of left ventricular outflow tract left ventricular end-systolic pressure and left ventricular end-systolic dimension were fell from 170.6+/-24.3 to 143.7+/-27.1 mmHg and from 1.78+/-0.4 to 1.76+/-0.4 cm respectively and left ventricular posterior wall thickness was increased from 1.10+/-0.2, to 1.27+/-0.3cm but it was not statistically singificant whereas left ventricular end-systolic wall stress fell from 79.2+/-24.9 to 57.1+/-27.6 kdynes/cm2(p=0.018) in 7 patients. For one patient who underwent reoperation peak aortic gradient fell from 83.0 to 59.7 mmHg whereas left ventricular end-systolic wall stress increased from 67.2 to 97.0 kdynes/cm2 The intervals did not change significnatly. CONCLUSION: We believe that probably some factors that are related to left ventricular geometry influenced the decreased left ventricular wall stress immediately after surgical correction of isolated congenital aortic stenosis. Left ventricular wall stress is a noninvasive measurement and can allow for more direct assesment than measuring peak aortic gradient particularly in consideration of the stress and oxygen consumption of the myocardium therefore we can conclude it is a useful measurement for postoperative assessment of congenital aortic stenosis.
Aorta ; Aortic Valve Stenosis* ; Blood Pressure ; Child ; Equidae ; Female ; Follow-Up Studies* ; Heart Ventricles ; Humans ; Hypertrophy, Left Ventricular ; Male ; Myocardium ; Oxygen Consumption ; Reoperation ; Stroke Volume

After aseptic or septic meningitis, some neurologic complications such as convulsions, delirium, rigidity, cerebral infarctions and cerebral hemorrhage can be developed. The cerebral infarction after meningitis is caused by arterial or venous occlusions. Involvement of small perforating arteries leads to ganglionic infarcts while severe sapsm of major vessels may lead to massive infarctions in the distribution of middle and/or anterior cerebral arteries. Cortical venous and/or dural thrombosis (especially in the superior sagittal sinus) produces typical features, including multiple areas of white matter hemorrhagic infarction. These neurologic complications are common in bacterial meningitis and very rare in aseptic meningitis. We experienced a case of cerebral infarction in MCA/ACA territory and subdural hemorrhage in occipital lobe after aseptic meningitis in 10 month-old-boy. We report a case with a brief review of related literature.
Anterior Cerebral Artery ; Arteries ; Cerebral Hemorrhage ; Cerebral Infarction* ; Delirium ; Ganglion Cysts ; Hematoma, Subdural* ; Infarction ; Meningitis ; Meningitis, Aseptic* ; Meningitis, Bacterial ; Occipital Lobe ; Seizures ; Thrombosis

The cytologic examination of the urine is very simple and inexpensive procedure for the detection and follow-up of the genitourinary tumors, and worthy as a mass screening test. To observe the accuracy of the cytologic examination on the genitourinary tumors, we have evaluated the results of the examination which were performed at the Department of Urology, Seoul National University Hospital during the period from January, 1977 to September, 1978. Two hundred fifteen patients were subjected to this study. Of which 108 cases were known as to have genitourinary tumors clinicopathologically. 107 cases who did not have genitourinary tumors were also included in to compare with the tumor patients. Following results were obtained according to the various analysis.
Follow-Up Studies ; Humans ; Mass Screening ; Seoul ; Urology

Microsporum gypseum, long considered to be of animal origin, has recently been found to be soil inhabitating fungus and abundant in soil throughout the world. M. Gypseum infections tend to increase nowadays in Korea. Nineteen cases of ringworm caused by M. gypseum were reported in Korean literature until 1980 to the best of our knowledge. We present 5 cases of M. gypseum infection confirmed by culture findings on Sabouraud agar media and microscopic examination. The first case was 4 year-old boy with solitary coin sinzed pruritic annular erythernatous plaque ontaining papules, pustules and scales on the right cheek of on month duration. The second case, 7 year-old boy, had solitary walnut sized ovoid plaque consisted with papulopustules, oozing and peripheral scaling on right cheek of one month duration. The third case, 5 year-old boy, had solitary egg sized pruritic erythematous plaque with papuIes, scales and crust on the right lower leg of three weeks duration. The fourth case, 63 year-old female, had solitary egg sized sharply demarcated erythematious scaly patch with central clearing on nose and. nasolabial area of 10 days duration. The last case was 2 year-old girl with solitary coin sized annular erythematous scaly pIaque on left lower leg of two weeks duration.
Agar ; Animals ; Cheek ; Child ; Child, Preschool ; Female ; Fungi ; Humans ; Juglans ; Korea ; Leg ; Male ; Microsporum* ; Middle Aged ; Nose ; Numismatics ; Ovum ; Seoul* ; Soil ; Tinea ; Weights and Measures

PURPOSE: To report a case of fungal keratitis 3 days after intracorneal ring segment (ICRS) implantation for keratoconus. CASE SUMMARY: A 65-year-old woman was referred to our clinic with refractory infectious keratitis in her left eye 3 days after ICRS insertion for keratoconus. Slit lamp examinations revealed infiltrates around the incision site with cellular reaction in the anterior chamber after the ICRS had been removed. Corneal scrapings were obtained for staining and cultures, and intensive topical antibiotics were administered. Initial microscopy and cultures were negative. Despite the use of intensive topical antibiotics, there was no improvement. Hyphae were isolated from additional corneal scrapings. The patient's symptoms and corneal findings improved following administration of topical amphotericin B and oral itraconazole. CONCLUSIONS: Infectious keratitis after ICRS implantation is an uncommon but sight-threatening complication. Fungal keratitis should also be considered if infectious keratitis after ICRS is unresponsive to antibiotics.
Aged ; Amphotericin B ; Anterior Chamber ; Anti-Bacterial Agents ; Eye ; Female ; Humans ; Hyphae ; Keratitis ; Keratoconus ; Microscopy

In case of limbitis, cytokines secreted by PMNs might inhibit the function of corneal epithelial stem cells located at the limbal basal cell layer. The purpose of this study was to examine whether PMNs factor affected stem cells (SC). PMNs obtained from the peritoneal cavity of rabbits after 0.2% glycogen stimulation incubated in DMEM at 37 degrees C for 24 hours. PMNs factor was obtained from the medium using dialysis. The death or inhibition of growth of rabbit corneal epithelial cells (CE) by PMNs factor was studied in vitro. PMNs factor and PBS as a control were injected into the limbal region for clinical evaluation and histopathologic study. ID 50 of PMNs factor for cultured CE was equal to the amount of polypeptide produced by 1.29 x 0 (7) PMNs. Cultured rabbit CE shrank and began to die 24 hours after exposure to PMNs factor. Abnormal findings were observed 5 days and 8 months after injection of PMNs factor at the limbus by light and electron microscopy. Clouding, defect, and vascularization of CE were noted several months after injection of PMNs factor. PMNs in limbitis may damage corneal epithelial stem cells and cause epithelial instability of the cornea.
Cornea ; Cytokines ; Dialysis ; Epithelial Cells ; Glycogen ; Microscopy, Electron ; Neutrophils* ; Peritoneal Cavity ; Rabbits ; Stem Cells*

BACKGROUND: IL - 5 has been recognized as a potent proeosinophilic cytokine and IL-10 has been reported as an important anti - inflammatory cytokine in allergic inflammation. But the clinical roles of these cytokines in allergic asthma are still unclear. Objectives : We studied the clinical implications of IL - 5 and IL - 10 secretions from stimulated peripheral blood mononuclear cells ( PBMC ) in Dermatophagoides farinae ( DF ) atopic asthmatics ( BA ). METHODS: Thirty - six DF sensitized BA and 9 non - atopic BA were enrolled for this study. Twenty - seven out of 36 subjects were challenged by inhalation of DF crude allergen. The isolated PBMCs were cultured for 6 days with DF antigen and the stimulatory index ( SI ) and secretions of IL - 5, IFN - y and IL - 10 from PBMC were measured. We analyzed these parameters with clinical parameters. RESULTS: SI (4.2 +/- 1.0 vs. 1.3 +/- 0.3, p<0.05) and secretions of IL - 5 ( 19.9 vs. 1.7 g/L, p< 0.001 ) and IL-10 ( 185.5 vs. 34.3 g/L, p(0.05 ) from the atopic BA were significantly higher than those of non-atopic BA, but the secretion of IFN - r was not different between the two groups ( 56.6 vs. 47.3 ug/L ). No significant difference in secretions of IL - 5, IL - 10, IFN - r and SI of PBMC was found between responder and non - responder of DF inhalation challenge test. Among responders to antigen challenge test ( n = 17 ), the production of IL - 5 correlated with the productions of IL - 10 (r = 0.773, p< 0.01 ) and methacholine PC20 ( r = 0.503, p< 0.05 ). Production of IL - 5 from the PBMC of atopic mild intermittent BA ( n = 10 ) was higher than that of atopic per'sistent BA ( n = 27 ) ( p< 0.01 ), but no difference in IL - 10, IFN - r and SI was found between the two groups. Conclusions : Allergen specific productions of IL - 5 and IL - 10 from the PBMC may be specific for atopic subjects and secretion of IL - 5 from the stimulated PBMC may contribute to the pathogenesis of atopic BA. The severity of BA may be more influenced by other factors.
Asthma ; Cytokines ; Dermatophagoides farinae ; Inflammation ; Inhalation ; Interleukin-10 ; Methacholine Chloride

BACKGROUND: Conventional echocardiography provides fundamental information about mitral valve morphology and function but is often subjective and has a relatively low specificity in evaluating valve calcific deposit, which is critical information for the preoperative decision. We hypothesized that mitral valvular calcification could be detected in standard two-dimensional echocardiograms of mitral valve in vivo by evaluating regional gray level(echo amplitude) using computerized image analysis so that we could overcome the subjectivity and low specificity of conventional echocardiography. METHODS: We tested this hypothesis by performing standard 2.5MHz two-dimensional echoes on mitral valve and myocardium in 30 patients with mitral stenosis, scheduled to undergo mitral valve replacement. We compared gray level of each region of interest in mitral valve and myocardium in stop-frame images with the degree of calcifications identified by pathologic and radiographic examinations. RESULTS: Ratio of mean gray level of mitral valve to mean gray level of myocardium was the most reliable value in evaluating degree of calcification. Quantitatively, region of calcification displayed the ratio of significantly higher value than that of no calcification. In case of anterior mitral valve, the ratio of the evident calcified region was greater than 3.11, that of the region without calcification was less than 2.42 and that of microcalcification was betwwn 2.42 and 3.11. For posterior mitral valve, the ratio of the evident calcified region was greater than 3.50, that of the region without calcification was less than 2.19 and that of microcalcification was between 2.19 and 3.50. The sensitivity and specificity of this method for assessment of degree of calcification was 75% and 100% for anterior mitral valve and 9% and 87.5% for posterior mitral valve. CONCLUSION: Mitral valvular calcification could be detected quantitatively in standard two dimensional echocardiograms of mitral valve in vivo by evaluating regional gray level(echo amplitude) using computerized image analysis.
Echocardiography ; Humans ; Mitral Valve ; Mitral Valve Stenosis* ; Myocardium ; Sensitivity and Specificity