No abstract available.
Ichthyosiform Erythroderma, Congenital*

Marchiafava-Bignami disease(MBD) is a rare complication of chronic alcoholism characterized by symmetrical demyelination of the corpus callosum. We report a case of MBD in a Korean patient having chronic alcohol dependence. The patient exhibited mental depression, weakness of all four limbs and dysarthria. Laboratory data showed mild hyponatremia. Magnetic resonance imaging(MRI) revealed unusual symmetrical resolving lesions of the putamen in addition to the typically observed lesion of the corpus callosum. The neurologic disturbances were gradually improved with the normalization of low plasma sodium levels. Marked improvement of abnormal MRI findings was noted after thiamine supplement, though the patient still exhibited severe cognitive impairment.
Alcoholism ; Corpus Callosum ; Demyelinating Diseases ; Depression ; Dysarthria ; Extremities ; Humans ; Hyponatremia ; Magnetic Resonance Spectroscopy ; Marchiafava-Bignami Disease ; Plasma ; Putamen ; Sodium ; Thiamine

PURPOSE: The purpose of this study is to identify the effects of job demand and recovery experience from job stress on job embeddedness among workers in the service industry. METHODS: The participants were 223 workers from the service industry in P and Y Cities with the help of a structured self-report questionnaire, administered between July 10 and August 20, 2017. The data were analyzed using descriptive statistics, t-test, ANOVA, Scheffé test, Pearson correlation coefficients and stepwise multiple regression. RESULTS: There were significant differences in job embeddedness in terms of satisfaction with salary, continuous service, perceived stress level and the perceived health status of the subjects. There were significant positive correlations between role clarification in job demands (r=.55), recovery experience from job stress (r=.27) and job embeddedness. From the multiple regression analysis, the most significant factors affecting job embeddedness were found to be role clarification in job demands (β=.47), recovery experience from job stress (β=.23), and perceived stress level (β=.18). These variables explain 34.0 % of the total variance in job embeddedness. CONCLUSION: In order to increase job embeddedness among workers in the service industry, it is necessary to prepare measures to increase recovery experience from job stress and to decrease role clarificationin job demand, and perceived stress level.
Commerce ; Personnel Loyalty ; Recovery of Function ; Salaries and Fringe Benefits

PURPOSE: Cholestatic liver disease is a frequent complication of prolonged parenteral nutrition, especially in premature infants. The purpose of present study is to evaluate the clinical and biochemical efficacy of ursodeoxycholic acid (UDCA) in premature infants with total parenteral nutrition (TPN) cholestasis. METHODS: Retrospective chart review of 31 prematures with TPN cholestasis in Neonatal Intensive Care Unit of Chonnam University Hospital from January 1995 and December 2002 was done. Prematures were divided into two groups based on UDCA treatment: the study group (n=22, with UDCA treatment) and the control group (n=9, without UDCA treatment). Treatment efficacy of UDCA was evaluated by monitoring the changes of serum direct bilirubin level for more than one to two months. RESULTS: In study group, cholestasis appeared at a mean age of 23+/-18.8 days after a mean of 21+/-19.7 days of TPN. UDCA was initiated (ranged 15-30 mg/kg/day) at a mean age of 54+/-22.3 days for a mean of 32+/-19.0 days. There was no significant difference in decrease of direct bilirubin level between the study and control group. However, the day of initial enteral feeding and full enteral feeding were earlier in control group compared with study group. CONCLUSIONS: This study shows that UDCA treatment is not effective in the treatment of TPN cholestasis among premature infants unlike that of results reported in children and adults. To reduce the incidence of TPN cholestasis in premature infants, early introduction of enteral feeding as soon as possible is most important.
Adult ; Bilirubin ; Child ; Cholestasis* ; Enteral Nutrition ; Humans ; Incidence ; Infant, Newborn ; Infant, Premature* ; Intensive Care, Neonatal ; Jeollanam-do ; Liver Diseases ; Parenteral Nutrition ; Parenteral Nutrition, Total* ; Retrospective Studies ; Treatment Outcome ; Ursodeoxycholic Acid*

Trisomy 14 mosaicism is a rare chromosomal abnormality with distinct and recognizable clinical features. We report a patient with presumed retinal dystrophy having diffuse retinal pigment epithelial abnormalities, which has not been previously reported in association with trisomy 14. This case expands the clinical spectrum of this rare entity.
Abnormalities, Multiple/genetics ; Chromosomes, Human, Pair 14 ; Female ; Humans ; Infant, Newborn ; Mosaicism ; Retinal Diseases/*congenital/genetics ; *Trisomy

Extramammary Pagets disease of the vulva is an uncommon vulvar neoplasm with a high rate of recurrence. We report a young woman in whom vulval Paget's disease occurred in association with local adenocarcinoma. The patient presented at the age of 28 years with slowly growing vulval mass which had some mucoid discharge. Biopsy of the mass showed Paget's disease with associated local adenocarcinoma. This patient received modified radical vulvectomy with unilateral inguinofemoral lymphadenectomy. Until now she is under follow up without evidence of recurrence for 24 months. According to our medline research from 1980 to 2000, this case is the youngest asian patient yet recorded. We recommend that abnormally growing vulvar mass need to be biopsied eventhough she is young.
Adenocarcinoma* ; Asian Continental Ancestry Group ; Biopsy ; Female ; Follow-Up Studies ; Humans ; Lymph Node Excision ; Paget Disease, Extramammary ; Recurrence ; Vulva ; Vulvar Neoplasms

PURPOSE: To describe the ophthalmoscopic features and natural history in a case series of eyes that developed intraocular hemorrhages associated with perinatal distress and to evaluate their clinical courses. METHODS: A retrospective chart review of 289 neonates with a medical history of perinatal distress was conducted. Among these 289 patients (578 eyes), 29 eyes of 17 neonates were found to have had retinal hemorrhages or vitreous hemorrhages (VH). A comprehensive chart review, including details of fundoscopic findings and perinatal history, was conducted. RESULTS: Intraocular hemorrhage was present in 5.5% of the patients. Most hemorrhages (82.7%) were intraretinal. In our population, 17% (n = 5) of hemorrhages resolved within two weeks, but 31% (n = 9) did not resolve even after four weeks. Most hemorrhages spontaneously resolved without any specific sequelae; however, one infant's dense unilateral VH persisted up to three months after birth. When the patient was seen again at 3.5 years of age, she had developed axial myopia and severe amblyopia of the involved eye. CONCLUSIONS: In asphyxiated newborns, the possibility of intraocular hemorrhages should be considered. Long-standing, dense hemorrhages obscuring the macula may lead to severe vision deprivation amblyopia. Therefore, ophthalmic examination should be considered in neonates with perinatal distress, and close observation is necessary for hemorrhages that do not resolve in this amblyogenic age group.
Asphyxia Neonatorum/*complications ; Female ; Follow-Up Studies ; Humans ; Infant, Newborn ; Male ; Ophthalmoscopy ; Retinal Hemorrhage/diagnosis/*etiology ; Retrospective Studies ; Time Factors ; Visual Acuity ; Vitrectomy

PURPOSE: To describe the ophthalmoscopic features and natural history in a case series of eyes that developed intraocular hemorrhages associated with perinatal distress and to evaluate their clinical courses. METHODS: A retrospective chart review of 289 neonates with a medical history of perinatal distress was conducted. Among these 289 patients (578 eyes), 29 eyes of 17 neonates were found to have had retinal hemorrhages or vitreous hemorrhages (VH). A comprehensive chart review, including details of fundoscopic findings and perinatal history, was conducted. RESULTS: Intraocular hemorrhage was present in 5.5% of the patients. Most hemorrhages (82.7%) were intraretinal. In our population, 17% (n = 5) of hemorrhages resolved within two weeks, but 31% (n = 9) did not resolve even after four weeks. Most hemorrhages spontaneously resolved without any specific sequelae; however, one infant's dense unilateral VH persisted up to three months after birth. When the patient was seen again at 3.5 years of age, she had developed axial myopia and severe amblyopia of the involved eye. CONCLUSIONS: In asphyxiated newborns, the possibility of intraocular hemorrhages should be considered. Long-standing, dense hemorrhages obscuring the macula may lead to severe vision deprivation amblyopia. Therefore, ophthalmic examination should be considered in neonates with perinatal distress, and close observation is necessary for hemorrhages that do not resolve in this amblyogenic age group.
Asphyxia Neonatorum/*complications ; Female ; Follow-Up Studies ; Humans ; Infant, Newborn ; Male ; Ophthalmoscopy ; Retinal Hemorrhage/diagnosis/*etiology ; Retrospective Studies ; Time Factors ; Visual Acuity ; Vitrectomy

Feto-maternal hemorrhage, the presence of fetal red blood cells in the maternal circulation, occurs in up to 75% of pregnancies. But its volume is usually very small. Feto-maternal hemorrhage of more than 30 ml of whole blood is relatively rare. The key features that lead to early diagnosis are the maternal history, fetal monitoring, the clinical and laboratory findings of anemia and a negative Coombs' test. Diagnosis is confirmed by Kleihauer-Betke test. Perinatal problems include fetal distress, neonatal anemia, hypovolemic shock, and death. The fetal outcome depends on the amount and rate of bleeding. The initial hemoglobin level was a better predictor than the volume of bleeding. We present two cases of severe neonatal anemia associated with massive feto-maternal hemorrhage, which was confirmed by Kleihauer-Betke test.
Pregnancy ; Female ; Infant, Newborn ; Humans

BACKGROUND: Clear cell acanthoma usually appears as an asymptomatic nodule on the leg. It has an unusual clinical feature in that it is presented as chronic eczema on the areola. The origin of clear cell acanthoma is not yet clear, although many hypotheses have been proposed, including a benign neoplasm or an inflammatory dermatosis. OBJECTIVE: In this study, clear cell acanthoma on the areola showing clinically eczematous features were analysed by immunohistochemical techniques, using antibodies against cytokeratin 16, involucrin and PCNA and compared with psoriasis and squamous cell carcinoma. METHODS: Using the immunohistochemical method with formalin-fixed, paraffin-embedded sections, we analysed the expression of cytokeratin 16, involucrin and PCNA in biopsy specimens of 6 cases of clear cell acanthoma on the areola, 5 cases of psoriasis, and 5 cases of squamous cell carcinoma. RESULTS: The expression of cytokeratin 16 was detected in spinous and granular layers in all cases of clear cell acanthoma and psoriasis and three cases of squamous cell carcinoma. Psoriasis showed slightly higher immunoreactivity than clear cell acanthoma and squamous cell carcinoma, but this difference was not statistically significant (p=0.142). The expression of involucrin was detected in spinous and granular layers in all cases of clear cell acanthoma, psoriasis, and squamous cell carcinoma. The immunoreactivities were similar. The expression of PCNA was detected in basal and spinous layers in two cases of clear cell acanthoma, four cases of psoriasis, and five cases of squamous cell carcinoma. The expression of PCNA was higher in psoriasis and squamous cell carcinoma than in clear cell acanthoma, and this difference was statistically significant (p=0.034, p=0.004). CONCLUSION: Clear cell acanthoma on the areola may result from increased psoriasis-like inflammatory proliferation and accelerated differentiation of keratinocytes.
Acanthoma* ; Antibodies ; Biopsy ; Carcinoma, Squamous Cell ; Eczema ; Keratin-16* ; Keratinocytes ; Keratins* ; Leg ; Proliferating Cell Nuclear Antigen* ; Psoriasis ; Skin Diseases