PURPOSE:Precocious puberty is the development of secondary sexual characteristics before the age of 8 years in girls and 9.5 years in boys. It is usually associated with premature, rapid skeletal maturation and closure of the epiphyseal plates, resulting in short stature compared with genetic height potential and can produce significant psychological distress for patients. We examined effects of treatment with long-acting gonadotropin-releasing hormone(GnRH) agonist on somatic and skeletal growth in patients with central precocious puberty(CPP). MATERIALS & METHODS:Two male and seven female patients were diagnosed as having central precocious puberty(CPP) on the basis of onset age of secondary sexual characteristics, bone age, results of GnRH stimulation test and levels of sex hormones. They were treated with Triptorelin or Leuprorelin acetate(80-100ug/kg, IM every 4 weeks) for 1 year. The patients have been analyzed in terms of changes in auxological parameters including height velocity(HV), HV SDS CA, height SDS CA, height SDS BA and predicted adult height(PAH) SDS before and 1 year after treatment with GnRH agonist. RESULTS:The growth velocity a year after treatment was decreased to 4.1+/-0.9 from 7.5+/-1.2cm/year(P<0.01) and the height velocity standard deviation score(SDS) for chronologic age decreased to -1.6+/-0.4 from 2.8+/-0.8(P<0.01). The height SDS for chronologic age was increased to 2.0+/-0.7 from 3.8+/-1.0 a year after treatment (P<0.01). However, no significant difference were observed in height SDS for bone age(-1.9+/-0.2 from -2.1+/-0.3)(p>0.05) and predicted adult height SDS(-2.2+/-0.5 from -2.3+/-0.4)(p>0.05) one year after treatment. CONCLUSION: We observed a remarkable growth deceleration a year after treatment with GnRH agonist in CPP patients. However, the results of this study shows no benefit of GnRH agonist treatment in improving predicted adult height. It is still not clear whether GnRH agonist treatment will eventually help the patients with CPP achieve a final adult height within the range of their genetic target height or not. Further extensive long-term study using strict selection criteria for GnRH agonist treatment is required to address this issue.
Adolescent ; Adult ; Age of Onset ; Deceleration ; Female ; Gonadal Steroid Hormones ; Gonadotropin-Releasing Hormone* ; Growth Plate ; Humans ; Leuprolide ; Male ; Patient Selection ; Puberty ; Puberty, Precocious* ; Triptorelin Pamoate

Chromomycosis is a chronic localized infection of the cutaneous and subcutaneous tissues and characterized by verrucoid, ulcerated and crusted lesions with sclerotic margins. It histologically show confluent granulomatous nodules containing large giant cells of the foreign body type. The organisms are differ from other yeastform fungi by the characteristic chestnut-brown color and by the septate division. A case of 51 year old woman with chromomycosis at submental area is presented.
Female ; Humans

PURPOSE: According to the statistics announced by the Ministry of Unification, the number of North Korean refugees living in South Korea has increased by 200 on average monthly in 2010. The number of refugees increased only by 300 annually until 2000. The total number of refugees as of February 2012 was 20,956. This study aims to investigate the psychobiology of the North Korean refugees who consulted psychiatric clinics among those living daily life in South Korea. METHODS: The subjects of this study were 85 North Korean refugees that consulted psychiatric clinics from January 1, 2005 to July 2011. This study obtained demographic and psychiatric information in a retrospective approach. RESULTS: Among the 85 North Korean refugees, 75 (88.2%) were females and their average age was 48 years of age. A total of 16 (18.8%) were admitted to a clinic and among the inpatients, 4 were admitted twice and two were admitted three times. As for the claimed symptoms of outpatients, insomnia was shown in 47 (55.3%) patients, headaches in 37 (43.5%), anxiety in 20 (23.5%), depression in 19 (22.4%), etc. The major symptoms represented by inpatients were insomnia in 14 (87.5%) patients, depression in 12 (75%), and headaches in 8 (50%), etc. CONCLUSION: The most frequent psychiatric symptoms of North Korean refugees living in South Korea were insomnia and headaches. It suggests that when performing psychiatric diagnosis and treatment of North Korean refugees, we have to take into consideration the fact that they claimed the physical symptoms more than the emotional ones. Also, from the aspect that most symptoms of North Korean refugees were insomnia, more profound research on sleep is required in the future.
Anxiety ; Depression ; Female ; Headache ; Humans ; Inpatients ; Mental Disorders ; Outpatients ; Refugees ; Republic of Korea ; Retrospective Studies ; Sleep Initiation and Maintenance Disorders

The accuracy of fine needle aspiration cytology (FNAC) of the lymph node was investigated through a review of 176 FNAC cases and the corresponding biopsies. We chose 157 FNAC cases after the exclusion of 19 inadequate ones. Sensitivity of malignancy was 94.0%, specificity 100%, false negativity 6.0%, and false positivity 0.0%. The overall diagnostic accuracy was 96.8%. Sensitivity of metastatic carcinoma was 98.0% and that of malignant lymphoma was 87.9%. False negative cases included one metastatic carcinoma and four malignant lymphomas. The aspirates of metastatic carcinoma with false negativity exhibited a diffuse smear of keratin debris without viable cells, which led to the difficulty in differentiation from benign epithelial cyst. The cases of malignant lymphoma with false negative diagnosis were two Hodgkin diseases, one Lennert's lymphoma, and one peripheral T cell lymphoma in the histologic sections. On the analysis of 39 cases of tuberculosis, 17 cases (43.6%) were diagnosed as tuberculosis, 4 (10.3%) as granulomatous lymphadenitis, 3 (7.7%) as necrotizing lymphadenitis, and 15 (38.5%) as reactive hyperplasia or pyogenic inflammation. Sensitivity of tuberculosis was 53.9%. In conclusion, lymph node FNAC is an excellent non-invasive diagnostic tool for the diagnosis of metastatic carcinoma. The diagnostic accuracy of malignant lymphoma could be improved with flow cytometry or polymerase chain reaction for antigen receptor genes. For the FNAC diagnosis of tuberculosis, AFB stain, culture, and PCR would be helpful as adjuvant techniques.
Biopsy ; Biopsy, Fine-Needle ; Diagnosis ; Flow Cytometry ; Hyperplasia ; Inflammation ; Lymph Nodes ; Lymphadenitis ; Lymphoma ; Lymphoma, T-Cell, Peripheral ; Polymerase Chain Reaction ; Receptors, Antigen ; Sensitivity and Specificity ; Tuberculosis

OBJECTIVES: This study aimed to investigate the psychiatric status of HIV-infected/AIDS inpatients in a general hospital over the past 2.5 years. METHODS: A retrospective chart review was conducted of psychiatric consultations performed between January 1, 2011, and July 30, 2013. The records of 97 HIV-infected/AIDS patients were analyzed. These included a total of 282 psychiatric consultations. RESULTS: Of the 97 patients, 91(93.8%) were male, the mean age was 48 years, and mean number of consultations was 2.8. Depressed mood was reported in 102 consultations(23.8%), insomnia in 60(14.0%), and anxiety in 31(7.2%). Psychiatric disorders diagnosed on initial consultation included depressive disorder(37 patients ; 37.0%), cognitive disorder(11 ; 11.0%), and delirium(9 ; 9.0%). Recommended psychotropic medication included Lorazepam(99 ; 17.2%), Escitalopram(90 ; 15.7%), and Quetiapine(84 ; 14.6%). CONCLUSIONS: The main complaints of HIV-infected/AIDS patients were depressed mood, insomnia, and suicidal ideation(including suicide attempts). In total, 85(93.3%) patients of those consulted were diagnosed as meeting the criteria for a psychiatric condition. However, considering that only 16.9% of patients consulted received follow-up treatment, longitudinal research is needed to examine the influence of psychiatric disorders on the transmission of HIV-infection/AIDS, as well as on prognosis and treatment adherence.
Anxiety ; Follow-Up Studies ; HIV ; Hospitals, General ; Humans ; Inpatients ; Male ; Prognosis ; Referral and Consultation ; Retrospective Studies ; Sleep Initiation and Maintenance Disorders ; Suicide

Background: Recent studies have shown that oral administration of probiotics may improve the immune imbalance caused by dysbiosis of the gut microbiome in atopic dermatitis (AD). This study aimed to investigate the clinical and immunological effects of Lactobacillus pentosus in children with mild to moderate AD. Methods: Children aged 2–13 years with AD were randomized to receive either 1.0 × 1010 colony-forming units of L. pentosus or placebo, daily, for 12 weeks. The clinical severity of AD and transepidermal water loss were evaluated. Blood eosinophil counts, serum total immunoglobulin E (IgE), and cytokine levels were measured. The diversity and composition of the gut microbiota were also analyzed. Results: Eighty-two children were recruited, and 41 were assigned to the probiotics intervention group. The mean scoring of atopic dermatitis (SCORAD) indices at baseline were 30.4 and 34.3 for the probiotics and placebo groups, respectively. At week 12, the mean indices were 23.6 and 23.1 for the probiotics and placebo groups, respectively. Clinical severity decreased significantly over time in both groups, with no significant difference between the two groups. In both groups, there were no significant differences in cytokine levels, microbial diversity, or the relative abundance of the gut microbiota at week 12 compared with the corresponding baseline values. The mean subjective scores of SCORAD indices after intervention for the probiotics group were significantly lower than those for the placebo group in IgE sensitized AD (P = 0.019). Conclusion Our results show improved symptoms in the probiotics and placebo groups, and we could not find additional effects of L. pentosus in AD. However, the mean subjective scores of SCORAD indices for the probiotics group are significantly improved compared with those for the placebo group in allergen-sensitized AD.

In 1971, for purpose of reduction of peak stress occuring in cement and trabecular bone of the acetabulum, Harris reported a series of metal-backed acetabular components with removable polyethylene liners that could be replaced if excessive wear occured. Modular designs of hip prostheses have become popular recently, but they introduce the risk of disassembly of the components postoperatively. And introduce of loosening and infection of femoral or acetabular components by debris of polyethylene liner. We report a case of mechanical disassembly of polyethylene liner in cementless metal backed cup, and review previously reported articles.
Acetabulum ; Hip Prosthesis ; Polyethylene

This study is aimed to elucidate the biological nature of the precancerous lesions and to evaluate whether the ethanol alters 3'-Methyl-4-dimethylaminoazobenzene (3'-Me-DAB) induced experimental hepatocarcinogenesis. A total of 108 Sprague-Dawley male rats were used for the experiment and divided into 6 groups according to 3'-Me-DAB and ethanol administration. Administration of the drugs were carried out daily by nasogastric tube insertion and the animals were sacrificed at different interval. A part of right lateral lobe was prepared for the histological examination. Cell kinetics of the immunohistochemical method for bromodeoxyuridine (BrdU). The administration of 3'-Me-DAB induced oval cell proliferation, hyperplastic nodule, cholangiofibrosis and carcinoma in the liver. The mean labelling indices, the percentages of BrdU labelled cells, of hepatocytes were increased by administration of 3'-Me-DAB, only to reverse after cessation of the drug (2.58 vs 0.61). The labelling indices of the oval cells were also affected by the administration and cessation of 3'-Me-DAB (11.41 vs 4.48). In contrast, the cholangiofibrosis did not decrease but were still increasing following cessation of 3'-Me-DAB administration (4.37 vs 5.17 and 8.25 vs 11.29). These finding that the hyperplastic nodule and particularly the cholangiofibrosis have an autonomous proliferative potential and are definite precancerous lesions in the experimental hepatocarcinogenesis. Short term administration of ethanol decreased the incidence of development of the precancerous lesions, but did not affect the labelling indices in all the pathologic lesions of hepatocarcinogenesis.
Male ; Humans ; Rats ; Animals ; Incidence

To elucidate the histologic pattern of alcoholic liver disease (ALD) in Korea, liver biopsies from 173 chronic alcoholics with clinical liver diseases were classified according to the pathologic parameters. One hundred and seventeen cases, the sum of 91 of 116 serum HBsAg negative and 26 of 57 HBsAg positive patients, had the histologic evidence of ALD. Fatty change(23.9%), alcoholic fibrosis (AF)(23.1%) and cirrhosis (23.1%), comprised the three major ALDs, and only 8.5% of cases fit the criteria of alcoholic hepatitis. Chronic sclerosing hyaline disease (CSHD), chronic active alcoholic hepatitis (CAAH) and AF, where non-cirrhotic fibrosis is the predominant change, comprised 44.5% of ALD. Both features of ALD and HBV liver disease (HBV-LD) were found in 17 cases that included 8 AF and 7 cirrhosis. These 17 patients tended to consume less alcohol than patients with other types of pure ALD except alcoholic heaptitis. Patients with the serum HBsAg positive ALD (37.4years) were about 8 years younger than those with the serum HBsAg negative ALD (45.1years). More or less fatty change and foamy degeneration were seen in 77.4% and 31.6% of ALD respectively. Mallory bodies, megamitochondria, iron deposition and perihepatocellular fibrosis were found in 20.5%, 29.9%, 42.7% and 77.8%, respectively. These findings indicate that non-cirrhotic chronic ALD such as CSHD, CAAH and AF are the important histologic patterns of ALD in Korea, and that chronic alcohol consumption and HBV may act synergistically in developing liver disease.
Biopsy

BACKGROUND: With increase of antibiotics use and invasive procedures, infections caused by multi-resistant Acinetobacter baumannii (MRAB) are increasing. Recently, we experienced the outbreak of- nosocomial infections caused by MRAB resistant to imipenem and cefoperazone/sulbactam in intensive care units (ICU) and general ward. We analyzed the clinical characteristics of the infected patients and antibiotic susceptibility of the organisms. And surveillance cultures and IRS-PCR were performed to find out the transmission route. METHODS: We collected data from physical examination and clinical records. We performed surveillance cultures of environment, patients not infected with MRAB in ICU, and hands of health care workers. RESULTS: Between November 1996 and June 1997, 49 strains of MRAB were isolated from the 26 patients hospitalized in Kangnam St. Mary' s Hospital. The lower respiratory infection (13 cases) was the most common infection and sputum was the most common sources (47.1%). All strains of MRAB showed the same genotype. In disk diffusion test, all strains were resistant to piperacillin, gentamicin, amikacin, ceftazidime, cefoperazone/sulbactam, aztreonam, imipencm, ciprofloxacin. From the surveillance cultures, the genotypically identical strains were isolated from ventilator Y-piece, the floor of ICU, and hands of health care workers. It suggested that this strain was transmitted through ventilatory device or hands of health care workers. We instructed all the health care workers to wash hands, to disinfect hospital environment completely. Since July 1997, no further case has occurred. CONCLUSIONS: Since A. baumannii could be transmitted through ventilatory devices and the hands of health care workers, it is important to wash hands and to disinfect hospital environment completely.
Acinetobacter baumannii* ; Acinetobacter* ; Amikacin ; Anti-Bacterial Agents ; Aztreonam ; Ceftazidime ; Ciprofloxacin ; Cross Infection* ; Delivery of Health Care ; Diffusion ; Genotype ; Gentamicins ; Hand ; Humans ; Imipenem* ; Critical Care Units ; Patients' Rooms ; Physical Examination ; Piperacillin ; Sputum ; Ventilators, Mechanical