No abstract available.
Leg*

Primary sclerosing cholangitis is a chronic disease of unknown cause, characterized by inflammation and fibrosis of the biliary tree with diffuse multifocal stricture formation. With increasing knowledge of primary sclerosing cholangitis, it is now recognized that in the setting of inflammatory bowel disease, cholangiocarcinoma is a complication of primary sclerosing cholangitis. We recently experienced a case of 41 year old female patient who had Crohns disease associated with primary sclerosing cholangitis and cholangioearcinoma. We report a case of primary sclerosing cholangitis with cholangiocarcinoma with literature review.
Adult ; Biliary Tract* ; Cholangiocarcinoma* ; Cholangitis, Sclerosing* ; Chronic Disease ; Constriction, Pathologic ; Crohn Disease ; Female ; Fibrosis ; Humans ; Inflammation ; Inflammatory Bowel Diseases ; Pancreas*

BACKGROUND: The purpose of this study was to examine the frequency and characteristics of needlestick/sharps injuries (NSIs) in nursing students in Korea. METHODS: The study was based on a survey of questionnaires completed by 341 nursing students who had sustained at least one NSI during clinical practice in hospitals. RESULTS: The NSI incidence rate was 36.4%. Approximately half of the students reported two to four NSIs. Most (90.2%) of the NSIs occurred on the fingertips and were caused by a hollow-bore needle (46.8%) or lancet (45.8%). Some students were exposed to used needles contaminated with unknown pathogens (37.3%), HBs Ag (2.3%), Venereal Disease Research Laboratory (VDRL) (0.8%), or HIV (0.6%). Students cited the reason for injury as carelessness, inexperience, hastiness, or recapping. Almost two-thirds of students who reported having experienced an NSI knew about post-exposure treatment. However, only one-third of the students with NSIs completed an official report. CONCLUSION: Korean nursing students lack knowledge about injury prevention, report procedures, and treatment after NSI. A revised educational approach with emphasis on occupational risk, skill development, and injury reporting is necessary to prevent NSI and to ensure that students obtain post-exposure prophylaxis.
Dietary Sucrose ; HIV ; Humans ; Incidence ; Korea ; Needles ; Needlestick Injuries ; Post-Exposure Prophylaxis ; Sexually Transmitted Diseases ; Students, Nursing ; Surveys and Questionnaires

We would like to correct the affiliation for the first author.

Necrolytic migratory erythema is a rare, distinctive, necrotizing cutaneous eruption usually associated with glucagonoma, an alpha-cell tumor of the pancreas. Other clinical features include ane- mia, diabetes mellitus and weight loss. However, it also occurrs without the pancreatic glucagonoma. So this rare condition is called pseudoglucagonoma syndrome, and has been described in association with chronic hepatic diseases, malabsorption with villous atrophy, chronic pancreatitis, celiac sprue, hypoproteinemia and odontogenic infection. We report a case of pseudoglucagonoma syndrome induced by malnutrition without glucagonoma. A 28-year-old Korean female was referred to our department complaining of multiple erythematous, desquamative, crusted and erosive patches on the extremities, and diffuse scalp alopecia for 5 years. She also had perianal erosion, angular cheilitis without glossitis, amenorrhea, axillary and pubic hair loss, and weight loss. Six years previously she had had Whipples operation for a pancreatic solid and papillary neoplasm. The laboratory data showed hypoalbuminemia, essential fatty acid deficiency, diabetes mellitus and slightly high levels of zinc and glucagon. A skin biopsy showed irregular acanthosis, epidermal edema and pallor, dyskeratosis, areas of superficial epidermal necrosis and vascular dilatation of the papillary dermis. The patient improved dramatically after intravenous hyperalimentation and oral intake of mediurn chain triglyceride. For 2.5 years she has taken medium-chain triglycerides without any other treatment, and no side effects on recurrence has been observed.
Adult ; Alopecia ; Amenorrhea ; Atrophy ; Biopsy ; Celiac Disease ; Cheilitis ; Dermis ; Diabetes Mellitus ; Dilatation ; Edema ; Extremities ; Female ; Glossitis ; Glucagon ; Glucagonoma ; Hair ; Humans ; Hypoalbuminemia ; Hypoproteinemia ; Malnutrition ; Necrolytic Migratory Erythema* ; Necrosis ; Pallor ; Pancreas ; Pancreatitis, Chronic ; Parenteral Nutrition, Total ; Recurrence ; Scalp ; Skin ; Triglycerides* ; Weight Loss ; Zinc

OBJECTIVE: The purpose of this investigation is to determine the frequency of chromosomal or genetic causes of recurrent spontaneous abortion. METHODS : A cytogenetic study was made in of 921 couples for 13 years from January 1984 to December 1997 in which the woman was ascertained to have had two or more spontaneous abortions at our Cytogenetic Laboratory, Institute of Reproductive Medicine and Population, Seoul National University. RESULTS : The overall incidence of chromosome anomaly was 80 out of 921 (8.7%). There were 34 cases (3.69%) of reciprocal balanced translocation and 13 cases (1.41%) of Robertsonian translocation. Also 17 cases (1.85%) of inversion and 5 cases (0.54%) of X chromosome mosiacism was observed. In the case of reciprocal balanced translocation, chromosome 8,6,7,13 were preferentially involved over others. And in the case of Robertsonian translocation, chromosome 13 was preferentially involved. CONCLUSION: Our study demonstrates that cytogenetic analysis is indicated in couples with 2 or more spontaneous abortion and about half of these disorders are reciprocal balanced or Robertsonian translocations.
Abortion, Spontaneous* ; Chromosomes, Human, Pair 13 ; Cytogenetic Analysis ; Cytogenetics* ; Family Characteristics ; Female ; Humans ; Incidence ; Pregnancy ; Reproductive Medicine ; Seoul ; X Chromosome

The halophilic bacterium, Vibrio vulnificus, causes acute fulminating wound infections and septicemia in human. Especially the septicemia shows high mortality above 50%. In Korea, septicemia by V. vulnificus was reported at westem and southern coast in every year. Here, we try to isolate this V. vulnipcus at Kyoung-nam area and coast of Pusan during 1996. Purposed sites were Dadaepo, Songjung, Chungsapo and Mipo of Pusan and Kijang, Ilkuang, Juksoung, Dongam, Waljun and Chilam of southern sea. Total 40 strains of V. vulnipcus were isolated from sea samples. Biochemical characteristics of isolated V. vulnificus were almost same with reference strain V. vulnificus ATCC 27562 on Farmer's tests and on API 20E kit test. V. vulnificus isolates in 1996, fermented cellobiose and salicin but arabinose. and had resistance to 7% sodium chloride.
Arabinose ; Busan* ; Cellobiose ; Humans ; Korea* ; Mortality ; Sepsis ; Sodium Chloride ; Vibrio vulnificus* ; Vibrio* ; Wound Infection

OBJECTIVE: This study evaluated the complaint rates of musculoskeletal symptoms and investigated the related factors of musculoskeletal symptoms in the caddies. METHODS: For 316 caddies working at 6 regular golf courses, we used the self-recording questionnaires to examine general characteristics, job stress factors, subjective musculoskeletal symptoms designed by NIOSH, working environments, and working contents. RESULTS: The complaint rates of musculoskeletal symptoms according to the musculoskeletal criteria of NIOSH were 41.8% in the leg/knee/ankle/foot, 35.8% in the shoulder, 35.8% in the upper back/lower back, 28.8% in the neck, and 28.5% in the arm/wrist/fingers. Important factors affecting musculoskeletal symptoms were daily working hours during the high-demand season in all anatomical sites except the arm/wrist/fingers. Other related factors were degrees of winding and inclined in the golf courses, violent language and violence of customers, inability to regulate the velocity and work load control, heavy physical burden, instability of employment, and possibility of unemployment according to the specialty of caddies. As a results of multivariate logistic regression analysis, musculoskeletal symptoms of the neck, shoulders, back/lower back and leg/knee/ankle/foot were significantly influenced by working time over 12 hours in the high-demand season, and symptoms of the arm/wrist/fingers by low decision latitude (P<0.05). CONCLUSIONS: The complaint rates of musculoskeletal symptoms in the caddies were affected by working time over 12 hours and low decision latitude against excessively high psychological job demand.
Employment ; Golf* ; Logistic Models ; National Institute for Occupational Safety and Health (U.S.) ; Neck ; Questionnaires ; Seasons ; Shoulder ; Unemployment ; Violence ; Wind

No abstract available.
Abscess* ; Citrobacter koseri

A clinico-pathologic study with an immunohistochemical examination for c-erbB-2 expression in 54 cases of ductal carcinoma in situ and 16 cases of Paget's disease of the breast was performed. c-erbB-2 oncoprotein overexpression was observed in 45% (24/54) and 88% (14/16) of ductal carcinoma in situ and Paget's disease, respectively. The overexpression of c-erbB-2 oncoprotein was significantly correlated with the nuclear grade of tumors and inversely with the status of the estrogen receptor. c-erbB-2 was positive in 4 out of 5 patients with metastasis to axillary lymph nodes and 3 out of 4 patients who died of the disease. Prognostic significance of c-erbB-2 oncoprotein in ductal carcinoma in situ was highly suggested. The expression of c-erbB-2 oncoprotein in Paget's disease was well correlated with coexisting infiltrating or in situ ductal carcinoma. The high positive rate of c-erbB-2 oncoprotein in ductal carcinoma with Paget's disease could be understood with a recent hypothesis that c-erbB-2 oncoprotein is involved in promotion of cell motility and the spread of carcinoma cells.
Neoplasm Metastasis