No abstract available.
Cryotherapy* ; Leishmaniasis, Cutaneous* ; Metronidazole*

No abstract available.
Myiasis*

PURPOSE: Proctitis is one of acute complications encountered when radiotherapy was applied to the pelvis. Radiation-induced proctitis represents similar microscopic findings that are observed in inflammatory bowel disease (IBD). Nitric oxide (NO) plays an important role in the inflammatory process and many data suggest a close relationship between NO production and gastrointestinal inflammation. This study was aimed to establish the optimal radiation dose for radiation-induced proctitis in rat and to find a relationship between radiation proctitis and NO production. MATERIALS AND METHODS: Female Wistar rats, weighing from 150 to 220 g, received various doses(10-30 Gy) of radiation to the rectum. On the 5th and 10th day after irradiation, rectal specimens were evaluated grossly and microscopically. In addition, the degree of NO production by irradiation dose was evaluated by study with NOS expression and nitrite production in the irradiated rectal tissue. To evaluate relationship between radiation proctitis and NO, we administered aminoguanidine, iNOS inhibitor and L-arginine, substrate of NOS to rats from 2 days before to 7 days after the irradiation. RESULTS: There were obvious gross and histological changes after 17.5 Gy or higher radiation dose but not with 15 Gy or less radiation dose. Twenty Gy or higher dose of radiation caused Grade 4 damage in most of rectal specimens which were more likely to be related to the late complications such as fibrosis, rectal bleeding and rectal obstruction. A single fraction of 17.5 Gy to the rat rectum is considered to be an optimal dose to produce commonly experienced proctitis in the clinic. The result demonstrated that severity of microscopic damage of rectal mucosa from irradiation significantly correlated with iNOS overexpression. However, administration of iNOS inhibitor or substrate of iNOS did not influence the degree of rectal damage. CONCLUSION: A single fraction of 17.5 Gy irradiation to the rat rectum considered to be an optimal dose for radiation induced proctitis model. These results indicated that an excess production of NO contributes to pathogenesis of radiation-induced proctitis in part but was not the direct cause of rectal damage.
Animals ; Arginine ; Female ; Fibrosis ; Hemorrhage ; Humans ; Inflammation ; Inflammatory Bowel Diseases ; Models, Animal ; Mucous Membrane ; Nitric Oxide Synthase ; Nitric Oxide* ; Pelvis ; Proctitis* ; Radiotherapy ; Rats* ; Rats, Wistar ; Rectum

BACKGROUND: Washboard nail most commonly involves the thumbnail or great toenail. As its name implies, it resembles a washboard with a series of evenly spaced ridges across the nail. A central depression can be seen as well. This can develop as the result of repeated habitual trauma to the proximal nail fold by the other fingers or by biting the nailplate. Thus, it is also called habit tic deformity or traumatic nail dystrophy. Although it is known to be not uncommon, there have been no studies on this with a sufficient number of cases and long term follow up. OBJECTIVE: This study was conducted to provide a better understanding of washboard nail and to estimate the outcome of it. METHODS: We reviewed all the medical records and clinical photographs of 21 patients who had been diagnosed with washboard nail at our department between July 2000 and July 2009. RESULTS: The male to female ratio was 1:1.3. The patients' ages varied from 6 to 68 years, with an average of 25.4 years. The mean duration at the first visit was 4.4 years. The most common involved site was both thumbnails. Predisposing factors were found in 42.9% of the patients, which included nail picking or onychophagia. The treatment options were primarily intralesional triamcinolone injection and topical steroid. If the patient had the habitual tic, we educated them to restrain it. The follow up periods varied from 1 to 32 months with a mean of 7.9 months. Among the 14 patients with adequate follow up, 50% of these patients showed clinical improvement. CONCLUSION: This study demonstrated the clinical features of washboard nail. Physicians should closely observe the nail changes and long-term follow up is needed to determine the therapeutic response of patients with washboard nail.
Bites and Stings ; Congenital Abnormalities ; Depression ; Female ; Fingers ; Follow-Up Studies ; Humans ; Male ; Medical Records ; Nail Biting ; Nails ; Tics ; Triamcinolone

BACKGROUND: Several investigators have linked the interleukin-4(IL-4) gene nearby markers located on chromosome 5 to atopy and demonstrated that the T allele of a polymorphism in the IL-4 gene promoter region -590C/T is associated with elevated levels of total serum IgE. IL-4 receptor alpha gene has been also reported to be involved in the development of atopy. Recently, the R allele of a polymorphism in the IL-4 receptor alpha gene (IL4R*A) has been reported to be associated with atopy. OBJECTIVE: The purpose of our study is to investigate the association of IL-4 promoter gene C-590T polymorphism and receptor alpha gene (-1902) IL4R*A polymorphism with atopic dermatitis in Korea. MATERIAL AND METHODS: Seventy one Korean patients with atopic dermatitis and one hundred and sixty six normal subjects participated in this study with the analysis of polymorphism of IL-4 promoter (-590C/T) gene and IL-4 receptor alpha(-1902) gene by using PCR-SSCP. RESULTS: The frequency of IL-4 promoter (-590) genotypes (T/T, T/C, C/C), genes (T, C), alleles (T, C) did not show any significant difference between atopic dermatitis patients and normal controls (p>0.05). There were weak associations in the frequency of IL-4 receptor alpha(-1902) genotypes (IL4R*G/IL4R*G) and genes (IL4R*A) in patients of atopic dermatitis and normal controls (p=0.05). But, the frequency of IL-4 receptor alpha(-1902) genotypes (IL4R*A/IL4R*G, IL4R*A/IL4R*A), genes (IL4R*G), alleles (IL4R*A, IL4R*G) did not show any significant difference between atopic dermatitis patients and normal controls (p>0.05). CONCLUSION: These data show that IL-4 promoter polymorphism (-590C/T) and IL-4 receptor alpha polymorphism (-1902) IL4R*A are not associated with atopic dermatitis in Korean. It is suggested that the difference between our results and previous reports means racial difference, cooperation of -590C/T or IL4R*A polymorphism with the other gene, and the existence of another polymorphism.

PURPOSE: Blood glucose control in diabetic mothers during pregnancy is very important because it can affect fetal and neonatal outcomes. We therefore investigated the clinical outcomes of infants of diabetic mothers in relation to the maternal HbA1c level. METHODS: The subjects were diabetic mothers and their newborns who were admitted in Wonkwang University Hospital from July 2007 to June 2012. We retrospectively reviewed the medical records of 73 neonates, out of the 128 born to diabetic mothers and investigated neonatal and maternal characteristics based on the differences in maternal HbA1c levels. 55 neonates was excluded because maternal HbA1c was not measured. RESULTS: The mean time for testing the maternal HbA1c was 30+/-5.0 weeks, and the mean level was 6.7+/-1.4%. The mean birth weight in neonates was 3,094+/-831.6 g and was higher in the group with > or =7% HbA1c than in the group with < or =6.4% HbA1c (3,370+/-950.8 g vs. 2,855+/-661.97 g, P=0.0113). When assessing neonatal morbidity, the rates of hypoglycemia (56.0% vs. 28.6%, P=0.0381), large baby (36.0% vs. 4.8%, P=0.0015) and congenital heart disease (CHD) (28% vs. 0%, P=0.0055) were higher in the group with > or =7% HbA1c than in those with < or =6.4% HbA1c. Serum blood sugar level was significantly lower in the group with > or =7% HbA1c than those with < or =6.4% HbA1c (26.5+/-10.5 vs. 35.9+/-8.3 mg/dL, P=0.0196). When considering the rate of large babies (> or =4,000g), there were no differences in birth weights between both groups. CONCLUSION: If the maternal HbA1c level during pregnancy is above 7% with glucose control failure, infants born to diabetic mothers are susceptible to hypoglycemia, large baby syndrome and CHD.
Birth Weight ; Blood Glucose ; Glucose ; Heart Defects, Congenital ; Humans ; Hypoglycemia ; Infant* ; Infant, Newborn ; Medical Records ; Mothers* ; Pregnancy ; Retrospective Studies

BACKGROUND: The laparoscopy requires CO2 insufflation and posture changes for operational convenience. However, above circumstances affect the cardiopulmonary systems significantly. And then intracranial pressure (ICP) may be also influenced. METHODS: To ascertain the changes of ICP, an experimental study was performed, in which the parameters of hemodynamic status, arterial blood gas components and ICP were measured from twelve cases of Korean mongrel dogs. Pneumoperitoneum was produced by CO2 insufflation(15 mmHg) and then posture was altered from horizontal to head-down tilt of 20, 30 and 40 degree*. The measurements were obtained before (control), after CO2 insufflated horizontal position at 20, 40 and 60 minute in CO2 insufflated tilt** and CO2 deflated horizontal***. RESULTS: MAP and HR were not related to the insufflated time and degree of tilt. CVP and PCWP were significantly increased after CO2 insufflated tilt (p<0.01), but returned to control after deflated supine. PaCO2 was not significantly changed after CO2 insufflated supine, but grdually increased with degree of tilt and time (p<0.01). ICP was increased at 40 and 60 minute of 20degree, and at 20 minute of 30degree(p<0.05), then markedly increased at 40 and 60 minute of 30degree, and at 20, 40 and 60 minute of 40degreetilt (p<0.01). The increment of ICP was parallel with time and degree of tilt. But, ICP was returned to control after deflated supine. CONCLUSIONS: ICP was increased significantly during laparoscopy in head-down tilt, although it was reversible. Therefore, the patient must be given special attention during laparoscopy in whom the increment of ICP may be harmful.
Animals ; Carbon Dioxide* ; Carbon* ; Dogs ; Head-Down Tilt* ; Hemodynamics ; Humans ; Insufflation* ; Intracranial Pressure* ; Laparoscopy ; Pneumoperitoneum ; Posture

Approximately one-third of all patients with renal cell carcinoma have metastases at the time of diagnosis. Metastasis of renal cell carcinoma (RCC) to the testis is a rare finding. The cases of testicular metastasis from renal cell carcinoma that have been reported in the literature are predominantly ipsilateral, and they are invariably found on the left side through the retrograde venous spread along the gonadal artery. We experienced a case of contralateral testicular metastasis from a right side renal cell carcinoma, so we discuss the clinical feature and pathophysiology of this case with a review of the related literature.
Arteries ; Carcinoma, Renal Cell* ; Diagnosis ; Gonads ; Humans ; Neoplasm Metastasis* ; Testis

No abstract available.
Pregnancy*

BACKGROUND: The risk of various complications after Achilles tendon lengthening is mainly related to the length of surgical exposure and the lengthening method. A comprehensive technique to minimize the complications is required. METHODS: The treatment of Achilles tendon tightness in 57 patients (95 ankles) were performed by using a short transverse incision on a skin crease of the heel and by Z-lengthening of the tendon. In the severe cases, two or three transverse incisions were required for greater lengthening of the tendon, and a serial cast or Ilizarov apparatus was applied for the gradual correction. The results of these 95 ankles were compared to those of 18 ankles, which underwent percutaneous sliding lengthening, and to the 19 ankles, which received Z-lengthening with a medial longitudinal incision. RESULTS: The functional and cosmetic satisfaction was achieved among those who underwent the tendon lengthening with the new technique. The mean American Orthopaedic Foot & Ankle Society (AOFAS) score improved from 56.1 to 81.8. The second operations to correct recurrence were performed in the two cerebral palsy patients. CONCLUSIONS: The new technique has a low rate of complications such as scarring, adhesion, total transection, excessive lengthening, and recurrence of shortening. The excellent cosmesis and the short operation time are the additional advantages.
Achilles Tendon/*surgery ; Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Humans ; Male ; Musculoskeletal Diseases/complications ; Tendinopathy/etiology/*surgery ; Tenotomy/*methods ; Young Adult