No abstract available.
Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis, Tuberculous*

We report a case of plexiform neurofibroma developed under the overlying speckled lentiginous nevus, which occurred in a 20 year-old man. In this patient and his family no other signs of von Recklinghausens disease were found. Discussion is focussed on the fact that both plexiform neurofibroma and speckled lentigmous nevus, which represent a defect in the neural crest, occurred in the same area of the skin.
Humans ; Neural Crest ; Neurofibroma, Plexiform* ; Neurofibromatosis 1 ; Nevus* ; Skin

In male reproducible health, fertility and IVF (in-vitro fertilization), semen analysis has been most important. Semen analysis can be divided into concentration, motional and morphological analysis of sperm. The existing method which was developed earlier to analyze semen concentrated on the sperm motility analysis. To provide more useful and precise solutions for clinical problems such as infertility, semen analysis must include sperm morphological analysis. But the traditional tools for semen analysis are subjective, imprecise, inaccurate, difficult to standardize, and difficult to reproduce. Therefore, with the help of development of microcomputers and image processing techniques, we developed a new sperm morphology analyzer to overcome these problems. In this study the agreement on percent normal morphology was studied between different observers and a computerized sperm morphology analyzer on a slide-by-slide basis using strict criteria. Slides from 30 different patients from the SNUH andrology laboratory were selected randomly. Microscopic fields and sperm cells were chosen randomly and percent normal morphology was recorded. The ability of sperm morphology analyzer to repeat the same reading for normal and abnormal cells was studied. The results showed that there was no significant bias between two experienced observers. The limits of agreement were 4.1%~-3.8%. The Pearson correlation coefficient between readers was 0.79. Between the manual and sperm morphology analyzer, the same findings were reported. In this experiments the slides were stained by two different methods, PAP and Diff-Quik staining methods. The limits of agreement were 7.2%~-5.7% and 6.0%~-6.3%, respectively. The Pearson correlation coefficients ware 0.76 and 0.91, respectively. The limits of agreement was tighter below 20% normal forms. In the experiments of repeatability, 52 cells stained by PAP and Diff-Quik staining methods were analyzed three times in succession. Estimating pairwise agreement, the kappa statistic for the pairs were 0.76, 0.81, 0.86, and 0.75, 0.88, 0.88 respectively. In this study it was shown that there was good agreement between manual and computerized assessment of normal and abnormal cells. The repeatability and agreement per slide of computerized sperm morphology analyzer was excellent. The computer's ability to classify normal morphology per slide is promising. Based on results obtained, this system can be of clinical value both in andrology laboratories and IVF units.
Andrology ; Bias (Epidemiology) ; Fertility ; Humans ; Infertility ; Male ; Microcomputers ; Semen ; Semen Analysis ; Sperm Motility ; Spermatozoa*

Two patients with cutaneous leishmaniasis were treated with itraconazole. One patient was a 24-year-old man who had several erythematous papulonodules on the extremities for 1 month, which revealed cutaneous leishmaniasis, histopathologically. He was treated with itraconazole (200 mg/day) for 2 months. After treatment he showed clinical healing and the biopsy specimens no longer showed leishmania organisms. The other patient was a 27-year-old female who had several erythematous papulonodules on the face and neck for 3 months. The skin lesions revealed leishmania organisms in the tissue sections and culture media. She was also treated with itraconazole (200 mg/day) for 2 months. After treatment she also showed satisfying clinical healing and the biopsy specimens revealed no leishmania organisms. No specific side effects were encountered in both patients during the treatment. From these results, itraconazole is considered to be one of the promising anti-leishmanial drugs.
Adult ; Biopsy ; Culture Media ; Extremities ; Female ; Humans ; Itraconazole* ; Leishmania ; Leishmaniasis, Cutaneous* ; Neck ; Skin ; Young Adult

No abstract available.
Apoproteins* ; Diabetic Nephropathies* ; Lipoproteins*

BACKGROUND: Shivering associated with spinal anesthesia is uncomfortable to the patient and may interfere the monitoring of patient. Hence, we have investigated whether intrathecal meperidine could decrease the incidence and intensity of shivering during spinal anesthesia for unilateral herniorrhaphy. METHODS: Forty ASA class 1 or 2 patients undergoing unilateral herniorrhaphy were randomly allocated into two groups (group C and M). The patients of group C (n = 20) received hyperbaric bupivacaine (0.5%; 13 mg) and normal saline (0.004 ml/kg), and the patients of group M (n = 20) received hyperbaric bupivacaine (0.5%; 13 mg) and meperidine (0.2 mg/kg). After spinal block, the incidence and intensity of shivering were determined objectively by observing involuntary muscle activity. The measurement of the mean arterial pressures and heart rates of the patients, for every two minutes for ten minutes, and subsequently for every five minutes for thirty minutes were carried out. We have also checked the highest sensory block level, and other side effects. RESULTS: There were no significant differences in age, height, weight and duration of surgery between the two groups. Also, the mean arterial pressures, heart rates, and the highest sensory block levels exhibited no differences between the two groups. But, the incidence and intensity of shivering in group M were significantly less than in group C (P<0.05). CONCLUSIONS: Intrathecal meperidine (0.2 mg/kg) was effective in reducing the incidence and intensity of shivering associated with spinal anesthesia for herniorrhaphy.
Anesthesia, Spinal* ; Arterial Pressure ; Bupivacaine ; Heart Rate ; Herniorrhaphy* ; Humans ; Incidence ; Meperidine* ; Muscle, Smooth ; Shivering*

No abstract available.
Churg-Strauss Syndrome* ; Humans ; Vasculitis*

BACKGROUND: Epidermal growth factor (EGF) , a potent stimulant of epithelialization, has been noted to increase the tickness of the epidermis, increase the epithelial cell proliferartion and keratinization, and accelerate wound contraction. OBJECTIVE: Our purpose was to evaluate the efficacy of topical application of recombinant human epidermal growth factor (rhEGF) in the healing of full-thickness excision and burn wound. METHODS: Full-thickness excision and burn wound were made on the back of the male Wistar rat. Recombinant human epidermal growth factor was applied twice a day and the size of the wound was measured with planimetry every other day for 21 days. The keratinocytes of the circumcised foreskin were cultured in different concentrations of recombinant human epidermal growth factor and proliferation of the keratinocytes was evaluated. RESULTS: 1. Regardless of wound types or base types, wound healing in the experimental groups (rhEGF 10, 30, 50g/g) was generally better than that in the control or vehicle group. 2. The duration of wound healing was decreased as follows in order; in full-thickness excision wound, rhEGF 50 g/g group, rhEGF 30 g/g group, rhEGF 10 g/g group, vehicle group, and control group and in full-thickness burn wound, rhEGF 30 g/g group, rhEGF 50g/g group, rhEGF 10g/g group, vehicle group, and control group. 3. In the biopsy specimen taken from the wound at 9th and 13th day, neodermis, neovascularization, the thickness and maturation of the collagen bundles, and reepithelithelialization were more increased in the experimental groups than in the control or vehicle group. 4. In vitro culture of epidermal cells showed similar proliferation in the concentration of rhEGF higher than 10 ng/ml. CONCLUSION: these findings suggest that topical application of recombinant human epidermal growth factor in the healing of full-thickness excision and urn wound.
Animals ; Biopsy ; Burns ; Collagen ; Epidermal Growth Factor* ; Epidermis ; Epithelial Cells ; Foreskin ; Humans ; Keratinocytes ; Male ; Rats ; Ticks ; Wound Healing* ; Wounds and Injuries*

OBJECTIVES: To propose a feasible, valid and appropriate study designs and epidemiologic methods for evaluating the adverse health effects of Agent Orange-chemical defoliants used in Vietnam- in Korea. METHODS: A literature study was performed on Agent Orange, herbicides, pesticides and dioxins. The study subjects, study design, exposure assessment and health outcomes assessment were examined in each study. The potential data sources for the study subjects, study design, exposure assessment and health outcomes assessment in Korea were investigated. RESULTS AND CONCLUSION: In earlier Korean studies, research subjects for studying the effects of Agent Orange were identified from the patients or persons who claimed to have Agent Orange-related diseases due to the difficulties in identifying the entire population of Vietnam veterans in Korea. In this study, an attempt was made to identify the total number of Vietnam veterans in Korea. As a result, the addresses of 20,000 Vietnam veterans were obtained. It is proposed that a retrospective cohort design on a sample of the total number of Vietnam veterans is a feasible and appropriate study design. Self report questionnaires and military records were proposed to assess the exposure level. It is believed that measuring the plasma or tissue TCDD should be used only for a validation study assessing the level of exposure. For the health outcomes assessment, it is possible to obtain the mortality, cancer frequency, physical examination, screening and medical insurance record data.
Citrus sinensis* ; Cohort Studies ; Data Collection ; Defoliants, Chemical ; Dioxins ; Epidemiologic Methods ; Herbicides ; Humans ; Insurance ; Korea ; Mass Screening ; Military Personnel ; Mortality ; Outcome Assessment (Health Care) ; Pesticides ; Physical Examination ; Plasma ; Questionnaires ; Research Subjects ; Retrospective Studies ; Self Report ; Tetrachlorodibenzodioxin ; Veterans* ; Vietnam*

Purpose: To evaluate the proportion of bevacizumab and the reason for its usage in wet age-related macular degeneration (AMD). Methods: Retrospective analysis of medical records was performed for 1,541 patients who received ranibizumab, aflibercept, or bevacizumab injection to treat wet AMD. The proportion of bevacizumab among the entire set of injections was identified. The reason for selecting bevacizumab was additionally identified. Results: During the study period, a total of 2,929 anti-vascular endothelial growth factor (anti-VEGF) injections were performed; 2,236 (76.3%) were ranibizumab or aflibercept injections and 693 (23.7%) were bevacizumab injections. The most common reason for bevacizumab usage was ‘having a 0.1 or worse best-corrected visual acuity or being unable to assure reimbursement due to the development of extensive scarring or geographic atrophy’ (297 bevacizumab injections, 42.9%). The second most common reason was ‘the inability to assure reimbursement such as extrafoveal choroidal neovascularization (CNV) or early CNV without definite fluid in the foveal region’ (201 bevacizumab injections, 29.0%). Conclusions Bevacizumab was used in 23.7% of the anti-VEGF injections to treat wet AMD. When analyzing patients’ treatment burden and financial impact, the results of the present study may provide useful information. Further multi-center studies are required to evaluate more precisely the usage of anti-VEGF drugs.