Tinea pedis is frequently found in those people with poor hygine and in hot and humid environments. The authors investigated the clinical, epidemiologicol a id mycological characteristics of tinea pedis in 138 sewerage workers attending a sewerage plant in Seoul. Tinea pedis was found in 82, with a prevalence of 59.4%. The prevalence of tinea pedis increased with age and the period working at sewerage plant, however, there was no statistical significance. Also there was no difference in the prevalence of tinea pedis between the clerical workers and the field workers. Positive rate for KOH smear was 73.2%, and culture positive rates were 42.7%, producing 35 strains of dermatophytes. Twertyeight strains of Trichophyton Rubrum and 7 strains of Trichophyton mentagrophytes were isolated. Twentyseven yeast-form colonies were isolated, and Trichosporon beigelii was foungl in 19 samples. Most of the yeast forms were found mixed with dermatophytes and moulcis, However, 6 were isolated from direct smear positive cases and yieIded pure colonies of yeast. These included 4 cases of T. beigelii, 1 case of Candida parapsilosis, and 1 case of Candida hormicola. In view of the recent report of these fungi as pathogenic organism, these isolates, rspecially T. beigelii, were considered as a causative agent of tinea pedis in certain groups like sewerage workers.
Arthrodermataceae ; Candida ; Fungi ; Health Personnel ; Humans ; Plants ; Prevalence ; Seoul ; Tinea Pedis* ; Tinea* ; Trichophyton ; Trichosporon ; Yeasts

Toxic shock syndrome (TSS) is a rare but life-threatening illness that is mainly caused by toxigenic strains of Staphylococcus aureus. Although TSS is classically known to be associated with tampon use, the number of TSS cases with non-menstrual causes such as skin and soft tissue infection has been increasing. Tattooing can result in several complications such as localized and systemic infections, inflammatory skin eruptions and neoplasms. We recently experienced a 26-year-old man diagnosed with typical TSS following tattooing. He complained of fever, chills and erythematous rash at tattoo site. Subsequently, the patient developed sign of shock. The skin cultures on the tattoo site were positive for methicillin-sensitive Staphylococcus aureus. The patient was successfully treated with vasopressor infusion and intravenous antibiotics and was discharged without complications. On discharge from the hospital 7 days later, desquamations on the tattoo site, fingers and toes were observed.
Adult ; Anti-Bacterial Agents ; Chills ; Exanthema ; Fever ; Fingers ; Humans ; Shock ; Shock, Septic* ; Skin ; Soft Tissue Infections ; Staphylococcus aureus ; Tattooing* ; Toes

Toxic shock syndrome (TSS) is a rare but life-threatening illness that is mainly caused by toxigenic strains of Staphylococcus aureus. Although TSS is classically known to be associated with tampon use, the number of TSS cases with non-menstrual causes such as skin and soft tissue infection has been increasing. Tattooing can result in several complications such as localized and systemic infections, inflammatory skin eruptions and neoplasms. We recently experienced a 26-year-old man diagnosed with typical TSS following tattooing. He complained of fever, chills and erythematous rash at tattoo site. Subsequently, the patient developed sign of shock. The skin cultures on the tattoo site were positive for methicillin-sensitive Staphylococcus aureus. The patient was successfully treated with vasopressor infusion and intravenous antibiotics and was discharged without complications. On discharge from the hospital 7 days later, desquamations on the tattoo site, fingers and toes were observed.
Adult ; Anti-Bacterial Agents ; Chills ; Exanthema ; Fever ; Fingers ; Humans ; Shock ; Shock, Septic ; Skin ; Soft Tissue Infections ; Staphylococcus aureus ; Tattooing ; Toes

PURPOSE: The internet is a vast resource for consumers. The internet is a decentralized, global medium, so quality management of health information is difficult for the lay person. Basic Life Support (BLS) is basic information provided for the lay person in the province of emergency medicine. The writers searched for BLS information on Korean and Japanese Web sites and assessed the quality of that information. METHODS: We used the search engine 'Yahoo! Korea' in Korea and 'Yahoo! Japan' in Japan. The search references were 'Basic Life Support' and 'Cardiopulmonary Resuscitation (CPR)'. The assessment was based on three 'Credibility' and seven 'Content' factors. 'Credibility' factors composed of 'Source', 'Context' and 'Currency'. 'Content' factors composed of six factors of accuracy of six course of BLS and one factor of 'Original Source Stated'. We make our own criteria for each factors. And, If the web site fitted the criteria, we give 1 point, if not, give 0point. So, 'Credibility' factors point is 3 points full mark and 'Content' factors point is 7 points full mark. RESULTS: Eight Korean and fifteen Japanese sites were found as a result of the search. No difference in 'Credibility' factors existed between the two nations' web sites. There was, however, a statistical difference in the 'Content' factors between the two nations' web site. The mean of 'Content' factors points is 3.75 and 5.06 in 7 points full mark, Korean web site and Japanese web site respectively. CONCLUSION: Improvement in the quality of BLS on internet web sites is needed, especially BLS on 'Recovery position', 'Assessment of circulation', and 'Cardiac comp ression'.
Asian Continental Ancestry Group ; Emergency Medicine ; Humans ; Internet* ; Japan* ; Korea* ; Resuscitation ; Search Engine

PURPOSE: In old age, abdominal aortic aneurysm (AAA) is not a rare disease and potentially fatal. Also, there has been a lack of concern for this disease in the emergency department. Our study investigated the clinical characteristics of AAAs seen in the emergency center to assess the needs of the diagnostic approach to this disease in the emergency center. METHODS: Eighty patients with an AAA between Jan. 1995 and Jul. 2002 were enrolled. Data were obtained from a retrospective review of medical records. We analyzed the clinical characteristics of the AAA on the basis of the patient 's age and sex, risk factors, presenting symptoms and signs, physical findings, diagnostic tools, and findings. RESULTS: AAAs were predominant in males (82.5%). A smoking history (57.5%), old age over 65 (71.3%) and hypertension (50.0%) were the most common risk factors. In this study, the initial diagnosis of a AAA was mostly determined by the existence of a pulsating abdominal mass, and the overall sensitivity of a pulsating abdominal mass was 57.5%. Although the most common presenting symptom was abdominal pain(51.3%), about one third of the patients had no subjective symptoms. Twenty-one of the patients had a ruptured AAA at the time of diagnosis. There was no remarkable difference in the incidence of large AAA (> 5 cm) or ruptured AAA between elderly (> 65years) and the young (< 65 years). CONCLUSION: Because of the absence or vagueness of symptoms and signs, an AAA might be initially excluded without a careful examination. For the early detection and prevention of a ruptured AAA, emergency medical doctors should carefully evaluate and assess patients with risk factors even though they have non-specific symptoms of the gastrointestinal or urinary system.
Aged ; Aortic Aneurysm, Abdominal* ; Diagnosis ; Emergencies ; Emergency Service, Hospital ; Humans ; Hypertension ; Incidence ; Male ; Medical Records ; Rare Diseases ; Retrospective Studies ; Risk Factors ; Smoke ; Smoking

T cell immunity and phagocytic activity were studied in the blood of patients with IgA nephropathy in order to clarify their roles in the pathogenesis of IgA nephropathy. The percentages of total T lymphocytes, helper T cell and suppressor T cells were significantly reduced in patients. A significantly elevated helper T cell/suppressor T cell ratio in patients showed a predominant reduction in suppressor T cells. There was a significant relationship between histologic findings and helper T cell/suppressor T cell ratio in patients. Natural Killer (NK) cell activity was significantly reduced but the lymphocyte response after phytohemagglutinin (PHA) stimulation was not in patients. ConA-induced suppressor cell activity was not depressed despite of a decrease in suppressor T cells in patients. Phagocytic activity of polymorphonuclear leucocytes (PMNs) ingesting yeasts was significantly reduced in patients. Also an inverse correlation was found between serum IgA levels and phagocytic activity of PMN. It is concluded that suppressor T cell defects, depressed phagocytic activity and impaired NK cell activity may play a role in the pathogenesis of IgA nephropathy.
B-Lymphocytes/immunology ; Glomerulonephritis, IGA/*immunology/pathology ; Humans ; Killer Cells, Natural/immunology ; Neutrophils/immunology ; *Phagocytosis ; T-Lymphocytes/*immunology ; T-Lymphocytes, Regulatory/immunology

PURPOSE: The aim of this study was to evaluate tolerance to adjuvant chemotherapy, and to compare survival between treatments using only surgery and using surgery with adjuvant chemotherapy, in elderly patients with advanced gastric cancer who were ≥75 years of age. MATERIALS AND METHODS: Patients ≥75 years of age who were diagnosed with pathological stage II or III gastric cancer were identified retrospectively and categorized into the surgery only and surgery with adjuvant chemotherapy groups. Clinicopathological and survival data were compared between these two groups. RESULTS: Among the 130 patients studied, 67 patients underwent curative surgery only, and 63 patients received adjuvant chemotherapy after curative surgery. In the latter group, adverse events were reported in 24 patients (38.1%). The treatments were discontinued in 19 patients (30.2%) owing to any reason. The overall 5-year survival rates of the surgery only and the surgery with adjuvant chemotherapy groups did not differ significantly (44.1% vs. 30.7%, respectively; P=0.804). Among 90 death events, deaths from recurrences of gastric cancer occurred in 42 patients. Multivariate analyses revealed that the American Society of Anesthesiologists score and the depths of tumor invasions were related to survival, and the addition of adjuvant chemotherapy after surgery did not influence survival. CONCLUSIONS: The decision for the addition of adjuvant chemotherapy for elderly patients should be taken after considering the condition of individual patients and their life expectancies.
Aged* ; Chemotherapy, Adjuvant* ; Drug Therapy ; Gastrectomy ; Humans ; Life Expectancy ; Multivariate Analysis ; Recurrence ; Retrospective Studies ; Stomach Neoplasms* ; Survival Rate

According to Moertel's classification, synchronous multiple gastric cancer is eonsidered to be a sort of multiple primary cancer, The clinical signifieance of multiplicity in gastric cancer was its location relative to the resection line. Compared with patients with single gastric cancer, multiple gastric cancer were more frequently found among the older men, and they were more commonly found in early gastric cancer. The frequency of multifocality in gastric cancer is 2.2-9% in the world literature reports and is increasing recently, with advance in the diagnostic method of gastric cancer. However, synchronous multiple gastric cancer which has more than four foci is rare. In Korea, there has been only one case reported about quadruple gaatric cancer. Recently, we experienced a case of a 58-year-old male patient with synchronously developed-quadruple gastric cancer on the body of stomach, for whom radical total gastrectomy and esophagojejunostomy was done. All of them were moderately differentiated adenocarcinoma. The mapping about four lesions showed that Borrmanin type III AGC extending to the serosa was placed on the posterior wall of higher body; EGC IIc invading the submucosa, the anterior wall of mid body, EGC III confined to the mucosa, the lesser curvature side of mid to lower body; EGC III localizing to the mucosa, the posterior wall of lower body. So we reported this case with a review of literatures.
Adenocarcinoma ; Classification ; Gastrectomy ; Humans ; Korea ; Male ; Middle Aged ; Mucous Membrane ; Serous Membrane ; Stomach ; Stomach Neoplasms*

We present a case of thoracic splenosis in a 42-yr-old man with a medical history of abdominal surgery for a penetration injury with an iron bar of the left abdomen and back. He had been in good condition, but a chest radiograph taken during a regular checkup showed a multinodular left pleura-based mass. Computed tomography (CT) showed that the mass was well-enhanced and homogeneous, indicating a sclerosing hemangioma. Following its removal by video-assisted thoracoscopic surgery, the mass appeared similar to a hemangioma, with marked adhesion to the left side diaphragmatic pleura and lung parenchyma. Frozen section showed that the lesion was a solid mass consisted with abundant lymphoid cells, suggesting a low grade lymphoma. On permanent section, however, the mass was found to be composed of white pulp, red pulp, a thick capsule and trabeculae and was diagnosed as ectopic splenic tissue, or thoracic splenosis. Review of the patient's history and chest CT at admission revealed that the patient had undergone a splenectomy for the penetration injury 20 yr previously.
Abdominal Injuries/complications ; Adult ; Diagnosis, Differential ; Humans ; Male ; Medical Records ; Spleen/injuries/surgery ; Splenectomy ; Splenosis/*diagnosis/etiology/radiography ; Thoracic Diseases/*diagnosis/etiology/radiography ; Thoracic Surgery, Video-Assisted ; Tomography, X-Ray Computed

Primary small cell neuroendocrine carcinoma in stomach is known to be very rare and only the twelve cases have been reported in the English literature. This tumor appears to be analogous to small cell carcinoma and carcinoid tumors of the lung, and is characterized by a very aggressive clinical course. Recently, we have experienced a 68-year-old man with primary small cell neuroendocrine carcinoma in the stomach, which had liver metastasis and peritoneal seeding. A positive Grimelius stain was present and immunohistochemical studies revealed positivity for neuron-specific enolase in the tumor. For its rarity, we report this case with review of literatures.
Aged ; Carcinoid Tumor ; Carcinoma, Neuroendocrine* ; Carcinoma, Small Cell ; Humans ; Liver ; Lung ; Neoplasm Metastasis ; Phosphopyruvate Hydratase ; Stomach*