An outbreak of dermatosis occurred at a machinery manufacture factory in kyongju on Aug 1995. Authors conducted a questionnaire survey among 92 workers in the factory and a dermatologist examined their skin lesions. Authors also collected moths and identified them. The results are as follows; 1. Forty-two cases of dermatosis were identified with attack rate of 45.7%. Attack rate was not different by company, age, sex, educational level and duration of employment. Attack rate was 47.8% among productive workers, 25.0% among clerical workers and 100.0% among patrolmen. 2. Two cases among 42 dermatosis cases and three subjects among 50 non-cases had a history of same dermatosis last year. Four of dermatosis cases had a history of dermatosis among their family members. 3. skin lesions of the cases were scattered or grouped rice-sized erythematous papules or vesicles. Duration of dermatosis from the onset to the time of survey was from one day to more than 30 days. The most frequent site of skin lesion was the arms(81.0%), and it was also observed at the neck(47.6%), abdomen(45.2%), chest(42.9%), legs(38.1%) and back(35.7%). skin lesion was aggravated with sweating(31.0%), after shower(16.7%) and with scratching(l1.9%). 4. Moths were collected and identified as Euproetis subflava(Bremer). Many poisons stings were observed on their wngs which is harmful to human. 5. Contact with moths' wing droppings to two authors on their forearms for provocation resulted in severe immediate pain followed by prolonged pruritus. Erythematous macules quickly appeared and suoceeded by firm wheal-like red papules. Authors thought that the outbreak of dermatosis was brought about by Euproetix subflava(Bremer). Further studies on the factors contributing to the prosperity of the moths in this area are needed.
Bites and Stings ; Employment ; Epidemiologic Studies* ; Forearm ; Gyeongsangbuk-do ; Humans ; Korea ; Moths* ; Poisons ; Pruritus ; Surveys and Questionnaires ; Skin ; Skin Diseases* ; Wings, Animal

Pressure sores are common complications in patients with spinal injuries or cerebrovascular accidents. The management of pressure sores requires prolonged hospitalization and repeated surgical interventions with a high recurrence rate. Particularly osteomyelitis following initial pressure sores persistently complicates wound healing and recovery. Furthermore, it may also ultimately result in serious sepsis; thus an early diagnosis of osteomyelitis in pressure sore patients is crucial along with appropriate surgical and antibiotic therapy. Although many diagnostic methods were reported, there is no single 'gold' standard for early diagnosis of pressure sore-associated osteomyelitis. Authors reviewed pre-operative CBC, plain X-ray, Tc-99m bone scan, and post-operative biopsy results in 37 patients who had received surgical treatment for pressure sores in a 5-year period from September 1991 to August 1996. Based on these reviews, authors compared and analyzed the sensitivity and specificity in diagnosing osteomyelitis.The results were as follows: 1. Of 37 patients studied, 25 cases were confirmed histologically as osteomyelitis. Ischial region revealed the highest incidence of pressure sore-related osteomyelitis(78%, 14 out of 18 cases) while the regional incidence was as following in descending order : ischial, sacral, and greater trochanteric area. 2. Tc-99m bone scan had superior sensitivity(100%) and specificity(83%) to other pre-operative studies in diagnosing osteomyelitis.In conclusion, authors suggest that Tc-99m bone scan is the best diagnostic method because of its high sensitivity and specificity if osteomyelitis is clinically suspected in pressure sore patients. And in case the test result is positive, agressive surgical bone resection and appropriate antibiotic therapy based on bacterial culture from deep bone specimen should be combined to prevent complications or recurrences.
Biopsy ; Early Diagnosis ; Femur ; Hospitalization ; Humans ; Incidence ; Osteomyelitis ; Pressure Ulcer* ; Recurrence ; Sensitivity and Specificity ; Sepsis ; Spinal Injuries ; Stroke ; Wound Healing

BACKGROUND: At the present time, more than 100 cases of squamous cell carcinoma (SCC) developing in neurotrophic ulcers of leprosy have been reported. But the histopathologic features and the differences between SCC in leprosy and de novo SCC was not described. OBJECTIVE: The purpose of this study was to evaluate the characteristics of SCC in leprosy and to investigate growth dynamics of SCC in ulcers in leprosy. METHODS: We reviewed the clinical features and the degree of histopathologic differentiation of 13 cases of SCC in ulcers of leprosy patients presenting at the KLCA from 1986 to 1998. And immunohistochemical staining with PCNA(proliferating cell nuclear antigen) and TUNEL staining were done in paraffin-embedded tissue sections from 18 sites of 13 cases of SCC in ulcers of leprosy. RESULTS: 1. The average duration of leprosy and of an ulcer prior to diagnosis of SCC was 43 years and 19 years, respectively. 2. Histopathologic grading of 13 cases was performed as follows:10 cases were well-differentiated and 3 cases were moderately-differentiated. 3. The PCNA LI(labelling index) was 47.26+/-7.38% in well-differentiated group and 48.86+/-9.39% in moderately -differentiated group. 4. The apoptotic index(AI) was 45.57+/-8.68% in well- differentiated group and 29.38+/-1.06% in moderately differentiated group. The AI in de novo SCC was 45.09+/-6.18%. CONCLUSION: (1) Malignant change in chronic ulcer in leprosy may be found more often if patients are examined with care. (2) Our leprosy case with SCC is a 63-year-old male with past history of lepromatous leprosy of 43 year duration having ulcer problems for 19 years before presenting with SCC on an average. (3) High-degrees of malignancy in SCC of leprosy patients might be caused by extended cell survival due to decreased apoptosis rather than increased cell proliferation.
Apoptosis ; Carcinoma, Squamous Cell* ; Cell Proliferation ; Cell Survival ; Diagnosis ; Humans ; In Situ Nick-End Labeling ; Leprosy* ; Leprosy, Lepromatous ; Male ; Middle Aged ; Proliferating Cell Nuclear Antigen ; Ulcer*

No abstract available.
Induction Chemotherapy* ; Nasopharyngeal Neoplasms*

Extrahepatic metastasis of hepatocellular carcinoma (HCC) can be found in various organs, but metastasis to the female genital tract is extremely rare. A 48-year-old woman who had undergone curative left lobectomy for small HCC 4 years earlier was admitted because of sequential alpha-fetoprotein elevation. Upon abdominal MRI and hepatic angiography, no evidence of HCC recurrence was found in the remnant liver. However, a positron emission tomography CT scan showed a hypermetabolic lesion in the uterine fundus, which was revealed as metastatic HCC after total hysterectomy. This is, to our knowledge, the first documented case of metastatic uterine tumor that originated from HCC without intrahepatic recurrence.
alpha-Fetoproteins ; Angiography ; Carcinoma, Hepatocellular ; Female ; Humans ; Hysterectomy ; Liver ; Middle Aged ; Neoplasm Metastasis ; Positron-Emission Tomography ; Recurrence ; Uterine Neoplasms

Injuries to the gallbladder are found in about only 2% of patients with blunt abdominal trauma, and isolated gallbladder perforation is even less common. The gallbladder is less accessible to trauma because it is partially embedded in the liver, cushioned by the surrounding omentum and bowel, and shielded by the rib cage. It is usually associated with other visceral injuries, especially the liver. The leakage of bile from a ruptured gallbladder may not immediately produce symptoms of peritonitis, making an early diagnosis difficult, and causes delays to treatment. A 47-year-old man presented to our emergency department complaining of diffuse abdominal pain after a pedestrian traffic accident, but his vital signs were stable. In the laboratory tests, his hemoglobin was normal, but his blood chemistry showed mild jaundice (bilirubin 3.6 mg/dl). An abdominal computed tomogram showed pericholecystic and a right paracolic fluid collection, with a collapsed gallbladder. The patient underwent an operation under a diagnosis of hemoperitoneum, and when the peritoneal cavity was entered, the gallbladder was ruptured at the fundus, and about 500 cc of bile had accumulated in the abdominopelvic cavity. The other visceral organs were non-specific. We report a case of an isolated rupture of the gallbladder, with a review of the associated literature.
Abdominal Pain ; Accidents, Traffic ; Bile ; Chemistry ; Diagnosis ; Early Diagnosis ; Emergency Service, Hospital ; Gallbladder* ; Hemoperitoneum ; Humans ; Jaundice ; Liver ; Middle Aged ; Omentum ; Peritoneal Cavity ; Peritonitis ; Ribs ; Rupture ; Vital Signs

PURPOSE: Leptomeningeal carcinomatosis occurs in about 5% of patients with solid tumor and is being diagnosed with increasing frequency as patients live longer and as neuro-imaging studies improve. In general, the most commom cancers that involved the leptomeninges are breast cancer, lung cancer, and malignant melanoma. MATERIALS AND METHODS: We investigated 25 patients presented with multiple neurologic symptoms and signs who were diagnosed with leptomeningeal carcinomatosis at the Yonsei Cancer Center from January 1990 to December 1999. RESULTS: The primary disease of leptomeningeal carcinomatosis were stomach cancer (10 cases), breast cancer (7 cases), lung cancer (5 cases), unknown primary cancer (2 cases) and common bile duct cancer (1 case). All patients were presented with multiple neurologic symptoms and signs involving the central nervous system (CNS), cranial nerve or spinal nerves. Twenty-one of twenty- five patients were treated with intrathecal chemotherapy, radiotherapy, or combination therapy. Fourteen of them (66.7%) experienced improvement or stabilization of neurologic symptom and sign. The median survival was 122 days (10-2190). CONCLUSION: In conclusion, although early diagnosis and active treatment of leptomeningeal carcinomatosis may improve the quality of life in selected patients, the median survival was relatively short. Therefore, new diagnostic and therapeutic strategy for leptomeningeal carcinomatosis were needed.
Breast Neoplasms ; Central Nervous System ; Common Bile Duct ; Cranial Nerves ; Drug Therapy ; Early Diagnosis ; Humans ; Lung Neoplasms ; Melanoma ; Meningeal Carcinomatosis* ; Neurologic Manifestations ; Quality of Life ; Radiotherapy ; Spinal Nerves ; Stomach Neoplasms

Extrahepatic metastasis of hepatocellular carcinoma (HCC) can be found in various organs, but metastasis to the female genital tract is extremely rare. A 48-year-old woman who had undergone curative left lobectomy for small HCC 4 years earlier was admitted because of sequential alpha-fetoprotein elevation. Upon abdominal MRI and hepatic angiography, no evidence of HCC recurrence was found in the remnant liver. However, a positron emission tomography CT scan showed a hypermetabolic lesion in the uterine fundus, which was revealed as metastatic HCC after total hysterectomy. This is, to our knowledge, the first documented case of metastatic uterine tumor that originated from HCC without intrahepatic recurrence.
alpha-Fetoproteins ; Angiography ; Carcinoma, Hepatocellular ; Female ; Humans ; Hysterectomy ; Liver ; Middle Aged ; Neoplasm Metastasis ; Positron-Emission Tomography ; Recurrence ; Uterine Neoplasms

Certain beneficial microorganisms isolated from rhizosphere soil promote plant growth and induce resistance to a wide variety of plant pathogens. We obtained 49 fungal isolates from the rhizosphere soil of paprika plants, and selected 18 of these isolates that did not inhibit tomato seed germination for further investigation. Based on a seed germination assay, we selected four isolates for further plant tests. Treatment of seeds with isolate JF27 promoted plant growth in pot tests, and suppressed bacterial speck disease caused by Pseudomonas syringae pathovar (pv.) tomato DC3000. Furthermore, expression of the pathogenesis-related 1 (PR1) gene was higher in the leaves of tomato plants grown from seeds treated with JF27; expression remained at a consistently higher level than in the control plants for 12 h after pathogen infection. The phylogenetic analysis of a partial internal transcribed spacer sequence and the β-tubulin gene identified isolate JF27 as Aspergillus terreus. Taken together, these results suggest that A. terreus JF27 has potential as a growth promoter and could be used to control bacterial speck disease by inducing resistance in tomato plants.
Aspergillus* ; Capsicum ; Germination ; Lycopersicon esculentum* ; Plants ; Pseudomonas syringae* ; Pseudomonas* ; Rhizosphere ; Soil

PURPOSE: Osteosarcoma is one of the most common juvenile malignant tumors in Korea. Combined modality treatment [pre-operative chemotherapy + surgery (limb salvage or amputation) + adjuvant chemotherapy] had improved the overall survival and quality of life. To improve the local control rate, we introduced pre-operative chemotherapy combined with intra-arterial (IA) cisplatin and continuous intravenous infusion (CI) of adriamycin. We evaluated the efficacy and feasibility, such as limb salvage rate, recurrence pattern and the survival impact, based on the histologic response of pre-operative chemotherapy. MATERIALS AND METHODS: Fourty-one patients with histologically-proven high grade osteosarcoma of the extremities were enrolled from January 1990 to June 1996. Pre-operative chemotherapy, cisplatin 120 mg/m2 IA and adriamycin 75 mg/m2/72hrs CI, was administered for 3 cycles with 3 week interval, followed by surgery. Post-operative chemotherapy was applied by the tumor necrosis rate. If the tumor necrosis of the specimen was more than 90%, the same regimen af the preoperative one was administered for 3 cycles. A salvage regimen (Ifosfamide 7.5 gm/m2/5d IV + high dose MTX 10 gm/m2 IV VP-16 360 mg/m2/3d IV) was administered every 3 weeks for 6 cycles if the tumor necrosis was <90%. RESULTS: Of 41 patients, 37 were evaluable for efficacy and toxicities, because 4 refused further chemotherapy after 1 or 2 cycles. Twenty-one patients were male and 16 female, with the median age of 16 years (8-41). The tumor locations were as follows: distal femur 20, proximal tibia 8, humerus 6, distal tibia 2 and 1 in proximal femur. All but one patient, who died of neutropenic sepsis, completed the planned pre-operative therapy. Of the 36 patients who received surgery, limb salvage surgery was possible in 30 patients (83.3%) and 27 patients (75%) showed a good response (10 with grade III, 27.8%; 17 with grade IV, 47.2%). With a median follow-up of 23 months, 3-year disease-free survival rate was 54.7% and overall survival rate was 78.3%. Of the 15 patients who recurred, the major metastatic site was the lungs. No operation-related mortality was observed. Most patients experienced grade III-IV nausea, vomiting and hematologic toxicities, which were reversible with supportive care. CONCLUSION: Pre-operative chemotherapy combined with IA cisplatin and CI adriamycin induced higher good response rate without survival benefits. To improve the survival rate, the design of good salvage chemotherapy with a non-cross resistant regimen should be considered.
Cisplatin* ; Disease-Free Survival ; Doxorubicin* ; Drug Therapy ; Etoposide ; Extremities ; Female ; Femur ; Follow-Up Studies ; Humans ; Humerus ; Infusions, Intravenous ; Korea ; Limb Salvage ; Lung ; Male ; Mortality ; Nausea ; Necrosis ; Osteosarcoma* ; Quality of Life ; Recurrence ; Sepsis ; Survival Rate ; Tibia ; Vomiting