No abstract available.
Eyelids ; Tinea* ; Trichophyton*

Malignant mixed Mullerian tumor(MMMT) of the ovary is very uncommon neoplasm consisting of both a sarcomatous and carcinomatous component. These tumors usually present in an advanced stage and are characterized by rapid growth and poor survival and appropriate treatment remained controversial. The patients with advanced stage ovarian cancer could only benefit from an optimal surgical debulking. However, the optimal cytoreductive surgery may often be difficult to achieve due to the initial extent of the disease. Thus primary surgery for this subset of patients may be questionable. So, we tried neoadjuvant Taxol and/or cis-platinum combined chemotherapy as primary treatment. At the end of neoadjuvant chemotherapy, the patient showed markedly decrease of serum CA 125 level(from 210 U/ml to 59 U/ml) and optimal cytoreductive surgery was performed. After surgery, adjuvant chemotherapy was administered and the serum CA 125 level decreased to the normal range. This case shows our experience of neoadjuvant chemotherapy followed by cytoreductive surgery and adjuvant chemotherapy in patient with primarily unresectable ovarian malignant mixed Mullerian tumor(MMMT).
Chemotherapy, Adjuvant ; Cisplatin ; Drug Therapy* ; Female ; Humans ; Ovarian Neoplasms ; Ovary ; Paclitaxel ; Reference Values

Malignant mixed Mullerian tumor(MMMT) of the ovary is very uncommon neoplasm consisting of both a sarcomatous and carcinomatous component. These tumors usually present in an advanced stage and are characterized by rapid growth and poor survival and appropriate treatment remained controversial. The patients with advanced stage ovarian cancer could only benefit from an optimal surgical debulking. However, the optimal cytoreductive surgery may often be difficult to achieve due to the initial extent of the disease. Thus primary surgery for this subset of patients may be questionable. So, we tried neoadjuvant Taxol and/or cis-platinum combined chemotherapy as primary treatment. At the end of neoadjuvant chemotherapy, the patient showed markedly decrease of serum CA 125 level(from 210 U/ml to 59 U/ml) and optimal cytoreductive surgery was performed. After surgery, adjuvant chemotherapy was administered and the serum CA 125 level decreased to the normal range. This case shows our experience of neoadjuvant chemotherapy followed by cytoreductive surgery and adjuvant chemotherapy in patient with primarily unresectable ovarian malignant mixed Mullerian tumor(MMMT).
Chemotherapy, Adjuvant ; Cisplatin ; Drug Therapy* ; Female ; Humans ; Ovarian Neoplasms ; Ovary ; Paclitaxel ; Reference Values

No abstract available.
Mycobacterium*

Scedosporium apiospermum is an asexual state of Pseudallescheria boydii which has been isolated from soil, sewage, and decaying vegetation. It can cause cutaneous infections by traumatic implantation of the contaminant due to penetrating injury. This ubiquitous fungus cause not only mycetoma, but also infections of variety of body sites including the skin. The localized skin infection due to this organism is much rare than mycetoma. We report a case of cutaneous S. apiospermum infection occurred in 80-year-old male. The skin lesion was manifested by a 8.0 x 4.0 cm-sized erythematous plaque with pustules and crusts on the dorsum of right hand. The fungal culture from the biopsy specimen on Sabouraud's dextrose agar showed white to gray colored cottony colonies of S. apiospermum. The nucleotide sequence of internal transcribed spacer for clinical isolate was identical to that of S. apiospermum strain IHEM 23829. The patient was treated with oral fluconazole for 3 months.
Agar ; Aged, 80 and over ; Base Sequence ; Biopsy ; Fluconazole ; Fungi ; Glucose ; Hand ; Humans ; Male ; Mycetoma ; Pseudallescheria ; Scedosporium* ; Sequence Analysis, DNA* ; Sewage ; Skin* ; Soil

Objective: To develop and validate a scale to assess people’s attitudes and perspectives toward persons with disabilities. Methods: The three-stage development of the scale included a preliminary version drafted from the literature review and a nominal group process. Thereafter, the draft was examined further and revised through two rounds of Delphi survey by 16 disability experts. Lastly, the psychometric properties of the scale were assessed through an online survey of 1,359 employees at three university hospitals. Results: A 32-item scale, defined after two Delphi surveys, was refined into 14 items with four subcategories: community integration, discomfort, charitability, and sense of burdening. The Cronbach’s alpha coefficient was 0.839 and domain reliability from 0.638 to 0.845. Recent education on disabilities yielded more positive attitudes toward persons with disabilities. Meaningful acquaintances with disabilities yielded more positive attitudes toward persons with disabilities. Conclusion This newly developed scale that measures attitudes toward persons with disability is reliable and valid. A future use of the scale could be to measure attitudinal improvements toward persons with disabilities after awareness education.

Objective: To develop and validate a scale to assess people’s attitudes and perspectives toward persons with disabilities. Methods: The three-stage development of the scale included a preliminary version drafted from the literature review and a nominal group process. Thereafter, the draft was examined further and revised through two rounds of Delphi survey by 16 disability experts. Lastly, the psychometric properties of the scale were assessed through an online survey of 1,359 employees at three university hospitals. Results: A 32-item scale, defined after two Delphi surveys, was refined into 14 items with four subcategories: community integration, discomfort, charitability, and sense of burdening. The Cronbach’s alpha coefficient was 0.839 and domain reliability from 0.638 to 0.845. Recent education on disabilities yielded more positive attitudes toward persons with disabilities. Meaningful acquaintances with disabilities yielded more positive attitudes toward persons with disabilities. Conclusion This newly developed scale that measures attitudes toward persons with disability is reliable and valid. A future use of the scale could be to measure attitudinal improvements toward persons with disabilities after awareness education.

Objective: To investigate the reliability of knee extensor strength measurements using a supine hand-held dynamometer (HHD) anchoring frame in patients with limited physical activity. Although an HHD is suitable for bedside use, its inter-rater reliability is low because measurements can be influenced by tester strength. Methods: Maximal knee extensor isometric strength was measured using an HHD anchored to the supine frame. Three trials of three maximal contractions were assessed by two raters. Results: A total of 33 inpatients who were non-ambulatory due to acute illness participated in the study. The intraclass correlation coefficients were 0.974 (inter-rater) and 0.959 (intra-rater). The minimal detectable changes in intra- and inter-observer measurements were 29.46 N (24.10%) and 36.73 N (29.26%), respectively. The limits of agreement ranged from -19.79% to 24.81% for intra-rater agreement and from -21.45% to 37.07% for inter-rater agreement. Conclusion The portable dynamometer anchoring system can measure the isometric strength of the knee extensor reliably in the supine position, and could be used for measurements in patients who have difficulty visiting the laboratory and maintaining a seated posture.

Background: To examine the incidence of traumatic spinal cord injury (TSCI) from all etiologies, we measured and compared the incidence of TSCI from three national or quasinational databases in South Korea, namely, the National Health Insurance Service (NHIS), automobile insurance (AUI), and Industrial Accident Compensation Insurance (IACI). Methods: We reviewed patients with TSCI reported in the NHIS database between 2009 and 2018, and in the AUI and IACI databases between 2014 and 2018. TSCI patients were defined as those first admitted to the hospital with a diagnosis of TSCI according to the International Classification of Diseases (10th revision) criteria. Age-adjusted incidence was calculated using direct standardization using the 2005 South Korean population or the 2000 US population as the standard population. The annual percentage changes (APC) of TSCI incidence were calculated. The Cochrane–Armitage trend test was performed according to the injured body region. Results: In the NHIS database, age-adjusted TSCI incidence using the Korean standard population increased significantly from 2009 to 2018 (from 33.73 per million in 2009 to 38.14 per million in 2018, APC = 1.2%, P = 0.014). Contrarily, age-adjusted incidence in the AUI database significantly decreased from 13.88 per million in 2014 to 11.57 per million in 2018 (APC = – 5.1%, P = 0.009). In the IACI database, the age-adjusted incidence showed no significant difference, while crude incidence showed a significant increase (from 22.02 per million in 2014 to 28.92 per million in 2018, APC = 6.1%, P = 0.038). According to the age group, all the three databases showed high incidences of TSCI in those in their 60s and 70s or older. Among those in their 70s or older, the incidence of TSCI increased dramatically in the NHIS and IACI databases, while no significant trend was found in AUI database. In 2018, the number of TSCI patients was the highest among those over 70 years of age in the NHIS, whereas among those in their 50s were the highest in both AUI and IACI. The proportion of patients with cervical spinal cord injury was the most common in all these databases. Conclusions The differences in trends in the incidence of TSCI may be due to the different etiologies and different characteristics of subjects depending on insurance type. These results imply the need for tailored medical strategies for the different injury mechanisms represented by three national insurance services in South Korea.

Fusarium(F.) species are hyalohyphomycetes isolated from plants, soil and air. Fusarium species can cause disseminated infections with involvement of multiple organs and numerous skin lesions in immunocompromised patients. And they can also cause local skin infections of trauma site. We report a case of localized skin infection by F. oxysporum in a 63-year-old immunocompetent woman. She presented with multiple, mild pruritic, 1.5 x 1.5 cm-sized, erythematous maculopapules on the left cheek after cosmetic procedure 4 months ago. Histopathologically, suppurative granulomatous inflammation, fungal elements were observed in dermis. Fungal culture on Sabouraud's dextrose agar showed rapid growing, whitish, cottony colonies at 25degrees C for 1 week. Numerous fusoid macroconidia were observed in slide culture by light microscopy. The nucleotide sequences of the internal transcribed spacer (ITS) region of clinical sample identical to that of F. oxysporum CID 220 strain (GenBank accession number HQ829117.1). The patient had been treated with itraconazole for 6 months. The skin lesion was improved. There was no recurrence 6 months after treatment.
Agar ; Base Sequence ; Cheek ; Dermis ; Female ; Fusarium* ; Glucose ; Humans ; Immunocompromised Host ; Inflammation ; Itraconazole ; Microscopy ; Middle Aged ; Recurrence ; Skin* ; Soil ; Wounds and Injuries