A small proportion of diabetics treated with exogenous insulin, reportedly ranging from 0.1% to 2%, experience systemic allergic reactions to insulin. We saw a 55-year-old male patient with insulin-dependent diabetes mellitus who had developed an anaphylatic reaction immediately after subcutaneous injections of neutral protamine Hagedorn (NPH) human recombinant insulin. Skin tests with insulins and a passive transfer test demonstrated that his reaction was IgE mediated. Since there were no therapeutic alternatives, desensitization with insulin was done following a slow protocol. It was successful and he was able to resume insulin therapy. During two year follow-up period, he did not developed any adverse reaction to insulin.
Anaphylaxis* ; Diabetes Mellitus, Type 1 ; Follow-Up Studies ; Humans ; Hypersensitivity ; Immunoglobulin E ; Injections, Subcutaneous ; Insulin* ; Insulins ; Intradermal Tests ; Male ; Middle Aged ; Skin Tests

No abstract available.
Ureaplasma urealyticum* ; Ureaplasma*

The advent of the global pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) necessitates a thorough study of the stability and transmissibility in the environment. We characterized the stability of SARS-CoV-2 in three water matrices: fresh, tap, and seawater. The minimum infective dose of SARS-CoV-2 in Vero cells was confirmed to be 10 3 PFU/mL. The stability of SARS-CoV-2 varied according to the water matrix: infective SARSCoV-2 was undetectable after treatment with fresh water and seawater, but remained detectable for 2 days in tap water, when starting with an initial concentration of 10 4 PFU/mL. When the starting concentration was increased to 10 5 PFU/mL, a similar trend was observed. In addition, viral RNA persisted longer than infectious virus in all water matrices. This study was conducted in stagnant water containing a significantly high titer of virus, thus, human-to-human transmission of SARS-CoV-2 through the actual aquatic environment is expected to be rare.

Although surgical techniques for treating acetabular fracture are evolving, the use of periacetabular screws is common, and their placement in acetabular surgery is still technically demanding. For instance, intraarticular screw perforation is a serious complication that may occur during surgical treatment of an acetabular fracture. Here, we describe the case of a 50-year-old female who experienced an intraarticular screw perforation after surgical treatment of a posterior acetabular wall fracture. Removal of the perforated screw was performed arthroscopically based on its ability to offer minimally invasive access to the hip joint. One year after removal of the screw, no radiological signs of osteoarthritic changes were observed. The patient regained normal ambulation without limitations to range of motion or hip pain. To our knowledge, this is the first report on the use of arthroscopy to treat intraarticular screw perforation after surgical treatment of an acetabular fracture.
Acetabulum ; Arthroscopy ; Female ; Hip ; Hip Joint ; Humans ; Middle Aged ; Range of Motion, Articular ; Walking

Triple X syndrome is a relatively rare sex chromosomal anomaly, and its association with psychopathology is not well understood. The authors report one case of obsessive-compulsive disorder(OCD)with karyotype-confirmed triple X syndrome, 47,XXX. She had incomplete sexual development, seconddary amenorrhea and multiple obsessive-compulsive symptoms. Magnetic resonance imaging of the brain revealed left occipital white matter hyperintensity lesion. The patient's multiple obsessive-compulsive symptoms were responded partially with fluoxetine and adjunctive buspirone treatment, however, her overall psychological functions were much improved. With the literature reviews, the authors suggest the possibility that a certain type of sex chromosome aneuploidy might be susceptible to obsessive-compulsive spectrum disorders(OCSDs)or OCD.
Amenorrhea ; Aneuploidy ; Brain ; Buspirone ; Female ; Fluoxetine ; Humans ; Magnetic Resonance Imaging ; Obsessive-Compulsive Disorder* ; Psychopathology ; Sex Chromosomes ; Sexual Development

We report two cases of murine typhus diagnosed by indirect immunofluorescent test. The patients showed cardinal symptoms and signs such as fever and chill, general myalgia, intractable headache and typical rash. Laboratory values and histopathologic findings were compatible with murine typhus. The oral administration of doxycycline improved dramatically the clinical manifestations of the two CCLSPS.
Administration, Oral ; Doxycycline ; Exanthema ; Fever ; Headache Disorders ; Humans ; Myalgia ; Typhus, Endemic Flea-Borne*

No abstract available.
Anesthetics*

We assessed about growth hormone binding proteins (GHBP) activity which was measured eluted biotin GH fraction with alkaline phosphatase-streptavidine in children with insulin dependent diabetes mellitus (IDDM), short stature due to growth hormone deficiency (GHD), chronic renal failure, short stature due to nutritional deficiency. hypothyroidism and normal control groups using high pressure liquid chromatography protein pak 300 sw column. The following results are observed: 1) There were 3 types of growth hormone (GH) in serum: first GH binded with type I (minor) GHBP suggesting 200K dalton of molecular weight, second GH binded with type II (major) GHBP suggesting 60~70K dalton of molecular weight, and third GH were free form GH suggesting 20~25K dalton of molecular weight. 2) Type II (major) GHBP showed considerable individual variation in all ages. Neonates had the lowest levels of GHBP activity, but by the puberty the levels had increased & remained stable from adolescent to adult periods. 3) GHBP activity of children with IDDM at diagnosis was low value as compared to the same agenormal control group (p<0.05), and difference of GHBP activity among children with IDDM was related with height velocity (r=+0.92). Follow up GHBP activity during insulin therapy was reverse correlation with HbAlc. 4) GHBP activity of children with GHD at diagnosis was a slightly low compared to aged matched control and follow-up GHBP activity after 1 dose GH therapy showed increasing tendency (r=-0.68). 5) Otherwise, children with chronic renal failure, short stature due to nutritional deficiency, and hypothyroidism were assessed lower value than normal control group. Above results, GHBP activity had the lowest levels at neonatal period and then increasing tendency until puberty period and remained steady level until adult period. Regulation of GHBP may be closely related with metabolic control state by insulin, GH, nutritional status, and thyroid hormone..
Adolescent ; Adult ; Biotin ; Carrier Proteins ; Child ; Chromatography, Liquid ; Diabetes Mellitus ; Diabetes Mellitus, Type 1 ; Diagnosis ; Follow-Up Studies ; Growth Hormone ; Humans* ; Hypothyroidism ; Infant, Newborn ; Insulin ; Kidney Failure, Chronic ; Malnutrition ; Molecular Weight ; Nutritional Status ; Puberty ; Thyroid Gland

BACKGROUND AND OBJECTIVES: Though the surgical intervention of subclavian artery stenosis has been effective, its high morbidity and mortality have limited its clinical application. In 1980 percutaneous balloon angioplasty of stenotic artery was introduced as a substitute for surgical intervention and subsequent reports have supported its efficacy noting that it is more effective when combined with stent. The purpose of this study was to assess the feasibility, safety, and efficacy of percutaneous intervention as an alternative or primary therapy for symptomatic subclavian artery stenosis. METHODS: Between September 1993 and October 1998, 17 lesions in 16 patients of symptomatic subclavian artery stenosis were enrolled as candidates for nonsurgical intervention. We performed percutaneous balloon angioplasty with stenting to the subclavian artery stenosis and evaluated the early results. RESULTS: 1)The patients had a mean age of 55+/-14 years and 13 of 16 patients were male. 2)Subclavian artery stenting was successful in 94% (16/17) of the lesion without significant complications. The cause of failure was suboptimal result after deployment of stent. 3)The types of stents deployed were Strecker stents in 4, Palmaz stents in 8, Wall stents in 3 and Jo stents in 2 cases. 4)The peak and mean pressure gradient reduced from 58.5+/-17.0 to 8.5+/-7.4 and 31.4+/-13.0 to 4.7+/-5.5 mmHg respectively (p<0.01) and the degree of luminal stenosis decreased from 92.5+/-8.5% to 10.0+/-14.3%. (p<0.01) CONCLUSION: Subclavian artery stenosis can be managed safely and effectively through percutaneous balloon angioplasty with stenting, with an excellent technical success rate and less morbidity and mortality particularly in patients coexisting other vascular and systemic diseases. However, the long-term patency and clinical effects should be warranted.
Angioplasty, Balloon ; Arteries ; Constriction, Pathologic ; Humans ; Male ; Mortality ; Phenobarbital ; Stents* ; Subclavian Artery* ; Subclavian Steal Syndrome

Forty patients(9 male and 31 female) with tsutsugamushi disease were evaluated clinically. The diagnosis of tsutsugamushi disease was confirmed by indirect immunofluoresent test or isolation of causative agent. More than 77% of patients were over 40 years of age. After the incubation period(5 to 13 days, average 8 days) symptoms developed suddenly. The frequent symtoms were fever(100%), chill(100%), headache(100%), rnalaise(97%), and myalgia(95%). On physical exammination the rash, eschar, and lymphadenopathy were found in 97%, 82%, and 67% respectively. Eschar was observed in the trunk, especially axillary, abdominal and inguinal area. Serum transarninase(SGOT snd SGPT) was elevated(89 and 87%). Urinalysis revealed proteinuria in 35%(12/34) and hematuria in 19%(7/36). Chest roentgram and ECG demonstrated abnormalities in 39%(14/36) and 73%(26/36) respectively, The treatment with doxycycline was very effective in all cases.
Diagnosis ; Doxycycline ; Electrocardiography ; Exanthema ; Hematuria ; Humans ; Lymphatic Diseases ; Male ; Proteinuria ; Scrub Typhus* ; Thorax ; Urinalysis