Bacteriological study, including antibiotic sensitivity tests, of 145 patients with pyodermas such as impetigo, superficial folliculltis, deep folliculitis, ecthyma, paronychia, cellulitis and secondary skin infections, was carried out during the period from June, 1981 to September, 1982 at the Department of Dermatology, Han II hospital. (countinued..)
Cellulitis ; Dermatology ; Ecthyma ; Folliculitis ; Humans ; Impetigo ; Paronychia ; Pyoderma* ; Skin

A 62 year old man had skin eruptions, general weakness, swallowing difficulty, and fever for 3 months. Diagnosis of dermatomyositis was established on the bases of clinical manifestations, muscle enzyrne study, electromyogram and histopathological findings of skin and muscle. Borrman type g stomach cancer was found by gastroendoscopy and computed tomography. He refused surgical operation for stomach cancer and died 2 months later.
Deglutition ; Dermatomyositis* ; Diagnosis ; Fever ; Humans ; Middle Aged ; Skin ; Stomach Neoplasms* ; Stomach*

No abstract available.
Child* ; Humans ; Staphylococcus aureus* ; Staphylococcus*

BACKGROUND: The efficacy of an epidural test dose for detecting inadvertent intravascular injection during general anesthesia with volatile anesthetics has not been clearly determined. The object of this study is to evaluate the efficacy of a simulated intravenous isoproterenol test dose in adult patients anesthetized with O2-N2O-enflurane. METHODS: Forty-five healthy adult patients were anesthetized with 1 vol% enflurane and nitrous oxide after endotracheal intubation and were randomized to one of three groups according to the dose of isoproterenol. Isoproterenol 1, 2 and 3 microgram groups (n = 15 each) received 3 ml of 2% lidocaine with 1, 2 and 3 microgram isoproterenol IV respectively, to simulate an intravascularly administered test dose. HR and systolic blood pressure were measured at 20-s intervals for 4 min after injection. RESULTS: Mean maximal heart rate increases were 15 8, 21 8, and 27 10 bpm (mean SD) in the isoproterenol 1, 2 and 3 microgram groups, respectively. Isoproterenol 3 microgram produced 100% sensitivity in the modified (> or = 10 bpm increase) HR criteria and 67% sensitivity in the conventional (> or = 20 bpm increase) HR criteria. CONCLUSIONS: To determine whether an epidural catheter may be in a blood vessel, various vasoactive drugs are often administered. The epidural test dose containing 3 microgram isoproterenol might be a reliable marker for intravascular injection based on the modified HR criterion.
Adult* ; Anesthesia, General ; Anesthetics ; Blood Pressure ; Blood Vessels ; Catheters ; Enflurane ; Heart Rate ; Humans ; Intubation, Intratracheal ; Isoproterenol* ; Lidocaine ; Nitrous Oxide

BACKGROUND: The efficacy of an epidural test dose for detecting inadvertent intravascular injection during general anesthesia with volatile anesthetics has not been clearly determined. The object of this study is to evaluate the efficacy of a simulated intravenous isoproterenol test dose in adult patients anesthetized with O2-N2O-enflurane. METHODS: Forty-five healthy adult patients were anesthetized with 1 vol% enflurane and nitrous oxide after endotracheal intubation and were randomized to one of three groups according to the dose of isoproterenol. Isoproterenol 1, 2 and 3 microgram groups (n = 15 each) received 3 ml of 2% lidocaine with 1, 2 and 3 microgram isoproterenol IV respectively, to simulate an intravascularly administered test dose. HR and systolic blood pressure were measured at 20-s intervals for 4 min after injection. RESULTS: Mean maximal heart rate increases were 15 8, 21 8, and 27 10 bpm (mean SD) in the isoproterenol 1, 2 and 3 microgram groups, respectively. Isoproterenol 3 microgram produced 100% sensitivity in the modified (> or = 10 bpm increase) HR criteria and 67% sensitivity in the conventional (> or = 20 bpm increase) HR criteria. CONCLUSIONS: To determine whether an epidural catheter may be in a blood vessel, various vasoactive drugs are often administered. The epidural test dose containing 3 microgram isoproterenol might be a reliable marker for intravascular injection based on the modified HR criterion.
Adult* ; Anesthesia, General ; Anesthetics ; Blood Pressure ; Blood Vessels ; Catheters ; Enflurane ; Heart Rate ; Humans ; Intubation, Intratracheal ; Isoproterenol* ; Lidocaine ; Nitrous Oxide

The use of CT is most reliable in diagnosis and management of brain abscess. Authors analized 17 cases of pathologically and clinically proven brain abscess during the period of 39 months from Jan. 1978 to Mar, 1982 at National Medical Center. The results were as follows; 1. The sex ration 9 males to 8 females, and no sexdifference was seen, and the greatest number of cases were seen below the age of 30(65%). 2. The otogenicinfection was the most frequent predisposing factors(8 cases). Other predisposing factors were postoperative infection (2 cases), pulmonary infection (2 cases), and congenital heart disease(2 cases). The most common site ofinvolvement was posterior fossa(5 cases). Next was temporal lobe (4 cases), and temporoparietal lobe (3 cases). 3.Most common presenting symptoms were headache, fever, focal neurological signs, and dizziness. 4. Among the 22 brain abscesses of 17 patients, the msot frequent CT finding in precontrast scan was a low density surrounded by afaint dense or dense ring (11 cases). Next was purely low density (6 cases). Associated hydrocephalus was found in4 cases, and multiple or multiloculated abscess was seen in 4 cases. 5. In post contrast scan, brain abscessusually show complete, oval or round shaped, thin, evening righ enhancement with mild or moderate surroundingedema, but there was no specific enhancement.
Abscess ; Brain Abscess ; Brain ; Causality ; Diagnosis ; Dizziness ; Female ; Fever ; Headache ; Heart ; Humans ; Hydrocephalus ; Male ; Temporal Lobe

BACKGROUND: Trichomycosis axillaris and pubis is a bacterial infection of the hair shaft. It is characterized by nodular thickening on the hair shaft, composed of colonies of aerobic Corynebacterium. Benzoyl peroxide and erythromycin topical application can be used successfully. OBJECTIVE: We performed this study to compare treatment efficacy of benzoyl peroxide and erythromycin in trichomycosis axillaris and pubis METHOD: The clinical study was made with 12 patients of trichomycosis axillaris and pubis. RESULT: Among 12 patients, 6 patients were treated by benzoyl peroxide topical application and the other by erythromycin. 1) All the affected patients were male, and mean age of onset was 31 years old. 2) Simultaneous involvement of axillae and pubis was found in 9 cases, and involvement of axillae only in 3 cases. 3) There was no statistically significant difference in the treatment efficacy between benzoyl peroxide and erythromycin (p> 0.05). 4) Infected hair shafts were removed by shaving in 7 cases. But shaving itself did not shorten the period for complete cure (p> 0.05). 5) Mean disease duration was 6.7 months and mean period for complete cure was 3.1 weeks. And there was no significant relation between disease duration and mean period for complete cure. 6) Only 1 case (8.3%) showed recurrence within 6 month-follow up, in which erythromycin topical application without shaving was used. 7) Among 12 cases, irritation and contact dermatitis were observed in 5 cases (41.7%). And these were all related with benzoyl peroxide application. CONCLUSION: Benzoyl peroxide is as effective as erythromycin in the treatment of trichomycosis axillaris and pubis. But, benzoyl peroxide have more side effect. Shaving itself is not necessag to treat trichomycosis.
Adult ; Age of Onset ; Axilla ; Bacterial Infections ; Benzoyl Peroxide* ; Corynebacterium ; Dermatitis, Contact ; Erythromycin* ; Hair ; Humans ; Male ; Recurrence ; Treatment Outcome

BACKGROUND: Pencil-point needle currently are used for spinal anesthesia because of an alleged lowered incidence of postdural puncture headache. Although the direction of the side hole is one of the important factors that might affect the level and the duration of anesthesia, those data are not readily available. The aim of this study was to assess if the side hole direction of pencil-point needle during hyperbaric tetracaine injection affects the level and the duration of anesthesia. METHODS: We induced spinal anesthesia in 80 young men presenting for elective orthopedic surgery. Patients were allocated randomly with the side hole direction of the 25 gauge pencil-point needle in one of the four directions; cephalad, caudad, left lateral, right lateral. Hyperbaric 0.5% tetracaine 15~17 mg (3 to 3.4 ml) was injected with the speed of 0.75 ml/sec. Maximum sensory block level, time to maximum sensory block level, duration of sensory block (2 segments regression time) were assessed by a blinded observer with the pin-prick test and degree of motor block were measured by Bromage motor scale. Data were analysed using the Kruskal-Wallis test followed by the Mann-Whitney U test and chi-square test as appropriate (SAS v. 6.04). RESULTS: Time to maximum sensory block level was significantly fast in group 'cephalad'. Other values have no statistical differences. Post-spinal headache was observed in one case in group 'caudad'. CONCLUSIONS: Using the pencil-point needle, the time to maximum sensory block level was fast in group cephalad but there were no differences in the maximum sensory block level and the duration of sensory block among the four groups.
Anesthesia ; Anesthesia, Spinal* ; Headache ; Humans ; Incidence ; Male ; Needles* ; Orthopedics ; Post-Dural Puncture Headache ; Tetracaine*

BACKGROUND: Postoperative patients frequently associate postoperative backache with epidural anesthesia administered for the operation. Epidural steroids are often used for the treatment of low back pain. We performed this study to compare the effect of epidural triamcinolone on the incidence and severity of postepidural backache after cesarean section. METHODS: Eighty patients scheduled for cesarean section under epidural anesthesia using 2% lidocaine received 40 mg of triamcinolone (n=40) or 1ml of normal saline (n=40) epidurally via indwelling catheter after delivery. Backache were checked preoperatively and 24, 48, 72hr postoperatively using VAS score. A patient was considered to have postepidural backache when the postoperative VAS score was higher than the preoperative score. RESULTS: The incidence and severity of postepidural backache were much less in triamcinolone group than in control group (p<0.05). CONCLUSION: Epidural triamcinolone has a preventive effect on postepidural backache in cesarean section patients.
Anesthesia, Epidural* ; Back Pain* ; Catheters, Indwelling ; Cesarean Section* ; Female ; Humans ; Incidence ; Lidocaine ; Low Back Pain ; Pregnancy ; Steroids ; Triamcinolone*

Microcystic adnexal carcinoma(MAC) is an unusual carcinoma of eccrine glands, composed of pilar and sweat duct structures. We report here a 64-year-old man with MAC on his left cutaneous upper lip. Microscopically, the tumor consisted of nests and gland-like structures within desmoplastic stroma, and it stained positively for carcinoembryonic antigen. The clinical appearance and histopathologic findings of the tumor may be mistaken for other benign and malignant entities. The patient was treated with excision and skin flap, and no recurrence over a 31-month follow up period.
Carcinoembryonic Antigen ; Eccrine Glands ; Follow-Up Studies ; Humans ; Lip ; Middle Aged ; Recurrence ; Skin ; Sweat