Mesenteric lymphadenitis due to Yersinia enterocolitica infection is not common in Korea. Although most cases of Yersinia enterocolitica-induced mesenteric adenitis are self limited, cardinal features of Yersinia enterocolitica-induced mesenteric adenitis are so similar to those of acute appendicitis that some of the patients undergo laparotomy with suspected appendicitis. The findings on laparotomy in such patients are usually enlarged mesenteric nodes with a normal or slightly inflamed appendix. Because histologic examination of the removed mesenteric lymph nodes reveals reactive hyperplasia in most cases, it is usually difficult to suspect Yersinia enterocolitica infection on morphology of the resected nodes. But suppurative granulomata of mesenteric lymph nodes, uncommonly encountered in Yersinia enterocolitica infection, strongly suggest yersinial infection. We report a case of mesenteric lymphadenitis in a 10-year-old boy, who underwent laparotomy with suspected acute appendicitis. The removed lymph node showed several suppurative granulomata in the cortex, suggesting yersinial infection. Serologic study confirmed Yersinia enterocolitica serotype O:3 infection.
Appendicitis ; Appendix ; Child ; Humans ; Hyperplasia ; Korea ; Laparotomy ; Lymph Nodes ; Lymphadenitis ; Male ; Mesenteric Lymphadenitis* ; Yemen ; Yersinia enterocolitica* ; Yersinia*

BACKGROUND: Quinidine appeared to increase serum digoxin levels when given with quinidine. Therefore elevated serum digoxin concentrations and clinical toxicity have been reported in patient receiving quinidine. Currently, Bayesian method which estimates the most probable parameters of the drug for each patient from population parameters data is useful approach for adjusting digoxin dosage. To increase the accuracy of Bayesian method, it is desirable to use population parameters of Korean. Therefore we evaluated the effect of quinidine on digoxin clearance in Korea. METHOD: Patient's records from 19 adult cardiac disease without CHF having normal renal and liver function from Seoul National University of Hospital respectively wre evaluated. Digoxin pharmacokinetic parameters, CL and Vd, were obtained from serum concentration of digoxin of single and combined therapy at each steady-state by using bayesian method. RESULTS: This study show that quinidine reduced the total body clearance of digoxin from 2.39+/-0.17 to 1.51+/-0.08ml/min/kg(p<0.05) and reduced the digoxin volume of distribution from 8.57+/-0.29 to 4.98+/-0.19L/kg(p<0.05). This results show that digoxin dosage reduced to 40-50% in Korean, if quinidine therapy is initiated.
Adult ; Bayes Theorem ; Digoxin* ; Drug Interactions ; Heart Diseases ; Humans ; Korea ; Liver ; Pharmacokinetics ; Quinidine* ; Seoul

No abstract available.
Candidemia* ; Humans

Background: Whole body scan using 131-iodine is performed to detect local recurrence or metastasis after thyroidectorny in differenciated thyroid cancer patients. The sensitivity of this procedure is related to the dose of radiopharmaceutical administered. It was reported that 131I posttreatment whole body scan demonstrate foci of tracer uptake not previously observed in diagnostic scan in 10~30% of cases. Posttreatment scans were most likely to reveal new foci in young patients(<45) and patients who had previously received radioactive iodine therapy. Method: We observed the frequency of discordant posttreatment scans and analysed the clicnical significance in 33 differenciated thyroid cancer patients who were admitted for radioiodine ablation from June, 1995 to April, 1996. Results: In 7 cases(21.2%), post treatment scan demonstrated cme or more foci of uptake and revealed less sites of uptake than diagnostic scan in 3 cases(9.1%). In one case with elevated thyroglobulin level and negative diagnostic scan, post treatment scan revealed new uptake sites with thyroid bed and cervical 1ymph node. The sites of discordant uptake were cervical lymph nodes in 4 cases and rnediastinal lymph node in one case, lung in one case, thyroid bed and cervical lymph nodes in one case, 3 cases of 7 pts(43%), demonstrated ane or more foci of uptake in post treatment scan, had history of previous radioiodine treatent. Conclusion: Post treatment scan confirmed uptake into remnant and metaststic tissues identified on the corresponding low dose diagnostic scans. Scanning after high dose radioiodine treatment frequently demonstrated one or more foci of uptake, especially in patients with previous radioiodine treatment, which were not visualized on the diagnostic low dose scan. Treatment scan may be useful for detection of remnant tissue or metastatic lesion in patients with elevated thyroglobulin and negative diagnostic scan.
Humans ; Iodine ; Lung ; Lymph Nodes ; Methods ; Neoplasm Metastasis ; Recurrence ; Thyroglobulin ; Thyroid Gland ; Thyroid Neoplasms ; Whole Body Imaging

BACKGROUND: Staphylococcus aureus and Group A beta-hemolytic Streptococci are the etiologic agents most commonly associated with cellulitis, but many other bacteria have also been shown to cause this condition. The positive bacterial culture rate is the most important factor in the treatment of cellulitis. However, the positive bacterial culture rate in the commonly used media, tends to be quite low. OBJECTIVE: The principal objective of this study was to improve the positive culture rate in cellulitis patients by using a new enriched broth. METHODS: Brewer modified thioglycollate medium (BTM) and Columbia broth (CB), both of which are widely utilized in clinical bacteriology for enriched growth, were compared with several novel enriched broths. These new enriched broths were mixtures of BTM-CB broth and added growth supplement factors. They included BTM-CB (BC), Modified BTM-CB (MBC) and supplement VX-BTM-CB (VXBC). MBC media included several growth supplements, such as hemin, vitamin K1, VX supplement, and Campylobacter growth supplement. Strains utilized in this study were common pathogens (Staphylococcus aureus, Streptococcus pyogenes, et al.), anaerobes, fastidious pathogens (Bacteroides fragilis, Campylobacter jejuni, Prevotella melaninogenica), uncommon pathogens (Actinobacter baumannii, Enterococcus faecalis, Streptococcus agalactiae). Positive culture rates were evaluated in each medium and measured via spectrophotometry at 660 nm. RESULTS: In vitro, all strains used in this study grew more quickly and densely in MBC media. CONCLUSION: Our results suggest that MBC media in a new enriched broth may improve bacterial culture rates in cellulitis patients. It will be necessary to study the efficacy of the MBC media in the culturing etiologic agents from tissues of cellulitis patients.
Bacteria ; Bacteriology ; Campylobacter ; Campylobacter jejuni ; Cellulitis ; Enterococcus faecalis ; Hemin ; Humans ; Organothiophosphorus Compounds ; Prevotella ; Spectrophotometry ; Staphylococcus aureus ; Streptococcus ; Streptococcus pyogenes ; Vitamin K 1

No abstract available.
Aged ; Biopsy ; Humans ; Liver Cirrhosis/diagnosis/*etiology/therapy ; Male ; Pericarditis, Constrictive/*complications/diagnosis/therapy ; Tomography, X-Ray Computed

BACKGROUND: Cytomegalovirus(CMV) disease is an important opportunistic infection and contributes to significant morbidity and mortality in immunocompromised hosts. To determine predisposing conditions to CMV disease and its prognosis, the authors reviewed the clinical courses of patients with CMV disease. METHODS: We reviewed medical records of 23 patients with CMV disease diagnosed at Seoul National University Hospital from 1987 to 1997. RESULTS: CMV pneumonia was diagnosed in 8 patients. Underlying conditions of the patients were allogeneic bone marrow transplant(BMT) in 4 patients, lupus nephritis in 1, dermatomyositis in 1, and renal transplantation recipient in 1. The cumulative dose of corticosteroid given to the BMT recipients before the development of CMV pneumonia ranged between 1,000 and 4,700 mg, whereas that to the non-BMT patients ranged between 2,100 and 6,000 mg. Of the 8 patients with CMV pneumonia, five patients(75%) died. Of the 15 CMV gastroenteritis, two had CMV gastric ulcers. The gastric ulcers showed clinical and endoscopic improvement with systemic ganciclovir therapy. Among 13 patients with CMV enterocolitis, nine had preceding GI diseases, and nine had received systemic corticosteroids. Five patients died. The mortality was lower in patients with underlying bowel diseases than in those without ones(22% vs. 75%, respectively). CONCLUSION: The mortality of CMV disease was 62.5%, 0%, and 38% in patients with CMV pneumonia, gastric ulcer, and enterocolitis, respectively. GVHD, systemic corticosteroid and/or immunosuppressive therapy were major risk factors of CMV diseases.
Adrenal Cortex Hormones ; Bone Marrow ; Cytomegalovirus* ; Dermatomyositis ; Enterocolitis ; Ganciclovir ; Gastroenteritis ; Humans ; Immunocompromised Host ; Kidney Transplantation ; Lupus Nephritis ; Medical Records ; Mortality ; Opportunistic Infections ; Pneumonia ; Prognosis ; Risk Factors ; Seoul ; Stomach Ulcer

No abstract available.
Scrub Typhus* ; Seoul*

Motor paralysis is a less common neurologic complication of herpes zoster. Until now, a few cases have been reported, and most of these cases showed brachial plexopathy involving one or two segments. We report a patient with pain and weakness on upper extremity diagnosed as brachial plexopathy after herpes zoster infection. An 88-year-old female patient complained not only tingling sense, pain, and swelling on right whole arm, but also weakness on this right upper extremity. On physical examination, weakness is seen in right shoulder abductionㆍshoulder flexionㆍelbow flexionㆍelbow extensionㆍ wrist extension (grade 4), finger flexionㆍfinger abductionㆍfinger extensionㆍfinger DIP flexion (grade 3). In electrodiagnostic study and magnetic resonance imaging study, she was diagnosed as the brachial plexopathy, whole branch involved. This is the only case of post-herpetic brachial plexopathy involving whole branch in domestic.

Motor paralysis is a less common neurologic complication of herpes zoster. Until now, a few cases have been reported, and most of these cases showed brachial plexopathy involving one or two segments. We report a patient with pain and weakness on upper extremity diagnosed as brachial plexopathy after herpes zoster infection. An 88-year-old female patient complained not only tingling sense, pain, and swelling on right whole arm, but also weakness on this right upper extremity. On physical examination, weakness is seen in right shoulder abductionㆍshoulder flexionㆍelbow flexionㆍelbow extensionㆍ wrist extension (grade 4), finger flexionㆍfinger abductionㆍfinger extensionㆍfinger DIP flexion (grade 3). In electrodiagnostic study and magnetic resonance imaging study, she was diagnosed as the brachial plexopathy, whole branch involved. This is the only case of post-herpetic brachial plexopathy involving whole branch in domestic.