Our present knowledge of impetigo contagiosa extends from its first description as a separate clinical entity by Fox in I864, and the proof of its bacterial etiology by Radcliffe-Crocker in 1881. Both staphylococci and streptococci have been discovered from the lesions, but the relative preponderance of each varies greatly, and reports are contradictory. Seventy-eight patients with impetigo contagiosa were studied bacteriologically in order to ascertain the primary etiologic agent. Also, a susceptibility test (Bauer- Kirby method) was done on the isolated organisms with 7 antibiotics which are used frequently in the clinical field. Specimens obtained from the skin lesions were cultured and organisms were isolated. They were identified by various biochemical and serological tests. A DN ase test, a carbohydrate fermentation test, and a coagulase test were done for the isolated staphylococci. A bacitracin disc method and a precipitin test(Lancefield method) were done for the isolated B-hemolytic streptococci. The results were as follows: Fifty-six cases(71.8%) were infected by staphylococcus only. Twenty cases(25.6%) were infected by a mixture of staphylococcus and p-hemo- lytic streptococcus. Only 2 cases(2.6%) were infected by B-hemolytic streptococcus alone. All 76 strains of staphylococci were identified as coagulase positive staphylococci. Among the 22 strains of B-hemolytic streptococci, 15 strains were identified as group A and remaining 7 strains were identified as group B. Coagulnse negative sta,phylococcus was not found. In the susceptibility test to 7 antibiotics, staphylococci showed susceptibility to lincomycin, erythromycin, cloxacillin, and chloramphenicol, and resistance to tetra-cycline, penicillin, and ampicillin. Streptococci showed susc.ptibility to all of the above antibiotics except tetracycline. From the results of this experiment, it was concluded that the primary etiologic agent of impetigo contagiosa was coagulase positive staphylococcus and streptococcus for the most part can be considered as a secondarily infecting agent. Coagulase negative staphylococcus apparently is not implicated as an etiologic agent of impetigo contagiosa. The results of the antibiotic susceptibility tests would seem to indicate that the use of such antibiotics as tetracycline, penicillin, and ampicillin is not indicated in the treatment of impetigo contagiosa.
Ampicillin ; Anti-Bacterial Agents ; Bacitracin ; Chloramphenicol ; Cloxacillin ; Coagulase ; Erythromycin ; Fermentation ; Humans ; Impetigo ; Lincomycin ; Penicillins ; Serologic Tests ; Skin ; Staphylococcus ; Streptococcus ; Tetracycline

No abstract available.

A multiple regression analysis using ordinary least square (OLS) is frequently used for the projection of healt expenditure as well as for the identification of factors affecting health care costs. Data for the analysis often have mixed characteristics of time series and cross section. Parameters as a result of OLS estimation, in this case, are no longer the best linear unbiased estimators (BLUE) because the data do not satisfy basic assumptions of regression analysis. The study theoretically examined statistical problems induced when OLS estimation was applied with the time series cross section data. Then both the OLS regression and time series cross section regression (TSCS regression) were applied to the same empirical data. Finally, the difference in parameters between the two estimations were explained through residual analysis.
Health Care Costs ; Health Expenditures*

Erythema Annulare Centrifugum is characterized by migratory annular, arcuate or polycyclic erythemas with central clearing. Its etiology is not conclusive but there are many reports about the etiology, i.e." due to dermatophytid"," the drugs",' intemal diseases", or" unknown etiology" etc. A case of Erythema Annulare Centrifugum with "unkown etiology" was reported. The patient revealed slightly elevated, migratory annular erythemas with central clearing on the both posterior portions of thighs. Histopathologically, there was no abnormality in the epidermis. In the dermis, cellular infiltrates sbowing fairly well demarcated perivascular coat-sleeve like arrangement and endothelial prolifera01
Dermis ; Epidermis ; Erythema* ; Humans ; Thigh

The authors observed 2 cases of poikilcdermatomyositis who were 16 and l0 years old female. The former visited our dept. due to rashes on the anterior portion of right thigh with 3 months duration. The skin lesion revealed mottled skin pigmentation, telangiectasia, atrophy, and cigarrette paper like wrinklings. On the palpation, hardness and tenderness in the lesion were felt. The latter visited our dept. due to weakness of the right lower extremity for 3years. The skin lesion revealed the same feature as the former but more prominent. Histophthologically, P.V.A. patterns are seen in the both skin lesions. The epidermis shows moderate atrophy of St. malphigi and flattening of reteridges. The dermis is edematous, vascular dilatations, and cellular infiltrations, most of lymphocytes, around the blood vessels. The muscle biopsies for the Quardriceps Femoris sbow Dermatomyositis patterns which the muscle bundles are degenerative changes and many cellular infiltrations, chiefly of lymphocytes, are seen between the muscle bundles. Diagnosis was confirmed by the clinical and histological pictures. These patients were markedly improved by the prednisolone therapy.
Atrophy ; Biopsy ; Blood Vessels ; Dermatomyositis ; Dermis ; Diagnosis ; Dilatation ; Epidermis ; Exanthema ; Female ; Hardness ; Humans ; Lower Extremity ; Lymphocytes ; Palpation ; Prednisolone ; Skin ; Skin Pigmentation ; Telangiectasis ; Thigh

According to literatures, the different types of fractures can occur as a result of arm wrestling ; Spiral fracture of the humeral shaft associating often with a bntterfly fragment, fracture of medial epicondyle of the humerus, and the marginal radial head fracture with anterior dislocation. The last type is very rarely reported. In addition to the fracture occurrence, other injuries such as muscular strain of the arm, and sprain or luxation of the shoulder, elbow and wrist joints can be taken place. However, it is thought that the most of those injuries by arm wrestling have been treated simply by general practioners unreported. The arouse the attention of the jury of the game, wrestlers and the surgenons, the cases of bony injuries sustained during the arm-wrestling are reported. Thirteen patients were treated by us since 1977. Among them, five cases had fractures of the humeral shaft, and eight cases had fractures of medial epicondyle of the humerus. Among the five shaft fractures, three were treated by conservatively, and two by operatively. Among 8 avulsion fractures of the medial epicondyle only two were treated conservatively, and 6 operatively. One patient sustained the medial epicondylar avulsion fracture twice for which K-wire fixation treatment was done. The results of treatment were all satisfactory. However, because of the possibility of wrestlers sustaining such injuries. Arm wrestling should not be considered a totally benign sport.
Arm ; Dislocations ; Elbow ; Head ; Humans ; Humerus ; Shoulder ; Sports ; Sprains and Strains ; Wrestling ; Wrist Joint

Abnormalities in the number and function of platelets may contribute to thromboembolic complications in patients with essential thrombocythemia(ET). Physicians often use hydroxyurea which reduces the platelet count for the initial treatment of ET. A 74-year-old man with ET was presented with headache, dysarthria, and right hemiparesis 10 months after discontinuation of hydroxyurea. Initial platelet count was 450x103/microliter and we gave him heparin. However, his platelet count rised upto 1,019x103/microliter within 4 days. He was on hydroxyurea 1.5 g/day and his symptoms improved with decrease of platelet count. We report a case of left MCA(middle cerebral artery) multifocal infarction in ET after discontinuation of hydroxyurea.
Aged ; Cerebral Infarction* ; Dysarthria ; Headache ; Heparin ; Humans ; Hydroxyurea* ; Infarction ; Paresis ; Platelet Count ; Thrombocythemia, Essential*

Vertigo mimicking labyrinthine lesions may have resulted from ischemic insult to the inner ear or the vestibular nerve and nucleus in the AICA infarction syndrome. A 56-year-old female was admitted to the emergency room with vertigo and hearing loss in right ear. On neurological examination, she had left beating jerky torsional and horizontal nystagmus with falling and past pointing to right side. Brain magnetic resonance images showed high signal intensity in anterolateral portion of inferior pons on T2- weighted images. Severe right facial palsy of peripheral type developed 24 hours after admission. Audiometry and electronystagmography documented absent auditory and vestibular function on the affected side. We argue that vertigo of the acute infarction in AICA territory can be involved the eight and seventh nerve root entry zoon and mimic labyrinthine lesions
Audiometry ; Brain ; Ear ; Ear, Inner ; Electronystagmography ; Emergency Service, Hospital ; Facial Nerve* ; Facial Paralysis ; Female ; Hearing Loss ; Humans ; Infarction* ; Middle Aged ; Neurologic Examination ; Nystagmus, Pathologic ; Pons ; Vertigo* ; Vestibular Nerve

No abstract available.
Glycemic Index ; Humans

Since the introduction of Holdsworth's new classification on fracture-dislocations of spine with particular emphasis on the role of posterior ligmaent complex, operative reduction and spinal fusion is considered to be an established procedure in treating unstable injuries of the thoracolumbar spine.By stabilizing unstable fractures,nursing, and rehabilitation become much easier. Among the various methods and devices, Harrington instrumentation and posterior spinal fusion have been used and found to be acceptable in our series. Twenty five consecutive patients with unstable fractures and fracture-dislocations' of thoracolumbar spine were treated by open reduction and spinal fusion with Harrington rod fixation at the Department of Orthopedic Surgery, Kang Nam General Hospital Public Corporation from the period of 1982 to 1985. The following results were obtained from analysis of the cases. l. Among 25 cases, 15 (60%) were due to flexion-rotation violence, 5 pure flexion,3 vertical compression, 1 shear fracture respectively. 2. Among 16 cases with neurologic deficit, 15 cases showed considerabel improvement after surgery. 3. Most of the cases showed satisfactory bony fusion, and average postoperative kyphotic angle was 14.4 after 3 months. 4. Although no particular external fixation was adopted, permitting mobility in bed, postoperative correction was relatively well maintained.
Classification ; Hospitals, General ; Humans ; Neurologic Manifestations ; Orthopedics ; Rehabilitation ; Spinal Fusion ; Spine ; Violence