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.
Lung Neoplasms* ; Lung*

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*

Retinoid, Ro l0-9359 is an aromatic analog of vitamin A acid or retinoic acid. The orally administrable retinoid has a therapeutic effect on the treatment of psoriasis, ichthyosis, Darier's disease, pustulosis palmoplantaris and skin cancer. However, some results have been reported previously, indicating that oral retinoid alone does not clear psoriatic lesions although some improvement may he noted. Morcover, promising results of combination treatment of psoriasis with the retinoid and local dithranol or PUVA have been reported. In the present study we report the clinical results obtained in 16 psoriatics after oral retinoid treatment, with and without the addition of topical cotricosteroid. We employed a new retinoid regimen orally in 16 adults with widcspread psoriatic lesions, Most of them bad been treated earlier with topical corticosteroids without beneficial effect. Of 16 cases 8 were treated with retinoid alone and the other 8 patients with topical corticosteroids in addition to the oral regimen, The results are summarized as follows: 1. Complete to good clearing of the lesions was seen in 5 of 8 patient with retinoid alone and in 7 of 8 patients using the combination treatment. 2. Side-effects appeared in all patients, the most prominent being dryness of the mouth or cheilitis in cases and pruritus in 10 cases. However, there were no abnormalities shown in liver function tests during or after treatment. From the above results the combination treatment with topical corticosteroids seems to be more effective than retinoid alone in the treatment of psoriasis. It is considered that the oral retinoid could be an alternative on the treatment of psoriasis.
Adrenal Cortex Hormones ; Adult ; Anthralin ; Cheilitis ; Darier Disease ; Humans ; Ichthyosis ; Liver Function Tests ; Mouth ; Pruritus ; Psoriasis* ; Skin Neoplasms ; Tretinoin

No abstract available.
Pulmonary Atelectasis*

Malignant eccrine poroma, or eccrine porocarcinoma, is a rare malignant cutaneous appendageal tumor arising from the intraepidermal eccrine sweat duct(acrosyringium), and usually develops ia an eccrine poroma of long-standing. We report a case of malignant eccrine poroma on the left buttock in a 72 year-old female. She was presented with a slightly pruritic, well-defined, reddish, firm, 4.5 x 4.5 x 0.7cm sized, protruding, ulcerated tumor. Histopathological examination revealed well-defined tumor cell nests in the epidermis and dermis. The tumor nests consisted of areas of eccrine poroma cells with benign appearance adjoining areas of anaplastic cells. Duct-like structures were observed within the tumor nests and showed a PAS-positive, diastase-resistant reaction. On immunohistochemical staining, the tumor cells were, positive for EMA, and most of tumor cells were negative but the duct-like structures were positive for CEA. She was treated with surgical excision. During the three year follow up period after excision, there was no recurrence.
Aged ; Buttocks ; Dermis ; Eccrine Porocarcinoma* ; Epidermis ; Female ; Follow-Up Studies ; Humans ; Poroma ; Recurrence ; Sweat ; Ulcer

PURPOSE: In order to recognize predictive factors of the recurrent seizure attacks with benign epilepsy of childhood with centrotemporal spike(BECCT), we have studied the factors such as age of seizure onset, sex of the patient, frequency and duration of seizure Prior to therapy, initial antiepileptic drug, which are presumed to influence the recurrence of seizure attack. METHODS: Among the children with BECCT, who visited the department of pediatrics, Chuncheon Sacred Heart hospital, Hallym University from Jan. 1985 to Dec. 1997, 52 patients who were followed up for more than 12 months after disappearance of the seizure, have been studied. The patients were divided into three groups, (group I; seizure duration is less than 3 months, groups II; seizure duration less than 12 months, group III; seizure duration more than 12 months) by duration of seizure recurrence, and compared with difference of seizure recurrence by predicting factor in each group. Data were analysed by using DBSTAT version 1.0 by ANOVA. RESULTS: 1) Age onset of seizure The age onset of seizure in group I is 8.6+/-2.0 years and 7.9 +/-3.5 years in group II, 6.2+/-1.7 years in group III. The younger the seizure standted, the more seizures recurred(p<0.05). Our study revealed no age differences of the seizure remission in 3 groups. 2) Sex : Among the 52 patients, 30 patients were male, 22 patients were female. The ratio of the male to female was 1:1(12/12) in group I, 1:1.5(2/3) in group II, 2.3: 1(16/7) in group III. The recurrence rate was higher in male than in female. But no statistically difference in recurrence rate by the sex was revealed. 3) Seizure duration and seizure frequency prior to therapy : In group I, pretreatment duration was 1.6+/-3.5 months, frequency of the attacks was 2.0+/-1.0. In group II, duration 1.3+/-1.2 months, frequency 3.2+/-0.5. In group III, duration 3.5+/-6.9 months, frequency 3.5+/-1.8. Our study revered statistically significant differences in values of frequencies and durations in each groups(p<0.05). 4) Initial anticonvulsant and seizure recurrence : Seizure recurred in 36% of patients treated by carbamazepine, and 55.6% of valproate, 66.7% of phenobarbital, 37.5% of diphenylhydantion. There was no significant relation between initial anticonvulsant and seizure recurrence in each group. CONCLUSION: Our data support that age onset and seizure frequency were predictive factor fort seizure recurrence. BECCT Is a age dependent genetic disorder with variable penetrance, having longer duration of seizure with earlier onset. Clinical seizures and abnormal EEG trait tend to remit at certain age, regardless of onset age and treatment.
Age of Onset ; Carbamazepine ; Child ; Electroencephalography ; Epilepsy ; Epilepsy, Rolandic* ; Female ; Gangwon-do ; Heart ; Humans ; Male ; Pediatrics ; Penetrance ; Phenobarbital ; Recurrence* ; Seizures* ; Valproic Acid

Pseudoxanthoma. elasticum is a rare, heritable, systemic disease of connective tissue characterized by degeneration of elastic tissue and mainly affecting the skin, eyes and blood vessels. Recently, according to Pope (1974), it can be inherited as an autosomal dominant or recessive trait. We presented a study of 5 cases of pseudoxanthoma elasticum of autosomal recessive inheritance, which showed typical peau d'orange skin lesions. Two among the 5 cases were associated with angioid streaks, a case with myopia and broderline mental retardation, and 2 cases without any other systemic disturbances.
Angioid Streaks ; Blood Vessels ; Connective Tissue ; Drug-Induced Liver Injury* ; Elastic Tissue ; Intellectual Disability ; Myopia ; Pseudoxanthoma Elasticum ; Skin ; Stevens-Johnson Syndrome* ; Wills

Pseudoxanthoma. elasticum is a rare, heritable, systemic disease of connective tissue characterized by degeneration of elastic tissue and mainly affecting the skin, eyes and blood vessels. Recently, according to Pope (1974), it can be inherited as an autosomal dominant or recessive trait. We presented a study of 5 cases of pseudoxanthoma elasticum of autosomal recessive inheritance, which showed typical peau d'orange skin lesions. Two among the 5 cases were associated with angioid streaks, a case with myopia and broderline mental retardation, and 2 cases without any other systemic disturbances.
Angioid Streaks ; Blood Vessels ; Connective Tissue ; Elastic Tissue ; Intellectual Disability ; Myopia ; Pseudoxanthoma Elasticum ; Skin ; Wills

We report an autopsy case of the brain stem glioma that extended extensively in the brain stem itself and cephalad. This 18-year-old boy first presented with dizziness, vomiting and left side weakness with left facial palsy. Brain MRI revealed a diffusely infiltrative tumor involving whole medulla, pons and lower midbrain. A total of 4000 R was given with some alleviation of respiratory difficulty. He died one year after the onset. Autopsy revealed the tumor involving pons, a portion of medulla oblongata, and cerebellum. The tumor showed diffusely infiltrative pattern and extended along the periventricular area to the thalamus and corpus callosum. The cut surface was grayish white and solid. It also showed areas of myxoid degeneration and necrosis probably related to radiation therapy. Microscopically the tumor was a cellular and pleomorphic glioma that showed some astrocytic differentiation. It was diffuse without geographic necrosis.