No abstract available.

We report a case of tinea corporis caused by Microsporum(M.) gypseum and keloid while applying tinea corporis with glacial acetic acid improperly in a 59 year-old female. The lesions were manifested by 7.0x4.5 cm-sized, localized pruritic fine scaly erythematous annular patch and keloid on left antecubital fossa. Culture from the annular skin lesion of patient on Sabouraud's dextrose agar showed typical colony of M. gypseum. The patient was treated with 250 mg of terbinafine daily for 1 month and topical lanoconazole application. Keloid was improved by intralesional steroid injection.
Acetic Acid ; Agar ; Female ; Glucose ; Humans ; Imidazoles ; Keloid ; Microsporum ; Naphthalenes ; Skin ; Tinea

We report a case of tinea corporis caused by Microsporum(M.) gypseum and keloid while applying tinea corporis with glacial acetic acid improperly in a 59 year-old female. The lesions were manifested by 7.0x4.5 cm-sized, localized pruritic fine scaly erythematous annular patch and keloid on left antecubital fossa. Culture from the annular skin lesion of patient on Sabouraud's dextrose agar showed typical colony of M. gypseum. The patient was treated with 250 mg of terbinafine daily for 1 month and topical lanoconazole application. Keloid was improved by intralesional steroid injection.
Acetic Acid ; Agar ; Female ; Glucose ; Humans ; Imidazoles ; Keloid ; Microsporum ; Naphthalenes ; Skin ; Tinea

We report a case of tinea corporis arising in previous burn area which shows tinea imbricata-like clinical appearance in a 69-year-old male. He showed round, 5.0x5.0 cm sized, fine scaly, well-defined erythematous patch with concentrically arranged rings of scales on the right forearm. Histopathologically, PAS staining revealed fungal hyphae in the horney layer of the epidermis. Fungal culture of scales of the lesions on Sabouraud's dextrose agar showed typical Trichophyton verrucosum. He was treated with oral terbinafine (250 mg/day) and topical lanoconazole for 1 month. Skin lesions improved one month after the treatment, and recurrence has not been observed
Agar ; Aged ; Burns ; Epidermis ; Forearm ; Glucose ; Humans ; Hyphae ; Imidazoles ; Male ; Naphthalenes ; Recurrence ; Skin ; Tinea ; Trichophyton ; Weights and Measures

Dermatophytes usually do not invade beyond the epidermis. However, mechanical breakage of the skin resulting from scratching or trauma and immunocompromised state, such as diabetes mellitus, lymphoma, and long term steroid use may allow penetration of the fungi into dermis. We report a case of trichophytic granuloma of the thigh caused by Trichophyton(T.) rubrum in a 21-year-old chinese male, who showed a pruritic, 17x10 cm sized, erythematous to brownish patch with multiple papules on the left thigh for 3 months. Fungal culture of the biopsy specimen grew out typical white cottony colonies of T. rubrum. Histopathologic examination of the skin lesions showed chronic granulomatous inflammation and fungal elements in the dermis. After one month of itraconazole therapy (200 mg/day), lesions were completely cleared.
Arthrodermataceae ; Asian Continental Ancestry Group ; Biopsy ; Dermis ; Diabetes Mellitus ; Epidermis ; Fungi ; Granuloma ; Humans ; Inflammation ; Itraconazole ; Leg ; Lymphoma ; Male ; Skin ; Thigh ; Trichophyton ; Young Adult

PURPOSE: Central venous catheterization is widely used to supply substantial amounts of fluids, total parenteral nutrition and hemodialysis in renal failure patients, as well as for measuring the central venous pressure. The most common complications encountered during central venous catheterization include catheter-related infections and subsequent sepsis. Therefore, when fever exists in patients with a central venous catheter, an immediate blood culture should be performed, and if the fever persists, an infection must be suspected and the catheter immediately removed; a culture of the catheter tip should also be performed. To date, no definite clinical details relating to this matter have been reported. METHODS: Between December 2002 and March 2005, a retrospective study was undertaken using the medical records of 85 patients. In those patients where a fever lasted for more than 8 hours, or when catheterization was no longer needed, the catheter tip cultures were sent to the microbiology laboratory. Blood cultures were also performed on 49 patients with a fever. The Chi-square method using the PC SPSS program, with P value less than 0.05 as statically significant. RESULTS: Of the 85 patients where the catheters were removed, significant microorganisms were detected 20 of the 49 with a fever. Only 5 of the remaining 36 patients had their catheters spontaneously removed. Moreover, 14 of the 20 patients with significant microorganisms were found to have kept their catheter in place for more than 14 days. Of the 49 patients with a fever, in who blood cultures were undertaken, 13 showed specific microorganisms, with 6 of these showing the same results for both their blood and catheter tip cultures, which enabled the definite diagnosis of the catheter-related infection and underlying sepsis. Various microorganisms were detected from the catheter tip cultures, including Staphylococcus species the CNS, with S. aureus being the most common, at 61.6%. CONCLUSION: A central venous catheter should be removed immediately when an infection is suspected, but early broad-spectrum antibiotics therapy should be commenced due to the time required to obtain the culture results. Moreover, even if a fever does not exist in patients with a catheter inserted for more than 14 days, infection and sepsis from the catheter should be of concern, with a more cautious approach being mandatory.
Anti-Bacterial Agents ; Catheter-Related Infections ; Catheterization ; Catheterization, Central Venous ; Catheters ; Central Venous Catheters* ; Central Venous Pressure ; Diagnosis ; Fever ; Humans ; Medical Records ; Parenteral Nutrition, Total ; Renal Dialysis ; Renal Insufficiency ; Retrospective Studies ; Sepsis ; Staphylococcus

BACKGROUND: Lung protective strategies, using low tidal volume in ARDS, improve survival rate in ARDS. However, low tidal volume ventilation may promote alveolar de-recruitment. Therefore, alveolar recruitment is necessary to maintain arterial oxygenation and to prevent repetitive opening and closure of collapsed alveoli in lung protective strategies. There has been a recent report describing improvement in arterial oxygenation with use of recruitment maneuver. However, impact of recruitment on outcome of ARDS is unknown. We evaluated whether short-term survival difference existed in patients with ARDS, who were performed alveolar recruitment maneuver(ARM) and prone position, according to response of alveolar recruitment or not. METHODS: All patients who were diagnosed with ADRS and received mechanical ventilation were included. ARM were sustained inflation(35-45 cmH2O CPAP for 30-40 sec.) or increasing level of PEEP. If these methods were ineffective, alveolar recruitment with prone position was done for at least 10 hours. PaO2/FiO2(P/F) ratio was determined before and at 0.5 and 2 hours after ARM. We defined a responder if the P/F ratio was increased over 50% of baseline value. We compared 10-days and 30-days survival rate between responders and non-responders. RESULTS: 20 patients(M:F=12:8, 63 +/- 14 age) were included. Among them, 12 patients were responders and 8 patients were non-responders. In responders, P/F ratio was increased from 92 +/- 25 mmHg to 244 +/- 85 mmHg. In non-responders, P/F ratio increased from 138 +/- 37 mmHg to 163 +/- 60 mmHg. Among non-responders, P/F ratio was improved over 50% in 2 patients after prone position. Overall, 14 patients were responders after ARM and prone position. The 10-days and 30-days survival rate in responders was significantly higher than in non-responders(86%, 57% in responders and 33%, 0% in non-responders)(p<0.05). There was no significant difference between responders and non-responders in age(71 +/- 11, 60 +/- 14), lung injury score(2.8 +/- 0.2, 2.9 +/- 0.45), simplified acute physiology score(SAPS) II (35 +/- 4.6, 34 +/- 5.7), positive end-positive pressure level(15.6 +/- 1.9 cmH2O, 14.5 +/- 2.1 cmH2O). CONCLUSION: ARM may improve arterial oxygenation in some patients with ARDS. These responders in patients with ARDS showed significant higher 10-days and 30-days survival rate than non-responders patients with alveolar recruitment.
Arm ; Humans ; Lung ; Lung Injury ; Oxygen ; Physiology ; Prone Position ; Respiration, Artificial ; Survival Rate ; Tidal Volume ; Ventilation

Bordetella (B) bronchiseptica is a common veterinary pathogen, but has rarely been implicated in human infections. Most patients with B. bronchiseptica infections are compromised clinically such as in patients with a malignancy, AIDS, malnutrition, or chronic renal failure. We experienced a case of relapsing peritonitis caused by B. bronchiseptica associated with continuous ambulatory peritoneal dialysis (CAPD). A 56-yr-old male, treated with CAPD due to end stage renal disease (ESRD), was admitted with complaints of abdominal pain and a turbid peritoneal dialysate. The culture of peritoneal dialysate identified B. bronchiseptica. The patient was treated with a combination of intraperitoneal antibiotics. There were two further episodes of relapsing peritonitis, although the organism was sensitive to the used antibiotics. Finally, the indwelling CAPD catheter was removed and the patient was started on hemodialysis. This is the first report of a B. bronchiseptica human infection in the Korean literature.
Anti-Bacterial Agents/pharmacology/therapeutic use ; Bordetella Infections/*diagnosis/microbiology ; Bordetella bronchiseptica/*metabolism ; Fibrosis ; Humans ; Kidney Failure/microbiology ; Male ; Middle Aged ; Peritoneal Dialysis, Continuous Ambulatory/*methods ; Peritoneum/pathology ; Peritonitis/*microbiology ; Recurrence

OBJECTIVES: The purpose of this study was to determine whether women with PCOS have greater subclinical atherosclerosis and evaluate the relationship to risk factors for atherosclerosis. METHODS: Women with PCOS(n=24) and age and body mass index(BMI)-matched cycling women(n=16) as control group underwent carotid scanning for the measurement of the IMT. We compared IMT and plaque between cases and controls, assessed some risk factors for atherosclerosis, and analyzed factors affecting IMT. RESULTS: There was no difference between the groups in waist-hip ratio(WHR) and in the levels of total cholesterol, triglyceride(TG), LDL, Lp(a), fibrinogen, homocystein, plasminogen activator inhibitor 1. However, HDL was significantly lower, and systolic and diastolic blood pressure, fasting blood sugar or insulin concentration and IMT was significantly higher in PCOS group than control group (51.1+/-11.6 vs 60.4+/- 10.0mg/dl, 119.4+/-12.5 vs 109.0+/-11.6mmHg, 79.1+/-11.1 vs 68.9+/-7.8mmHg, 93.6+/-11.1 vs 85.0+/-5.9 mg/dl, 8.9+/-5.2 vs 5.0+/-3.3milliunit/ml, 0.57+/-0.12 vs 0.49+/-0.11mm respectively, all p<.05). In the analysis of correlation between the IMT and clinical characteristics, PCOS status, BMI, systolic and diastolic blood pressure, fasting blood sugar or insulin concentration, TG, HDL, fibrinogen were significantly independent variables (Coefficients of correlation were 0.358, 0.461, 0.452, 0.349, 0.405, 0.466, 0.478, -0.433, 0.349 respectively, all p<.05). The factors affecting IMT by multivariate regression were PCOS status and fasting insulin concentration. CONCLUSIONS: We concluded that women with PCOS might have an increased risk of subclinical atherosclerosis and insulin resistance was assumed to be the main risk factor of atherosclerosis.
Atherosclerosis* ; Blood Glucose ; Blood Pressure ; Cholesterol ; Fasting ; Female ; Fibrinogen ; Humans ; Insulin Resistance* ; Insulin* ; Ovary* ; Plasminogen Activator Inhibitor 1 ; Polycystic Ovary Syndrome ; Risk Factors

The Committee of Clinical Practice Guidelines of the Korean Diabetes Association revised and updated the '3rd Clinical Practice Guidelines' at the end of 2010. In these guidelines, the committee recommends active screening of high risk individuals for early detection and added HbA1c level as a diagnostic criterion of type 2 diabetes to produce a more practical approach based on clinical studies performed in Korea. Furthermore, committee members emphasize that integrated patient education for self-management is an essential part of patient care. The drug treatment algorithm was also updated based on the degree of hyperglycemia and patient characteristics.
Committee Membership ; Diabetes Mellitus, Type 2 ; Humans ; Hyperglycemia ; Korea ; Mass Screening ; Patient Care ; Patient Education as Topic ; Self Care