BACKGROUND: Anaerobic bacteria constitute a major part of the normal flora of the human skin, mucous membrane and intestinal tract, and can cause various infections. The incidence of anaerobic infections may differ greatly, depending on each country or hospital. METHODS: We evaluated the recent trends of anaerobic bacteria isolated from clinical specimens at Severance Hospital from 1986 to 1995. Specimens were cultured using thioglycollate medium and phenylethanol blood agar (PEBA) for 2-3 days under anaerobic condition. Identification of organism was based on conventional or commercial kit systems. RESULTS: During this period, a total of 2,664 isolates of anaerobic bacteria were obtained from 2,251 clinical specimens. The average number of anaerobes per specimen was 1.2. The frequent sources of isolation were specimens from the abdomen, followed by soft tissue, and head and neck. B. fragilis (46.3%) was the most frequently isolated gram-negative bacilli, and P. magnus (37.6%) and C. perfringens (18.8%) were the most frequently isolated gram-positive anaerobes. Abdominal, soft tissue, and head and neck infections were frequent clinical conditions. Among the anaerobe-positive specimens, only 16.8% yielded anaerobe alone while the remaining 83.2% revealed mixed infection with aerobic bacteria. CONCLUSIONS: It was concluded that B. fragilis is the most common species among gram-negative bacilli, and that P. magnus is the most common among gram-positive cocci. As well, the anaerobes are frequently isolated from specimens of the abdomen, head and neck, and soft tissue; and anaerobic infections are commonly mixed with aerobic bacteria.
Abdomen ; Agar ; Bacteria, Aerobic ; Bacteria, Anaerobic* ; Bacteroides fragilis ; Coinfection ; Gram-Positive Cocci ; Head ; Humans ; Incidence ; Mucous Membrane ; Neck ; Phenylethyl Alcohol ; Skin

Composite grafting remains a technique which is used reluctantly and without great hope of success. In the recent two years, unexpectedly good result of composite graft was gained from 30 cases. The purpose of our study is to identify factors influencing success and to overlook long-term problems from a cosmetic and a functional view point. A retrospective review and a questionnaire about 30 fingers of 29 patients which were operated for composite graft at Kyongju hospital of Dongguk university from March 1997 to February 1999 were carried out. In all cases of composite grafting, tie-over dressing and heat lamp were applied and left for five days. And following result and conclusion were obtained. 1. 24(80%) of 30 finger tips replaced as composite graft were survived completely or partially. 2. At children with an age range 1 to 14, the survival rate (100%) of composite grafted tips was higher than that (75%) at adults. So, patient's age was important factor for success. 3. The type of injury was more important factor than the level of amputation. The survival rate(100%) of tips to cutting injury was higher than that(75%) of tips to crushing injury. 4. The delay in time from amputation and replacement did not significantly correlate with the survival rate. But, all tips replaced within 3 hours were survived completely or partially. 5. Even if partial necrosis on grafted tips was present, a result of long-time conservative treatment with minimal debridrement was excellent. Especially in children, the tips with conservative treatment showed normal appearance, several months later. 6. Cosmetic and functional results were better in child group and in groups with higher survival rate. Most common problem in cosmetic aspect was a short digit and that in functional aspect was a tender tip. 7. As a heat lamp increased blood supply, we could obtain better outcome.
Adult ; Amputation ; Bandages ; Child ; Fingers ; Gyeongsangbuk-do ; Hope ; Hot Temperature ; Humans ; Necrosis ; Surveys and Questionnaires ; Retrospective Studies ; Survival Rate ; Transplants*

OBJECTIVES: There is a growing trend of medical students using electronic devices for studying. This paper analyzes such trend and assesses if the utilization of devices is adequate to effectively help students to study. METHODS: Survey of total 155 medical students about the usage of the electronic devices for studying during the first year of medical school was done. The answers were matched with their exam scores in the first year. RESULTS: Most of students were using a device, as a learning tool and the most important purpose of it was its convenience, especially for taking notes during lectures. However, students who didn't use a device when they learned anatomy or who studied with the printouts showed a tendency of receiving better scores on exams. CONCLUSION: Utilizing electronic devices for studying tends to be more convenient, but not effective for studying anatomy.
Educational Technology ; Humans ; Learning ; Lectures ; Schools, Medical ; Students, Medical*

Postoperative respirative depression is a major factor limiting the use and safety of intraoperative narcotics. The need for an effective and safe narcotic antagonist to reverse this side effect without complication persists more than three decades of research. While narcotic induced respiratory depression can be reversed by appropriate, specific narcotic antagonist, it has not been possible to nulify the frespiratory depressant effects of narcotic without simultaneously nullifying the analgesic effects. Doxspram hydrochloride, respiratory stimulant, has been found to be significantly potent and selectively respirogenic. The present study undertakes to determine whether doxapram is ablereverse the respiratory depressnat effect of mrphine without mullifying the analgesic effects. In this study, 20 patients in 29 ASA class l patients given intravenous morphine, 0.5mg/kg, for elective surgery, produce postoperative respiratory depression. Inadequate spontaneous respiration at the end of anesthesia were treated with doxapram. The results were as follows: 1) Doxapram (mean 21.6mg) was able to reverse the respiratory depressant effect of morphine without nullifying the analgesic effect. 2) There was no hemodynamic alteration during reversal.
Anesthesia ; Depression ; Doxapram* ; Hemodynamics ; Humans ; Morphine* ; Narcotics ; Respiration ; Respiratory Insufficiency*

BACKGROUND: Cytomegalovirus infection is an important cause of morbidity and mortality after organ transplantation. Thus, rapid, sensitive and specific laboratory test, such as CMV antigenemia assay and polymerase chain reaction (PCR) is necessary to determine a patient's risk of CMV disease and to monitor the effectiveness of antiviral therapy. We compared the results of CMV-PCR and CMV early antigen immunostaining (CMV-EA) with CMV-specific IgM antibody to evalutate clinical usefulness for the early diagnosis of CMV infection and monitoring of antiviral therapy. METHODS: We analyzed 170 samples submitted for CMV tests between September 1995 and April 1996 in Yonsei University College of Medicine Severance Hospital. CMV-PCR and CMV-EA were performed with buffy coat cells and detection of CMV-specific IgM antibody was performed by enzyme-linked fluorescent assay (ELFA). RESULTS: One hundred and seventy samples of 159 patients were tested and analyzed. The concordance rate of CMV-PCR, CMV-EA and CMV-specific IgM in the same blood sample was 75.3%. The total incidence of CMV disease was 2.5%. The sensitivity and specificity based on the patients' clinical status of PCR were 100% and 91.6% respectively. In CMV-EA immunostaining method, they were 75.0% and 100% respectively. And, for CMV-specific IgM antibody ELFA, the sensitivity was only 50.0% and the specificity was 96.4%. CONCLUSIONS: CMV-PCR and CMV-EA immunostaining are reliable methods as rapid early detection of CMV infection. The sensitivity and specificity are very high comparing to CMV- specific IgM antibody. It could also be concluded that they have advantages not only for early diagnosis but also monitoring or follow-up of a therapeutic course as quantitative assays.
Cytomegalovirus Infections* ; Cytomegalovirus* ; Early Diagnosis ; Follow-Up Studies ; Humans ; Immunoglobulin M ; Incidence ; Mortality ; Organ Transplantation ; Polymerase Chain Reaction* ; Sensitivity and Specificity ; Transplantation ; Transplants

The anesthesiologist is sometime presented with the problem of coagulation defects through the perioperative period. The possible causes of inappropriate hemostasis in this situation are numerous, and multiple mechanism may be simultaneously involved. Coagulation and fibrinolysis variables were measured in 15 patients who had undergone prolonged major surgery or received massive transfusion before and until 10 days after operation. Hemostactic surveys included platelet count, fibrinogen, prothrombin time, activated partial thromboplastin time, antithrombin lll, and fibrin degraduation products. No patients had major hemorrhage, thrombosis, or disseminated intravascular coagulation, but laboratory findings suggest that a hypercoagulable state existed even 10 days postoperatively. The results were as follows: 1) Platelet counts decreased just after operation, but significantly increased to 154% of the control value 7 days after operation and 204% 10 days postoperatively. 2) Prothrombin time was significantly prolonged just after operation compared to the control value, but returned to normal in 4 days postoperatively. 3) Fibrinogen decreased just after operation, but significantly increased to 165% of the control value 4 days after operation, 178% 7days after operation and 191% 10 days postoperatively. 4) Activated partial thromboplastin time was not changed through the entire period. 5) Antithrombin lll was not changed through the entire period. 6) Fibrin degradation product was within normal ranges before operation, but in 11 cases it exceeded normal range from 1 to 10 days postoperatively.
Disseminated Intravascular Coagulation ; Fibrin ; Fibrinogen ; Fibrinolysis* ; Hemorrhage ; Hemostasis ; Humans ; Partial Thromboplastin Time ; Perioperative Period ; Platelet Count ; Prothrombin Time ; Reference Values ; Thrombosis

Two young men were seen with nausea, vomiting, dermatitis, seizure after two-four days of occupational exposure to caprolactam, a nylon fiber precursor. There were no significant results in laboratory test, brain CT, EEG except leukocytosis, hyperglycemia. Caprolactam has been shown to induce convulsive disorder in experimental animal studios and Tuma et al (1981) described that one worker acutely exposed to caprolactam developed generalized tonic-clonic seizure with leukocytosis. The coincidence of typical skin lesion with otherwise unexplained generalized tonic-clonic seizure in those young man strongly suggests that caprolactam was causal agent.
Animals ; Brain ; Caprolactam* ; Dermatitis ; Electroencephalography ; Humans ; Hyperglycemia ; Leukocytosis ; Male ; Nausea ; Nylons ; Occupational Exposure ; Seizures* ; Skin ; Vomiting

This paper describes a case of intrapericardial teratoma in a 20-day-old female meonate, who suffered from cyanosis and respiratory difficulty. She was evaluated by echocardiography, chest CT and MRI, the suspected cyanosis and respiratory difficulty. She was evaluated by echocardiography, chest CT and MRI, the suspected intrapericardial mass was identified and surgically removed. The postopervative diagnosis was intrapericardial teratoma, grade II. This case is reported with brief review of some related literature.
Cyanosis ; Diagnosis ; Echocardiography ; Female ; Humans ; Magnetic Resonance Imaging ; Teratoma* ; Tomography, X-Ray Computed

Hidradenitis suppurativa (HS) is a chronic inflammatory condition with an unclear etiopathogenesis that is considered to be a follicular occlusive disease. We present a case of HS that was suspected to have developed as a complication of subdermal excision. A 19-year-old man who had undergone subdermal excision due to osmidrosis presented 7 months after surgery with a persistent painful mass in his left axilla. Despite medical treatment, incision, and drainage, a painful enlarged abscess recurred in the left axilla and was cured completely by deroofing surgery. However, 15 months after subdermal excision, he revisited the hospital because of a painful mass in the right axilla. The patient’s condition met the diagnostic criteria of HS. After several recurrences, a cure was achieved by radical wide excision. Mechanical stress like that associated with subdermal excision is considered to be a possible etiological factor of HS. In addition, pathological changes at the sebofollicular junction allow rupture and leakage of folliculopilosebaceous units upon exposure to mechanical stress, which may result in the aggressive subcutaneous extension of inflammation. We suggest that HS should be considered in patients with a recurrent abscess after subdermal excision, and recommend surgical treatment as a possible option if conservative treatment is clinically ineffective.

BACKGROUND: Since better understanding of the associations between blood pressure and blood lipids may provide insight into the mechanisms by which hypertension is associated with increased risk of coronary heart disease, this study is aimed to explore the associations of blood pressure with serum lipids, BMI, age, FBS and life style factors. METHODS AND RESULTS: In this study, 20,826 men and 10,209 women were included for the assessment of the cross-sectional relations of blood lipids, BMI, Blood pressure and Life style factors. Stratified analyses and multivariable methods were used to control for potential confounding anthropometric and lifestyle variables. Total cholesterol and Triglyceride levels increased significantly with increasing systolic or diastolic blood pressure in both sexes. Men of 20-29 years old had steeper regression slopes for blood pressure by total cholesterol level than did women of similar age. In men, the association between blood pressure and total cholesterol level decreased with age, whereas in women, no change was observed regarding age. Body mass index modified the relation, whereas smoking, exercise, and alcohol consumption had little influence on the association. HDL cholesterol level had little influence on blood pressure. In the group of age <40, age accounted more than BMI for hypertension, whereas in group of age > or =40, BMI accounted more. In the group of age < 40, other variables ,besides age and BMI, are suggested to influence more on male hypertension than female hypertension. CONCLUSION: These results provides evidence that there are interrelations between blood pressure, blood lipids and life style factors that may influence the mechanisms of coronary heart disease.
Adult* ; Alcohol Drinking ; Blood Pressure* ; Body Mass Index ; Cholesterol ; Cholesterol, HDL ; Coronary Disease ; Female ; Humans ; Hypertension ; Life Style ; Male ; Smoke ; Smoking ; Triglycerides