To study the gyrA mutations of E. coli from clinical specimens, 410 strains were isolated from 1994 to 1997 in Kyungpook National Vniversity hospital. Antimicrobial susceptibility tests, PCR and sequencing of gyrA, and in vitro induction of quinolone resistance were done. The frequency of quinolone resistant E. coli strains increased constantly during 1994 through 1996. Quinolone-resistant strains were more often resistant to unrelated antibiotics than quinolone-susceptible strains (chi-square test, p<0.05). All of the randomly selected 55 quinolone- resist#ant strains were highly resistant to nalidixic acid (NAL) but had low level resistance to fluoroquinolones. All of the 55 quinolone-resistant strains showed an amino acid substitution of Ser -> Leu (TCG -> TIG) at codon 83. In addition, four different types of amino acid substitution affecting codon 87 (Asp) were detected, 1) type I: Asn (GAC -> AAC); 2) type II: Tyr (GAC -> TAC); 3) type III: Oly (GAC -> GGC); 4) type IV: His (GAC -> CAC). The mutation of type IV has not been reported previously in quinolone-resistant E. coli strains. It is thought that the specific amino acid substitution probably affects minimum inhibitory concentrations (MIC) of quinolones because the MICs of ciprofloxacin, norfloxacin, and ofloxacin in type II were significantly higher than those of type I. By in vitro induction, MICs to quinolone-susceptible strains resulted in the increase in the MICs of all quinolones tested by 2- to 2048-fold. The induced mutants by quinolones had amino acid substitutions at codon 83, SerLeu or Asp87Asn, Gly or Tyr. Alteration of Ser83 results in the most effective increase in the MIC of quinolone such as NAL and alterations of Asp87 result in the effective increase of MIC of fluoroquinolone. These results suggest that the continuous use of quinolones might induce the specific amino acid substitution at gyrA.
Amino Acid Substitution ; Anti-Bacterial Agents ; Ciprofloxacin ; Codon ; Escherichia coli* ; Escherichia* ; Fluoroquinolones ; Gyeongsangbuk-do ; Microbial Sensitivity Tests ; Nalidixic Acid ; Norfloxacin ; Ofloxacin ; Polymerase Chain Reaction ; Quinolones

The second case of this serial reports under the title of unusual cutaneous manifestations of connective tissue diseases is a woman with primary idiopathic dermatomyositis who developed cutaneous ulcerations on her arms and legs, which is thought to b a rare manifestation of adult dermatomyositis. These multiple ulcerations are about bean sized, polymorphous, and grouped on the poikilodermatous lesional skin. In this patient these ulcerative lesions became regressive and healed with disfiguring scars after the activity of the disease has controlled by prednisolone and methotrexate.
Adult ; Arm ; Cicatrix ; Connective Tissue Diseases* ; Connective Tissue* ; Dermatomyositis* ; Female ; Humans ; Leg ; Methotrexate ; Prednisolone ; Skin ; Ulcer*

No abstract available.
Craniocerebral Trauma* ; Head* ; Perfusion* ; Tomography, Emission-Computed, Single-Photon*

Majocchi's disease is one of chronic vascular disorders of the skin, histologically showing capillaritis with lymphoid cell infiltration. Although the hypothesis of delayed type hypersensitivity reaction against foreign antigen is proposed as the mechanism producing this condition, there are much yet to be defined. We tried to examine the lesional skin of five patients with Majocchi's disease by the direct immunofluorescence with anti-human immunoglobulins, C 3, and fibrin. As a result we found the deposition of immunoglobulins (M, and G) in papillary blood vessels in four patients, and C 3 and fibrin were found in all five patients. C3 was also found at the dermoepidermal junction in three patients. These findings suggest the posssibility that antibody mediated immunologic processes may alsobe involved in the pathogenesis of this disorder. With this observation Majocchis disease could be considered as a chronic immune vasculitis.
Blood Vessels ; Fibrin ; Fluorescent Antibody Technique, Direct ; Humans ; Hypersensitivity ; Immunoglobulins ; Lymphocytes ; Skin ; Vasculitis

OBJECTIVE: To evaluate the relationship between amniotic fluid interleukin-8 and the presence, severity and pattern of acute inflammatory lesions in the placenta delivered after preterm labor with intact membranes. METHODS: The relationship between placental histologic finding and amniotic fluid interleukin-8 was examined in 46 consecutive patients who were admitted with the diagnosis of preterm labor with intact membranes and who delivered singleton gestations within 5 days. RESULTS: The prevalence of acute histologic chorioamnionitis was 63.0%(29/46) and that of positive amniotic fluid culture was 17.4%(8/46). The most frequent site of histologic inflammation was chorion-decidua(56.5%, 26/46). The median amniotic fluid interleukin-8 increased significantly according to the presence and higher severity of inflammation in each type of placental section (p<0.05 for each). Three patterns of inflammation were identified in chorion-decidua: non-marginating, marginating, and mixed. Median amniotic fluid interleukin-8 and the rate of severe histologic chorioamnionitis (grade> or = 4) increased significantly in the order of non-marginating, marginating, and mixed (p<0.05 for each). CONCLUSION: Both the presence and greater severity of acute histologic chorioamnionitis are associated with an elevated amniotic fluid interleukin-8. A marginating and mixed pattern of inflammation are associated with a higher amniotic fluid interleukin-8. Amniotic fluid interleukin-8 is a reliable prenatal marker of histologic chorioamnionitis.
Amniotic Fluid* ; Chorioamnionitis ; Diagnosis ; Female ; Humans ; Inflammation* ; Interleukin-8* ; Membranes ; Obstetric Labor, Premature* ; Placenta ; Pregnancy ; Prevalence

No abstract available.
Aneurysm* ; Kidney* ; Renal Artery*

A Dieulafoy's lesion is an uncommon, but important, cause of gastrointestinal bleeding. It is associated with massive, life-threatening hemorrhage and is typically difficult to diagnose. Although originally described in the stomach and rarely found below the proximal stomach, identical lesions have been reported in other gastrointestinal organs, including the duodenum, jejunum, colon, and rectum. Most cases occur with bleeding in the gastrointestinal tract. However, we present an incidental asymptomatic Dieulafoy's lesion in the colon, which was treated successfully by using an endoscopic hemoclipping technique.
Colon ; Duodenum ; Gastrointestinal Tract ; Hemorrhage ; Jejunum ; Rectum ; Stomach

PURPOSE: To evaluate the radiologic manifestations of the rectal leiomyosarcoma. MATERIALS AND METHODS: We reviewed CT and barium study of 2 cases of rectal leiomyosarcoma, which were operated and pathologically proved. RESULTS: In both cases colon studies showed a huge smooth marginated filling defect in the rectum. Precontrast CT scans showed a well-circumscribed, slightly Iobulated, inhomogeneous mass without calcification. Postcontrast scans showed minimal enhancement with internal low-density areas. In pathologic specimens there were large areas of necrosis and hemorrhage in the masses. Pericolic fat infiltration, lymph node metastasis, or distant metastasis were not detected. CONCLUSION: Leiomyosarcoma is rarely developed in the rectum, but general radiologic findings are similar to that of other part of the gastrointestinal tracts except for the tendency of intraluminal growth due to narrow pelvic space.
Barium ; Colon ; Gastrointestinal Tract ; Hemorrhage ; Leiomyosarcoma* ; Lymph Nodes ; Necrosis ; Neoplasm Metastasis ; Rectum ; Tomography, X-Ray Computed

BACKGROUND: The purpose of this study was to discover ways to screen urine culture specimens through Gram stains, urine stick analyses and microscopic examinations for the laboratory cost saving. METHODS: One hundred and fifty-eight urine specimens for culture were included. Fifty uL of urine were inoculated onto one well each of 10-well slide, dried on the hot plate, and Gram-stained. The results combined with routine urinalyses including urine nitrite and leukocyte esterase, and pyuria, were compared with the routine culture results. RESULTS: The screening of bacteriuria by Gram stains, urinalyses and microscopic examinations revealed the high sensitivity (91.9%) and negative predictive value(95.5%) with cost saving of 41.8% of inoculating media. Not considering the Gram stains, the screening revealed 83.8% sensitivity and 92.5% negative predictive value, even if the cost saving of inoculating media were as high as 50.1%. CONCLUSION: It was demonstrated that it was sensitive and economic and produced rapid preliminary results to screen bacteriuria by the Gram stains combined with urinalyses and microscopic examinations.
Bacteriuria ; Coloring Agents ; Cost Savings ; Leukocytes ; Mass Screening* ; Pyuria ; Urinalysis*

Magnetic resonance (MR) images of 14 consecutive patients with pathologically proven primary intracranial lymphoma were reviewed. All patients had a brain MR imaging before any treatment and were immunologically competent. MR images were acquired using 2.07 (n= 6) or 0.57 (n= 8) machine. The MR images were reviewed regarding the location, multiplicity, size, signal intensity, margin, shape, and the extent of surrounding edema of the lesion. Seven patients had multiple lesions, 2 to 4 in number. A total of 26 lesions was found; 25 were parenchymal lesions and one was dural lesion. The location of tumor was either central (r= 11) or peripheral (n= 14). The size of tumor was variable ranging from 0.6cm to 6.0cm in its maximal diameter. The tumors were isointense (n= 19) or hypointense (n= 7) relative to gray matter on T1-weighted images, isointense (n= 24) or hyperintense (n=2) on proton-density weighted images, and isointense (n= 21) or hyperintense (n= 5) on 78-weighted images. On gadolinium-enhanced T1-weighted images of 13 patients strong enhancement was seen in 22 of 23 lesions. Nineteen lesions showed smooth, well-defined margin, whereas remaining 7 lesions showed irregular, ill-defined margin. The shape of the tumor was diverse; round of ovoid (n= 15), lobulated (n= 9), or short linear (n= 2). These results suggest that one should consider the diagnosis of CNS lymphoma in cases with single or multiple masses that abut CSF space and show iso-or similar intensity to gray matter with strong enhancement on MR images.
Brain ; Diagnosis ; Edema ; Gray Matter ; Humans ; Lymphoma* ; Magnetic Resonance Imaging*