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

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

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

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

Econazole is one of the new imidazole derivatives displaying antifungal and antibacterial properties in vitro and in vivo. The present study was undertaken to evaluate the therapeutic efficacy of Econazole in patients with dermatomycoses anl to determine the minimal inhibitory concentration in vitro. A total of 48 patients with various forrns of dermatomycoses(25 patienta with T. cruris, 13 with T. pedis, l with T. corporis, 4 with T. versicolor and 5 with candidiasis) entered this study at the Departement of Dermatology, University Hospital, College of Medicine, Seoul National University during 3 months period. from July to September, 1976. Dia,gnosis was established clinically as well as microscopically by direct KOH mount. All patients were instructed to apply 1:o Econazole solution two to three times daily on the affected area for four to seven weeks and weekly examination of the clinical lesions and direct KOH mount were performed. In addition, minimal inhibitory concentration for Trichophyton mentagrophy tes was determined by the modified dilution technique in vitro. The results were as follows. 1. Thirty five patients (72. 9F) were cured clinically and microscopieally and thc remainders showed marked clinical improvement but positive KOH mount at 4 th week of treatment. At 7th week, nine (18.8io) of the remainders were cured clinically and microscopically and the overall cure rate at 7th week was 91. 7%. Five patients with tinea cruris experienced trar.sient irritation derrnatitis on their crural regions. 2. The minimal inhibitory coriceritration of Econazole for Trichophyton mentagrophytes was 25 pg per ml. of medium. The authors concluded that the 1 i Econazole was highly effective in the treatment of superficial rnycoses and the side effects were rninimal and only transient.
Dermatology ; Dermatomycoses* ; Dronabinol ; Econazole* ; Humans ; Indicator Dilution Techniques ; Seoul ; Tinea ; Trichophyton

We present a patient who developed a pseudolymphoma after ear piercing. A patch test showed gold sensitivity. Therefore, long standing dermal exposure to gold from a pierced-type earring might have produced the patient's disease. This patient did not respond to an intralesional steroid injection and was finally treated with a complete resection of the lesion. It is proposed that every patient with a hyperplastic lesion in the ear lobe should be taken a biopsy in order to rule out the possibility of a pseudolymphoma. When a pseudolymphoma develops in the ear lobe, a complete surgical excision could be the treatment of choice, especially for the prevention of recurrence.
Biopsy ; Body Piercing* ; Ear* ; Humans ; Patch Tests ; Pseudolymphoma* ; Recurrence

Kearns-Sayer syndrome, a rare mitochondrial disorder, is composed of chronic progressive external ophthalmoplegia, atypical retinal pigmentation and complete heart block, and also causes numerous neurologic or endocrinologic symptoms. On muscle biopsy, a "ragged red fiber" was seen with Gomori trichrome stain, On electron microscopy, aggregations of abnormal mitochondria were demonstrated, confirming the diagnosis of mitochondrial myopathy. We report a case of Kearns-Sayer syndrome we have experienced.
Biopsy ; Diagnosis ; Heart Block ; Microscopy, Electron ; Mitochondria ; Mitochondrial Diseases ; Mitochondrial Myopathies ; Ophthalmoplegia, Chronic Progressive External ; Pigmentation ; Retinaldehyde