The hydrophobicity assay and DNA probe hybridization assay were compared for analysis of enterotoxigenic Escherichia coli(ETEC), heat-labile enterotoxin(LT) and heat-stable enterotoxin (ST). The ETEC isolated from diarrheal patients were serotyped and investigated for the presence of colonization factor antigens CFA/1, CFA/II, CFA/III and CFA/IV with the expression of mannose-resistant hemagglutination(MRHA) and the levels of surface hydrophobicity. The following results were obtained. 1. Out of these 48 strains, 34 strains were found to be positive for LT production by DNA probe hybridization assay. Out of 34 strains, 1 strain was ST producer, 25 strains were LT producers, and 8 strains were produced both ST+LT producers by DNA probe hybridization assay. 2. Out of 34 strains of positive DNA probe hybridization test, 31 strains was positive in the hydrophobicity test. Among strains of positive hydrophobicity test, 20, 1, and 7 strains produced only LT, only ST and both ST-LT, respectively. Screening efficiency for identifying ETEC by salting out test was 82.4% in sensitivity and 78.6% in specificity. For ETEC detection, the hydrophobicity assay was the least sensitive but was simple, rapid and a good substitute for the DNA probe hybridization assay. 4. CFAs were identified in 43.8% of ETEC strains; 2.1% of the CFAs strains with CFAs harbored CFA/I, 29.2% carried CFA/II, 16.7% carried CFA/III and CFA/IV. And 35.4% expressed none of these CFAs. CFA/I was found in ETEC of serotype 0128: K67, CFA/II was 0128: K67, 0142: K+ and 0159: K+, CFA/III was 086a: K15 and 0128: K67, CFA/IV was 0 86a: K15, 0128: K67, 0125: K70 and 0148: K+.
Colon ; DNA* ; Enterotoxigenic Escherichia coli* ; Enterotoxins ; Escherichia ; Humans ; Hydrophobic and Hydrophilic Interactions* ; Mass Screening ; Sensitivity and Specificity

Livedoid vasculitis is characterized clinically by smooth or depressed ivory-white scars surrounded by hyperpigmentation and telangiectasia with or without preceding purpuric in-filtrated papules and plaques and histologically by intravascular deposition of fibrin. Its pathophysiology is still obscure. Many treatment modalities have been used, but results are not satisfactory. Recently, there have been experiences of successful treatments with danazol, a synthetic androgen. We used danazol in three patients who presented with livedoid vasculitis and were relatively resistant to treatments with aspirin and/or pentoxifylline. After 4 to 8 weeks, there was remarkable clinical improvement in all three patients.
Aspirin ; Cicatrix ; Danazol* ; Fibrin ; Humans ; Hyperpigmentation ; Pentoxifylline ; Telangiectasis ; Vasculitis*

No abstract available.
Aneurysm

OBJECTIVE: To compare the visibility and procedural parameters between a standard spinal needle and a new laser-etched needle (LEN) in real-time ultrasonography guided lumbar medial branch access in a phantom of the lumbosacral spine. METHODS: We conducted a prospective single-blinded observational study at a rehabilitation medicine center. A new model of LEN was manufactured with a standard 22-gauge spinal needle and a laser etching machine. Thirty-two inexperienced polyclinic medical students performed ultrasonography-guided lumbar medial branch access using both a standard spinal needle and a LEN with scanning protocol. The outcomes included needle visibility score, needle elapsed time, first-pass success rate, and number of needle sticks. RESULTS: The LEN received significantly better visibility scores and shorter needle elapsed time compared to the standard spinal needle. First-pass success rate and the number of needle sticks were not significantly different between needles. CONCLUSION: A new LEN is expected to offer better visibility and enable inexperienced users to perform an ultrasonography-guided lumbar medial branch block more quickly. However, further study of variables may be necessary for clinical application.
Humans ; Needles* ; Needlestick Injuries ; Observational Study ; Phantoms, Imaging ; Prospective Studies ; Rehabilitation ; Spine ; Students, Medical ; Ultrasonography ; Zygapophyseal Joint

STUDY DESIGN: A retrospective analysis of the patients who had cauda equina syndrome caused by a herniated lumbar disc. OBJECTIVES: To assess the clinical debates concerning the diagnosis, treatment, and results of treatment. SUMMARY OF LITERATURE REVIEW: This syndrome has been considered as an absolute indication of surgical treatment in the herniated lumbar disc and poor prognosis after surgery were reported. Although there are debates on the timing of surgery, early recognition early surgical treatment are recommended for a better results of treatment. MATERIALS AND METHODS: 23 consecutive patients having a cauda equina syndrome caused by herniated lumbar disc were reviewed retrospectively. They were 14 males and 9 females having ages of 41.6 in average. The incidence of this syndrome was 3.8% of the patients who had surgical treatment of herniated lumbar disc. RESULTS: All patients had bladder dysfunction in addition to the low back pain and radicular pain in the leg, but five patient did not recognize their urinary retention which were shaded by severe leg pain. A surgical treatment were performed for all patients at 6.8 days in average after onset of the bladder dysfunction. At follow-up of 3 years and 3 months in average after surgery, 20 patients(86.9%) had satisfactory resolution of the low back pain and leg pain, and all patients had complete recovery of motor weakness except one patients who had residual foot drop. Bladder function recovered satisfactorily in 18 patients (78.3%), but 4 patients had some difficulty of urination and one patient needed a sphinterotomy for urination. CONCLUSIONS: The cauda equine syndrome in herniated lumbar disc was often not recognized early and a poor result of treatment was not rare, particularly in the patients who had acute onset and severe bladder dysfunction. So, early diagnosis and active surgical treatment are recommended for a better results of treatment.
Cauda Equina* ; Diagnosis ; Early Diagnosis ; Female ; Follow-Up Studies ; Foot ; Humans ; Incidence ; Leg ; Low Back Pain ; Male ; Polyradiculopathy* ; Prognosis ; Retrospective Studies ; Urinary Bladder ; Urinary Retention ; Urination

Background : Atopic dermatitis(AD) is a common disease, and population-based studies indicate that the frequency of AD has increased substantially during recent decades. However, there have been few studies on the hospital based relative frequency, and clinical and laborat,ory findings of AD in Korea. OBJECTIVE: The presenl study was aimed to elucidate the relative frequency of AD on the outpatient base, and to investigate the clinical manifestations and immunological laboratory findings. METHODS: Our study was designed by analysing outpatients with AD via physical examination, questionnaires and immunological investigations such as skin prick tests, Multi test CMI, and measurernent of eosinophil counts, total IgE, Derrnatophagoides pteronyssinus-specific IgE and eosinophil cationic protein(ECP). RESULTS: The results were as follows : 1. The relat,ive frequen:y of AD on the hospital base in 1995-1996 was 8.6%. 2. The mean age of onset was 3.36 years. 57.3% of the patients had their onset of eczema by the age of 1 year, 65.5% by 2 years and 83% by 5 years. The most common site at the onset was the face followed by antecubital area, popliteal area, neck, and trunk. 3. The predilection site on physical examination were the face, neck, antecubit,al area, popliteal area and trunk in decreesing order. 4. Concomitant allergic rhinitis, keratoconjunctivitis and asthma were present in 2~3.4%, 14.1%, and 9.5% of patients with AD, respect.ively, whereas pure AD was present in 34.1%. 5. Family history of atopy was observed in 60.5% of AD patient.s. 6. The most frequent ninor fea~ture of AD was xerosis followed by perifollicular accentuation, allergic shiner, cheilitis, imitation allergy, palrnar hyperlinearity and molluscum cantagiosum. 7. Seasonal aggravation was found in 86.8% of patients with AD, especially in summer and winter, The rnost significant aggravating factors were wools followed by sweating, heating, dryness, excessive bat.hing and emotional stress. 8. Abnormal levels of .osinophils, total IgE and ECP were seen in 44.8%, 78.9% and 31.7% Of patients with AD, respec.ively. 9. Cell mediated immunty was decreased in 68.2% of patients with AD. 10. Positive reactivity( at least rnore than one allergen) in the skin prick t,est was noted in 76% of pat,ients with AD and the most popular 8 allergens were D. pteronyssinus, D. farinae, cat fur, M4 mixed threshing dust., dog hair, mugwort pollen, H3 tree pollen and birch pollen. 11. The specific IgE aritibodies to D. pteronyssinus(>+1) were found in 72.3% of AD patients and correlated with the r esults of the skin prick test in 76%. CONCLUSION: The hospi al-based relative frequency of AD investigated in our study tends to be increased. As the clinica features and laboratory findings of AD might be influenced by genetic, environrnental and psychological factors, the systernic evaluation of patients with AD will be needed.
Age of Onset ; Allergens ; Animals ; Artemisia ; Asthma ; Betula ; Cats ; Cheilitis ; Cyprinidae ; Dermatitis, Atopic* ; Dogs ; Dust ; Eczema ; Eosinophils ; Hair ; Heating ; Hot Temperature ; Humans ; Hypersensitivity ; Immunoglobulin E ; Keratoconjunctivitis ; Korea ; Neck ; Outpatients ; Physical Examination ; Pollen ; Psychology ; Rhinitis ; Seasons ; Skin ; Stress, Psychological ; Sweat ; Sweating ; Wool ; Surveys and Questionnaires

No abstract available.
Urinary Tract Infections* ; Urinary Tract*

BACKGROUND AND OBJECTIVES: Recently, canal down mastoidectomy tends to be more frequently selected for complete eradication of the lesion and prevention of recurrence. Therefore, the problems attendant to the open mastoid continue to be of concern. Although various techniques have been used to solve the cavity problems, no single procedure has yet been devised that entirely accomplished this purpose. We evaluated the effects of partial mastoid obliteration using inferior based musculoperiosteal flap and autogenous conchal cartilage chips. MATERIALS AND METHODS: Twenty four cases were performed with mastoid obliteration using inferior based musculoperiosteal flap and autogenous conchal cartilage chips obtained from meatoplasty. There were 11 cases for control which were performed with canal down mastoidectomy without obliteration. We compared these two groups in the duration of epithelialization, accumulation of debris, presence or absence of drainage, shape of remodeled canal and caloric response and evaluated survival or atrophy of flap and absorption of cartilage chips. RESULTS: Obliteration group showed more rapid healing and epithelialization and less accumulated epithelial debris. Atrophy of flap or absorption of cartilage was not observed. There was no draining ear but vertigo with nystagmus on caloric stimulation developed in both groups. CONCLUSION: This partial mastoid obliteration technique used easy and quick application instead of complete restoration of canal wall, and it may be also valuable in providing rapid epithelialization and reducing mastoid bowl volume with relatively round canal shape. Furthermore, epitympanic obliteration using cartilage chips may be an effective method to prevent formation of attic retraction pocket.
Absorption ; Atrophy ; Cartilage* ; Drainage ; Ear ; Methods ; Recurrence ; Vertigo

Subperiosteal abscess of the mastoid region and Bezold's abscesses have become very rare since introduction of antibiotics. Subpriosteal abscess is usually seen in children who have acute mastoiditis. Its occurrence in adults or in associated with chronic otitis media is even more unusual. Bezold's abscess, a complication of acute otitis media in adult who has well pneumatized air cells in the tip of the mastoid, is also rarely seen in the current era of antibiotics. This paper reports a case of postauricular subperiosteal and Bezold's abscess complicating chronic suppurative otitis media with cholesteatoma in a 37-year old woman with review of literatures.
Abscess* ; Adult ; Anti-Bacterial Agents ; Child ; Cholesteatoma* ; Female ; Humans ; Mastoid ; Mastoiditis ; Otitis Media ; Otitis Media, Suppurative*

The most common cause of orbital in/fection is a sinusitis, and if this orbital complication is not provided with appropriate and intensive treatments, serious status such as visual loss or life-threatening may occur. Osteomyelitis rarely results from sinusitis, and in cases where it happens, the frontal sinus is the most frequently involved site. However, zygomatic osteomyelitis has not been reported so far. We present a case of maxillary sinusitis which was initiated by oroantral fistula, and developed to preseptal and postseptal abscess, penetrating into the orbital septum. The case was complicated by zygomatic osteomyelitis. This case was successfully treated by draining pus by endonasal endoscopic sinus surgery, infraorbital incision, and was followed by antibiotic therapy for about 8 weeks.
Abscess* ; Frontal Sinus ; Maxillary Sinus ; Maxillary Sinusitis ; Orbit ; Oroantral Fistula ; Osteomyelitis* ; Sinusitis ; Suppuration