BACKGROUND: Antistreptolysin O (ASO) has been widely used to diagnose Streptococcus Pyogenes infections and their sequelae, rheumatic fever and acute glomerulonephritis. Butt in some cases there is no elevation of ASO that it is necessary to add one or more tests detecting immune response to S. pyogenes.. The authors analyzed the distribution of antideoxyibonuclease (ADNase) B and antistreptolysin O (ASO) among the children of an elementary school in Seoul and calculated their upper limit of normal (ULN) value. METHODS: ADNase B concentrations were determined by nephelometry (Behring Nephelometer 100 Analyzer, Germany) on 236 sera of healthy elementary school children in Seoul. Throat cultures were taken at the same time to compare ADNase B lovels between S. pyogenes carriers and non-carriers. RESULTS: The distribution of ADNase B concentrations among school children ranged from 77 (detection limit) to 1616 IU/ml and the ULN was estimated to be 362 IU/mL. The carriers of S. pyogenes clad significantly higher ADNase B levels (mean 392 IU/ml) than carriers of non-group A beta-hemolytic streptococci (BHS, 236 IU/ml) oY non-carriers of BHS (234 IU/ml). The relationship between ADNase B (Y) and ASO (X) levels was Y=0.4X+173 (r2=0.209). CONCLUSIONS: The distribution of ADNase B levels showed no close correlation with that of ASO, and ADNase B test was considered to have additive value to ASO test for detecting S. pyogenes infection.
Antistreptolysin ; Child* ; Glomerulonephritis ; Humans ; Nephelometry and Turbidimetry ; Pharynx* ; Rheumatic Fever ; Seoul* ; Streptococcus pyogenes

Vibrio damsela is a halophilic bacterium that has been reported to cause skin ulcers and death in damselfish (Chromis punctipinnis) as well as wound and soft-tissue infections in human. Most of the previously reported cases in humans haute involved wound infections associated with exposure to seawater or handling fish. We experienced a case of primary septicemia due to V. damsela after eating raw fists in a healthy 66-year-old woman who had neither wounds nor history of exposure to sea- water. She presented fever and diarrhea followed by rapidly pregressive bullae and painful edema on left band and forearm. The patient was Improved by intensive surgical debrldement of necrotic tissue and antibiotic therapy.
Aged ; Diarrhea ; Eating ; Edema ; Female ; Fever ; Forearm ; Humans ; Seawater ; Sepsis* ; Skin Ulcer ; Vibrio* ; Wound Infection ; Wounds and Injuries

We present two oases of Eruptive Vellus Hair Cysts(EVHC) in 30- year-old and 27- year old women. They had 6 to 10 discrete, asymptomatic, brown or reddish brown papules on the neck, axilla, chest and extremities. The clinical impressions were epidermal cyst and steatocystoma multiplex espectively, but histopathological exarnination revealed smal1 cysts in middermis containing numerous vellus hairs cut transversely or obliquely and surrounding granulomatous foreign body reaction typical to EVHC. Transepithelial elimination was not found.
Axilla ; Epidermal Cyst ; Extremities ; Female ; Foreign-Body Reaction ; Hair* ; Humans ; Neck ; Steatocystoma Multiplex ; Thorax

The 447 cases of skin tumors were studied at the departments of dermatology and surgical pathology, National Medical Center in Seoul during the period of 18 years and 8 months from January, 1959 to August, 1977. The results were as follows: 1) the total number of specimens surveyed in the study was 447, among which benign tumors accoungted for 234 cases and malignant tumors for 213. 2) Male to female ratio for benign tumors was 1.2:1 and for malignant tumors 2.2:1. 3) Among the 234 cases of benign tumors, 67 cases were epidermal cyst. 53 cases of hemangioma and 34 cases of pigmented neni. 4) Among the 2 cases of malignant melanoma. 5) The peak age incidence for benign tumors were below the 2nd decade, The peak ago incidence for malignant tumors were 50th decade. 6) the sites of predilection of the epidermal cysts were trunk, face and neck. The sites of predilection of the hemangiomas and pigmented nevi were face. 7) The sites of peredilection of the squamaous cell carcinomas were penis(27.1%), lower extremities(25.7%) and face(21.5%) The sites of predilection of the basal cell carcinomas were face(83.3%) 8) The ratio of squamous cell carcinoma ws basal cell careinoma was 4:1. 9) The accuracy of clinical dianosis were 42.7% for benign tumors and 79.3% for malignant tumors.
Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Dermatology ; Epidermal Cyst ; Female ; Hemangioma ; Humans ; Incidence ; Male ; Melanoma ; Neck ; Nevus, Pigmented ; Pathology, Surgical ; Seoul ; Skin*

Dilutional hyponatremia secondary to fluid retention in the postoperative period may be related to a persistent and inappropriate secretion of ADH, possibly orginated from surgical stress, pain, fear and others. It is also serious and over 50% mortality when it should be combined with neurological feature, especially generalized convulsion. But this phenomenon is transitory and complete curable with active management. So Anesthesiologists should be aware of this symptoms by measure of elctrolytes is postanesthetic period. We experienced 2 cases of dilutional hyponatremia with convulsion in postoperative period.
Hyponatremia* ; Mortality ; Postoperative Period ; Seizures*

A 18 year old male with myesthenia gravis. Osserman Adult B type, underwent thymectany under general anesthesia combining the use of the new competitive muscle relaxant. Vecuronium, with initial dose of 0.08mg/kg. Neuromuscular blockade of Vecuronium in this myasthenic patient was monitored carefully from induction to postanesthetic period and it was compared with neuromuscular blockade of vecuronium(0.08mg/kg) and pancuronium(0.08mg/kg) in non-myasthenic patient. In this dose of Vecuronium in myasthenic patient, easy to achive endotracheal intubation, it's duration action and recovery were makedly prolonged and delayed than those of non-myasthenic patient and weakly approximated to those of pancuronium in non-myasthenic patients. Conclusively, the reduced dosage of vecuronium with careful neuromuscular monitering in myasthenic patient should be more effective and safe without any difficulties of anesthetic management and ventilatory support on post-operative period.
Adolescent ; Adult ; Anesthesia, General ; Humans ; Intubation, Intratracheal ; Male ; Myasthenia Gravis* ; Neuromuscular Blockade ; Pancuronium ; Thymectomy* ; Vecuronium Bromide*

Mucoepidermoid carcinoma of the thymus is an extremely rare malignant mediastinal neoplasm, and to our knowledge, only 13 cases have been reported. We report a case of mucoepidermoid carcinoma of the thymus that was seen in a 53-yr-old man with right chest pain. Chest CT scan showed a huge, cystic mass having a focal solid portion with direct invasion of the adjacent anterior chest wall and pericardium in the anterior mediastinum. Mucoepidermoid carcinoma of the thymus should be included in the differential diagnosis for masses of the anterior mediastinum associated with extensive cystic changes, although the carcinoma is exceedingly rare.
Carcinoma, Mucoepidermoid/*diagnosis/pathology ; Fatal Outcome ; Humans ; Male ; Mediastinal Neoplasms/*diagnosis/pathology ; Middle Aged ; Thymus Neoplasms/*diagnosis/pathology

Although throat culture is a gold standard to diagnose group A streptococcal (GAS) pharyngitis or its sequelae, antistreptolysin O (ASO) is useful to confirm the diagnosis. In case there is no elevation of ASO, it is necessary to add one or more serologic tests, such as antideoxyribonuclease (ADNase) B test. ADNase B levels were analyzed in the carriers of beta-hemolytic streptococci (BHS) in this study. ADNase B concentrations were determined quantitatively by nephelometry (Behring Nephelometer 100 Analyzer, Germany) on 157 sera of healthy elementary school children in Chungnam who were positive of BHS in the throat culture. ASO levels were measured previously by autoanalyzer (Hitachi 747, Japan). Mean ADNase B and ASO levels were compared according to serological group of BHS and number of colonies. The carriers of GAS had significantly higher ADNase B levels (mean 453 IU/ml) than those of non-A beta-hemolytic streptococci (NGAS, 278 IU/ml), while the difference of ASO levels between GAS (482 IU/ml) and NGAS (350 IU/ml) carriers was not so high. The carriers who had more than 10 CFU of BHS had significantly higher ADNase B or ASO levels than those who had less than 10 CFU. The correlation between ADNase B (Y) and ASO (X) was Y=0.4X+229 (r2=0.13). ADNase B test could discriminate GAS from NGAS more effectively than ASO test. The carriers who have more than 10 CFU might undergo asymptomatic infection, as their ADNase B or ASO levels were significantly high. Because distribution of ADNase B showed little correlation to that of ASO, ADNase B test could be used as a supplementary test to diagnose GAS infection.
Antistreptolysin ; Asymptomatic Infections ; Child ; Chungcheongnam-do ; Diagnosis ; Humans ; Nephelometry and Turbidimetry ; Pharyngitis ; Pharynx ; Serologic Tests

PURPOSE: We made investigation into the etiology, clinical manifestations, laboratory findings, treatments, outcomes, prognosis and prognostic factors of acute myocarditis in children. METHODS: We have reviewed the medical records of the patients who were admitted to the Chonbuk National University Hospital for recent 10 years. Patients were divided in two groups with base on the outcomes. One is recovery group and the other is mortality group. And we analyzed the clinical findings and compared between two groups. RESULTS: Ten of 27 patients were expired with fulminant myocarditis or complication of acute myocarditis. Seventeen patients were recovered. Left ventricular fractional shortening on the echocardiogram was a valuable prognostic factor. Seventeen patients were treated with IVIG. Seven patients were evaluated the viral etiology. Coxsackie B5, coxsackie B3, coxsackie A10 and adenovirus were detected. CONCLUSION: Left ventricular fractional shortening was a valuable prognostic factor. It is necessary to research antegrade multicenter study about acute myocarditis.
Adenoviridae ; Child* ; Humans ; Immunoglobulins, Intravenous ; Jeollabuk-do ; Medical Records ; Mortality ; Myocarditis* ; Prognosis*

BACKGROUND: In the United States, the Centers for Disease Control and Prevention recorded a 20-fold increase in the incidence of vancomycin-resistant enterococci (VRE) associated with nosocomial infections between 1989 and 1991. Although VRE has been reported in Korea since 1992, infections caused by these organisms are still extremely rare in Pusan, Korea. Therefore, a point prevalence culture survey was carried out to investigate the prevalence of intestinal colonization with VRE among patients admitted to Kosin Medical Center, which can predict the appearance of clinical infections with VRE. METHODS: Between July 1997 and August 1997, stool specimens were obtained from 303 patients. Specimens were placed in bile esculin azide broth containing vancomycin (64 microgram/mL) and aatreonam (60 microgram/mL). Cultures were done for 48 hours at 37degrees C, and turbid solutions were subcultured on blood agar. Minimal inhibitory concentrations (MIC) of vancomycin and teicoplanin to Enterococcus isolates were determined by Etest on Mueller-Hinton agar. For amplification of the vanA, vanB, and vanC genes, polymerase chain reactions were performed. RESULTS: VRE isolates were isolated from 6 of the patients (2%). Four of them were identified as E. faecium, and 1 was identified as E. avium, and 1 was identified as Enterococcus spp. All of them were highly resistant to vancomycin (MICs >256 microgram/mL), and they were also resistant to teicoplanin (MICs 32-->256 microgram/mL). All of 6 VRE strains carried vanA gene. CONCLUSION: The colonization of VRE was not infrequent among the patients of a university hospital in Pusan, Korea. Moreover, a large proportion of the colonizing VRE was revealed Enterococcus faecium with vanA gene, which implies quite a possibility of a sudden rising of infections by this organism in the near future. So we propose that the vancomycin susceptibility test should be done for every enterococcal isolate from clinical specimens and the intestinal colonization rate of VRE should be closely monitored at regular intervals for the purpose of surveillance 50 that proper establishment of plans for the prevention of this troublesome pathogen's spread can be promptly made.
Agar ; Bile ; Busan ; Centers for Disease Control and Prevention (U.S.) ; Colon* ; Cross Infection ; Enterococcus ; Enterococcus faecium ; Esculin ; Humans ; Incidence ; Korea ; Polymerase Chain Reaction ; Prevalence ; Teicoplanin ; United States ; Vancomycin