BACKGROUND: Antibiotic therapy has proven an effective method of treatment on the majority of patients with pyogenic lung abscess and infected bulla. When medical therapy has failed, pulmonary resection is the current generally recommended therapy. But nowdays complications of percutaneous tube drainage has decreased with the use of small catheter. So we evaluated the effect of percutaneous tube drainage as an alternative therapy to the pyogenic lung abscess and infected bulls refractory to medical therapy in preference of the pulmonary resection. METHOD: Nine cases of the lung abscess and three cases of infected bulls which has large cavity size over 6cm, and has underlying diseases such as lung cancer, diabetes mellitus, refractory to over 1 week of antibiotics, were performed percutaneous tube drainage with All Purpose Drainage catheter(Medi-tech, Watertown, USA) under fluoroscopy. RESULTS: All the cases except one case which complicated empyema was improved clinically. Fever was down within 4days of percutaneous tube drainage(mean : 1.9days). Mean duration of tube drainage was 9.9days. CONCLUSION: Percutaneous tube drainage is an effective and relatively safe procedure in the management of lung abscesses that do not response to medical therapy We speculate this procedure should be considered as an alternative therapy for the lung abscess refractory to medical therapy in preference to the surgery. The safety and effectiveness of this procedure in infected bulla should be evaluated with an additional study.
Anti-Bacterial Agents ; Catheters ; Diabetes Mellitus ; Drainage* ; Empyema ; Fever ; Fluoroscopy ; Humans ; Lung Abscess* ; Lung Neoplasms ; Lung*

No abstract available.
Meningioma* ; Optic Nerve* ; Orbit*

BACKGROUND: The erythromycin-resistance rate and phenotype distribution of Streptococcus propenes are quite different by geographical variation and study period. The aim of the present study was to determine the evolution of resistance to erythromycin and the frequency of erythromycin resistance phenotype of S. pyogenes isolated from Wonju Christian Hospital. METHODS: The minimal inhibitory concentrations (MICs) of erythromycin and clindamycin for 94 S. pyogenes isolated from clinical specimens between 1990 to 1998 were investigated. Double disk test of erythromycin (78microgram) and clindamycin (25microgram) were performed for 15 isolates of erythromycin resistant S. pyogenes to evaluate the erythromycin resistance phenotype. RESULTS: The resistance rates of 94 isolates of S. pyogenes were 16%(15/94) to erythromycin and 4%(4/94) to clindamycin. The frequency of erythromycin resistance phenotype in decreasing order were M phenotype (47%), inducible resistance phenotype (40%), and constitutive resistance phenotype (13%). Erythromycin-resistant S. pyogenes did not exist until 1993, but was isolated since 1994, and ranged from 14.0% to 24.0% during the period of 1994-1998. CONCLUSIONS: Our finding documents the emergence of high resistance rates to erythromycin in S. pyogenes at Wonju area since 1994. The M phenotype (47%) and inducible resistance phenotype (40%) account for the majority of erythromycin-resistant S. pyogenes.
Clindamycin ; Erythromycin* ; Gangwon-do ; Phenotype* ; Streptococcus pyogenes* ; Streptococcus*

A 3-year-old-male had the appearance of red urine at birth and developed recurrent bullae in sun-exposed area of the skin, erythrodontia, alopecia, splenomegaly and hemolytic anemia, We observed coral red fluorescence of the teeth and urine under Wood's light and detected excessive excretion of the uroporphyrin in the urine and coproporphyrin in the stool wlth inreased porphyrin in the blood. Fluorescence of erythrocyte was demonstrated by:fluoreacence microscopy. Histologic findings showed subepidermal bulla with PAS-positive hyaline deposits around the blood vessels and revealed IgG deposits in the wall of blood vessels and dermo-epidermal junction by direct immunofluorescence.
Alopecia ; Anemia, Hemolytic ; Anthozoa ; Blood Vessels ; Erythrocytes ; Fluorescence ; Fluorescent Antibody Technique, Direct ; Hyalin ; Immunoglobulin G ; Microscopy ; Parturition ; Porphyria, Erythropoietic* ; Porphyrias ; Skin ; Splenomegaly ; Tooth

PURPOSE: The purpose of this study was to identify the effects of aromatherapy on blood pressure and stress responses of clients with essential hypertension. METHOD: There were fifty-two subjects divided into an essential oil group, placebo group, and control group by random assignment. The application of aromatherapy was the inhalation method of blending oils with lavender, ylangylang, and bergamot once daily for 4 weeks. To evaluate the effects of aromatherapy, blood pressure and pulse were measured two times a week and serum cortisol levels, catecholamine levels, subjective stress, and state anxiety were measured before and after treatment in the three groups. Data was analyzed by repeated measures of ANOVA, one-way ANOVA, and chi-square-test using the SPSS 10.0 program. RESULTS: The blood pressure, pulse, subjective stress, state anxiety, and serum cortisol levels among the three groups were significantly statistically different. The differences of catecholamine among the three groups were not significant statistically. CONCLUSION: The results suggest that the inhalation method using essential oils can be considered an effective nursing intervention that reduces psychological stress responses and serum cortisol levels, as well as the blood pressure of clients with essential hypertension.
Adult ; Aged ; *Aromatherapy ; Biological Markers/blood ; Blood Pressure ; Cananga ; Female ; Humans ; Hypertension/nursing/*therapy ; Male ; Middle Aged ; Oils, Volatile/*therapeutic use ; Plant Oils/therapeutic use ; Stress, Psychological/*therapy

A 50-year-old woman with lupus erythematosus profundus of about a year's duration was reported. The patient had no history of discoid lupus erythematosus or systemic lupus erythematosus. Dermatologic examination revealed two, firm, freely movable, well demarcated, subcutaneous plaques, with mildly erythematous overlying skin, measuring 2 x 2 cm (right), 5 x 5 cm (left), was present on the both deltoid region. Histopathologically, this showed panniculitis. Diret immunofluorescence studies showed IgG and IgM deposition on the dermoepidermal junction.
Female ; Fluorescent Antibody Technique ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Lupus Erythematosus, Discoid ; Lupus Erythematosus, Systemic ; Middle Aged ; Panniculitis ; Panniculitis, Lupus Erythematosus* ; Skin

Fractures of the acetabulum are relatively uncommon, but because they involve a major weight bearing joint in the low extremity, they assume great clincal importance. The principle of management for this fracture is as for any other displaced intra-articular fracture, nsmely that anstomical reduction is essential for good long term function of the obtained by closed means, but more often, open reduction followed stable internsl fixation allowing early active or passive motion will be required. In the past, the achievement of this ideal, that is anatomical reduction, has been difficult because technical problems such as those caused by complicated anatomy, difficulty with surgical exposure, severe comminution in many cases, and major associated injuries. We classified the acetabular fractures of 71 patients with 72 hips from 1980 to 1987 and clinical analysis was performed on 51 hips allowing the possible follow-up evaluation beyond the 12 months. Following results were obtained. 1. The most common associated injury was the pelvic bone fracture(25.5%). 2. The most common types of fracture on each classification were posterior wall fracture in Letournel(37.5%), posterior acetabular fracture in Rowe & Lowell(42.3%), central fracture- dislocation without involving of weight bearing dome of acetabulum in Carnesale(23.9%). 3. According to calssification method, the interpretation for characteristics of fracture type and frequency of acetabular fracture was very different each other. 4. The Leournels classification was relatively simple and could contain with many types of fracture and was helpful to determine the index of treatment. 5. The prognosis of linear undisplaced fracture and posterior fracture was better than acetabular medial, superior and bursting fracture in both conservative and operative treatment. 6. The posterior wall fracture with widely displaced fracture or joint instability, acetabular dome fracture, intraarticular fragment was absolute indication for operative treatment. 7. The treatment result and prognosis was influenced to the accurate classification of fracture type, anatomical reduction and rigid internal fixation.
Acetabulum ; Classification ; Dislocations ; Extremities ; Follow-Up Studies ; Hip ; Humans ; Intra-Articular Fractures ; Joint Instability ; Joints ; Methods ; Pelvic Bones ; Prognosis ; Weight-Bearing

Tuberous sclerosis is an autosomal dominant disorder of cellular differentiation that affect the brain, skin, heart, kidney and other organs. We experienced three cases of tuberous sclerosis that affect multiple organs in mother and two daughters. We report these cases with brief review and related literatures.
Brain ; Heart ; Humans ; Kidney ; Mothers* ; Nuclear Family* ; Skin ; Tuberous Sclerosis*

The CD44 protein has a functional domain for binding hyaluronic acid, maintaining the integrity and structure of the epithelium. The purpose of this study is to evaluate the presence and comparison of distribution of CD44 in human and rabbit corneas using immunohistochemical staining method. Immunostaining for CD44 was observed in the epithelium, endothelium and human stromal keratocytes. In particular, the strong positive deposition for CD44 can be seen in basal and limbal layers of the epithelium and in the endothelium. Immunodeposits for CD44 in rabbit cornea were detected in superficial parts of the epithelium, while they were localized in deep stromal keratocytes and the endothelium. In conjunctival tissue, immunostaining for CD44 was found in the epithelium, connective tissue, and vascular endothelium in human specimen but was faintly demonstrated only in the extracellular matrix of connective tissue in the rabbit conjunctiva. No immunostaining for CD44 was seen in control case. Our results suggest that CD44 protein can be seen both in human and rabbit corneas. However, there was different distribution of CD44 between two specimens.
Conjunctiva ; Connective Tissue ; Cornea* ; Endothelium ; Endothelium, Vascular ; Epithelium ; Extracellular Matrix ; Humans* ; Hyaluronic Acid

An alkali burn of the cornea severely damages not only the epithelium but also the underlying keratocytes and endothelium, the extracellular matrix is thought to play an important role in burn wound healing of the cornea. The glycoprotein CD44 of extracellular matrix has been implicated in biological cell behavior, including lymphocyte binding to endothelial venules, embryonic development cell migration, cell differentiation, and tumor metastasis. The purpose of this study is to investigate the presence and distribution of CD44 in wound healing using immunohistochemical staining method after alkali burning of rabbit cornea. 2 hour after burn, there was no immunodeposit for CD44 at keratocytes and endothelial cells at denuded epithelial burn area. 4 hours postburn, the epithelial cell gradually migrated over the burn area from the peripheral unburn area and immunodepositive staining of the keratocytes was observed at the margin of burn site. 24 hours postburn, immunopositive reaction for CD44 at adjacent alkali burn area was more strongly labeled, but the peripheral epithelial response of unburn area was faintly labeled by them. 48 hours postburn, immunopositive reaction gradually shifted from the border portion of alkali burn to the center portion of burn site. On days 7, the epithelium was completely reepithelized over the burn area and 3 weeks postburn, immunostaining were demonstrated the entire layer of burn site. The recovering time of the nornal immunostaing for CD44 of the rabbit cornea from the alkali burn was taken about 7 weeks. Our results suggest that the CD44 protein can be seen in proliferating in the epithelial cells, the keratocytes end endothelial cells, and is thought to play an important role in wound healing of the alkali burn cornea.
Alkalies* ; Burns* ; Cell Differentiation ; Cell Movement ; Cornea ; Embryonic Development ; Endothelial Cells ; Endothelium ; Epithelial Cells ; Epithelium ; Extracellular Matrix ; Female ; Glycoproteins ; Lymphocytes ; Neoplasm Metastasis ; Pregnancy ; Venules ; Wound Healing* ; Wounds and Injuries*