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*

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 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

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

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*

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

BACKGROUND: To assess the effects of mDOT implementation on sputum smear conversion for AFB (Acid fast bacilli) positive pulmonary tuberculosis patients, modified Directly Observed Treatment (mDOT) was started on October 8th 2001 at a health center in Seoul. mDOT was defined through weekly interviewing and supervising of a patient by a supervisor (doctor, nurse, or lay health worker). The sputum smear conversion of a mDOT group was compared with that of a self-medication (self) group. METHODS: This study included 52 AFB positive pulmonary tuberculosis patients registered at a health center in Seoul between October 8th 2001 and April 23rd 2002. 24 and 28 patients were enrolled in the mDOT and self medication groups, respectively. Paired (1:1) individual matching, by gender, extent of disease, relapse and age-matching variables, was performed between the two groups, resulting in 20 paired matches. This prospective study was planned as an unblinded, non-randomized quasi- experimental pilot project. Outcomes were identified from results of sputum smear examinations for AFB in both groups at 2 weeks, and 1 and 2 months. The paired matching data were analyzed using the SAS program version 8.1 by McNemar test. RESULTS: At the end of 2 weeks of treatment, the sputum smear conversion of the mDOT group was somewhat higher than that of the self medication group (78.57 vs. 50%, p-value=0.289), and after 1 month of treatment no statistically significant difference was shown between the two groups (83.33 vs. 50, p-value=0.125). At the end of 2 months of treatment (initial intensive phase), the sputum smear conversions of the mDOT and self groups were 95 and 75%, respectively (p-value=0.219). CONCLUSIONS: The implementation of mDOT did not result in clinically significant increases in the sputum smear conversion at 2 weeks, and 1 and 2 months compared with that of the self medication group. However, the increases experienced might contribute to diminishing the infectious period of AFB positive patients, and this approach may act as a guide for a specific group of patients. In this study, mDOT was performed for one hundred percent of the intensive treatment phase. It can also be an effective treatment for pulmonary tuberculosis patients, and may be useful for some high risk tuberculosis patients.
Humans ; Pilot Projects ; Prospective Studies ; Recurrence ; Self Medication ; Seoul ; Sputum* ; Tuberculosis ; Tuberculosis, Pulmonary

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*

PURPOSE: There has been a difficulty in measuring angle kappa because special instrument was required. To measure the angle kappa conveniently, we designed a new method using slit lamp biomicroscope. METHODS: We measured the angle kappa in 124 eyes of 62 patients with newly designed method and compared the measurement by new method with those by T-shape ruler or the major amblyoscope. RESULTS: We found the average angle kappa was +3.12 degrees by slit lamp, +2.85 degrees by major amblyoscope and +3.04 degrees by T shape ruler method. There was no significant difference between slit lamp and either major amblyoscope method (p=0.48) or T shape ruler (p=0.18). CONCLUSIONS: The new method of measuring angle kappa using slit lamp biomicroscope seemed to be a convenient and relatively accurate method for measuring of angle kappa and appeared to be beneficial in measurement of ocular deviation.
Humans