Vibrio vulntficus is a halophilic, gram-negative, motile, marine rod tha is capable of causing rapidly progressing, life-threatening infection in human. The illnesses associated with this organism can be categorized clinically as four groups such as wound infection, primary sept cemia, gastrointestinal illness, and other infection. The clinica1 manifestation of patients with primarys pticemia can vary from fever and chills alone to a more severe illness including secondary skin lesions, multisystem organ failure and shock. Several skin lesions are found in patients with this septicemia, including edema, blister, gangrene, localized swelling, and papura and, less comrnonly, cyanosis, maule and patch, papule, wheal, and pustule. The cutaneous lesions appear mostly on the legs. The hist pathologic findings differ according to the clinieal stage(inflammatory, bullous, and gangrenous) of the lesions. Mortality is very high. The organism is isolated mostly from skin lesion and/or blood. Vibrio vulnifices is sensitive to chloramphenicol, gentamicin, tubramycin, tetracycline, and 3rd generation cephalosporins. Most cases occur during the summer montlis, in men and in person 40 or more year of age. The illness begin with septicemia, often within 2 days of the consumption of various kinds of raw seafood such as fish, shell- fish, and brown seaweed. Patierts frequently have preexisting liver diseae and/or alcohol abuse. For prevention of Vibrio vulni ficus infections, persons with liver diseases or alcohol abuse should avoid consuming or handling raw seafood. Clinicians should start appropriate therapy promptly in patients with chronic underlying disease and a recent history of raw seafood con umption who present with unexplained febrile illness.
Alcoholism ; Blister ; Cephalosporins ; Chills ; Chloramphenicol ; Cyanosis ; Edema ; Epidemiology ; Fever ; Ficus ; Gangrene ; Gentamicins ; Humans ; Leg ; Liver ; Liver Diseases ; Male ; Mortality ; Seafood ; Seaweed ; Sepsis ; Shock ; Skin ; Tetracycline ; Vibrio vulnificus* ; Vibrio* ; Wound Infection

From the leprosy patients hospitalized at the Korean National Leprosarium on Snrokdo Island, forty-five leprosy patients with plantar ulcers were selected randomly for microbiological studies. A total of 84 strains of bacteria, with the most common being Neieseria sicca (25 strains: 29.8%), 34 strains (40. 5%) were present as a pure growth and 50 strains (59. 5%) were present in ulcers with multiple infection. Antibiotic susceptibility tests indicated that bacterial isolates were rather highly susceptible to gentarnicin and kanamycin, but varying degree of isolates were resistant to 12 antibiotics including streptomycin, rifampicin, lincomycin, penicillin, terramycin and colimycin etc. From a total of 30 plantar ulcers, 17 ulcers produced 24 strains of fungi and 1 strain of Balanticlium coli. They consisted of 17 strains of saprophytic fungi (70. 8%) and 7 strains of yeast-like fungi (29. 2%). Of the culture media for Balantidium coli, Sabourauds glucos medium is the most specific and selective that the author found.
Anti-Bacterial Agents ; Bacteria ; Balantidium ; Colistin ; Culture Media ; Foot Ulcer* ; Fungi ; Humans ; Kanamycin ; Leprosy* ; Lincomycin ; Oxytetracycline ; Penicillins ; Rifampin ; Streptomycin ; Ulcer

PURPOSE: It is difficult to determine the activity of tuberculosis radiologically. Therefore there have been efforts to assess the activity using radiopharmaceuticals such as 67Ga, 99mTc-tetrofosmin, and 99mTc-MIBI. But there may be some discrepancy in defining the term 'activity' between clinicians and nuclear physicians. While negative conversion of sputum acid fast bacilli (AFB) is defined as 'disappearance of activity' by clinicians, a loss of uptake in previously positive lesion is accepted as 'disappearance of activity' by nuclear physicians. We designed a prospective study to see if the negative conversion of sputum AFB could directly match the disappearance of radioactivity of the lesion. MATERALS AND METHODS: Fifteen patients with bacteriologically confirmed active localized pulmonary tuberculosis were scanned 10 and 60 min after intravenous injection of 550 MBq 99mTc-MIBI. In 6 patients, who showed negative conversion of sputum AFB after 3-7 months of chemotherapy, 99mTc-MIBI scan was repeated. For the purpose of comparison, target/nontarget ratios of the lesions were determined. RESULTS: 12/15 (80%) patients with active pulmonary tuberculosis showed increased uptake of 99mTc-MIBI in tuberculous lesion. After negative conversion of sputum AFB, 5/6 (83%) patients still showed increased uptake, although the intensity of uptake decreased. CONCLUSION: Uptake of radioactivity decreased but did not disappear after negative conversion of sputum AFB. 99mTc-MIBI scan may be useful to address the degree of inflammation of pulmonary tuberculous lesion, but the uptake did not directly match the activity defined by positivity of sputum AFB. We nuclear physicians might have used the term 'activity' somewhat differently from clinicians who treat patients with tuberculosis.
Drug Therapy ; Humans ; Inflammation ; Injections, Intravenous ; Prospective Studies ; Radioactivity ; Radiopharmaceuticals ; Sputum ; Tuberculosis* ; Tuberculosis, Pulmonary*

PURPOSE: The purpose of this paper is to describe the CT findings of a variety of branchial cleft anomalies in the head and neck area. MATERIALS AND METHODS: We reviewed the CT findings of 16 patients with neck lesion pathologically proved as branchial cleft anomalies. There were two first and 12 second branchial cleft cysts, one first and one second branchial cleft sinuses. RESULTS: Two cases of first branchial cleft cysts were manifested as thin walled, cystic masses at auricular area. One first branchial cleft sinus was an external opening type and manifested as an ill defined, enhancing solid lesion at posterior auricular area. All 12 cases of second branchial cleft cysts demonstrated a typical location, displacing the sternocleidomastoid muscle posteriorly, the carotid artery and internal jugular vein complex medially and the submandibular gland anteriorly. Eight cases of second branchial cleft cysts were seen as fluid-filled, round or ovoid shaped cysts, and 3 cases of them were seen as irregular-shaped cysts. In one case. suppurative adenopathy with loss of soft tissue planes around the cyst was observed. One case of second branchial cleft sinus was manifested as a tubular-shaped, enhancing lesion at submental area and containing external opening site draining into the anterior border of the sternocleidomastoid muscle. CONCLUSION: We conclude that CT provides important diagnostic and therapeutic informations in patients with a neck mass believed to be a branchial cleft anomaly, as it can differentiate various forms of the branchial anomalies by their characteristic location and shape.
Branchial Region* ; Branchioma ; Carotid Arteries ; Head ; Humans ; Jugular Veins ; Neck ; Submandibular Gland

Membranous glomerulonephropathy (MGN) is the most common primary cause of the nephrotic syndrome in adults, accounting for about 20% of the cases in most series. MGN is idiopathic in the majority of cases, however approximately 25% of adults have identifiable causes (secondary MGN). To evaluate the clinical and pathologic characteristics of MGN, we reviewed the clinical data and renal biopsies from 141 cases of MGN. The mean age of the patients at biopsy was 43 years old, but patients of all age were seen (range from 3 to 76 years of age). There were 88 males and 53 females. There were 99 idiopathic MGN cases and 42 secondary MGN cases. The associated causes of secondary MGN included hepatitis B infection (18 cases), SLE (10 cases), drugs (4 cases), post-transplantation MGN (5 cases), diabetes mellitus (4 cases), syphilis (1 case) and hepatitis B infection associated with rheumatoid arthritis. The prevalence of histologic stages by Ehrenreich and Churg was as follows. Stage I was 24 cases, stage II was 72 cases, stage III was 35 cases, and stage IV was 9 cases. All patients had proteinuria. Nephrotic syndrome was observed in 39%, edema in 73%, microscopic hematuria in 49%, gross hematuria in 28%, hypertension in 13%, and the serum creatinine level above 1.5 mg/dl was in 13%. Cases with glomerulosclerosis was observed in 45 cases with an increased percentage of glomerulosclerosis in the higher grade. Immunofluorescence (IF) examination showed predominantly granular IgG (118 cases) and C3 (84 cases) stainings along the glomerular capillary wall. In idiopathic MGN, sparse mesangial IF staining was noted up to 10% of the cases. However, mesangial IF staining in SLE was observed in 33%, hepatitis B infection in 28% and diabetes mellitus in 50%. An electron microscopic examination revealed subepithelial electron dense deposits of immune complex in all cases. The prevalence of mesangial and subendothelial electron dense deposit in idiopathic MGN was present in 19% and 6%, respectively. In SLE cases, mesangial and subendothelial deposits were observed in 78% and 56%, respectively. In hepatitis B infection, mesangial and subendothelial deposits were observed in 54% and 69%, respectively. In conclusion, immune deposits in the mesangium are scanty in idiopathic MGN, and if pronounced this should increase suspicion of underlying systemic diseases, such as SLE or other infectious diseases.
Adult ; Antigen-Antibody Complex ; Arthritis, Rheumatoid ; Biopsy ; Capillaries ; Communicable Diseases ; Creatinine ; Diabetes Mellitus ; Edema ; Female ; Fluorescent Antibody Technique ; Glomerulonephritis, Membranous* ; Hematuria ; Hepatitis B ; Humans ; Hypertension ; Immunoglobulin G ; Male ; Nephrotic Syndrome ; Prevalence ; Proteinuria ; Syphilis

No abstract available.
Korea* ; Strikes, Employee*

No abstract available.
Abdominal Wall* ; Fascia* ; Ligaments*

Vibrio vulnificus is a halophilic gram-negative, marine bacterium which causes fulminating and potentially fatal human disease. A new sensitive and specific serogrouping procedure was developed for identifying V. vulnificus. Reference antis:ra(01-014) to V. vulnificus were prepared by vaccinated rabbits with heat-killed bacteria, and the antisera were examined whether erogrouping test will be available for rapid and sensitive identification method of V. vulnifiius or not. All of thirty-seven clinical strains tested were agglutinated with 5 kinds of aritisera such as 04A, 01, 013, 03, and 014. Of these serovar 04A was predominant(75.7%). The author investigated the correlation among certain serovars, consumed seafoods, and nortality rate to verify whether the serovar is of pognostic value. There was no significant orrelation among them. These results suggest theart serogrouping procedure could be of value in rapidly identifying V. vulnificus.
Bacteria ; Humans ; Immune Sera ; Rabbits ; Seafood ; Vibrio vulnificus* ; Vibrio*

BACKGROUND: Vibrio vulnificus(V. vulnificus) is a pathogenic, marine, halophilic, Gram negative bacillus which causes fulminant infection in humans through skin wounds. or the ingestion of raw seafoods or Most cases are reported sporadically in summer in the south-western coastal area of Korea. OBJECTIVE: We studied the distribution of V. vulnificus in sea water, fishes, shellfish and sea mud from May to October in 1996 and the relationship between regional distribution and environmental factors. METHODS: We collected the sea water, sea mud, fishes and seafoods from May to October in Kunsan, Daechun, Moochangpo, Puan, Youngkwang and cultured it in Thiosulfate-Citrate-Bile salt-Sucrose(TCBS) agar, Cellobiose-Polymyxin B-Colistin(CPC) agar, and Sodium dodecyl sulfate- Polymyxin B-Sucrose(SPS) agar. At the same time we investigated environmental factors such as temperature, pH, salinity, turbidity, dissolved oxygen(DO), NO3 of sea water. RESULTS: Twelve strains(2.17%) of V. vulnificus were isolated from a total of 552 specimens. The V. vulnificas isolation rate from sea mud was higher than in sea water and shellfish. Areas where V. vulnipcus was isolated were Kunsan and Daechun. It was isolated during June, July and August. The Isolation rate was higher with CPC agar than TCBS, SPS agar. When V.vulnificus was isolated at Kunsan, the environmental factors of sea water noted were as follows: temperature, 25.3C; turbidity, 121Formazine turbidity units; salinity, 12.2%; DO, 7.3mg/L; pH, 7.37 and NO3, 1.18mg/L. CONCLUSION: CPC agar is the best medium of the three above used for the isolation of V. vulnificus from environmental samples. V. vulnificus was highly isolated in the Kunsan area because of the high water temperature and turbidity, low salinity and weak alkali state of the sea water in comparision with other areas. We suggest that high temperature and turbidity, low salinity and weak alkalinity of sea water are very important environmental factors for the growth of V. vulnificus.
Agar ; Alkalies ; Bacillus ; Eating ; Fishes ; Humans ; Hydrogen-Ion Concentration ; Jeollabuk-do ; Korea* ; Polymyxins ; Salinity ; Seafood ; Seawater* ; Shellfish ; Skin ; Sodium ; Vibrio vulnificus* ; Vibrio* ; Water ; Wounds and Injuries

Using the 15 strains of Vibrio eulnificus isolated from the blood and tissue fluid of the patients with primary septicemia, cultural characteristics were studied on various media. The media to be used in culturing Vibrio vulnificus should contain sodium chloride, because it could not survive on the media without NaCl. The organism grew poorly or not at all on the media with eosin-y, methylene blue, crystal violet, or azide, because these substances suppress its growth. Vibrio vulnificus grew well in the enrichment media such as brain heart infusion, tryptic soy broth, and nutrient broth with 0. 5% NaCl.
Brain ; Cultural Characteristics* ; Gentian Violet ; Heart ; Humans ; Methylene Blue ; Sepsis ; Sodium Chloride ; Vibrio vulnificus* ; Vibrio*