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*

BACKGROUND: As many as several weeks of incubation may be necessary for the recovery of mycobacteria when conventional culture media are used. Previous studies evaluating Mycobacteria Growth Indicator Tube (MGIT) as a rapid for the growth and detection of mycobacteria from clinical specimens have been reported. We compared MGIT with Ogawa media for the recovery of mycobacteria from clinical specimens. METHODS: Ninety nine clinical specimens received in the laboratory of Wonju Christian Hospital from June to September 199 were used for this study. The specimens from nonsterile body sites were digested, decontaminated, and concentrated, for culture and Ziehl-Neelsen stain, and specimen were inoculated onto MGIT tube and 3% Ogawa egg medium, and cultured for 8 weeks. RESULTS: Of the 38 specimens culture-positive for mycobacteria, 3 grew isolates in MGIT medium only, 8 grew isolates in Ogawa media only, and 27 grew isolates in both media. Mean (median, range) times to detection of mycobacteria were 13.7 (5.5, 2-48) days with MGIT and 19.6 (18, 13-37) days with Ogawa (P>0.05). The number recovered with MGIT plus Ogawa media was 24 (63.2%) within 14 days of receipt of specimen, and 31 (81.6%) within 21 days. The contamination rates were 31 % for MGIT and 1 % for Ogawa media. CONCLUSIONS: MGIT appears useful to quickly detect and identify mycobacteria from clinical specimens. However, because the number of culture-positive specimen in MGIT was not greater than those recovered with Ogawa media, MGIT should be used in combination with solid media to reduce turnaround times and increase the isolation rate.
Culture Media ; Gangwon-do ; Mycobacterium ; Ovum

BACKGROUND: As many as several weeks of incubation may be necessary for the recovery of mycobacteria when conventional culture media are used. Previous studies evaluating Mycobacteria Growth Indicator Tube (MGIT) as a rapid for the growth and detection of mycobacteria from clinical specimens have been reported. We compared MGIT with Ogawa media for the recovery of mycobacteria from clinical specimens. METHODS: Ninety nine clinical specimens received in the laboratory of Wonju Christian Hospital from June to September 199 were used for this study. The specimens from nonsterile body sites were digested, decontaminated, and concentrated, for culture and Ziehl-Neelsen stain, and specimen were inoculated onto MGIT tube and 3% Ogawa egg medium, and cultured for 8 weeks. RESULTS: Of the 38 specimens culture-positive for mycobacteria, 3 grew isolates in MGIT medium only, 8 grew isolates in Ogawa media only, and 27 grew isolates in both media. Mean (median, range) times to detection of mycobacteria were 13.7 (5.5, 2-48) days with MGIT and 19.6 (18, 13-37) days with Ogawa (P>0.05). The number recovered with MGIT plus Ogawa media was 24 (63.2%) within 14 days of receipt of specimen, and 31 (81.6%) within 21 days. The contamination rates were 31 % for MGIT and 1 % for Ogawa media. CONCLUSIONS: MGIT appears useful to quickly detect and identify mycobacteria from clinical specimens. However, because the number of culture-positive specimen in MGIT was not greater than those recovered with Ogawa media, MGIT should be used in combination with solid media to reduce turnaround times and increase the isolation rate.
Culture Media ; Gangwon-do ; Mycobacterium ; Ovum

This study was undertaken for the clinical analysis and evaluation on 121 patients with incompetent internal os of the cervix, who were admitted and treated with McDonald operation or Shirodkar operation at the Soonchounhyang Medical Center from January 1991 to December 1995. The results of this study were as follows : 1. The incidence of this IIOC was 1.1% of 11,116 cases of total delivery. 2. The mean age of IIOC was 31.7 years old. 3. The average number of gravida was 3.2. 4. The most common contributary factor was previous history of artificial abortion (51.2 %), and midtrimester abortion (17.4 %), cervical laceration due to previous vaginal delivery (8.3 %) etc. was followed. 5. The success rate of operation was 76 %, and the highest success rate (85.7 %) was reveald with period from 15th weeks to 16th weeks of gestation. 6. When cervical dilatation was abscent or small, the success rate of operation was high. 7. The factors of failed operation were preterm labor (58.7 %), PROM (34.5 %), and PIH, bleeding. 8. The delivery method after operation was vaginal delivery in 83 cases (68.6%) and cesarean section in 38 cases (31.4 %).
Cervix Uteri* ; Cesarean Section ; Female ; Hemorrhage ; Humans ; Incidence ; Labor Stage, First ; Lacerations ; Obstetric Labor, Premature ; Pregnancy ; Pregnancy Trimester, Second

Fibromyalgia is a chronic pain syndrome of unknown etiology that is characterized by diffuse musculoskeletal pain, fatigue, sleep disturbance, memory disturbance, and exaggerated tenderness over particular paired locations. Fibromyalgia is found in 2% to 4% of the general population and more common in women, with symptoms usually appearing between 20 and 55 years of age. The diagnostic criteria for fibromyalgia syndrome established in 1990 by the American College of Rheumatology (ACR), includes widespread pain for at least 3 months and point tenderness upon the application of a 4 kg weight at 11 or more of the 18 characteristic tender points. The 2010 ACR preliminary diagnostic criteria have been developed, which are strongly correlated with the 1990 ACR criteria and provide an alternative approach to diagnosis. Patients with fibromyalgia syndrome have lower pain thresholds and experience an altered temporal summation to pain stimuli. The sensitization of pain perception occurs in the dorsal horn of patients with fibromyalgia. However, it is unknown whether sensitization is due to increased pain fiber facilitation, or decreased inhibition. Pregabalin is approved by the United States Food and Drug Administration for the management of fibromyalgia patients. Tricyclic antidepressants, cardiovascular exercise, cognitive behavioral therapy and patient education are also effective in reducing the pain experienced by fibromyalgia patients. This article provides an overview of fibromyalgia syndrome, which is currently thought to be partly responsible for chronic diffuse pain.
Animals ; Antidepressive Agents, Tricyclic ; Chronic Pain ; Cognitive Therapy ; Fatigue ; Female ; Fibromyalgia ; gamma-Aminobutyric Acid ; Horns ; Humans ; Memory ; Musculoskeletal Pain ; Pain Perception ; Pain Threshold ; Patient Education as Topic ; Rheumatology ; United States Food and Drug Administration ; Pregabalin

Parkinsonism is not commonly associated with intracranial tumors. The most common brain tumor causing parkinsonism is meningiomas. We are presenting two cases of meningiomas whose major manifestations included parkinsonism. In one, parkinsonian symptoms initially partially responded to L-dopa and bromocriptine. A CT scan taken for a stroke-like episode revealed a meningioma of left frontal convexity. After neurological sequelae of CO poisoning, the patient poorly responded to antiparkinsonian drugs. Surgical treatment of meningioma did not result in satisfactory control of extrapyramidal symptoms. In the other with a parasagittal meningioma, parkinsonian symptoms were postoperatiYely improved. Because no curative treatment is available for the majority of parkinsonian patients, early detection of an underlying neoplasm may result in a most rewarding outcome. It would be desirable to perform CT or MRI in cases of parkinsonism with other associated neurological manifestation. Unilaterality of parkinsonian symptoms may also be indication.
Brain Neoplasms ; Bromocriptine ; Frontal Lobe* ; Humans ; Levodopa ; Magnetic Resonance Imaging ; Meningioma* ; Neurologic Manifestations ; Parkinsonian Disorders* ; Poisoning ; Reward ; Tomography, X-Ray Computed

We reviewed 27 patients wlth cerebellar infarction which was demonstrated by brain CT and/or MRI. Infarction occurred in the territory of posterior inferior cerebellar artery (PICAj in 16 patients, and the territory of the superior cerebellar artery(SCA) was involved in 5 patients. Antenor inferior cerebellar artery(AICA) infarcts occurred in 3 patients. Both PICA and SCA temtories were involved in 2 patients. In the remaining 1 patient, the infarct encompassed the borderzone between the SCA and PICA territories. The main symptoms and signs were sudden onset of vertigo, dizziness, nausea, vomiting, dysmetria, ataxia, nystagmus, and headache. There were signs of associated brain stem infarction or occipitotemporal infarction; rostral basilar artery syndrome, classic SCA syndrome, Wallenberg syndrome, internuclear ophthalmoplegia, facial palsy, hearing impairment. Presumed cerebral embolism was the main stroke mechanism in the SCA terntories. Six patients with brainstem compression or brainstem involvement showed consciousness deterioration, and only one of them died as a result of extensive cerebellar infarctions involving both SCA and PICA territories Cerebellar infarction may run a more benign course than previously thought.
Arteries ; Ataxia ; Basilar Artery ; Brain ; Brain Stem ; Brain Stem Infarctions ; Cerebellar Ataxia ; Consciousness ; Dizziness ; Facial Paralysis ; Headache ; Hearing Loss ; Humans ; Infarction* ; Intracranial Embolism ; Lateral Medullary Syndrome ; Magnetic Resonance Imaging ; Nausea ; Ocular Motility Disorders ; Pica ; Stroke ; Vertigo ; Vomiting

BACKGROUND: Vancomycin-esistant enterococci (VRE) were first recovered from clinical isolates in Korea in 1992, and the incidence has been steadily increasing. The goal of this study was to determine the isolation trend of VRE by year and genotypes of VRE isolated from clinical specimens in Wonju area. METHODS: We investigated the patients' medical records to determine the incidence of VRE among enterococci isolated from 1995 to 1999 in Wonju Christian Hospital, performed antimicrobial susceptibility tests to vancomycin and teicoplanin by agar dilution methods, and genotyped them with multiplex polymerase chain reaction for 117 cryopreserved VRE isolates. RESULTS: VRE were first isolated in December 1995. Overall incidence of VRE during the period of 1996 to 1999 was 6.1% (164/2,682). The annual incidence of VRE was 1.9% in 1996, 5.5% in 1997, 6.7% in 1998, and 9.7% in 1999. The species of VRE included 115 (69.7%) E. faecium, 11 (6.7%) E. faecalis, 17 (10.3%) E. casseliflavus, 10 (6.1%) E. gallinarum, and 12 (7.3%) Enterococcus species. Of 117 VRE, E. faecium and E. faecalis strains were phenotyped as VanA, and genotyped as vanA with the exception of five VRE which the genotypes were not identified. All E. gallinarum and E. casseliflavus strains were genotyped as vanC- and vanC-, respectively. CONCLUSIONS: VRE were first isolated in 1995. And the isolation rate of VRE were increasing trend from 1.9% in 1996 and 9.7% in 1998. Most of VRE were E. faecium with vanA genotype.
Agar ; Enterococcus ; Gangwon-do* ; Genotype* ; Incidence ; Korea ; Medical Records ; Multiplex Polymerase Chain Reaction ; Teicoplanin ; Tertiary Healthcare* ; Vancomycin

BACKGROUND: Vancomycin-esistant enterococci (VRE) were first recovered from clinical isolates in Korea in 1992, and the incidence has been steadily increasing. The goal of this study was to determine the isolation trend of VRE by year and genotypes of VRE isolated from clinical specimens in Wonju area. METHODS: We investigated the patients' medical records to determine the incidence of VRE among enterococci isolated from 1995 to 1999 in Wonju Christian Hospital, performed antimicrobial susceptibility tests to vancomycin and teicoplanin by agar dilution methods, and genotyped them with multiplex polymerase chain reaction for 117 cryopreserved VRE isolates. RESULTS: VRE were first isolated in December 1995. Overall incidence of VRE during the period of 1996 to 1999 was 6.1% (164/2,682). The annual incidence of VRE was 1.9% in 1996, 5.5% in 1997, 6.7% in 1998, and 9.7% in 1999. The species of VRE included 115 (69.7%) E. faecium, 11 (6.7%) E. faecalis, 17 (10.3%) E. casseliflavus, 10 (6.1%) E. gallinarum, and 12 (7.3%) Enterococcus species. Of 117 VRE, E. faecium and E. faecalis strains were phenotyped as VanA, and genotyped as vanA with the exception of five VRE which the genotypes were not identified. All E. gallinarum and E. casseliflavus strains were genotyped as vanC- and vanC-, respectively. CONCLUSIONS: VRE were first isolated in 1995. And the isolation rate of VRE were increasing trend from 1.9% in 1996 and 9.7% in 1998. Most of VRE were E. faecium with vanA genotype.
Agar ; Enterococcus ; Gangwon-do* ; Genotype* ; Incidence ; Korea ; Medical Records ; Multiplex Polymerase Chain Reaction ; Teicoplanin ; Tertiary Healthcare* ; Vancomycin

Osteoma of the tongue is a rare entity of unknown origin. Clinically, the majority of the osteoma are described as growth of pedunculated mass on the posterior dorsum of the tongue without symptoms. The mechanism for its formation is unknown, but various theories have been proposed. Surgery is an appropriate treatment and no recurrence after surgery has been reported. We experienced a 68 year old man with undiagnosed osteoma of the tongue, incidentally detected during gastroscopy. We report this case with a review of literature.
Aged ; Gastroscopy ; Humans ; Osteoma ; Recurrence ; Tongue