BACKGROUND: Enterococci exhibit intrinsic resistance or high-level minimum inhibitory concentration (MIC) to beta-lactams than other streptococci. This appears to be due to low affinity of penicillin-binding proteins and rarely production of beta-lactamase, which gives the reason of testing beta-lactamase for blood and cerebrospinal fluid isolates. Ampicillin is more effective than penicillin in vitro, and MIC of ampicillin is generally 1 dilution lower than that of penicillin. The purpose of this study is to detect beta-lactamase producing enterococci an6 to compare MICs of ampicillin and penicillin by Vitek system (bioMerieux, Hazelwood, MO, USA) with those by agar dilution method. METHODS: We collected 110 isolates of Enterococcus faecalis and 51 isolates of E. faecium from clinical specimens in 1998. MICs of antibiotics were determined by agar dilution method and Vitek system. We also performed beta-lactamase test by the Cefinase (Becton Dickinson, USA) for 512 isolates of E. faecalis and 189 isolates of E. faecium collected in 1998. RESULTS: The most common sites of isolates were blood, bile, surgical/traumatic wounds, closed and open pus and urine. MICs of ampicillin were 1 to 2 dilution lower than those of penicillin for E. faecalis (P=0.03). But there were no significant differences in MICs for E. faecium (P=0.19). Five isolates (4 E. faecalis and 1 E. faecium) were susceptible to ampicillin but resistant to penicillin. There were no beta-lactamase producing enterococci among 701 isolates tested. CONCLUSIONS: MIC by Vitek system tends to be 1 to 2 dilution lower than MIC by agar dilution method to beta-lactams, and MIC of ampicillin is 1 to 2 dilution lower than MIC of penicillin, which could result in discrepancy in interpretation of susceptibilty tests. A beta-lactamase test for enterococci is not recommeneded for routine test in Korea.
Agar ; Ampicillin ; Anti-Bacterial Agents* ; beta-Lactamases ; beta-Lactams ; Bile ; Cerebrospinal Fluid ; Enterococcus faecalis ; Enterococcus* ; Korea ; Microbial Sensitivity Tests ; Penicillin-Binding Proteins ; Penicillins ; Suppuration ; Wounds and Injuries

No abstract available.
Bacteria, Anaerobic*

No abstract available.
Animals ; Rats*

BACKGROUND: Oncogenes and EGF-Receptor(EGFR) may be involved n different stages of the multistep carcinogenesis process. A specific pattern of karyotypic abnormalities in solid tumors can be detected by cytogenetic methods. OBJECTIVE: This study is intnded to observe the cytomolecular kiologic chracterization of c-myc, erb B and EGFR genes in squasnous cell carcinoma(SCC) of the skin and cervix. METHODS: We have eytogenet,ically examined the short-term culturs from SCC. The rearrangement, amplification or expressi.on of erb B, c-myc, and EGFR genes were studied by Southern blot, analysis of genomic DNA and by slot blot analysis of tota! RNA extracted from biopsies of normal skin and SCC tissues. EGFR expression was examined immunohistochemially using monoclonal antibodies and the localizat,ion of the c-myc oncogene mRNA by in situ hybridization. RESULTS: A remarkably structural aberration was del 6(q21-qter) counted 20 metaphases among 28 metaphases ana1yzed. In nunierical aberration, all chromosomes were lost or gained randomly. Amenploid including triploid and tetraploid were observed in 8 metaphases, 6 tumor cells contained marker chromosome. In Southern blot analysis, rearrangement and amglificaton of EGFR in primary squamous cell carcinoma of cervix uteri and skin respectively. In slot blot analysis, the levels of c-myc, erb B and EGFR mRNA increaaed respectively 3.5, 2.5 and 2.8 times in SCC when compared to normal tissues. In immunoperoxidase stain, EGFR was present, in SCC where keratinocytes with strong cyto-plasmic staining but no membr, line labelling, where as in normal skin the were primarily present in t,he membrane and cytoplasm of basal cells. In situ hybridization with c-myc cDNAs allowed detection of grains representative of biotin labelled cDNA-mRNA hybrids in the frozden section of SCC tissues. CONCLUSION: These results suggest that specific patterns of karyotypir abnormalites, rearrangement, or amplification of EGFR gene, and overexpression of oncogenes and EGFR gene may be associated with the carcinogenesis of SCC.
Antibodies, Monoclonal ; Biopsy ; Biotin ; Blotting, Southern ; Carcinogenesis ; Carcinoma, Squamous Cell* ; Edible Grain ; Cervix Uteri ; Cytogenetics ; Cytoplasm ; DNA ; DNA, Complementary ; Epidermal Growth Factor* ; Female ; Genes, erbB-1 ; In Situ Hybridization ; Keratinocytes ; Membranes ; Metaphase ; Oncogenes ; RNA ; RNA, Messenger ; Skin ; Tetraploidy ; Triploidy

We report a case of xanthoma disseminatum in a 24 year old male paitient. Multiple yellow-brown papules developed on the flexor aurfaces, such as the neck, axillae, antecubital fossae, groin, and perianal regions. Some papules were detected arouns the eyes and uvulai. biopsy specimen revealed a dense infiltrate of histiocytes, foam cells, Touton giant cells, and other inflammatory cells. No Langerhans granules were seen in the electron microscopic analysis.
Axilla ; Biopsy ; Foam Cells ; Giant Cells ; Groin ; Histiocytes ; Histiocytosis, Non-Langerhans-Cell* ; Humans ; Male ; Neck ; Xanthomatosis* ; Young Adult

PURPOSE: To investigate the prognosis, survival rate and curve on the eyes for corneal dystrophy and corneal degeneration, we performed statistical analysis. METHODS: Forty-one recipients (62 eyes) have received penetrating keratoplasty for corneal dystrophy and corneal degeneration for about 14 years from April 1984 to October 1997. We analyzed survival rate and curve on sex, age and type of corneal dystrophy and corneal degeneration. RESULTS: Mean age was 35 years and sex distribution of recipient was predominant in female patients (M: 16 recipients, 19 eyes, F: 25 recipients, 43 eyes). In the causative disease of first keratoplasty, corneal dystrophy and corneal degeneration were 46 eyes and 16 eyes. Granular type was the most common type of keratoplasty. In 62 grafts, graft rejection was developed in 19 eyes (30.6%). Graft rejection periods ranged from 53 days to 10 years and 3 months. Mean graft rejection time was 2 years and 8 months. In this study, 5 years survival rate developed in 75% of corneal dystrophy and developed in 31% of corneal degeneration. The statistical analysis showed significant relationship between survival rate and disease type (p=0.0032, p<0.05). But age and sex were not maintained with association with survival rate (p>0.05). CONCLUSIONS: This result suggests that corneal dystrophy was higher than corneal degeneration in survival rate with statistically significant difference. But sex and age did not have influence on survival rate.
Corneal Transplantation ; Female ; Graft Rejection ; Humans ; Keratoplasty, Penetrating* ; Prognosis* ; Sex Distribution ; Survival Rate* ; Transplants

The exact incidence of esophagitis in gastroesophageal reflux disease (GERD) remains poorly understood in Korea. To determine incidence of esophagitis in GERD, from August 1988 to July 1993, endoscopy, esophageal manometry with Bernstein test, and ambulatory 24 hour esophageal pH monitoring were carried out in a group of 349 patients with symptoms of heartburn or noncardiac chest pain. Based on these studies, 151(40%) patients had some degree of GERD and pstients were categorized as having: pathologic reflux, 98 patients; symptomatic reflux, 42 patients; and sensitive mucosal reflux, 11 patients. Among 151 patients with GERD, 27 patients(18%) had some degree of esophagitis. In conclusion, 40% of patients with symptoms suggestive of GERD have GERD. GERD is divided into subgroups; pathologic reflux, symptomatic reflux, and mucosal sensitive reflux. Less than 20% of GERD have esophagitis or esophageal mucosal injury and these low incidence of mucosal injury in Korean may be due to increased esophageal mucosal resistance.
Chest Pain ; Endoscopy ; Esophageal pH Monitoring ; Esophagitis* ; Esophagitis, Peptic ; Gastroesophageal Reflux* ; Heartburn ; Humans ; Incidence* ; Korea ; Manometry

As various diagnostic and treatment technologies evolve, the performance of diagnostic and therapeutic procedures on pediatric patients outside operating rooms is rapidly becoming more common. Procedural sedation and analgesia refers to the use of sedatives and analgesics to provide anxiolysis, analgesia, and immobilization during the procedure. There is a need for a common guideline that may be used by different health professionals, including anesthesiologists, pediatricians, emergency medicine physicians, dentists, radiologists, and others that are involved in these settings. Furthermore, during the entire process an anesthesiologist should be responsible for the training of those involved. Procedural sedation and analgesia is a branch of clinical medicine that includes informed consent, fasting before sedation, patient evaluation, medication administration, patient monitoring, recovery and discharge, and cardiopulmonary resuscitation. Complications associated with procedural sedation and analgesia may occur due to a drug overdose or side effects, inadequate patient monitoring, physician's errors, and/or insufficient recovery. Although the most common complications are airway obstruction or respiratory depression, these may be prevented by careful patient monitoring and appropriate emergency response. Further progress in procedural sedation and analgesia will require research, an assessment of newer sedatives, and improvements in the reporting system for adverse events.
Airway Obstruction ; Analgesia ; Analgesics ; Cardiopulmonary Resuscitation ; Child ; Clinical Medicine ; Conscious Sedation ; Deep Sedation ; Dentists ; Drug Overdose ; Emergencies ; Emergency Medicine ; Fasting ; Health Occupations ; Humans ; Hypnotics and Sedatives ; Immobilization ; Informed Consent ; Monitoring, Physiologic ; Operating Rooms ; Respiratory Insufficiency

No abstract available.
Candida albicans* ; Candida*

Acute coronary syndrome (ACS) consists of unstable angina, non-ST segment elevation myocardial infarction (NSTEMI), and STEMI. The pathology underlying ACS is acute thrombosis in a coronary artery, which is usually caused by plaque rupture in a mild stenotic lesion. A rupture-prone plaque is known as a vulnerable plaque (VP), although recently the definition of VP has been expanded to include rapidly progressive plaque. Although no single method can predict future cardiac events in mild stenotic lesions, there have been big advances in detecting VP, such as virtual histology-intravascular ultrasound and optical coherence tomography. These techniques look for thin cap fibroatheromas, which is the most common type of VP, characterized by a thin fibrous cap <65 microm, a large necrotic core, and marked macrophage infiltration of the fibrous cap. The recent concept of VP, the methods for detecting VP, and the treatment of VP are discussed.
Acute Coronary Syndrome ; Angina, Unstable ; Coronary Vessels ; Macrophages ; Myocardial Infarction ; Plaque, Atherosclerotic ; Rupture ; Thrombosis ; Tomography, Optical Coherence