Despite significant advances in obstetric and pediatric health care, Streptococcus agalactiae(Lancefield group B β-hemolytic Streptococcus, GBS) remains one 91 the most prevalent and devastating pathogens in peripartum women and their newborn infants. It may cause urinary tract infection, chorioamnionitis and endometritis, bacteremia, and cesarean wound infection in the peripartum period. It was Pasteur who first identified microbes in the blood and lorchia of septic women. After that, in 1938 the isolation of S. agalactiae from three mortally ill women was reported, thereby implicating it as another cause of puerperal sepsis. S. agalactiae is now one of the most common causes of neonatal sepsis and meningitis in the United States. However, in Korea there have been only twenty-three cases of neonatal meningitis and/or sepsis due to group B β-hemolytic streptococcus reported. Recent studies have noted other serious infections in adults, including bacteremia, pneumonia, cellulitis, osteomyelitis, meningitis, and endocarditis. In Korean adults no case of pneumonia due to S. agalactiae has been reported till now. As minimal inhibitory concentration of penicillin was reported to be higher for S. agalactiae than for S. pyogenes, minimal inhibitory concentration of penicillin for S. agalactiae should be tested. Herein we describe the course of a case of S. agalactiae pneumonia and bacteremia in a 74-year-old diabetic man, and we review the literatures.
Adult* ; Aged ; Bacteremia ; Cellulitis ; Chorioamnionitis ; Delivery of Health Care ; Endocarditis ; Endometritis ; Female ; Humans ; Infant, Newborn ; Korea ; Meningitis ; Osteomyelitis ; Penicillins ; Peripartum Period ; Pneumonia* ; Pregnancy ; Sepsis ; Streptococcus agalactiae* ; Streptococcus* ; United States ; Urinary Tract Infections ; Wound Infection

No abstract available.
Helicobacter pylori* ; Purpura, Thrombocytopenic, Idiopathic*

No abstract available.
Helicobacter pylori* ; Purpura, Thrombocytopenic, Idiopathic*

PURPOSE: This study was performed to examine if CT classification of renal blunt injury could aid in expectation of hemodynamic stability and clinical decision of whether to intervene surgically. MATERIALS AND METHODS: Over a 80-month period between July 1987 and March 1994, 41 patients were admitted to our hospital with the diagnosis of renal blunt injury. The renal blunt injuries were classified on Fedede's three-point scale CT classification methods :grade I, contusion, intrarenal hematoma, segmental infarction, and small subcapsular hematoma;grade II, complete or incomplete laceration, large subcapsular hematoma, and renal fracture;grade Ill, shattered kidney and renal pedicle injury. Hemodynamic stability, treatment method and clinical outcome of the patients with different CT grade were analyzed retrospectively. RESULTS: All 34 patients with grade I or II CT findings were hemodynamically stable and were successfully managed with conservative method. Among 7 patients with grade III CT findings, 6 patients were hemodynamically unstable. Out of the 6, One patient with grade IIIb or renal pedicle injury was expired before surgical intervention due to ischemic shock. Four patients were intervened surgically with one failure to thrive. The remaining one patient refused to be intervened surgically, and was discharged against medical advice. Only one out of 7 patients was hemodynamically stable and was managed conservatively. CONCLUSION: The patients with grade I or II CT findings are prone to be hemodynamically stable and to be managed with conservative method. But the patients with grade III CT findings are more likely to be hemodynamically unstable. Therefore patients with grade III CT findings should be closely monitored and be pre- pared for the possibility of immediate surgical intervention
Classification* ; Contusions ; Diagnosis ; Failure to Thrive ; Hematoma ; Hemodynamics ; Humans ; Infarction ; Kidney ; Lacerations ; Retrospective Studies ; Shock ; Wounds, Nonpenetrating

No abstract available.
Fibroma

BACKGROUND: As indicators of obesity, waist circumference (WC), body mass index (BMI), and adiponectin are well known risk factor for diabetes mellitus. The objectives of this study were to measure the independent association between these obesity indicators and diabetes and to examine the combined effect of these indicators on diabetes in a Korean population. METHODS: The WC, BMI, and serum adiponectin were measured in 6,505 healthy Koreans and were classified into tertile groups for men and women. The independent and combined associations of the obesity indicators with diabetes were measured using logistic regression analyses. Diabetes was defined as fasting serum glucose greater than 126 mg/dL or taking medication. RESULTS: Levels of adiponectin were inversely associated with BMI and WC and directly associated with age and high density lipoprotein cholesterol (HDL) cholesterol (P <0.001). After adjusting for age, WC, and other lifestyle factors, low levels of adiponectin were associated with an increased prevalence of diabetes. Further adjustment for HDL cholesterol and triglyceride attenuated this association in both men and women. The best cut-off value of adiponectin in terms of identifying the presence of diabetes was 5.5 /ml with a sensitivity and specificity of 46.7% and 63.9% for men and 9.5 /ml with a sensitivity and specificity of 68.2% and 55.2 for women. CONCLUSIONS: These results suggest that adiponectin was associated with diabetes. The association was independent of WC and was partly modified by HDL and triglyceride. There were no effect modifications of adiponectin with WC on diabetes.
Adiponectin* ; Blood Glucose ; Body Mass Index ; Cholesterol ; Cholesterol, HDL ; Diabetes Mellitus ; Fasting ; Female ; Humans ; Life Style ; Logistic Models ; Male ; Obesity ; Prevalence ; Risk Factors ; Sensitivity and Specificity ; Triglycerides ; Waist Circumference

BACKGROUND: Fundus photographs performed during health check-up were reviewed to determine the usefulness in mass screening. METHODS: Subjects consistine of 3017 people who had undergone physical health check up at the Health Clinic, Dong-Eui Medical Center in 1997 and whose fundus photographs of both eyes were taken showing clearly visible posterior pole and optic disc were chosen as subjects. Medical records which included cases of reported close exam and causes, actual cases of close exam and final diagnoses. RESULTS: Of the 3017 people, reported close exam was performed in 665 (22.0%). Among them glaucoma was suspected in 460 retinal hemorrhagic lesion in 63, retinal degenerative lesion in 67 and others in 75. There were 187 actual cases(28.1%) of close exam including glaucoma suspect in 79, retinal hemorrhagic lesion 47, retinal degenerative lesion 34 and others 27. Among 187 actual cases of close exam, 140 people (1.3%) were eventually diagnosed as glaucoma suspect (60), retinal hemorrhagic lesion (38), retinal degenerative lesion (21) and others (21). CONCLUSIONS: Fundus photographs are useful in mass screening, but performing close exam to enhance the usefulness of the fundus photographs is necessary.
Diagnosis ; Glaucoma ; Mass Screening* ; Medical Records ; Retinaldehyde

A 24-year Korean woman presented with bizarre pigmentary skin changes. Eruptive vellus hair cysts (EVHC) were observed in conjunction with Hypomelanosis of Ito (HI). Also, the karyotype of 45XO with typical clinical symptoms of Turner's syndrome was detected in this patient, which has been rarely reported in HI as a chromosomal defect. EVHC may manifest as a rare skin manifestation of Hl.
Female ; Hair* ; Humans ; Hypopigmentation* ; Karyotype ; Skin ; Skin Manifestations ; Turner Syndrome*

No abstract available.
Mucocutaneous Lymph Node Syndrome*

Viru-Merz® ointment,1% tromantadine hydrochloride, is a topical antiviral agent used for recurrent herpes simplex. There are many reported cases of contact dermatitis by tromantadine.But erythema multiforme-like eruptions in association with Viru-Merz® Ointment has not been reported. A 31-year-old woman, who applied Viru-Merz® ointment for a recurrent herpes simplex labialis, developed an allergic contact dermatitis. Erythema multiforme like eruptions with typical target feature followed around the eczematous lesions on the face, and spread progressively on the neck and trunk. A patch test revealed positive reaction to Viru-Merz® ointment.
Adult ; Dermatitis, Allergic Contact ; Dermatitis, Contact ; Erythema Multiforme* ; Erythema* ; Female ; Herpes Simplex ; Humans ; Neck ; Patch Tests