BACKGROUND: Community-acquired pneumonia(CAP) remains a leading cause of morbidity and mortality worldwide. Recently, the evolution of drug-resistant microorganisms has become a serious problem in CAP management. Specific antimicrobial therapy is the cornerstone of CAP management. However, obtaining an accurate etiologic diagnosis clinically is not easy and empirical antimicrobial treatment is usually administered prior to the correct microbiologic diagnosis. In this study, the clinical usefulness of empirical CAP treatment was investigated. METHODS: A total 35 cases were studied prospectively over a 16-month period in Mokpo Catholic Hospital from Dec. 1995 to Mar. 1997. The microbiologic diagnosis was made by sputum, blood culture, a specific serum antibody test and an immunologic study. RESULTS: The causative organisms were isolated in 10 (30%) out of 33 cases: 8 cases and 1 case on the sputum culture and blood culture respectively, and 1 case by an indirect hemagglutinin test. 12 cases had underlying diseases: pulmonary tuberculosis 4, alcoholism 4, diabetes mellitus 3, and liver cirrhosis 1. Antimicrobial treatment was given empirically and all cases recovered. CONCLUSION: A definite microbiologic diagnosis before commencing the appropriate treatment in CAP is not straightforward. Empirical therapy according to a clinical assessment is important and helpful. However, every effort to make the correct etiologic diagnosis should be taken.
Alcoholism ; Diabetes Mellitus ; Diagnosis ; Hemagglutinins ; Jeollanam-do* ; Liver Cirrhosis ; Mortality ; Pneumonia* ; Prospective Studies ; Sputum ; Tuberculosis, Pulmonary

PURPOSE: Dysregulation of gastric epithelial cell proliferation and apoptosis are important in development of ulcer, atrophy and neoplasia in Helicobacter pylori (H. pylori) infection. The aim of this study was to investigate the effect of infection of H. pylori on gastric epithelial cell proliferation and apoptosis in children. METHODS: Histological grading by updated Sydney system, PCNA immunostaining and TUNEL method were performed in H. pylori positive (N=58) and negative (N=40) gastric biopsy specimens. RESULTS: In H. pylori positive children, there were significantly higher grade of polymorphonuclear neutrophil activity (P=0.000), chronic inflammation (P=0.000), epithelial damage (P=0.000) and lymphoid follicles (P=0.000) than in H. pylori negative children. Intestinal metaplasia was not seen in H. pylori positive children. PCNA index was significantly different between H. pylori positive children (67.8+/-18.13) and H. pylori negative children (54.8+/-14.46, P=0.000). There was positive correlation between PCNA index and H. pylori density (r=0.277, P=0.007), polymorphonuclear neutrophil activity (r=0.280, P=0.007) and chronic inflammation (r=0.284, P=0.006). Apoptosis index of H. pylori positive children (0.44+/-0.447) was significantly higher than of H. pylori negative children (0.14+/-0.196, P=0.000). There was positive correlation between apoptosis index and H. pylori density (r=0.472, P=0.000), polymorphonuclear neutrophil activity (r=0.370, P=0.001) and chronic inflammation (r=0.483, P=0.000). There was positive correlation between PCNA index and apoptosis index (r=0.353, P=0.003). CONCLUSION: The PCNA and apoptosis index in H. pylori positive children were significantly higher than in H. pylori negative children. This study suggested that gastric epithelial cell proliferation and apoptosis are important to pathogenesis of H. pylori infection in children.
Apoptosis* ; Atrophy ; Biopsy ; Child* ; Epithelial Cells* ; Helicobacter pylori* ; Helicobacter* ; Humans ; In Situ Nick-End Labeling ; Inflammation ; Metaplasia ; Neutrophils ; Proliferating Cell Nuclear Antigen ; Ulcer

We report a case of pneumonia in 36 year-old male patient who presented acute respiratory failure and associated radiologic findings of bilateral ground-glass opacity with focal cystic changes, showing rapidly aggravating course and was diagnosed as concomitant Pneumocystis carinii and Cytomegalovirus pneumonia accompanied by acquired immunodeficiency syndrome through antemortem open lung biopsy.
Acquired Immunodeficiency Syndrome ; Biopsy ; Cytomegalovirus ; Humans ; Lung ; Male ; Pneumocystis carinii ; Pneumonia ; Respiratory Insufficiency*

Ulcerative colitis has been recognized as a premalignant condition because a considerable proportion of patients with colitis eventually develop colorectal carcinoma at the site of the inflammatory disease. Malignant lymphoma occurring in cases of long-standing ulcerative colitis is rare. Cancer risk is positively correlated with duration and anatomic extent of colitis, but do not appear to be increased by early age at onset of disease. Patients with chronic ulcerative colitis should have periodic rectal and colonoscopic biopsies, and those with moderate to marked dysplasia require colectomy because of the increased risk of colon carcinoma. We report a case of malignant lymphoma in patient with ulcerative colitis.
Biopsy ; Colectomy ; Colitis ; Colitis, Ulcerative* ; Colon ; Colorectal Neoplasms ; Humans ; Lymphoma* ; Ulcer*

Intractable diarrhea associated with secondary amyloidosis in rheumatoid arthritis (RA) is a serious clinical entity with poor prognosis. We describe a 39-year-old male RA patient who presented with intractable diarrhea. Biopsy findings of terminal ileum and colon revealed amyloidosis secondary to RA. Effective treatment of rheumatoid arthritis resulted in remission of intractable diarrhea caused by amyloid protein deposition.
Adult ; Amyloid ; Amyloidosis* ; Arthritis, Rheumatoid* ; Biopsy ; Colon ; Diarrhea* ; Humans ; Ileum ; Male ; Prognosis

Rhizobium radiobacter, which has been previously discribed as Agrobacterium radiobacter, is a group of phytopathogenic organisms widely distributed in soil. Over the past decade, increasing number of infections due to Rhizobium radiobacter has been reported. Rhizobium radiobacter is now recognized as rare human pathogens affecting mostly immunocompromised hosts and is an opportunistic pathogen often associated with indwelling catheters. We report a case of bacteremia due to Rhizobium radiobacter in an acquired immunodeficiency syndrome (AIDS) patient. The patient was admitted for fever. In the blood culture, Rhizobium radiobacter was isolated. These symptoms and signs were successfully resolved with antibiotics.
Acquired Immunodeficiency Syndrome* ; Agrobacterium tumefaciens* ; Anti-Bacterial Agents ; Bacteremia* ; Catheters, Indwelling ; Fever ; Humans ; Immunocompromised Host ; Rhizobium* ; Soil

Rhizobium radiobacter, which has been previously discribed as Agrobacterium radiobacter, is a group of phytopathogenic organisms widely distributed in soil. Over the past decade, increasing number of infections due to Rhizobium radiobacter has been reported. Rhizobium radiobacter is now recognized as rare human pathogens affecting mostly immunocompromised hosts and is an opportunistic pathogen often associated with indwelling catheters. We report a case of bacteremia due to Rhizobium radiobacter in an acquired immunodeficiency syndrome (AIDS) patient. The patient was admitted for fever. In the blood culture, Rhizobium radiobacter was isolated. These symptoms and signs were successfully resolved with antibiotics.
Acquired Immunodeficiency Syndrome* ; Agrobacterium tumefaciens* ; Anti-Bacterial Agents ; Bacteremia* ; Catheters, Indwelling ; Fever ; Humans ; Immunocompromised Host ; Rhizobium* ; Soil

No abstract available.
Carcinoma, Small Cell* ; Female ; Ovary*

Primary Sjogren's syndrome (pSS) is a chronic autoimmune disease with welldocumented association of lymphoid malignancies during the progress of the disease. Although several types of malignancy and pseudomalignancy have been reported in pSS, low-grade non-Hodgkin's lymphomas are the most frequently observed. Reactive plasmacytosis mimicking myeloma is a very rare condition in association with pSS. We describe a 72-yr-old woman with pSS who presented with hypergammaglobulinemia, and extensive bone marrow and lymph node plasmacytosis, which mimicked multiple myeloma. In this patient, there was an abnormal differentiation of memory B cells to plasma cells in the peripheral blood suggesting underlying pathogenetic mechanism for this condition.
Aged ; Antigens, CD19/analysis ; Antigens, CD27/analysis ; Bone Marrow Examination ; Diagnosis, Differential ; Female ; Fluorescent Antibody Technique/methods ; Humans ; Multiple Myeloma/*pathology ; Plasma Cells/chemistry/*pathology ; Sjogren's Syndrome/*pathology

PURPOSE: The purpose of this study was to identify the knowledge, perception and hand hygiene performance rate of hospital nurses and to identify any correlation between them.METHOD: Data were collected from 205 nurses working in a university hospital in Chungcheong-do. A self-report survey method was utilized. Participants completed the hand hygiene knowledge questionnaire.RESULTS: The average knowledge of hand hygiene was 11.76 (out of 18 points), and the average perception of hand hygiene was 35.55 (out of 96). The hand hygiene performance rate was 85.62%. Knowledge of hand hygiene showed significant differences according to age (F = 75.821, p < .001), gender (t = 25.049, p < .001) and working period (F = 24.843, p < .001). The most important explanatory factor in hand hygiene performance was hand hygiene perception (β= .26), followed by working period (β= .14). These variables accounted for 10.0% of subjects' hand hygiene performance.CONCLUSION: The results of this study suggest that continuous and effective education is needed to strengthen knowledge and perception of the importance of hand hygiene practice for nurses to prevent healthcare-associated infections.
Cross Infection ; Education ; Hand Hygiene ; Hand ; Methods ; Surveys and Questionnaires