No abstract available.
Vibrio vulnificus* ; Vibrio*

No abstract available.
Vibrio vulnificus* ; Vibrio*

Vibrio vulnificus infection is one of the most fatal diseases in Korea. This study was undertaken to determine the cellular fatty acid (CFA) compositions of ninety-five clinical strains of V. vulnificus isolated from Korea during 1985-1995. We compared these results with the CFA profile of V. vulnificus in the Microbial Identification System (MIS) (CLIN library version 3.9; Microbial ID Inc., Newark, Del.), and also evaluated the MIS ability to identify V. vulnificus. Subgrouping of V. vulnificus by CFA analysis was performed and its results were compared with those of serotyping. Most of the CFAs in V. vulnificus strains were similar to the CFA profile of V. vulnificus in the MIS, but some distinctive differences were observed. First, means of two major CFAs, 16:0 and 16:1w7c, were 22.16% and 18.26% in this study, but 23.52% and 25.44% in the MIS respectively. Second, all isolates had 11:Oiso3OH, which was not present in the MIS. Eighty-five strains (89.5%) disclosed the first choice identification of V. vulnificus by the MIS, but only two strains (2.1%) were identified with SI values of 0.6. Remaining ten strains (10.5%) showed 'NO MATCH' results. Cluster analysis of CFA could separate V. vulnificus into nine subgroups, and predominant subgroups were subgroup VII (45 strains) and V (36 strains). There was heterogeny between subgroups by CFA and serotypes of V. vulnificus. The strains of 04 serotype which accounted for 80% (76/95) of the isolates were distributed into six different subgroups such as VII (40 strains), V (27 strains), III (4 strains), I (2 strains) and VI (1 strain). These showed that V. vulnificus strains isolated from Korea had different characteristics in the CFA composition in comparison with the MIS V. vulnificus library. Subgrouping by the CFA analysis might be a useful tool for the epidemiological study of V. vulnificus infection in Korea.
Korea* ; Serotyping ; Vibrio vulnificus* ; Vibrio*

BACKGROUND: Little Is known about the compared efficiency of different third generation enzyme-linked immunosorbent assays (ELISA) fort the detection of anti-HCV. We examine the relative sensitivity and specificity of three third-generation anti-HCV assays, and results of discrepant samples among the anti-HCV ELISA are compared with data of a third-generation recombinant immunoblot assay and reverse transcription polymerase chain reaction (RT-PCR) . METHODS:A total of 167 samples (61 positive and 106 negative), screened by a second-generation IMx(R) anti-HCV assay (Abbott 2.0; Abbott Laboratories, USA), weve tested with Innotest HCV 3.0(R) (Green Cross, Korea), LG HCD 3.0(R) (LG, Korea) and DONG-A HCV 3.0(R) (Dong-4, Korea). The discrepant specimens among the 4 anti-HCV ELISA were tested by LG HCD Confirm(R) (LG, Korea) and RT-PCR. RESULTS: The concordance rates of all 4 ansi-HCV ELISA were 80.2% (134/167) and 92.2% (154/167), respectively. The 28 and 31 of 33 specimens showing discrepancy among 4 anti-HCV ELISA were tested with LG HCD Confirm and RT-PCR, respectively. Serum HCV RNA was positive in 2 of 2 reactive and in 6 of 26 nonreactive on LG HCD Confirm. The sensitivity, specificity, positive predictive value, negative predictive value and concordance rate of 4 anti-HCV ELISA were 97.7%, 85.2%, 70.0%, 99.0% and 88.5% (Abbott 2.0) ; 81.4%, 96.7%, 89.7%, 93.7% and 92 7% (Innotest 3.0), 81.4%, 98.4%, 94.6%, 93.8% and 93.9% (LG 3.0), 86.0%, 95.7%, 88.1%, 95.1% and 93.3% (DONG-A 3.0), respectively. CONCLUSIONS: These data indicate that the sensitivity and specificity of 3 third-generation anti-HCV ELISA are comparable, and that these reagents demonstrate improved specificity compared to the second-generation ELISA.
Enzyme-Linked Immunosorbent Assay* ; Indicators and Reagents ; Polymerase Chain Reaction ; Reverse Transcription ; RNA ; Sensitivity and Specificity

BACKGROUND: Sorbitol fermenting Escherichia coli O157 were reported. And E. coli O157:H7 produce various Shiga toxin (Stx) such as Stx1, Stx2, or variants of Stx2. In this study, we tried to establish laboratory methods that detect E. coli O157:H7 quickly and precisely by analyzing sensitivity of colony hybridization test and PCR technique. METHODS: Stx1-producing E. coli ATCC 43890, Stx2-producing E. coli ATCC 43889, and Stx2vha- producing E. coli ATCC 51435 were tested. Three strains of E. coli were diluted with 0.1 g of diarrheal stools from 107 CFU to 101 CFU respectively. The stool samples were incubated overnight in MacConkey agar plates. A mean of 63 colonies were hybridized by stx1- and stx2-specific oligonucleotide probes. PCR for stx1 gene and stx2 gene was done after overnight- incubation of stool samples in the LB broth with vancomycin (6 ug/mL). Positive colonies by colony hybridization were confirmed by PCR for stx1 gene and stx2 gene. RESULTS: Colony hybridization test could detect Stx1-producing E. coli at 103 CFU per 0.1 g of stool, Stx2-producing E. coli at 105 CFU per 0.1 g of stool, and Stx2vha-producing E. coli at 104 CFU per 0.1 g of stool. PCR technique after enrichment in LB broth with vancomycin (6 ug/mL) could detect stx1-, stx2-, and stx2vha-containing E. coli at 10 CFU per 0.1 g of stool respectively. CONCLUSOIN: A combination of colony hybridization and PCR after enrichment in broth with vancomycin (6 ug/mL) is useful for the rapid and precise diagnosis of infections of Shiga toxin-producing E. coli O157:H7.
Agar ; Diagnosis ; Escherichia coli O157 ; Escherichia coli* ; Escherichia* ; Oligonucleotide Probes ; Polymerase Chain Reaction ; Shiga Toxin ; Sorbitol ; Vancomycin

To determine the ocular toxicity after intrachoroidal steroid injection in the rabbit eye, 0.15ml(40 mg/ml) triamcinolone acetonide, 0.15ml(40 mg/ml) methylprednisol one acetate and 0.15ml balanced salt solution(as controls) were injected into the choroid. The results were shown normal in fundus examination, electroretinography, and electron microscopy throughout the two weeks course of the experiment. From these result, it would appear that intrachoroidal 6 mg steroid injection demonstrated the lack of ocular toxicity.
Choroid ; Electroretinography ; Microscopy, Electron ; Pathology ; Triamcinolone ; Triamcinolone Acetonide

PURPOSE: The purpose of this study was to pave the way for developing nursing intervention strategies to enhance family resilience by identifying unique patterns of resilience in families of elderly patients with dementia. METHODS: The Q-methodology was used to define types and describe characteristics of family resilience. After in-depth interviews with 12 family members of patients with dementia and study of related literature, final 50 Q-samples were selected by collecting the opinions of experts. The selected 50 Q-statements were sorted by 30 family members (P-samples). The PC-QUNAL program was used to analyze Q-sort data. RESULTS: Four distinctive Q-factors for family resilience were identified: I. Seeking positive meaning, II. Developing reasonable cooperation with family members, III. Accepting reality passively, IV. Depending on external resources. CONCLUSION: Families caring for elderly patients with dementia show unique patterns of family resilience, which result from multi-factors, such as their own belief systems or culture, organizational patterns, and communication processes, in dealing with crisis. The results of this study can be useful in confirming the types of resilience of families of patients with dementia and their characteristics, and the underlying data can be used as to develop tailored nursing strategies for strengthening family capacities to master adversity.
Aged ; Dementia ; Humans ; Organizational Culture ; Q-Sort

Primary cutaneous aspergillosis is rare. In this report we describe primary skin infection by Aspergillus in 9 children with leukemia. The skin lesion was characterized clinically by erythematous macule and papule associated with pain and itching, followed by a rapid progression to ulcer and central black eschars with raised erythematous border at the site of venipuncture, insertion of intravenous cannula, or where arm boards had been taped to extremities. Diagnosis was confirmed by skin biopsy and wound culture. Positive revealed in 6 patients, including A. glaucus in 2 cases, A. flavus in 1 case. Treatment consisted of temporary withdrawl of anticancer chemotherapy, intravenous amphotericin B, oral flucytosine, itraconazole and/or rifampin. One patient recovered completely without antifungal medication with resolution of leukopenia. Six of eight treated patients recovered. One patient discharged against medical advice, while cutaneous aspergillosis was improving. One patient died with persistent skin lesion and neutropenia. We conclude that primary cutaneous aspergillosis is increasingly recognized in association with intravenous cannula, intravenous puncture or prolonged contact with arm boards in immunocompromised patients, and that this serious disease can be treated successfully with appropriate management.
Amphotericin B ; Arm ; Aspergillosis* ; Aspergillus ; Biopsy ; Catheters ; Child* ; Diagnosis ; Drug Therapy ; Extremities ; Flucytosine ; Humans ; Immunocompromised Host ; Itraconazole ; Leukemia ; Leukopenia ; Neutropenia ; Phlebotomy ; Pruritus ; Punctures ; Rifampin ; Skin ; Ulcer ; Wounds and Injuries

BACKGROUND: Despite progress in intubation techniques, dental trauma is one of the most common complications of general anesthesia. As the flange of the Macintosh blade appears responsible for most dental injuries, we modified the ordinary Macintosh blade by partially removing its flange and evaluated the effectiveness of the modified blade in terms of reducing potential of dental injuries. METHODS: Four hundred and eighty-three patients scheduled for elective surgery requiring general anesthesia with endotracheal tube placement were included in this prospective study. Laryngoscopy was performed twice, once using an ordinary Macintosh No. 3 blade and once using the modified Macintosh blade. The modification consisted of reducing the height of the flange by partial removal, as described by Callander et al. When optimum visibility of the glottis was obtained, the distance between the flange of the blade and the upper incisor was measured. We compared blade-tooth distances and laryngoscopic views for the two blades. RESULTS: The modified blade with low-height flange provided more distance than the ordinary type of blade (P<0.01). The incidence of direct contact between the blade and the upper tooth was 20.3% when the ordinary blade was used, and nearly 80% of these did not involve direct contact when using the modified blade. In addition, the modified blade provided a greater field of view than the ordinary blade (P<0.01). CONCLUSIONS: The modified Macintosh blade used in this study proved to be a useful device, which could reduce dental injuries and provide a better laryngoscopic view during laryngoscopy.
Anesthesia, General ; Glottis ; Humans ; Incidence ; Incisor ; Intubation ; Intubation, Intratracheal ; Laryngoscopes* ; Laryngoscopy ; Prospective Studies ; Tooth

Disseminated Fusarium infection has rarely been encountered in neutropenic cancer patients. The clinical features include fever, positive blood cultures, severe myalgias, disseminated ecthyma gangrenosum-like skin lesions, ocular symptoms and multi-organ-system involvement. The mortality rate reported so far exceeded 70% despite antifungal treatments. We report here the first two cases of disseminated fusarial infections in Korea. The first patient contracted pneumonia during severe neutropenic period following consolidation chemotherapy for acute myelogenous leukemia(AML). Fusarium oxyshrum was cultured from bronchoalveolar lavage fluid. The patient remains free of fungemia after successful antifungal treatment of high-dose amphotericin B and terbinafine. The second patient had relapsed AML and suffered from disseminated fusarial infection involving lungs with characteristic skin lesions. The patient succumbed to refractory leukemia and the fungal infection. A brief review of the literature ensues with the case report.
Amphotericin B ; Bronchoalveolar Lavage Fluid ; Child* ; Consolidation Chemotherapy ; Ecthyma ; Fever ; Fungemia ; Fusariosis ; Fusarium ; Humans ; Korea ; Leukemia* ; Lung ; Mortality ; Myalgia ; Pneumonia ; Skin