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*

Implanting a pacemaker is the most often used intervention for treating bradycardia. The most commonly used pacemaker is the intracardiac pacemaker, yet it can have many complications. An infected pacemaker can spread to systemic infection and the condition of the patient can quickly get worse, so if an infected pacemaker is suspected, then the pacemaker must be removed. Apart from the use of interventional methods such as a loop or a weight, we can take a more aggressive approach by using extracorporeal circulation for removal of the pacemaker. We report here on two cases in which extracorporeal circulation was used to remove the infected pacemakers.
Bradycardia ; Cardiopulmonary Bypass ; Extracorporeal Circulation ; Humans

No abstract available.
Fascioliasis* ; Humans*

We report a case of non-secretory plasma cell leukemia with complex chromosomal abnormalities including t (11;14)(q13;q32). A 57-year-old man was admitted to hospital due to anemia, thrombocytopenia and renal insufficiency. Bone marrow examination and peripheral blood smear revealed a large number of immature plasma cells with positivity for CD38. Monoclonal gammopathy or abnormal paraproteins were not observed in serum protein electrophoresis and immunofixation. The cytogenetic analysis showed complex chromosomal abnormalities [45, XY, -1, t (11;14)(q13;q32), t (12;17)(p13;q21)]. He was died of adult respiratory distress syndrome on the 6th hospital day.
Anemia ; Bone Marrow Examination ; Chromosome Aberrations* ; Cytogenetic Analysis ; Electrophoresis ; Humans ; Leukemia, Plasma Cell* ; Middle Aged ; Paraproteinemias ; Paraproteins ; Plasma Cells* ; Plasma* ; Renal Insufficiency ; Respiratory Distress Syndrome, Adult ; Thrombocytopenia

BACKGROUND: For the treatment of primary varicose vein of greater saphenous vein(GSV) due to reflux from incompetent saphenofemoral junction(SFJ), several methods such as ligation and stripping, or duplex-guided sclerotherapy have traditionally been introduced. As for sclerotherapy, the recurrence rate has been reported to be very high. In spite of higher success rate, traditional high ligation with stripping of GSV requires several days' admission with general anesthesia and several more days before returning to normal daily life. New modalities, which are less invasive and possibly have lower recurrence to rate with a chance for early ambulation, are being proposed. They are such as endovenous radiofrequency(RF) therapy, endovenous laser therapy, etc. OBJECTIVE: We tried to evaluate the efficacy and safety of endovenous RF therapy as an alternative to high ligation and stripping in case of GSV varicosity in mild to moderate degrees. METHODS: Both GSV varicosities and varicosed tributaries are marked by doppler and/or ultrasonic imaging. A catheter connected to RF generator is inserted proximally through the incision of vein wall percutaneously, usually above or below the knee. After confirming position of the SFJ using ultrasound, the catheter is progressed as far as to 1-2cm below the SFJ. Then, the generator is activated and the catheter withdrawn slowly for complete heating and occlusion of the target vein. Additional ambulatory phlebectomy or sclerotherapy is optional. We wrap the limbs with self-adhesive short stretch bandage for 2-3 days and encourage the patient to walk regularly and wear compressive stocking later. RESULTS: We performed endoluminal RF treatment on 10 legs of 9 patients(5 males and 4 females). Follow-up intervals varied from 2 to 10 months. Patients were generally satisfied with improvement of symptom. On the clinical evaluation with doppler and duplex examination, there were a few blood flows except only some segments of GSV in 7 patients CONCLUSION: Although endoluminal RF therapy may have a somewhat higher recurrence rate than that of traditional high ligation with stripping of GSV, endoluminal RF therapy is expected to have several advantages over traditional surgery, including less invasiveness, no need for admission or general / spinal anesthesia, earlier return to normal daily life, and finally easy performance, especially for the dermatologist.
Anesthesia, General ; Anesthesia, Spinal ; Bandages ; Catheters ; Early Ambulation ; Extremities ; Follow-Up Studies ; Heating* ; Hot Temperature* ; Humans ; Knee ; Laser Therapy ; Leg ; Ligation ; Male ; Recurrence ; Saphenous Vein* ; Sclerotherapy ; Ultrasonography ; Varicose Veins* ; Veins

BACKGROUND: Osteoporosis, one of the most common metabolic bone disease, might be influenced by the severity of Parkinson's disease (PD). Objectives : We investigated the relationship between the Bone Mineral Density (BMD) and the severity of PD in postmenopausal and senile women. METHODS: We measured BMD of lumbar spine (L1-L4) by Dual energy X-ray absorptiometry (DEXA; Hologic QDR-4500A). We compared BMD between patient group (30 patients with PD) and control (183 postmenopausal and senile health women). The patients were divided into two groups according to osteoporosis and analyzed the following potential factors influencing BMD in PD; age, duration of symptom, age of onset, Hoehn and Yahr stage (H-Y stage), UPDRS motor score, duration of treatment, body mass index (BMI), dominant symptom such as tremor or rigidity. RESULTS: 1. BMD was significantly decreased with aging (p <0.01) in control group, but BMD tend to decreased with aging in PD (p=0.08). 2. BMD of patient group was significantly lower than that of control group (p<0.001). 3. BMD of osteoporosis group was significantly related to BMI (p<0.05) and conversely related to H-Y staging(p <0.05), UPDRS motor score (p <0.01). 4. However, BMD of osteoporosis group were not related to age, duration of symptom, age of onset, dominant symptom and duration of treatment (p>0.05). CONCLUSION: Osteoporosis is related to H-Y stage, UPDRS motor score and BMI as well as aging in PD.
Absorptiometry, Photon ; Age of Onset ; Aging ; Body Mass Index ; Bone Density* ; Bone Diseases, Metabolic ; Female ; Humans ; Osteoporosis ; Parkinson Disease* ; Spine ; Tremor

Cerebrospinal fluid (CSF) leak or shunt overdrainage is a well-known cause of orthostatic headaches and low CSF pressures. We report two cases of orthostatic headache with pneumocephalus on brain imaging. The orthostatic headache developed after drainage of spinal operation site and epidural block. Brain MRI revealed characteristic findings of CSF hypovolemia including pachymeningeal enhancement and mild subdural fluid collections. Air was also observed in the ventricular or subarachnoid space in both patients, which might enter the subarachnoid or ventricular space during a procedure via the pressure gradient or an injection.
Brain ; Drainage ; Headache ; Humans ; Hypovolemia ; Neuroimaging ; Pneumocephalus ; Subarachnoid Space

PURPOSE: Many different procedures for rectal prolapse have been described, but optional surgical treatment remains controversial. The aim of this report is to introduce an innovative and effective method of surgical treatment to restore anal continence and anatomic correction of rectal prolapse. METHODS: Data were retrospectively collected and analyzed on 11 patients (7 male and 4 female) who underwent transanal posterior anorectoplasty for complete rectal prolapse between Jan. 1995 to Dec. 2000. This procedure is summarized to five steps as follows: 1. Partial resection of posterior rectal ampulla. 2. Longitudinal plication with posterior fixation. 3. Posterior levatorplasty. 4. One layer suture as longitudinal fashion. 5. Gant-Miwa operation-like procedure on anterior rectum. RESULTS: There were no cases of postoperative infection and bleeding. There were no cases of recurrence of the rectal prolapse except 1 case of ant. mucosal prolapse which was successfully treated with one more Gant-Miwa operation-like procedure at postoperative 3 months. Fecal incontinence were in two cases at postoperative 12 months which were estimated as grade 2 by assessment of bowel function by Kirwan. CONCLUSIONS: Although, the best operation for rectal prolapse remains controversial subject, authors believe that transanal posterior anorectoplasty should be considered as effective new surgical procedure for the treatment of rectal prolapse.
Ants ; Fecal Incontinence ; Hemorrhage ; Humans ; Male ; Prolapse ; Rectal Prolapse* ; Rectum ; Recurrence ; Retrospective Studies ; Sutures

BACKGROUND: Remarkable progress has recently been made in achieving successful early repair of congenital heart disease with using cardiopulmonary bypass in the neonatal period. The aim of this study is to evaluate our short-term outcomes for performing neonatal cardiac surgery under extracorporeal circulation. MATERIAL AND METHOD: Fifty five neonates underwent open heart surgery from February 2002 to December 2007. The mean ages and body weight was 13.5 days and 3.2 kg, respectively. The diagnoses of the patients were transposition of the great arteries (14), total anomalous pulmonary venous connection (7), large ventricular septal defect (VSD) (7), coarctation of the aorta with VSD (6), interrupted aortic arch (5) and others (16). RESULT: Six patients had difficulties being weaned from extracorporeal circulation. Four patients left the operating room with an open sternum. Low cardiac output syndrome and acute renal insufficiency were observed in 3 patients each, respectively. Post-operative complications were observed in 27 patients (49.1%). The postoperative mortality was 12.7% (7 patients); 5 patients experienced early hospital death and 2 experienced late death (2). CONCLUSION: In our hospital, early surgical repair with extracorporeal circulation in neonates was feasible with tolerable mortality. Further follow-up is required to establish the long-term survival and complications.
Acute Kidney Injury ; Aorta, Thoracic ; Aortic Coarctation ; Arteries ; Body Weight ; Cardiac Output, Low ; Cardiopulmonary Bypass ; Extracorporeal Circulation ; Follow-Up Studies ; Heart ; Heart Diseases ; Heart Septal Defects, Ventricular ; Humans ; Infant, Newborn ; Operating Rooms ; Sternum ; Thoracic Surgery

BACKGROUND: There is no clear dermatologic definition to describe sensitive skin which usually includes subjective and psychological meanings. Some individuals exhibit exaggerated response, especially on the face, ranging from itching to intense adverse reaction like erythema, wheal, and eczema in comparison to normal ones when exposed to external irritants, allergens, environmental changes or internal stimulants. OBJECTIVE: To diagnose sensitive skin, lactic acid sting test is well known to represent a person who has subjective symptoms like itching, burning, prickling and stinging. We tried to compare several lactic acid sting tests to search for sensitive skin conveniently and rationally. METHODS: A total of 50 panelists (25 people of sensitive group and 25 people of control group, respectively) were selected by the method of self-assessment questionnaires related to sensitive skin. The panelists were tested on face, by conditioning 3 variances (5% or 10% Lactic acid, Hydration, Hilltop chamber), in 2 week intervals, 8 times totally. RESULTS: When lactic acid sting tests were performed using Hilltop chamber, there were more positive responders in sensitive group(p<0.05). There was statistically a significant difference between the 2 groups in the comparison of mean values of lactic acid sting scores (p<0.05). Sensitive group showed higher sting scores and exhibited much more difference with time (p<0.05). CONCLUSION: Our experiment showed that occlusive technique using Hilltop chamber was an inspiring and useful method of several lactic acid sting tests to find out sensitive skin.
Allergens ; Bites and Stings* ; Burns ; Eczema ; Erythema ; Humans ; Irritants ; Lactic Acid* ; Pruritus ; Self-Assessment ; Skin* ; Surveys and Questionnaires