PURPOSE: This study was conducted to investigate the epidemic pyrogenic reactions that occurred hospital-widely in 51 patients on 30-31 Mar. 1995 at a tertiary, educational, and acute care hospital. METHODS: The remained intravenous (IV) drugs and IV fluids that were infused to patients (N=51) who developed pyrogenic reactions were cultured and tested pyrogenic matter. Pyrogenic test was done by Limulus Amebocyte Lysate (PyrotellRMA,USA). RESULTS: IV normal saline 50 cc bottles (AAXSAT and AAX5AV) those were collected being used from case patients, and new bottles stocked in the drug storage were positive to pyrogenic test. Used normal saline collected from case patients were cultured coagulase-negative Staphylococus. Moreover the company, manufacturer of these fluids reported the positive pyrogenic test on these IV fluids (AAXSAT and AAX5AV). CONCLUSION: This epidemic was a pyrogenic reaction for infused the intrinsic contaminated fluid with pyrogen. We could prevent not the additional pyrogenic reactions in study hospital but national wide epidemics to apply the rapid and well-designed epidemic investigation and infection control.
Bacteremia ; Cross Infection ; Drug Storage ; Horseshoe Crabs ; Humans ; Infection Control

It has been Known that silicone intubation may be an effective procedure for total or partial obstruction in infants of age one year or less, and the older the patient, the lower the success rate. We had performed silicone intubation on 40 eyes of 39 patients from january 1995 to May 1996, and they were divided into 3 groups according to age: group 1, 6 months to 6 years: group 2,6 to 16.: group 3, one 16 years. The success rate was 92.4% in groups 1 and 2, respectively: 83.3% ingroup 3. The success rate in patients with partial obstruction in group 3 was 100% In view of the results of the present study, silicone intubation may be in primary procedure for partial obstruction of lacrimal drainage system.
Drainage ; Humans ; Infant ; Intubation* ; Silicones*

Squamous cell carcinoma(SCC) is a recognized late complication of chronic discoid lupus erythematosus(CDLE). There are many case reports of SCC in white patients with chronic DLE. However, it is uncommon in blacks and Asians. The etiology of squamous cell carcinoma is multifactorial. The predisposing factors for the development of SCC in these patients include actinic keratosis, Bowen's disease, burn scars, arsenic keratosis, and chronic discoid lupus erythematosus. Of these causes, SCC developing in the lesions of CDLE is very rare. We report a patient who has been evaluated for ten years with a diagnosis of discoid lupus erythematosus and has squamous cell carcinoma.
African Continental Ancestry Group ; Arsenic ; Asian Continental Ancestry Group ; Bowen's Disease ; Burns ; Carcinoma, Squamous Cell* ; Causality ; Cicatrix ; Diagnosis ; Humans ; Keratosis ; Keratosis, Actinic ; Lupus Erythematosus, Discoid*

No abstract available.
Gallstones* ; Lithotripsy* ; Ultrasonography*

No abstract available.
Humans*

PURPOSE: To report a case of corneal perforation caused by non-infectious corneal ulcer in a patient with toxic epidermal necrolysis (TEN). METHODS: A 29-year-old female visited the hospital with bullous lesions on the erythematous body surface. She also had severe conjunctivitis and keratitis in both eyes. She had been taken antibiotics and analgesics for nasopharyngitis. The patient was diagnosed with TEN. Although she was hospitalized and treated in the department of internal medicine, the left cornea was severely necrotized and became thinner. Slit-lamp examination showed focal descematocele in the central cornea. The result of corneal culture was negative and corneal infiltration that would suggest an infectious ulcer was not observed. RESULTS: The patient was in poor general health because of pneumonia. We performed tectonic amniotic membrane transplantation to prevent corneal perforation. Fibrovascular tissues were growing on the amniotic membrane from the surrounding conjunctiva. However, they did not cover the descemetocele area. Her general condition continued to worsen and she was transferred to the intensive care unit. The cornea was perforated and the patient died of septic shock. CONCLUSIONS: Corneal perforation may occur in a patient with TEN without secondary bacterial infection. Therefore, patients with TEN need to be informed of this serious complication and the possible need for more intensive treatment.
Adult ; Amnion ; Analgesics ; Anti-Bacterial Agents ; Bacterial Infections ; Blister ; Conjunctiva ; Conjunctivitis ; Cornea ; Corneal Perforation* ; Corneal Ulcer* ; Female ; Humans ; Intensive Care Units ; Internal Medicine ; Keratitis ; Nasopharyngitis ; Pneumonia ; Shock, Septic ; Stevens-Johnson Syndrome* ; Ulcer

A retrospective review was done on 15 eyes of consecutive patients who presented to the Asan Medical Center with scleronecrosis between January 1993 and June 1996 was studies. Ten eyes were managed by autologous conjunctival graft(group 1) and others by autologous conjunctiva/tenon graft(group 2), followed over 9 months, and the outcome evaluated included symptoms and complications. All patients had scleronecrois size less than 3mm in diameter with foreign body sensation, tearing, and pain etc. In both group, the symptoms were improved after surgery. The complications were that first group was slippage of donor tissue in graft site in two eyes and focal hyperemia in all cases. Management of slippage was sucessfully performed by reoperation; focal hyperemia was gradually improved no other specific management. These results indicate that autologus conjunctiva and autologous conjunctiva/tenon graft may be effective for the treatment of small scleronecrosis.
Chungcheongnam-do ; Conjunctiva ; Foreign Bodies ; Humans ; Hyperemia ; Reoperation ; Retrospective Studies ; Sensation ; Tissue Donors ; Transplants*

The urethral polyp is relatively unusual lesion but recently, has been reported more frequently Polyps of the anterior urethra are less common than those of the posterior urethra. The lesion is usually encountered in the young child but has occurred in the adult. Recently, we found two cases of urethral polyp. So, we report these with a brief review of the literature.
Adult ; Child ; Humans ; Polyps* ; Urethra

p27(kip1) protein, a cyclin-dependent kinase inhibitor, has been reported to be a powerful negative prognostic marker in patients with breast carcinoma. However, to this day, studies on p27(kip1) protein expression in ductal carcinoma in situ (DCIS) have been extremely limited. We studied the immunohistochemical expression of p27(kip1) protein in 49 cases of the DCIS and compared the findings to the clinicopathologic parameters, cyclin D1, p53 and estrogen receptor (ER). Positive nuclear staining of p27(kip1) protein was identified in 23 (46.9%) cases. The p27(kip1) protein expression correlated positively with the cyclin D1 immunopositivity (p<0.005) and ER expression (p<0.005). No significant associations were seen in the p27(kip1) protein expression and clinicopathologic parameters. The overexpression of cyclin D1 (59.2% of the cases) correlated positively with ER expression (p<0.001). The p53 protein expression was identified in 30.6% and seemed to be correlated inversely with ER expression (p=0.06). The DCISs with high grade nuclei were more likely to be p53-positive (p<0.05). Our data suggest that the expression of p27(kip1) protein as well as cyclin D1 and p53 protein may be influenced by the ER status in DCIS. The significantly positive correlation of p27(kip1) protein and cyclin D1 expression (p<0.005) supports the theory that the balance of the two opposing signals is important in determining the cell proliferation in breast cancers. Therefore, a comprehensive understanding of loop reaction of p27(kip1)-cyclin D1-ER may be necessary for the treatment of DCIS.
Breast Neoplasms ; Breast* ; Carcinoma, Ductal* ; Carcinoma, Intraductal, Noninfiltrating* ; Cell Proliferation ; Cyclin D1* ; Cyclins* ; Estrogens ; Humans ; Phosphotransferases ; Staphylococcal Protein A

Hemangioma is the most common tumor occuring in infancy as a well-circumscribed, strawberry-like mass. Hemangiomas evolve in three phases ; postnatal endothelial proliferation (about 12 months), variable stability, and slow involution(around 18 months to 10 years). In most instances, the diagnosis of common hemangioma can be established on the basis of the history and physical examination. Ultrasound, when combined with color doppler imaging and doppler spectral analysis of vascular channels, can be so much useful to predict the exact nature of tissue content and the characteristics of vascular flow in hemangiomas. This technique has many advantages such as non-invasiveness, relatively low cost, no need for heavy sedation. Doppler ultrasound can reflect the changes in echogenecities and flow patterns according to the respective evolutional phases of hemangiomas. Color doppler ultrasound were performed to 20 infants and children with clinical hemangiomas. We investigated the peak systolic velocity(PSV) and resistive index(RI) of feeder arteries in hemangiomatous lesions. PSVs and RIs showed differences in their mean values between the patients under 1 year old and those older than 1 year old of age. The compression therapy and/or oral steroid therapy were applied to 10 patients, who showed high PSVs and low RIs, on the purpose of reducing in-flow. After at least 6 months' treatment, we noticed the decreased PSVs together with increased RIs in 7 patients showing clinical improvement. Color doppler ultrasound should be one of the optional imaging modalities for various items; assessment of evolutional phases in hemangiomas, decision of treatment modalities and evaluation of treatment effects to hemangiomas.
Arteries ; Child ; Diagnosis ; Hemangioma* ; Humans ; Infant ; Physical Examination ; Ultrasonography*