Staphylococcus aureus is one of many causative agents of the fu uncles. As the S. aureus strains resistant to penicillinase-repsistant penicillins (methicillin-resistant S. aureus, MRSA) are more frequently isolated, their accuiate identification became a very important step in selection of an appropriate therapeutic regimen. We report herein a case of multiple furunculosis caused by metkicillin-resistant S. aureus in a 11-year-old male patient, who was successfully treated with sulbactam/ampicillin and amikacin.
Amikacin ; Child ; Furunculosis* ; Humans ; Male ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus ; Penicillins ; Staphylococcus aureus

No abstract available.
External Fixators* ; Fractures, Open* ; Tibia*

Essential thrombocythemia is a kind of myeloproliferative disorder characterized by primary elevation in the number of platelet and by multiple episodes of bleeding or thrombotic complications. Rarely, thrombocythemia itself causes coronary arterial occlusion and leads to ischemic heart disease. Fewer than twenty cases of coronary artery occlusive disease in thrombocythemia have been reported since Cheitlin et al had included thrombocythemia in their review of rare causes of myocardial infarction. We experienced a case of coronary artery disease in a 53-year-old woman with thrombocythemia, who had not coronary artery disese risk factors at all. Presence of multiple thrombus in the coronary artery was suggested in coronary angiography.
Angina, Unstable* ; Blood Platelets ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vessels ; Female ; Hemorrhage ; Humans ; Middle Aged ; Myeloproliferative Disorders ; Myocardial Infarction* ; Myocardial Ischemia ; Risk Factors ; Thrombocythemia, Essential ; Thrombocytosis* ; Thrombosis

Coronary neovascularity may be formed in patients with the left atrial thrombus, and coronary artery disease may be associated with valvular heart disease. From August 1989 through September 1990, 109 patients over 40 years old with valvular heart disease were performed coronary arteriogram to evaluate the incidence of the associated coronary artery disease. And 9 patients with left atrial thrombi detected noninvasively were also performed coronary arteriogram to evaluate the significance of the neovascularity to predict the left atrial thrombus. The results were as follows : 1) Significant coronary arterial lesion(greater than 50% narrowing of the luminal diameter) was noted in three of 109 patients over 40 years old(2.8%), but there was no typical chest pain in all of the three patients. 2) The coronary neovascularity was found in 19 of 118 patients -18 with mitral valvular disease and one with combined valvular disease. All of the patients with the coronary neovascularity had established atrial fibrillataion and the neovasculaity was originated from the left circumflex artery in all of them. 3) Prosthetic valve replacement was performed in 42 of 118 patients during the study period and left atrial thrombus was found in ten patients with mitral valve disease. Neovascularity on coronary arteriogram was detected in six patients(sensitivity 60%) of the above 10 patiets, and 28 patients without neovascularity had no left atrial thrombus (28/32, specificity 87.5%). Our observation revealed that neovascularity might represent the left atrial thrombus in valvular heart disease, and the incidence of the associated coronary artery disease in valvular heart disease was very low(2.8%) in Korea. Coronary arteriography as a routine preoperative evaluation might be unnecessary in valvular heart disease in Korea.
Adult ; Angiography ; Arteries ; Chest Pain ; Coronary Artery Disease ; Heart Valve Diseases* ; Humans ; Incidence ; Korea ; Mitral Valve ; Phenobarbital ; Sensitivity and Specificity ; Thrombosis

Dorsal root ganglionotomy of the S5 nerve is useful for pain around the coccyx. The S5 dorsal root ganglion lies behind the sacrum at a level 1 cm caudal to the S2 foraminal opening and approximately 2 mm lateral to the midline of the sacrum. A small burr-hole was made through the plates of the posterior sacrum to approach the dorsal root ganglion of S5 nerve. Sensory stimulation was performed at 0.3 V, 50 Hz. No motor fasciculations was noted at 0.6 V, 2 Hz. A thermal lesion was created at 75oC for 60 sec. The patient whom we report now was a 67-year-old male who suffered from the pain around the coccyx due to rectal cancer metastasis. He failed to respond to other oral and invasive conventional therapy. We experienced a successful result in the treatment of his intractable pain after the S5 dorsal root ganglionotomy.
Aged ; Coccyx ; Fasciculation ; Ganglia, Spinal ; Humans ; Male ; Neoplasm Metastasis ; Pain, Intractable ; Rectal Neoplasms ; Sacrum ; Spinal Nerve Roots*

The high prevalence of migraine. Raynaud's phenomenon, visual field defect and Crohn's disease in variant angina raises the possibility that a common underlying defect of mechanism may partially account for all conditions. These are generalized vascular smooth muscle hypercontractility syndromes. Recently high prevalence of esophageal motility disorders has been noted in patients with coronary artery spasm or microvascular angina, leading to the hypothesis of a generalized abnormality in smooth muscle function1,4,5). We expirienced a case of 55-year-old man with angiographically proven variant angina. Who showed reflux esophagitis, classic migraine and Raynaud's disease.
Coronary Vessels ; Crohn Disease ; Esophageal Motility Disorders ; Esophagitis, Peptic* ; Humans ; Microvascular Angina ; Middle Aged ; Migraine Disorders ; Migraine with Aura* ; Muscle, Smooth ; Muscle, Smooth, Vascular ; Prevalence ; Raynaud Disease* ; Spasm ; Visual Fields

BACKGROUND: Trichophyton(T.) mentagrophytes is one of common dermatophytes in Korea. The strain has a various colonial morphology; the colonial morphology of granular and powdery forms is very similar to Microsporum(M.) persicolor. OBJECTIVE: We tried to evaluate the mycologic features of T. mentagrophytes and to investigate the possibility of existence of M. persicolor among granular forms of T. mentagrophytes isolated in Korea. METHODS: Fifty strains of T. mentagrophytes var. mentagrophytes were examined and compared with standard strain of RV 28710 Nannizzia (Arthroderma) persicolor(+), RV 28709 Nannizzia (Arthroderma) persicolor (-), RV 27960 Arthroderma vanbreuseghemii(+), RV 27961 Arthroderma vanbreuseghemii (-), RV 26678 Arthroderma benhamiae (+) and RV 26680 A
Arthrodermataceae ; Daegu* ; Humans ; Korea ; Microsporum* ; Tinea* ; Trichophyton*

Objectives: This study aims to compare attitude toward suicide among the elderly with suicide attempt, suicide ideation, and without suicide ideation and attempt. Methods: We recruited study groups according to suicide risk. Suicide attempt/ideation group were recruited from Busan Regional Suicide Prevention Center. Control group was recruited from general population. Suicide attempt group was those who attempted suicide within 6 months prior to study participation. Suicide ideation group was those who had suicide ideation within 6 months prior to study participation but did not have lifetime history of suicide attempt. Control group was those who did not have either lifetime history of suicide ideation and attempt. Attitude toward suicide was evaluated by Korean version of Attitude Toward Suicide-20 (ATTS-20) Questionnaire. Results: Total of 141 elderly people aged over 60 were recruited. Four subscale scores of ATTS-20 (permissiveness and nonintervention; preventability and incomprehensibility; universality; unpredictability) were significantly lower in the suicide attempt group than suicide ideation and control group. Conclusion The results of present study suggest that the elderly who had history of suicide attempt are more permissive toward and have lack of comprehension of suicide. These results can be useful to develop effective suicide intervention and prevention strategy for the elderly.

BACKGROUND: Rocuronium has been reported to develop a rapid onset of action and may be suitable as a component of a rapid-sequence intubation. The purpose of this study was to compare the onset of rocuronium at the adductor pollicis and the larynx and to determine the time suitable for intubation. METHODS: Fifteen ASA physical status 1 and 2 adult patients were studied. Anesthesia was induced and maintained with propofol and alfentanil. The recurrent laryngeal nerve was stimulated superficially and movement of the vocal cords were recorded on video tape by using a fiberoptic bronchoscope passed via a laryngeal mask airway. Neuromuscular function was recorded at the adductor pollicis by using mechanosensor. After the administration of rocuronium 0.9 mg.kg(-1), the times to loss of fourth twitch response in train -of - four stimulation at the larynx and hand were observed. RESULTS: The times to loss of fourth twitch response in train-of-four stimulation at the larynx and hand are 47.3 +/- 12.8 sec and 70 +/- 13.6 sec respectively. CONCLUSIONS: Video imaging may be a useful research technique for estimating the neuromuscular blockade at the larynx and showing the onset time of rocuronium is significantly faster at the larynx than hand.
Adult ; Alfentanil ; Anesthesia ; Bronchoscopes ; Hand ; Humans ; Intubation ; Laryngeal Masks ; Larynx* ; Neuromuscular Agents* ; Neuromuscular Blockade ; Propofol ; Recurrent Laryngeal Nerve ; Research Design ; Vocal Cords

BACKGROUND: Because doxylamine succinate (DS) is an over-the-counter medicine, it can be obtained easily and is frequently used in suicidal attempts. Patients usually recover without serious complications, but occasionally rhabdomyolysis and even death can occur in DS intoxication. In this study, the authors tried to find out the independent predictors of high peak serum CK levels, i.e. probable rhabdomyolysis in DS intoxication. METHODS: The medical records of 41 patients who visited a hospital for DS intoxication from January 1, 2002 to April 30, 2003, were reviewed retrospectively. RESULTS: In the group of DS only, initial occult blood of urine (P=0.003), initial WBC count (P=0.003) and confusion (P=0.007) were the best predictors of the peak serum CK level (2=0.724). In the group of DS with other drugs intoxication, initial creatinine level (P=0.003) and initial occult blood of urine (P=0.007) were the best predictors of the peak serum CK level (r2=0.784). In the cases of rhabdomyolysis patients, the time taken for the CK level to be increased over 1,000 IU/L was 1.9level to be increased over 1,000 IU/L was 1.9+/-0.6 days. CONCLUSION: In DS only intoxication, occult blood in initial urine analysis, initial high WBC count and confusion can be thought of as useful clinical predictors for high peak serum CK level case. In DS with other drugs intoxication, initial creatinine level and initial occult blood of urine can be considered as the best predictors. More than 2 days will be needed for the observation of serious complications in DS intoxication.
Creatinine ; Doxylamine* ; Humans ; Medical Records ; Occult Blood ; Retrospective Studies ; Rhabdomyolysis ; Succinic Acid