Toxic shock syndrome (TSS) is a rare but life-threatening illness that is mainly caused by toxigenic strains of Staphylococcus aureus. Although TSS is classically known to be associated with tampon use, the number of TSS cases with non-menstrual causes such as skin and soft tissue infection has been increasing. Tattooing can result in several complications such as localized and systemic infections, inflammatory skin eruptions and neoplasms. We recently experienced a 26-year-old man diagnosed with typical TSS following tattooing. He complained of fever, chills and erythematous rash at tattoo site. Subsequently, the patient developed sign of shock. The skin cultures on the tattoo site were positive for methicillin-sensitive Staphylococcus aureus. The patient was successfully treated with vasopressor infusion and intravenous antibiotics and was discharged without complications. On discharge from the hospital 7 days later, desquamations on the tattoo site, fingers and toes were observed.
Adult ; Anti-Bacterial Agents ; Chills ; Exanthema ; Fever ; Fingers ; Humans ; Shock ; Shock, Septic* ; Skin ; Soft Tissue Infections ; Staphylococcus aureus ; Tattooing* ; Toes

No abstract available.
Cyclosporine* ; Scleroderma, Localized*

No abstract available.
Cyclosporine* ; Scleroderma, Localized*

This study was aimed at investigation of the stimulatory innervations on the rat urinary bladder. Detrusor muscle strips of 15 mm long were suspended in isolated muscle chambers containing 1 ml of PSS maintained at 37℃ and aerated with 95% O²/5% Co². Isometric myography was performed, and the results were as followings: Muscle strips showed “on-contraction” by electric field stimulation (EFS) frequency-dependently. The EFS-induced contraction was not affected by hexamethonium, a ganglion blocker, but abolished by tetrodotoxin, a nerve conduction blocker. Physostigmine, a cholinesterase inhibitor enhanced the EFS-induced contraction which was inhibited by hemicholinium, an inhibitor of choline uptake at the cholinergic nerve ending. Such an EFS-induced contraction was antagonized by atropine only partially, and the atropine-resistant portion was completely abolished by the desensitization of purinergic receptors by prolonged incubating of the strips in the presence of high concentration of ATP. Bethanechol, a cholinergic agonist, elicited concentration-dependent contraction. Adenosine triphosphate (ATP), a purinergic agonist, induced a weak but concentration-dependent contraction of short duration. Bethanechol-induced contraction was not affected by ATP-desensitization, and ATP-induced contraction was not affected by tetrodotoxin. These results suggest that there are at least two main stimulatory components of innervations in the detrusor muscle, cholinergic muscarinic and purinergic; and those receptors are independent each other.
Adenosine Triphosphate ; Animals ; Atropine ; Bethanechol ; Choline ; Cholinergic Agonists ; Cholinesterases ; Ganglion Cysts ; Hemicholinium 3 ; Hexamethonium ; Myography ; Nerve Endings ; Neural Conduction ; Physostigmine ; Rats* ; Receptors, Purinergic ; Tetrodotoxin ; Urinary Bladder*

OBJECTIVE: In view of the facts that education about diseases and realization of the need for drugs can improve compliance of the patients, we assessed the knowledge about drugs and medication compliance in psychiatric outpatients. In addition, we investigated factors that influence patients' compliance to develop a model of medication compliance. METHODS: One-hundred twelve male and eighty female psychiatric outpatient were asked about drug information using questionnaires. We developed a model that predicts medication compliance using chi square tests and multiple regression analysis. RESULTS: More than a hart of the patients knew at least one of the names and the effects of the drugs they had taken, but many of them didn't know the side effects of drugs. About eighty percent of the patients showed good compliance. Knowledge of side effects, belief in the benefits of drugs, and level of education could predict medication compliance reliably. CONCLUSIONS: Because education level could not be managed by physician, we could enhance compliance through education about drug side effects and benefits of medications.
Compliance ; Education ; Female ; Humans ; Male ; Medication Adherence* ; Outpatients* ; Surveys and Questionnaires

In order to investigate the efficacy and safety of oral fosinopril, a new phosphorus containing angiotensin converting enzyme inhibitor, a single dose of 10 to 20mg was administered in 23 hypertensive patients with diastotic blood pressure above 95mmHg and all other anti-hypertensive agents were not administered during 4 weeks of study. Blood pressure and heart rate were measured on the 2nd and 4th week of therapy. The complete blood count with platelet count, blood chemistry by SMA-12 and serum electrolytes were performed at the begining and 4th week of therapy. The urinalysis and electrocardiography were performed at the beginning and 4th week of therapy. Any kinds of side effects were actively questioned by the examining physicians. The following results were obtained : 1) At the beginning and 4th weeks of therapy, the average systolic and diastolic pressure were 170.0+/-17.6/101.6+/-6.1mmHg, 142.7+/-15.1/87.3+/-6.7mmHg respectively. The systolic and diastolic blood pressure were declined statistically significantly(p<0.05) throughout the period of treatment and diastolic blood pressure of all subjects except 3 patients(86%) was maintained below 90mmHg after 4th week of treatment. 2) There was no significant change in the pulse rate before and after therapy. 3) There were no significant changes in blood chemistry, serum electrolytes, hematologic findings, urinalysis and electrocardiographic findigns. 4) side effect were developed in 5 patients(23%) with dry cough, 3 patients(13%) with headache and 2 patients with facial edema but side effects were mostly mild in nature without potenitally serious episodes. These results suggested that antihypertensive therapy with onec-daily fosinopril was effective and well tolerated in essential hypertensive patients.
Antihypertensive Agents ; Blood Cell Count ; Blood Pressure ; Chemistry ; Cough ; Edema ; Electrocardiography ; Electrolytes ; Fosinopril* ; Headache ; Heart Rate ; Humans ; Hypertension ; Peptidyl-Dipeptidase A ; Phosphorus ; Platelet Count ; Urinalysis

Toxic shock syndrome (TSS) is a rare but life-threatening illness that is mainly caused by toxigenic strains of Staphylococcus aureus. Although TSS is classically known to be associated with tampon use, the number of TSS cases with non-menstrual causes such as skin and soft tissue infection has been increasing. Tattooing can result in several complications such as localized and systemic infections, inflammatory skin eruptions and neoplasms. We recently experienced a 26-year-old man diagnosed with typical TSS following tattooing. He complained of fever, chills and erythematous rash at tattoo site. Subsequently, the patient developed sign of shock. The skin cultures on the tattoo site were positive for methicillin-sensitive Staphylococcus aureus. The patient was successfully treated with vasopressor infusion and intravenous antibiotics and was discharged without complications. On discharge from the hospital 7 days later, desquamations on the tattoo site, fingers and toes were observed.
Adult ; Anti-Bacterial Agents ; Chills ; Exanthema ; Fever ; Fingers ; Humans ; Shock ; Shock, Septic ; Skin ; Soft Tissue Infections ; Staphylococcus aureus ; Tattooing ; Toes

BACKGROUND: Most febrile neutropenic patients are treated in an aggressive manner. However, identification of low-risk patients may enable clinicians to administer risk-based treatment. The object of this study is to certify the factors associated with increased risk at the time of visiting the emergency department. METHODS: This is a retrospective study. We reviewed the medical records of 101 febrile neutropenic patients who had visited the emergency department of Seoul National University Hospital from January 1998 to August 1999. We assumed 22 risk prediction factors that could be assessed at admission to the emergency department and 5 factors that could be assessed during treatment course. To find independent risk-prediction factors, we analyzed these factors respectively by using multiple regression analysis. RESULTS: Tachycardia(aOR=136.5), altered mentality(aOR=28.8), decreased renal function(aOR=20.1), and significant comorbidity(aOR=17.2) are the independent factors associated with higher mortality. Altered mentality(aOR=31.6) and decreased renal function(CCr<75ml/min, aOR=5.4) are those associated with a higher incidence of septic shock. Independent factors associated with persistent(more than 3 days) fever are the early(within 10 days) onset of fever after last chemotherapy(aOR=8.8) and the existence of new pulmonary infiltrates on a simple chest X-ray(aOR=4.3). CONCLUSION: The stability of vital signs, the change of mentality, the renal function, the existence of significant comorbidity, the existence of new pulmonary infiltrates, and the rate of neutropenia are clinically useful risk-predication factors in febrile neutropenia at the time of visiting the emergency department.
Comorbidity ; Emergency Service, Hospital ; Febrile Neutropenia ; Fever ; Humans ; Incidence ; Medical Records ; Mortality ; Neutropenia ; Retrospective Studies ; Seoul ; Shock, Septic ; Thorax ; Vital Signs

PURPOSE: To evaluate the relationship between factors of metabolic syndrome(MS) to prostate volume and lower urinary tract symptom in men over sixties. MATERIALS AND METHODS: A total of 624 male subjects aged 60 to 90 years were enrolled. Prostate volume, urinary flow rate, voided volume, post void residual urine volume, voiding symptoms and MS-related parameters were investigated. Patients were divided into two groups; those with MS (n=223) and those without(n=401). Prostate volume, urodynamic factors and voiding symptoms were compared based upon MS categories. RESULTS: The MS and control group showed no significant differences with respect to age(74.8+/-5.6 vs. 74.0+/-5.4, respectively, p=0.083) and prostate specific antigen levels(1.8+/-1.5 vs. 1.7+/-1.5, respectively, p=0.248). However, the MS group had significantly greater waist circumference, blood pressure, fasting blood sugar level, hypertriglyceridemia and lower high density lipoprotein(HDL) cholesterol than the control group(p<0.05). Patients with MS showed significantly larger total prostate volume(p=0.008) and transitional zone volume(p=0.012). There were no differences between two groups respect to maximum flow rate, voided volume and residual volume (p>0.05). There was a significant relationship between prostate volume and obesity(p=0.016), however other MS factors such as low HDL, hypertension, non-insulin dependent diabetes mellitus and hypertriglyceridemia were not associated with prostate volume(p>0.05).CONCLUSIONS: Metabolic syndrome is associated with prostate volume related factors, but not to voiding dysfunction in Korean men over sixties. Among subcategories of MS, obesity is the most strongly related factor to prostate volume.
Aged ; Blood Glucose ; Blood Pressure ; Cholesterol ; Diabetes Mellitus ; Fasting ; Humans ; Hypertension ; Hypertriglyceridemia ; Male ; Metabolic Syndrome X ; Obesity ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Residual Volume ; Urinary Tract ; Urination Disorders ; Urodynamics ; Waist Circumference

BACKGROUND: Skin lesions and pain are the most distinctive features of herpes zoster. Light-emitting diode (LED) therapy is an effective treatment known for its wound-healing effects. OBJECTIVE: To determine whether the LED treatment affects wound healing and acute pain in acute herpes zoster ophthalmicus. METHODS: We recruited 28 consecutive Korean patients with acute herpes zoster ophthalmicus for the study. In the control group (group A), 14 subjects received oral famcyclovir. In the experimental group (group B), 14 subjects received oral famcyclovir and 830 nm LED phototherapy on days 0, 4, 7, and 10. In order to estimate the time for wound healing, we measured the duration from the vesicle formation to when the lesion crust fell off. The visual analogue scale (VAS) was used for the estimation of pain on days 4, 7, 10, and 14. RESULTS: The mean time required for wound healing was 13.14+/-2.34 days in group B and 15.92+/-2.55 days in group A (p=0.006). From day 4, the mean VAS score showed a greater improvement in group B, compared with group A. A marginal but not statistically significant difference in the VAS scores was observed between the two groups (p=0.095). CONCLUSION: LED treatment for acute herpes zoster ophthalmicus leads to faster wound healing and a lower pain score.
Acute Pain ; Herpes Zoster ; Herpes Zoster Ophthalmicus ; Humans ; Phototherapy ; Pilot Projects ; Skin ; Wound Healing