Vibrio parahaemolyticus is a gram-negative halophilic organism commonly associated with outbreaks of acute gastroenteritis which also sometimes causes serious wound infection. It is an uncommon cause of bacteremia. We have experienced a case of bacteremia due to Vibrio parahaemolyticus in a 59-year old man who initially presented with edema and dyspnea. He was diagnosed as liver cirrhosis, gastric cancer, and hepatoma. On hospital day 13, Vibrio parahaemolyticus was isolated from blood culture. The isolate showed typical cultural and biochemical characteristics such as salt tolerance and did not ferment lactose. The isolate was intermediate to ampicillin but susceptible to other agents.
Ampicillin ; Bacteremia* ; Carcinoma, Hepatocellular ; Disease Outbreaks ; Dyspnea ; Edema ; Gastroenteritis ; Humans ; Lactose ; Liver Cirrhosis ; Middle Aged ; Salt-Tolerance ; Stomach Neoplasms ; Vibrio parahaemolyticus* ; Vibrio* ; Wound Infection

BACKGROUND: Recent data suggest that the colonization rate of group B streptococci(GBS) in pregnant women and the incidence of neonatal infections by GBS is increasing trend in Korea, but the antimicrobial susceptibilities and serotypes in pregnant women have not been reported in Korea. So, we studied to define the antimicrobial susceptibility patterns and frequency of serotypes of GBS in pregnant women. METHODS: The susceptibility and serotyping of 60 GBS isolates from 27 pregnant women and four isolates from their two neonates were tested by an agar dilution method and agglutination test, respectively. The typing sera used in this study were Ia, Ib, II, III, IV, and V. RESULTS: Minimal inhibitory concentration range of 60 GBS from pregnant women were penicillin G 0.015-0.12 microgram/ml, vancomycin 0.5-2 microgram/ml, clindamycin 0.015-4.0 microgram/ml, chloramphenicol 2-4 microgram/ml, erythromycin 0.015-2 microgram/ml, tetracycline 0.5-256 microgram/ml, cephalothin 0.12-0.25 microgram/ml, ceftriaxone 0.03-0.12 microgram/ml, respectively. The resistance rate of GBS were 6.7% to clindamycin, 0% to erythromycin, and 98.3% to tetracycline. Most of GBS serotypes from pregnant women in decreasing order were Ib(48.3%), Ia(24.1%), III(20.7%). CONCLUSION: All GBS strains isolated from pregnant women are highly susceptible to commonly used antimicrobial agents with the exception of tetracycline. The low prevalence of severe neonatal GBS infections in Korea is not due to the absence of serotype III, but probably due to a low genital carriage rate of GBS by pregnant women.
Agar ; Agglutination Tests ; Anti-Infective Agents ; Ceftriaxone ; Cephalothin ; Chloramphenicol ; Clindamycin ; Colon ; Erythromycin ; Female ; Humans ; Incidence ; Infant, Newborn ; Korea ; Penicillin G ; Pregnant Women* ; Prevalence ; Serotyping ; Tetracycline ; Vancomycin

No abstract available.
Female ; Female* ; Humans ; Menarche* ; Menstruation*

BACKGROUND: Group B streptococci (GBS) are the most common cause of sepsis and meningitis in newborns in the United States and Europe, and maternal colonization rate of GBS is the most important factor of group B streptococcal neonatal infections. But, in Korea, studies on the maternal colonization rate of GBS are rare due to low incidence of neonatal group B streptococcal infections, particularly, data on colonization rate of GBS during first trimester is nearly absent. The aim of this study was to establish the rates of maternal carriage of GBS and the distribution of GBS serotypes in first trimester of pregnancy. METHODS: During the period of June to December 1997, we studied women attending private clinic. A total of 309 women in first trimester were enrolled in the study. Cotton swab specimens from vagina and cervix were placed to new Granada tube medium. The new Granada tube medium with specimen swab was incubated in 5% CO2 atmosphere at 35degreesC. For the identification of GBS, the colonies showing orange color on new Granada tube medium were tested with Streptex group B Streptococcus reagent (Wellcome Diagnostics, UK). Serotyping was done by Hemolytic Streptococcus Group B Typing Sera (Denka Seiken, Japan). The typing sera used in this study were Ia, Ib, II, III, IV, and V. RESULTS: Of the pregnant women in first trimester, 2.3% (7/309) were colonized with GBS, and all seven women who colonized GBS were positive in vagina and cervix at the same time. Frequency of serotype III and Ib were 71.4% (5/7) and 29.6% (2/7), respectively. Serotypes Ia, II, VI, and V were absent. CONCLUSIONS: Maternal carriage rate of GBS in first trimester of pregnancy was 2.3%, and serotype III was the most common serotype. Serotypes Ia, II, VI, and V were absent.
Atmosphere ; Cervix Uteri ; Citrus sinensis ; Colon* ; Europe ; Female ; Humans ; Incidence ; Infant, Newborn ; Korea ; Meningitis ; Pregnancy ; Pregnancy Trimester, First* ; Pregnancy* ; Pregnant Women ; Sepsis ; Serotyping ; Streptococcal Infections ; Streptococcus ; Streptococcus agalactiae ; United States ; Vagina

Localized fibrous tumor is an uncommon submesothelial origin tumor found in pleura most commonly. Sixty five-year-old man with right lower quadrant pain was admitted. He was treated with resection of tumor and was diagnosed as localized fibrous tumor of pelvic cavity. He is now being followed up without any evidence of recurrence for 34 months. This case is presented with reviewing references.
Pleura ; Recurrence

BACKGROUND: The inhalational anesthesia is performed by the administration of inhalational agents and fresh gases. Low and high flows have their own advantages and disadvantages. In Korea, many anesthesiologists use more than 2 L/min of fresh gas flow (FGF). This study was performed to analyze the practice and knowledge of FGF use by Korean Anesthesiologists. METHODS: A questionaire was sent to 122 anesthesiologists (15 university hospitals and 16 general hospitals) who attended the 47th Annual Autumn Meeting of the Korean Society of Anesthesiology in 2002. The questionaire covered topics dealing with inhalational agents, FGF, and safety systems for inhalational anesthesia practice. RESULTS: The most preferred inhalational anesthetic was sevoflurane (65.6%). 88.5% of respondents used more than 2 L/min of FGF. The majority of the respondents, however, did not consider the reasons for using certain levels of FGF. Only 27% of hospitals had pulse oximetry, capnogram or muti-gas analysis, fail-safe device, and a scavenging system. CONCLUSIONS: Many anesthesiologists, especially trainees, failed to consider the use of FGF during inhalational anesthesia. Therefore, special consideration should be given to the training and education of trainees about the proper of FGF.
Anesthesia ; Anesthesiology ; Surveys and Questionnaires ; Education ; Gases ; Hospitals, University ; Korea ; Oximetry

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*

Spindle cell hemangioendothelioma was first described in 1986 by Weiss and Enzinger as a low grade angiosarcoma resr mbling a cavernous hemangioma and kaposis sarcoma. Recently, it is suggested to be non neoplastic lesion or reactive process arising from pre-existing vascular mal- formation. We report a case of spindle cell hemangioendothelioma in a 9-month-old boy. He had multiple, variable sized, colorful, cutaneous or subcutaneous nodules on the forearm and hand. The tumor first appeared on the forearm as erythematous patches at birth and grew rapidly with- in 3 months. Histopatholgical findings showed that the lesion was composed of thin walled cavernous spaces mixed with spindle cells and occasional epithelioid endothelial cells containing intracytoplasmic vacuole. Most af the endothelial cells lining the cavernous spaces and intracytoplasmic lumina, were positive for factor VIII associated antigen. But the spindle cells were negative. Atypical vascular structures resembling arteriovenous shunts were noted around the tumor suggesting a reactive proliferation due to disturbance of local blood flow. Several turnors were excised. No recurrence has been recognized in the one year- follow-up period.
Endothelial Cells ; Factor VIII ; Follow-Up Studies ; Forearm ; Hand ; Hemangioendothelioma* ; Hemangioma, Cavernous ; Hemangiosarcoma ; Humans ; Infant ; Male ; Parturition ; Recurrence ; Sarcoma, Kaposi ; Vacuoles

BACKGROUND: The bcl-2 is an oncogene involved in tumorigenesis by blocking apoptosis, or programmed cell death and over-expression of bcl-2 protein has been reported in several malignant tumors such as lung cancer, basal cell carcinoma, breast cancer and malignant melanoma. However, there have been only a few studies about bcl-2 expression of cutaneous T cell lymphoma. OBJECTIVE: The purpose of this study was to examine whether there is any difference in expression of bcl-2 between mycosis fungoides(MF), angiocentric T cell lymphoma, angioimmunoblastic T cell lymphoma, subcutaneous T cell lymphoma and anaplastic large cell lymphoma. We also evaluated the statistical significance between expression of bcl-2 and the prognosis of the diseases. METHODS: Routine paraffin sections of formalin-fixed 36 tissues (14 MF, 7 angiocentric T cell lymphoma, 5 subcutaneous panniculitic T cell lymphoma, 2 anaplastic large cell lymphoma, 1 angioimmunoblastic T cell lymphoma, 1 unspecified peripheral T cell lymphoma, 2 small plaque parapsoriasis, 2 psoriasis and 2 lichen planus) were labelled with anti-bcl-2 monoclonal antibody using an avidin- biotin-peroxidase complex. Normal skin for bcl-2 served as negative controls. RESULTS: The results were as follows. l. All cases of benign inflammatory diseases, small plaque parapsoriasis and patch stages of MF showed positive staining for bcl-2. Therefore, there were no differences in expression of bcl-2 among these diseases. 2. In the plaque and tumor stages of mycosis fungoides, statistically significancant differences in bcl-2 expression were not found during disease progression. 3. bcl-2 expression in peripheral T cell lymphoma (five in seven cases of angiocentric T cell lymphoma showed positive staining but all other peripheral T cell lymphoma was negative) decreased significantly (p<0.05) than that of MF. 4. No statistical significance was found between bcl-2 expression and prognosis of cutaneous lymphoma (p>0.05). CONCLUSION: These results suggest that the loss of bcl-2 expression may play a significant role in progression of cutaneous T cell lymphoma except in MF and angiocentric T cell lymphoma.
Apoptosis ; Breast Neoplasms ; Carcinogenesis ; Carcinoma, Basal Cell ; Cell Death ; Disease Progression ; Lichens ; Lung Neoplasms ; Lymphoma ; Lymphoma, Large-Cell, Anaplastic ; Lymphoma, T-Cell ; Lymphoma, T-Cell, Cutaneous* ; Lymphoma, T-Cell, Peripheral ; Melanoma ; Mycosis Fungoides ; Oncogenes ; Paraffin ; Parapsoriasis ; Prognosis ; Psoriasis ; Skin

PURPOSE: The aim of this study was to investigate treatment results, toxicity and efficacy of hyperfractionated radiation therapy combined with paclitaxel for paraaortic node recurrence in cervix cancer. MATERIALS AND METHODS: Between September 1997 to March 1999, 12 patients with paraaortic node recurrence in cervix cancer who previously received radical or postoperative radiotherapy were treated with hyperfractionated radiation therapy combined with paclitaxel. Of these, 2 patients who irradiated less than 30 Gy were excluded, 10 patients were eligible for this study. Median age was 5 1 years. Initial FlGO stage was 1 stage IB1, 2 stage IIA, 7 stage IIB. For initial treatment, 7 patients received radical radiotherapy and 3 received postoperative radiotherapy. The paraaortic field encompassed the gross recur rent disease with superior margin at T 12, and inferior margin was between L5 and S 1 with gap for previously pelvic radiation field. The radiation field was initially anterior and posterior opposed field followed by both lateral field. The daily dose was 1.2 Gy, twice daily fractions, and total radiotherapy dose was between 50.4 and 60 Gy(median, 58.8 Gy). Concurrent chemotherapy was done with paclitaxel as a radiosensitizer. Dose range was from 20 mg/m to 30 mg/m (median, 25 mg/m'), and cycle of chemotherapy was from 3 to 6 (median, 4.5 cycle). Follow-up period ranged from 3 to 21 months. RESULTS: Interval between initial diagnosis and paraaortic node recurrence was range from 2 to 63 months (median, 8 months). The 1 year overall survival rate and median survival were 75% and 9.5 months, respectively. The 1 year disease free survival rate and median disease free survival were 30% and 3 7 months, respectively. At 1 month after treatment, 4 (40%) achieved a complete response and 6 (63%) experienced a partial response and all patients showed response above the partial response. There was distant metastasis in 6 patients and pelvic node recurrence in 2 patients after paraaortic node irradialion. There was 2 patients with grade 3 to 4 leukopenia and 8 patients with grade 1 to 2 nausea/ vom ting which was usually tolerable with antiemetic drug. There was no chronic complication in abdomen and pelvis during follow up period. CONCLUSION: Hyperfractionated radiation therapy combined with paclitaxel as a radiosensitizer showed high response rate and few complication rate in paraaortic node recurrence in cervix cancer. Therefore, present results suggest that hyperfractionated radiation therapy combined with paclitaxel chemotherapy can be used as optimal treatment modality in this patients.
Abdomen ; Cervix Uteri* ; Diagnosis ; Disease-Free Survival ; Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Leukopenia ; Neoplasm Metastasis ; Paclitaxel* ; Pelvis ; Radiotherapy ; Recurrence* ; Survival Rate ; Tolnaftate ; Uterine Cervical Neoplasms*