OBJECTIVE To give details of the resistance of Staphylococcus aureus infection to various types of drugs.METHODS The laboratory data of resistant S.aureus from Nov 2005 to Dec 2006 were investigated and analyzed and compared the results to the standard sample.RESULTS The sequence of the antibacterial agents resistant to the S.aureus in decreasing order was azithromycin(91.66%),penicillin(88.57%),ceftazidime(87.50%) and amoxicillin(73.53%) with the age distribution of the sufferers from 31-40 years old. It was found 23.86% patients(42 samples) had the positive rate in prostatic fluid of 32.95%.CONCLUSIONS Based on the patient conditions,provide the appropriate drug treatment would avoid the occurrence of resistant S.aureus.

PURPOSE: This study is aimed to investigate perceptions of caregivers and medical staff toward do not resuscitate (DNR) and advance directives (AD). METHODS: Participants were 141 caregivers and 272 medical staff members from five general hospitals. A questionnaire used for the study consisted of 20 items: 14 about DNR perceptions, three about AD, one each for age, gender and employment. RESULTS: Both medical staff and caregivers strongly recognized the need for DNR and AD, and the level of recognition was higher with medical staff than caregivers (DNR chi2=44.56, P=0.001; AD chi2=16.23, P=0.001). The main reason for the recognition was to alleviate sufferings of patients in the terminal phase. In most cases, DNR and AD were filled out when patients with terminal conditions were admitted, and patients made the decisions by consulting with their guardians. Medical staff better recognized the need and for growing demand for guidelines for the DNR and AD decision making process than caregivers (chi2=7.41, P=0.0025). CONCLUSION: This study showed that patients highly rely on their caregivers when making decisions for DNR and AD. Thus, it is important that patients and caregivers are provided with objective information about the decisions. Since participants' strong support for DNR and AD was mainly aimed at alleviating patients' suffering, further study is needed in the association with hospice care. Medical staff also needs to understand the different views held by caregivers and fully consider the disparity when informing patients/caregivers to make the DNR and AD decisions.
Advance Directive Adherence ; Advance Directives ; Caregivers* ; Decision Making ; Employment ; Hospice Care ; Hospitals, General ; Humans ; Medical Staff* ; Personnel, Hospital ; Resuscitation Orders ; Surveys and Questionnaires

We have performed epikeratoplasty to correct the visual acuity in high myopia who are more than -8.0D and intolerant to the wearing of contract lens, and for the aphakic eyes. It has been also applied to supress the progression of keratoconus. Of 118 eyes performed from january 1989 to july 1992, a total of 90 eyes which could be followed up were subject to the review, including 66 high myopic eyes, 18 keratoconus, and 6 aphakic eyes. In myopic patients, uncorrected visual acuity was stable from a proeperative mean of 0.04 to 0.58 at 4 months. Spherical equivalent was stable from a preoperative mean of -13.99 to -2.01 at 4 months. In keratoconus patients with mean 10.1 months follow-tp, uncorrected visual acuity was changed from 0.05 to 0.33 Corrected viaual acuity was changed from 0.15 to 0.60, keratometry reading was changed from 55.87D to 45.92D. Of 6 aphakic eyes, spherical equivalent of 3 pediatric: aphakic eyes under the age of 3 was changed from +15.0D to +3.41, for the other 3 adult aphakic eyes, spherical equivalent was changed from +9.5D to +1.83D and uncorrected visual acuity was changed from 0.03 to 0.32. Epikeratoplasty is effective surgery applicable to the correction of myopia more than -8.0D, keratoconus, and aphakia.
Adult ; Aphakia* ; Epikeratophakia* ; Humans ; Keratoconus* ; Myopia* ; Visual Acuity

BACKGROUND: Keloids and hypertrophic scars may complicate wound healing secondary to trauma or surgery. They are benign growths of dermal collagen that usually cause major physical, psychological, and cosmetic problems for patients. OBJECTIVE: The purpose of this study was to evaluate the efficacy of using a 5-FU (Fluorouracil)/Triamcinolone acetonide (TCN) mixture to treat keloids and hypertrophic scars. Further, the results were compared via TCN alone. METHODS: Patient chart from 2007 to 2011 were reviewed. Patients were stratified into 2 groups: (1) intralesional injection of TCN 0.1 ml (40 mg/ml) mixed with 5-FU 0.9 ml (50 mg/ml), every 2 weeks; (2) intralesional injection of TCN (20 mg/ml), every 2 weeks. Lesions were assessed for height, erythema, pliability, pruritus, pain/tenderness, patient-self assessment and side effects at baseline (initiation of treatment) and at weeks 2, 4, 6. RESULTS: There has been 23 patients (43 lesions) that completed the study. At the 2, 4, 6 week visits, both groups showed an acceptable improvement in all nearly parameter., However, in comparison between the groups, there was no statistically significant differences (p>0.05). Complications such as injection pain and hyperpigmentation were seen in both treatment groups. CONCLUSION: The overall efficacy of 5-FU/TCN mixture was comparable with TCN alone.
Cicatrix, Hypertrophic ; Collagen ; Cosmetics ; Erythema ; Fluorouracil ; Humans ; Hyperpigmentation ; Injections, Intralesional ; Keloid ; Pliability ; Pruritus ; Triamcinolone ; Triamcinolone Acetonide ; Wound Healing

Ultraviolet light(193nm) produced by an Excimer laser has a photochemical effect upon organic structures, which breaks molecular bonds without producing thermal damage. We performed argon fluoride Excimer laser radial keratotomy and treated 32 eyes of myopia and myopic-astigmatism from Febraury to september, 1989. All eyes were followed up over 3 months, and the results were as follows: 1. Mean reduction by skiascopy was 2.47 diopters, that is, 1.9 diopters of moderate myopia, 2.75 diopters of high myopia. By keratometry, mean reduction was 1.45 diopters, that is, 1.68 diopters of moderate myopia, 1.33 diopters in high myopia. In correction for best visual acuity, spectacle diopters were decreased average 2.40 diopters, that is, 2.35 diopters of moderate myopia, 2.45 diopters of high myopia. The astigmatic reduction in 2 cases were 2.0 diopters and 3.0 diopters respectively after Ruiz operation. 2. Uncorrected visual acuity after surgery was 20/50 or better in 41% of entire eye group, that is, 67% of moderate myopia, 25% of high myopia.
Argon ; Astigmatism* ; Fluorides ; Keratotomy, Radial* ; Lasers, Excimer* ; Myopia* ; Retinoscopy ; Visual Acuity

The device for central photorefractive keratectomy(CPRK) was recently introduced for the correction of myopia. Of 61 sighted myopic eyes treated by CPRK. there were 21 female and 40 male patients. The eves were classified in the 3 refraction groups. Group I included eyes with myopia ranging from -2.0 to -4.75 D (3 eyes); Group II eyes with myopia ranging from -4.0 to -5.75 D (17 eyes); and Group III eyes with myopia ranging from -6.0 to -9.0 D (41 eyes). On the sixth postoperative months, mean skiascopic correction of the group I, II, and Ill were 2.30 D, 4.19 D and 6.01 D, respectively, and mean reduction of keratometric diopter of the group I, II and Ill were 2.28 D, 2.99 D and 3.26 D, respectively. Six months postoperatively, mean uncorrected visual acuity of the group I, II and Ill were 20/30, 20/25 and 20/40, respectively. The CPRK was better to the correction of moderate and high myopia than Excimer laser RK(Radial Keratotomy) or RK by diamond knife.
Diamond ; Female ; Humans ; Lasers, Excimer* ; Male ; Myopia* ; Photorefractive Keratectomy* ; Visual Acuity

Cutaneous metastasis is a relatively rare complication of internal malignancy and has been reported in 0.7% to 9% of all malignant cancers. It may be an important clue for undiagnosed malignancies or even the prognosis of primary cancers. Cutaneous metastatic cancers vary in type and are rarely presented with zosteriform distribution. The lung is one of the most common primary sites of zosteriform cutaneous metastasis. We describe a 52-year-old man with a prior history of lung cancer in whom zosteriform cutaneous metastasis developed along the right T4-5 dermatome on his trunk. This case highlights the importance of the differential diagnosis of cutaneous metastasis with zosteriform distribution and the need of skin biopsy in order to confirm the early diagnosis.
Biopsy ; Diagnosis, Differential ; Early Diagnosis ; Lung ; Lung Neoplasms ; Neoplasm Metastasis ; Prognosis ; Skin

Herpes zoster is a common viral disease that accompanies segmental, painful vesicular eruptions along the dermatome. Motor involvement can also occasionally occur in this disease entity and its reported incidence is between 0.5% and 5%. However, the impairment of motor function often goes unrecognized, probably because of severe pain that is a more prominent feature than motor weakness. We experienced an 83-year-old female patient with herpes zoster infection of the right C5-7 dermatomes, who showed right upper extremity paralysis. We examined the limb using motor nerve conduction velocity (MNCV) test and concluded that herpes zoster caused patient's motor paralysis. After 4 months, her motor paralysis was completely recovered spontaneously.
Aged, 80 and over ; Extremities ; Female ; Herpes Zoster ; Humans ; Incidence ; Neural Conduction ; Paralysis ; Upper Extremity ; Virus Diseases

Cutaneous tuberculids are relatively rare hypersensitivity reactions to Mycobacterium tuberculosis, characterized by erythematous eruption on the skin of a tuberculosis patient. Papulonecrotic tuberculid, lichen scrofulosorum, erythema induratum and nodular tuberculid were originally included in tuberculids. However, some cases are difficult to classify into the subtypes because of their broad spectrum of cutaneous manifestations and various histopathologies. This is particularly true in immunocompromised patients. We report a case of atypical cutaneous tuberculid in an immunocompromised patient in whom mycobacterical DNA was not demonstrated by PCR. However, the diagnosis of latent tuberculous infection was supported by IFN-gamma assay (QuantiFERON(R)-TB Gold test) and tuberculous lymphadenitis was diagnosed. The skin lesions responded dramatically to anti-tuberculous therapy, and there has been no evidence of recurrence.
DNA ; Erythema Induratum ; Humans ; Hypersensitivity ; Immunocompromised Host ; Lichens ; Mycobacterium tuberculosis ; Polymerase Chain Reaction ; Recurrence ; Skin ; Tuberculosis ; Tuberculosis, Cutaneous ; Tuberculosis, Lymph Node

PURPOSE: Patients with work related burns suffer from anxiety, depression, insomnia and suicide ideation etc. Psychiatric symptoms could be reduced by treatment. Almost all patients are referred to psychiatric intervention in our hospital. However, a number of patients show non-adherence. The aim of this study is to figure out the reason of non-adherence and psychiatric symptoms of work related burns patients. METHODS: 123 patients participated in this study. Startle, Physiological arousal, Anger, and Numbness (SPAN), Feeling Suicide, Patient Health Questionnaire-2 (PHQ-2) were administered as screening tool. Questions about psychiatric intervention and reasons to refuse psychiatric intervention were asked. RESULTS: 32% patients were depressed, 34% patients had suicide ideation and 59% had PTSD after work related burns. However, 46% of burn patients had not been treated. Stigma of psychiatric intervention and concerns about dependency were major reasons for non-adherence. CONCLUSION: There are gap between necessity and reality of psychiatric intervention on work related burn patients.
Anger ; Anxiety ; Arousal ; Burns ; Dependency (Psychology) ; Depression ; Humans ; Hypesthesia ; Mass Screening ; Occupational Injuries ; Referral and Consultation ; Sleep Initiation and Maintenance Disorders ; Stress Disorders, Post-Traumatic ; Suicide