Fourty three patients known to hnve cervical intraepithelial neoplasia were assigned to Papanicolaou smear in five different ways, i, e, A) cotion tipped wood applieator at the pasterior vaginal fronix and the ectocervix, B) cotton tipped wood applicator at the ectocervix and the endocervical canal, C) Cytohrush at the endocervical canal, D) Cervexbrusk and E) Cyto-spatula. At the completion of cytologic study, all the subjects were done colposcopically directed biopsy and/or ECC. To evaluate the false negative rates of the cytologic test, cervical cone biopsy or hysteectorny was performed on all the patient. The false negat,ive rates were 53.5% in A) 39.5% in B), 14,0% in C), l8.6% in D), 25.6% in E) and statistical differences occurect between each group, It was also found that bleedings were most frequently endountered in E) and the encocervical cells were most frequently appeared in C). With these results, it can he stated that the rate of negative encocervical cells in the srnear were correlated with the false negative rates of cervical cytology.
Biopsy ; Cervical Intraepithelial Neoplasia ; Cervix Uteri* ; Female ; Humans ; Papanicolaou Test ; Wood

BACKGROUND: In recent years, the incidence of extended-spectrum beta-lactamase (ESBL) producing Klebsiella has been steadily increased, and the newer species K. planticola and K terrigena, formerly regarded as nonpathogen, have been reported with astonishing frequency from human infectious processes by some investigators. The aim of this study is to elucidate the isolation rate and antimicrobial susceptibility of recent clinical Klebsiella isolates. METHOD: For the clinical Klebsiella isolates during the period of June 1999 to May 2000, isolation frequency of Klebsiella species by specimen, departments, age, and sex were analyzed. And antimicrobial susceptibilities were also analyzed. RESULT: Isolation rate of Klebsiella in order of decreasing frequency were K. pneumoniae (74:7%), K. oxytoca (12.1%), K. ozaenae(1.7%), K. planticola(1.0%), K. terngena(0.9%), and K, ornithinolytica (0.7%), respectively. K. rhinoscleromatis was not isolated. Compared with outpatients, increase of resistance rates of inpatients's Klebsiella isolates were 10% in ciprofloxacin, 15% in cefoperazone/sulbactam, and the others were ranged from 24% to 31%. Isolation rate of ESBL producing K. pneumoniae by double disk (DD) synergy test was 41%, and detection rates by antimicrobial agents were as follows: cefotaxime (95%), aztreonam (58%), and ceftriaxone (37%). Antimicrobial susceptibility rate with the exception of ampicillin and imipenem decreased from the range of 81%-96% on admission day to 29-62% after one week on admission. CONCLUSION: The isolation rates of K. planticola and K. terrigena were less than 1%. The proportion of ESBL producing K. pneumoniae was 41 %. And the vast majority of multidrug resistant Klebsiella including ESBL producing strains are acquired by hospitalization.
Ampicillin ; Anti-Infective Agents ; Aztreonam ; beta-Lactamases ; Cefotaxime ; Ceftriaxone ; Ciprofloxacin ; Epidemiology* ; Hospitalization ; Humans ; Imipenem ; Incidence ; Klebsiella pneumoniae ; Klebsiella* ; Outpatients ; Pneumonia ; Research Personnel

BACKGROUND: In recent years, the incidence of extended-spectrum beta-lactamase (ESBL) producing Klebsiella has been steadily increased, and the newer species K. planticola and K terrigena, formerly regarded as nonpathogen, have been reported with astonishing frequency from human infectious processes by some investigators. The aim of this study is to elucidate the isolation rate and antimicrobial susceptibility of recent clinical Klebsiella isolates. METHOD: For the clinical Klebsiella isolates during the period of June 1999 to May 2000, isolation frequency of Klebsiella species by specimen, departments, age, and sex were analyzed. And antimicrobial susceptibilities were also analyzed. RESULT: Isolation rate of Klebsiella in order of decreasing frequency were K. pneumoniae (74:7%), K. oxytoca (12.1%), K. ozaenae(1.7%), K. planticola(1.0%), K. terngena(0.9%), and K, ornithinolytica (0.7%), respectively. K. rhinoscleromatis was not isolated. Compared with outpatients, increase of resistance rates of inpatients's Klebsiella isolates were 10% in ciprofloxacin, 15% in cefoperazone/sulbactam, and the others were ranged from 24% to 31%. Isolation rate of ESBL producing K. pneumoniae by double disk (DD) synergy test was 41%, and detection rates by antimicrobial agents were as follows: cefotaxime (95%), aztreonam (58%), and ceftriaxone (37%). Antimicrobial susceptibility rate with the exception of ampicillin and imipenem decreased from the range of 81%-96% on admission day to 29-62% after one week on admission. CONCLUSION: The isolation rates of K. planticola and K. terrigena were less than 1%. The proportion of ESBL producing K. pneumoniae was 41 %. And the vast majority of multidrug resistant Klebsiella including ESBL producing strains are acquired by hospitalization.
Ampicillin ; Anti-Infective Agents ; Aztreonam ; beta-Lactamases ; Cefotaxime ; Ceftriaxone ; Ciprofloxacin ; Epidemiology* ; Hospitalization ; Humans ; Imipenem ; Incidence ; Klebsiella pneumoniae ; Klebsiella* ; Outpatients ; Pneumonia ; Research Personnel

No abstract available.
Fibronectins* ; Plasma* ; Pre-Eclampsia*

The addition of a monthly course of progesterone decrease the incidence of endometrialhyperplasia and endometrial carcinoma. The progesterones used in hormonal replacementtherapy(HRT) differ markedly in their progesteronic, androgenic and even estrogenicactivities. These characteristics may influence both symptomatic and metabolic side effects.The purpose of this study was to examine effect of bone and lipid metabolism inpostmenopausal women treated with conjugated equine estrogens plus dydrogesterone.A total 131 postmenopausal women(surgical menopause=95, natural menopause=36)and not-treated postmenopausal women(control=22) were invited to participate in thisstudy. Patients were divided into groups which had received conjugated equine estrogen(CEE)0.625 mg/day 21-day-cycle each month(n=20), CEE 0.625 mg/day plus Dydrogesterone 10mg/day 10-day-cycle each month(n=111), and no treatment control group(n=20).Serum lipid and lipoprotein(Triglyceride, Total cholesterol, High density lipoprotein, Lowdensity lipoprotein) and serum osteocalcin, urinary Deoxypyridinoline were examined in allpatients.There were no significant differences in bone and lipid metabolism between CEE andCEE plus Dydrogesterone groups.In conclusion, Dydrogesterone may be used safely in postmenopausal women withoutMetabolic side effect.
Cholesterol ; Dydrogesterone* ; Endometrial Neoplasms ; Estrogens, Conjugated (USP)* ; Female ; Hormone Replacement Therapy ; Humans ; Incidence ; Lipid Metabolism ; Lipoproteins ; Metabolism* ; Osteocalcin ; Progesterone

BACKGROUND: The VITEK-2 yeast susceptibility test (AST-YS01; bioMerieux, Hazelwood, MO, USA) has recently been introduced as a fully automated, commercial antifungal susceptibility test system that determines MIC endpoints spectrophotometrically, thereby eliminating subjective errors. We compared the ATB FUNGUS 2 (bioMerieux) and VITEK-2 (AST-YS01) systems to the CLSI M27 method for susceptibility testing of Candida isolates. METHODS: We tested 59 Candida species that were isolated from blood cultures at Wonju Christian Hospital between September 2008 and August 2009. We compared MIC results for amphotericin B, flucytosine, fluconazole and voriconazole using the ATB FUNGUS 2 and VITEK-2 (AST-YS01) tests to those obtained by the CLSI M27 broth microdilution method. RESULTS: Within two-fold dilutions of MICs, the agreement of the ATB FUNGUS 2 and VITEK-2 (AST-YS01) tests with the CLSI method according to antifungal agents were: amphotericin B, 100% vs. 100% flucytosine, 100% vs. 100% fluconazole, 83.6% vs. 98.3% and voriconazole, 83.6% vs. 96.7%, respectively. The categorical discrepancies for fluconazole and voriconazole were 20.4% and 18.6% for ATB FUNGUS 2, and 6.8% and 0% for VITEK-2 (ASTYS01). There were no major errors for fluconazole and voriconazole in either ATB FUNGUS 2 or VITEK-2 (AST-YS01) tests. CONCLUSION: The VITEK-2 system (AST-YS01) appears to be rapid and highly correlative with the CLSI method, suggesting that it is effective for antifungal susceptibility testing for Candida species in clinical settings.
Amphotericin B ; Antifungal Agents ; Candida ; Fluconazole ; Flucytosine ; Fungi ; Pyrimidines ; Triazoles ; Yeasts

OBJECTIVE: To measure gynecologic resources required to care for women who have unscheduled vaginal bleeding while using hormone replacement therapy. MATERIALS AND METHODS: Between January 1996 to December 1998, women presenting with abnormal withdrawal bleeding on HRT were identified and associated clinic visits and gynecologic procedures were recorded during a mean follow-up of 2 years. RESULTS: Among women using cyclic HRT, 28.9% had> OR =1 visit for unscheduled vaginal bleeding 8.7% had> OR =1 endometrial biopsy. Among women using continuous combined HRT, 19.3% had> OR =1 visit for unscheduled vaginal bleeding and 6.4% had> OR =1 endometrial biopsy. The gynecologic procedures used in women using cyclic HRT were 20% of reassurance, 50% of ultrasonograpy, 30% of endometrial biopsy and in women using continuous combined HRT were 50% of reassurance, 16.6% of ultrasonograpy, 33.3% of endometrial biopsy. The results of endometrial biopsy were reported all the benign condition. CONCLUSION(S): Unscheduled vaginal bleeding markedly decreased after 12 months of therapy in women using continuous combined HRT but did not decline among those using cyclic HRT.
Ambulatory Care ; Biopsy ; Female ; Follow-Up Studies ; Hemorrhage ; Hormone Replacement Therapy* ; Humans ; Uterine Hemorrhage*

Aerococcus viridans, a catalase-negative gram-positive coccus rarely causing bacteremia, was isolated from blood cultures of a 52-yr-old man under the gran-ulocytopenic condition. The isolate showed the typical characteristics of A. viridans, i.e., tetrad arrangements in gram stain, positive pyrrolidonyl aminopeptidase (PYR) and negative leucine aminopeptidase (LAP) reactions, and no growth at 45 degrees C.The isolate was revealed to be highly resistant to penicillin, erythromycin, clindamycin, and ceftriaxone, although most strains of A. viridans isolated from the previously reported patients were susceptible to penicillin and other commonly used antibiotics. Even though A. viridans is rarely associated with human infections, it could be a potential causative agent of bacteremia, especially in immunocompromised patients.
Agranulocytosis/*complications/microbiology/physiopathology ; Bacteremia/*complications/microbiology/physiopathology ; Ceftriaxone/pharmacology ; Clindamycin/pharmacology ; *Drug Resistance, Multiple, Bacterial ; Erythromycin/pharmacology ; Gram-Positive Bacterial Infections/*complications/microbiology/physiopathology ; Humans ; Male ; Middle Aged ; Penicillins/*pharmacology ; Streptococcaceae/*drug effects/isolation & purification

Pasteurella dagmatis is an oxidase and catalase positive, facultative anaerobic, gram-negative coccobacillus classified as a member of the family Pasteurellaceae. Pasteurella species are commonly colonizing the oropharynx of healthy domestic and wild animals including cats and dogs. These are usually pathogenic to domestic animals, but rarely to human beings. Pasteurella infection of human causes pneumonia, empyema, meningitis, peritonitis, bone and joint infection and septicemia. Recently, we experienced a case of dog-bite wounds from which Pasteurella dagmatis was isolated in a 39-year-old woman. To our knowledge, this is the first report of Pasteurella dagmatis isolated from dog-bite wounds in Korea.
Adult ; Animals ; Animals, Domestic ; Animals, Wild ; Catalase ; Cats ; Colon ; Dogs ; Empyema ; Female ; Humans ; Joints ; Korea ; Meningitis ; Oropharynx ; Oxidoreductases ; Pasteurella Infections ; Pasteurella* ; Pasteurellaceae ; Peritonitis ; Pneumonia ; Sepsis ; Wounds and Injuries*

BACKGROUND: Vancomycin-resistant enterococci (VRE) were first recovered from clinical isolates in Korea in 1992, and the incidence has been steadily increasing. Alternatives to vancomycin are few because VRE are frequently resistant to commonly used antimicrobial agents. The present study was designed to assess the in-vitro activity of fosfomycin to clinical isolates of VRE. METHODS: For 199 VRE isolates from 1995 to 2000, and 91 enterococcal isolates that were consecutively isolated during the January of 2001 at Wonju Christian Hospital, fosfomycin (200 microgram) disk diffusion test was done by NCCLS method. The number of enterococcal isolates tested for fosfomycin were as follows:58 E. faecalis (42 vancomycin susceptible isolates, 16 vancomycin resistant isolates, and 1 vancomycin intermediate resistance isolate); 210 E. faecium (185 vancomycin resistant and 25 vancomycin susceptible isolates); 15 E. gallinarum, and 6 E. casseliflavus isolates. RESULTS: Among the VRE isolates, the resistance rates of fosfomycin according to enterococcal species were 6.3% in E. faecalis, 4.9% in E. faecium, 0% in E. casseliflavus, and 16.7% in E. gallinarum. CONCLUSION: Fosfomycin could be a potentially useful drug for the treatment of infections caused by VRE.
Anti-Infective Agents ; Diffusion ; Enterococcus faecalis ; Enterococcus faecium ; Fosfomycin* ; Gangwon-do ; Incidence ; Korea ; Vancomycin*