BACKGROUND: Althogh drug euption refers to a common dermatological condition, there are numerous holdbacks on the diagnosis. OBJECTIVE: This study atternpts to define the clinical features and causavite drug of the patients with drug eruptions, and to evalarate the diagnostic value of various skin tests. METHOD: 130 patients with drug eruptions were reviewed clinically. In 54 patients, intradermal test, patch test, and scratch patch test were performed using suspected drugs. Result : The exanthematous eruption(53.0%), fixed drug eruptior.(29.2%), and urticaria(6.2%) were the common types of the drug eruption. The common causative agenst of drug eruptions were antibiotics/antimicrobials, antipyretics/NSAIDs, and CNS depressants. 28 paitients out of the 54 patients on skin tests with suspected drugs had positive results in at least one slinest. CONCLUSION: In our study, we were able to obtain somewhat meaningfi 1 results based on data from the combination of various skin tests.
Central Nervous System Depressants ; Diagnosis ; Drug Eruptions* ; Humans ; Intradermal Tests ; Patch Tests ; Skin Tests* ; Skin*

Sarcomatoid renal cell carcinoma is an uncommon tumor that has to be distinguished from renal carcinosarcoma. We have described three cases of sarcomatoid renal cell carcinoma showing different clinical and light microscopic features. An ultrastructural study of the tumor cells from the sarcomatoid area revealed frequent desmosomal junction, confirming the epithelial nature of the neoplasm. All three cases showed an aggressive clinical course and tended to invade adjacent organs or tissues. We believe that an histological and immunohistochemical examination in conjunction with an electron microscopic examination are necessary to diagnose sarcomatoid renal cell carcinoma.
Carcinoma, Renal Cell* ; Carcinosarcoma* ; Desmosomes ; Microscopy, Electron

OBJECTIVE: The patients of endometriosis may complain of dysmenorrhea, pelvic pain, and dyspareunia, but may be asymptomatic. We studied on the correlation between the pain and the psychologic stress, Also, we studied on the correlation between serum CA-l25 levels and the psychologic stress. METHODS: The data was obtained from il7 endometriosis patients. Psychological stress was studied with STAI(Stait-Trait Anxiety Inventory) and BDI(Beck Depression Inventory). We compared the degree of anxiety and depression according to existence of pain and the duration of pain. Also we examed the scores of STAI and BDI according to the level of serum CA-125. RESULTS: The pain group had more depression and anxiety, in comparison to the pain-free group. And the depression and anxiety significantly increased in long-term pain group. There was no correlation between the level of serum CA-125 and the depression,or axiety. CONCLUSION: The pain of endometriosis may play a role of pychological stress to the patients, so it seems to increase depression and anxiety.
Anxiety ; Depression ; Dysmenorrhea ; Dyspareunia ; Endometriosis* ; Female ; Humans ; Interleukin-7 ; Pelvic Pain ; Stress, Psychological*

BACKGROUND: Cleaning and disinfection of fiberoptic bronchoscope requires careful attention, especially to mycobacterium species because the contamination of mycobacteria could raise confusion on diagnosis. Recently, we detected contamination of Wydex(R) solution used in bronchoscope washer with Mycobacterium chelonae. In this study, we evaluated the mycobactericidal effect of 12 kinds of disinfectants for M. chelonae. METHOD: To evaluate the bactericidal effect of Wydex(R) 2%, Cidex(R) 2.25%, Cidex(R) 3%, Bacteriokiller (BK) disinfectant, Perasafe(R), HICLO-S(R), Lamicine(R), ethanol, Instrusept(R), Virkon(R), Betadine(R), and Vipon(R) against M. chelonae, culture was performed after exposure of two M. chelonae strains (ATCC 35749, the type strain and the strain isolated from contaminated Wydex(R) solution) to each disinfectant solution. The growth of organism was examined for up to 8 weeks. RESULTS: Growth of M. chelonae (reference strain of ATCC 35749 and isolated strain) was observed after a week incubation for Wydex(R) 2%, Cidex(R) (2.25%, 3%) and control. For BK disinfectant and Perasafe(R), they grew after 2-3 weeks, and 3-4 weeks, respectively. For HICLO-S(R) and Lamicine(R), only the contaminated strain grew after two and three weeks, respectively. For ethanol, Virkon(R), Betadine(R), Vipon(R), and Instrusept(R) , growth was not observed from either strain. CONCLUSIONS: On the basis of these results, Instrusept(R), virkon(R), ethanol, Betadine(R), and Vipon(R) were effective for the disinfection of M. chelonae. Especially, Instrusept(R) was thought to be useful as a disinfectant for bronchoscopes because it has advantages including non-corrosiveness, chemical stability, and non-irritativeness. And additional washing with ethanol might be effective. The finding that strain isolated from contaminated bronchoscopes was more resistant to disinfectants than reference strain suggested that the more resistant strains are selected throughout the improper disinfection.
Bronchoscopes ; Diagnosis ; Disinfectants* ; Disinfection ; Ethanol ; Mycobacterium chelonae* ; Mycobacterium*

BACKGROUND: Nosocomial urinary tract infection (UTI) accounts for 35% of the nosocomial infection and 80-90% of them are associated with urethral catheters. Recently, we experienced an outbreak of nosocomial UTI caused by multidrug-resistant Pseudomonas aeruginosa in neurosurgical intensive care unit (NSICU). METHODS: We investigated clinical records of the patients and observed the methods of care of urethral catheters in NSICU. Identification of P. aeruginose was done by API NE (API system; bioMerieux, France) and antibiotic susceptibility tests were done by disk diffusion method. Random Amplification of Polymorphic DNA (RAPD) assay was used as a genotyping method. RESULTS: Between November 1997 and January 1998, 11 P. aeruginosa strains were isolated from the urine of 11 patients hospitalized in NSICU of Kangnam St. Mary's Hospital. Routine regular bladder irrigation, and emptying urine with common urinal had been done falsely. Antibiogram of the isolates showed resistance to multiple antibiotics including imipenem, gentamicin. amikacin, piperacillin, ciprofloxacin, ceftazidime, and cefoperazone/sulbactam. RAPD of the outbreak strains showed clonal relatedness, which was different from those of other clinical strains, We instructed all the health care workers to stop bladder Irrigation, and to use the separate urinals for each patient. Thereafter, no further case of P. aeruginosa UTI has occurred. CONCLUSION: An outbreak of UTI, caused by a single clone of P. aeruginosa, was confirmed by RAPD and was eradicated after correction of false practice on care-of urinary catheter.
Amikacin ; Anti-Bacterial Agents ; Ceftazidime ; Ciprofloxacin ; Clone Cells ; Cross Infection ; Delivery of Health Care ; Diffusion ; DNA ; Drug Resistance, Multiple ; Gentamicins ; Humans ; Imipenem ; Intensive Care Units ; Microbial Sensitivity Tests ; Piperacillin ; Pseudomonas aeruginosa* ; Pseudomonas* ; Urinary Bladder ; Urinary Catheters ; Urinary Tract Infections* ; Urinary Tract*

We present here, a case of pemphigus erythematosus developed in a 31-year-old woman, who had been suffering from repeated episode, of remission and exacerbation with several erythematous, and somewhat oozing patche accompanying a mild pruritus or her face, upper part of the back and anterior chest. In serological studies, she had antinuclear antiboc@lies at. a titer of 1:160. Histopathological finding showed subcorneal bullae. Immunofluorescent study revealed IgG and C, deposition in the intercellular space of the epidermis and along the de rmoepidermal junction.
Adult ; Epidermis ; Extracellular Space ; Female ; Fluorescent Antibody Technique ; Humans ; Immunoglobulin G ; Pemphigus* ; Pruritus ; Thorax

No abstract available.
Blotting, Southern* ; Diagnosis* ; DNA* ; Humans*

Two strains of vancomycin-resistant Leuconostoc species were isolated from blood cultures in two compromised patients. The isolates produced gas from Lactobacillus MRS booth, hydrolysed esculin, and produced no ammonia from arginine, thus fulfilling the major criteria as Leucorostoc spp. We recommend that clinical laboratories should perform susceptibility test to vancomycin for clinical isolates (especially from cerebrospinal fluid and blood) which resemble streptococci so as not to confuse Leuconostoc spp. with more commonly isolated pathogens such as streptococci.
Ammonia ; Arginine ; Bacteremia* ; Cerebrospinal Fluid ; Esculin ; Humans ; Lactobacillus ; Leuconostoc* ; Vancomycin

BACKGROUND: An accurate and rapid method for specise identification of coagulase negative staphylococci(CNS) has been increasingly necessary for the clinical significance and planning the management of patients with staphylococcal infections. Recently, it has been reported that there is a highly conserved area on their 60KDa heat shock protein(HSP60) gene sequences between the interspecies of CNS and it can be amplified by a set of universal degenerate primer. This led us our attention to focus on whether the PCR-based RFLP method using Mse / restriction enzyme could be a useful tool for the species identification of CNS. METHODS: In the present study, we performed PCR-based RFLP analysis using a set of degenerate primers covering HSP60 and Mse / restriction enzyme on the reference strains and 25 clinical isolates(10 of S. epidermidis, 10 of S. haemolyticus, 4 of S. lugdunensis and 1 of S. warneri) which were previously identified by the API-STAPH, Vitek GPI card and/or with conventional biochemical test. RESULT: All the seven reference strains revealed that each strain has a distinct electrophoresed band patterns with combination of different number (up to 8) and size of fragments. And these distinct band patterns showed remarkable concordance with the seven reference strains and 25 clinical isolates. CONCLUSION: These result strongly suggest that the PCR-RFLP method using degenerate primers covering the HSP60 gene and Mse / digestion enzyme offer a convenient and accurate tool for species-specific identification of CNS.
Chaperonin 60* ; Coagulase* ; Digestion ; Heat-Shock Proteins* ; Hot Temperature* ; Humans ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Shock ; Staphylococcal Infections

Lymphoid tumors of the orbit are rare, and sometimes it is not possible either clinically or histologically to differentiate between lymphoid tumor and pseudolymphoma. Some authors assert that the degree of cytologic differentiation appears to be the single most important factor for determining the prognosis of patients with orbital lymphoid lesions. However, the cytomorphologic basis is not so helpful to diagnose and classify our case, which shows some discrepancy between pathological findings and clinical and radiological findings. At first we misdiagnosed our case as orbital malignant lymphoma on the basis of cytomorphology and immunohistochemical study. But no responce to local intensive radiotherapy and the follow up study of the patient suggest orbital pseudolymphoma.
Follow-Up Studies