No abstract available.
Nortriptyline* ; Pharmacokinetics*

Actinomycoces is a gram positive, anaerobic, branching and non-acid fast bacterium which is a normal habitant of the skin, oral cavity, tonsil and gastrointestinal tract and its human infection is rare. Pelvic actinomycoses is frequently caused by Actinomycoces israel-ii. It is chronic, progressive, and more suppurative than granulomatous disease, and the symptoms are usually persistent and gradual, therefore the misdiagnosis and improper trea-tment are not uncommon. Actinomycoses is generally classified as cervicofacial, abdominal and thoracic type ac- cording to the site of the primary infection. Many actinomycotic pelvic infections in women used intrauterine device with long du- ration were reported, in contrast, others suggest that actinomycoces developed opportunistic infection irrespective of intrauterine device presence. We have experienced 4 cases of pelvic actinomycoses, one case with IUD(Lippes' loop) in a 47 year old woman, the other case with abdominal wall ctinomycoses in a 34 year old woman, the third case without IUD in a 41 year old woman, the fourth case with IUD(Cu-7) in a 37 year old woman and reported them with a review of literature.
Abdominal Wall ; Actinomycosis* ; Adult ; Diagnostic Errors ; Female ; Gastrointestinal Tract ; Humans ; Intrauterine Devices ; Middle Aged ; Mouth ; Opportunistic Infections ; Palatine Tonsil ; Pelvic Infection ; Skin

Coronary artery and valvular injuries after blunt chest trauma are an unusual condition. This diagnosis is very difficult to estabilish, but prompt diagnosis and proper management are important in life saving. We report one patient who develop left main coronary artery dissection, tricuspid insufficiency, mitral insufficiency and pericardial rupture following blunt chest trauma. One year ago, he had suffered a frontal impact in a traffic accident and recieved anti-tuberculosis medication for 10 months for chest discomfort. The correct diagnosis was confirmed noninvasively by transesophageal echocardiography and the patient was treated left main coronary artery dissection flap removal, mitral valve replacement, tricuspid valvuloplasty and repair of ruptured pericardium. The postoperative course was uneventful and the patient was fully recovered.
Accidents, Traffic ; Coronary Vessels* ; Diagnosis ; Echocardiography, Transesophageal ; Humans ; Mitral Valve ; Mitral Valve Insufficiency* ; Pericardium ; Rupture* ; Thorax*

BACKGROUND: This study was purposed to identify the knowledge and performance level of the infection control guidelines and to improve their performance level of infection control for those nurses who care patients directly. METHODS: This study was based on the survey questionnaires about infection control guidelines with the total 626 nurses in Seoul and Kyunggi areas for the period between May 26, 2003 and July 14, 2003. RESULTS: The average knowledge level of infection control was 0.84 +/-0.07 (score range 0-1) and the average performance level of the infection control was 4.44+/-10.27 (score range 0-5). The correlation between knowledge and performance of the infection control showed positive correlation (r=.39; P<.001). The knowledge and performance level of the 'Prevention of the central catheter infection' were higher than other infection control guidelines. The performance levels of the 'Prevention of the surgical site infection' were lower than other infection control guidelines. The correlation between knowledge and performance of the 'Prevention of the nosocomial pneumonia' (r=.389; P<.001). 'Prevention of the urinary tract infection' (r=.325; P<.001), 'Prevention of the central catheter infection (r=.290; P<.001) and 'Intravascular infection control' (r=.446; P<.001) showed positive correlation. CONCLUSION: The study demonstrated that the nurses' knowledge and performance of infection control guidelines showed positive correlation. So the education on the infection control is required indispensably and it would contribute to reduce the hospital infection rate by performing the right treatment on the infection control with the basis of accurate knowledge.
Catheters ; Cross Infection ; Education ; Gyeonggi-do ; Humans ; Infection Control* ; Seoul ; Urinary Tract ; Surveys and Questionnaires

Surgery, anticoagulation therapy, pregnancy, and hormone treatments, such as bromocriptine, are well-characterized precipitating factors for pituitary apoplexy. However, whether cytotoxic chemotherapy for systemic cancer could cause pituitary apoplexy has not been investigated. Here, we present a case of a 41-year-old woman who developed a severe headache with decreased visual acuity after intravenous cytotoxic chemotherapy to treat metastatic breast cancer. Preoperative neuroimaging revealed pituitary adenoma with necrosis. Operative findings and pathologic examination concluded extensive necrosis with a small intratumoral hemorrhage in a pre-existing pituitary adenoma. We reviewed two additional previously published cases of pituitary apoplexy after systemic chemotherapy and suggest that cytotoxic chemotherapy may induce pituitary apoplexy.
Adult ; Breast Neoplasms* ; Breast* ; Bromocriptine ; Drug Therapy* ; Female ; Headache ; Hemorrhage ; Humans ; Necrosis ; Neuroimaging ; Pituitary Apoplexy* ; Pituitary Neoplasms ; Precipitating Factors ; Pregnancy ; Visual Acuity

Ginseng root rot caused by Cylindrocarpon destructans is the most destructive disease of ginseng. Six different fungicides (thiophanate-methyl, benomyl, prochloraz, mancozeb, azoxystrobin, and iprodione) were selected to evaluate the inhibitory effect on the mycelial growth and conidial germination of C. destructans isolates. Benomyl and prochloraz were found to be the most effective fungicides in inhibiting mycelial growth of all tested isolates, showing 64.7% to 100% inhibition at a concentration of 10 µg/mL, whereas thiophanate-methyl was the least effective fungicide, showing less than 50% inhibition even at a higher concentration of 100 µg/mL. The tested fungicides exhibited less than 20% inhibition of conidium germination at concentrations of 0.01, 0.1, and 1 µg/mL. However, the inhibition effect of mancozeb on condium germination of C. destructans was significantly increased to 92% to 99% at a higher concentration of 100 µg/mL, while the others still showed no higher than 30% inhibition.
Benomyl ; Fungi* ; Germination* ; Panax* ; Spores, Fungal ; Thiophanate

Streptococcus salivarius meningitis is very uncommon, and most cases are iatrogenic, occurring after invasive procedures such as spinal anesthesia or lumbar puncture etc.. Post-traumatic occurrence of this infection is especially rare. A 20-year-old man with a previous history of skull base fracture was seen at the emergency department with signs of acute bacterial meningitis. The CSF had a few gram positive cocci with neutrophilic pleocytosis, which were identified as S. salivarius by the Vitek system (bioMerioux, Inc., Hazelwood, MO, USA), rapid ID 32 Strep (bioMerieux, Marcy-l'Etoile, France) and 16S rRNA sequencing. The microorganism showed intermediate resistance to penicillin (MIC=0.25 microg/mL) but was susceptible to cefotaxime (MIC=0.25 microg/mL) and vancomycin (MIC= 0.75 microg/mL). The patient was treated with ceftriaxone and vancomycin. He also had his CSF leakage repaired by an endoscopic approach. To our knowledge, this is the first case of S. salivarius meningitis reported in Korea.
Anesthesia, Spinal ; Cefotaxime ; Ceftriaxone ; Cerebrospinal Fluid Rhinorrhea ; Emergencies ; Gram-Positive Cocci ; Humans ; Korea ; Leukocytosis ; Meningitis ; Meningitis, Bacterial ; Neutrophils ; Penicillins ; Skull ; Skull Base ; Skull Fractures ; Spinal Puncture ; Streptococcus ; Vancomycin ; Young Adult

BACKGROUND: The aim of this study was to analyze the clinical manifestations and efficacy of treatment regimens in order to determine the adequate combination of anti-tuberculotic agent and duration of treatment for tuberculous lymphadenitis. METHODS: We made a review of 373 patients with tuberculous lymphadenitis, who were admitted to four medical college hospitals in Taegu Korea from 1989 to 1998, and their diagnoses were confirmed histologically and bacteriologically. RESULTS: The incidence of tuberculous lymphadenitis was 71.3% in women and 57.7% were between the ages of 20 and 39 years. The most common symptom was painless swelling. The most commonly involved lymph nodes were unilateral superficial cervical lymph node groups. Tuberculous lymphadenitis was accompanied with active pulmonary tuberculosis, commonly. The sensitivity of fine needle aspiration(FNA) in tuberculous lymphadenitis was 79.6% and 92.2% of the patients had a strong positive reaction to the tuberculin skin test. The most commonly prescribed anti-tuberculotic regimen was the combination of INF, RMP, EMB and PZA(62.6%). Eighty percent of patient were treated for 9-12 months. There was no significantly difference in the recurrence rate of tuberculous lymphadenitis between the combinations of anti-tuberculotic agent, including INF and RMP, and between the durations of treatment, for a period of 6 months of treatment, for a period of 6 months of more. CONCLUSION: The combination of FNA cytologic examination and tuberculin skin test may be helpful in the diagnosis of tuberculous lymphadenitis. We propose that the combination of anti-tuberculotic agents, INH, RMP, EMB, and PZA, be prescribed to patients for 6 to 9 months.
Daegu ; Diagnosis ; Female ; Humans ; Incidence ; Korea ; Lymph Nodes ; Needles ; Recurrence ; Skin Tests ; Tuberculin ; Tuberculosis, Lymph Node* ; Tuberculosis, Pulmonary

BACKGROUND: CD24, also referred to as the heat stable antigen in mice, is a glycosyl phosphatidylinositol- linked glycoprotein expressed by thymocytes, B cells, neutrophils and immature neuronal cells. It has been recently observed in a variety of human malignancy. Here, we demonstrated the expression of CD24 in gastric adenocarcinomas. METHODS: A total of 40 gastric adenocarcinomas and 20 tubular adenomas were immunohistochemically examined for the expression of CD24 and matrix metalloproteinase-2 (MMP-2) proteins. The immunoreactivity of CD24 was semiquantitatively scored (0, 1+, 2+) and compared with clinicopathologic variables and MMP-2 expression in tumor cells. RESULTS: CD24 was rarely expressed in normal gastric tissue and not expressed in tubular adenoma. In contrast, a moderate/strong expression (2+) of CD24 was observed in 25% of gastric adenocarcinomas, and 30% cases showed a weak CD24 staining (1+). Moreover, CD24 expression was significantly correlated with the depth of tumor invasion and MMP-2 expression. CONCLUSION: These results suggest that the aberrant expression of CD24 in gastric adenocarcinomas might be associated with tumor progression and invasiveness.
Adenocarcinoma* ; Adenoma ; Animals ; Antigens, CD24 ; B-Lymphocytes ; Glycoproteins ; Hot Temperature ; Humans ; Matrix Metalloproteinase 2 ; Mice ; Neoplasm Invasiveness ; Neurons ; Neutrophils ; Stomach Neoplasms ; Thymocytes

BACKGROUND: Lung cancer incidence is gradually leveling off in developed countries but is continuing to rise in Korea. Because of the rapid increasing in smoking prevalence among women and youngers, the lung cancer incidence is expected to increase within next three and four decades. The aims of the present study are to analyses the smoking habits in patients with lung cancer and to evaluate of the relative risk of smoking habits in patients with lung cancer. METHOD: The present investigation was hospital-based, case control study. It included data from 93 case subjects with lung cancer and 1132 controls with disease unrelated to smoking using smoking history questionnaire by direct personal interview. RESULT: Compared with non-smoker, those who smoked more than 50 years had an odds ratio for lung cancer of 8.8(1.8-20.7). The odds ratios was 8.5(3.5-20.7) for those whose total number of cigarettes per days exceeded 41 and 5.5(2.3-13.3) for men with started habitual smoking less than 20 years old. The risk was increased in men with more than 41 pack years of cigarette smoking(OR:5.5, 95% CI:2.6-11.9). Odds ratios associated with cigarette smoking were 2.5(1.1-5.8), 5.1(2.6-10.4) for exsmoker and current smoker, respectively and 2.2(1.0-4.6) for non-filter smoker with more than 16 years. CONCLUSION: There was a clear dose-response relationship between the risk of lung cancer and smoking. We conclude that smoking dose is important risk factor for lung cancer and smoking habits may be, also.
Case-Control Studies ; Developed Countries ; Female ; Humans ; Incidence ; Korea ; Lung Neoplasms* ; Lung* ; Male ; Odds Ratio ; Prevalence ; Surveys and Questionnaires ; Risk Factors ; Smoke* ; Smoking* ; Tobacco Products ; Young Adult