Antibiotics were reported to be able to alter bacterial surface properties in subinhibitory concentrations (sub-MICs). The effects of sub-MICs of certain antibiotics on a bacterial surface property such as hemagglutination, as well as on the cell morphology were studied using Streptococcus gordonii and Staphylococcus aureus. The effect of sub-M1Cs of antibiotics on the binding of these bacteria to immobilized fibrinogen were also investigated. The MICs of antibiotics were determined by culturing S. gordonii and S. aureus in media supplemented with serially diluted drug solutions, and one-half the MIC was used as the sub-MIC of the drugs, unless stated otherwise. Sub-MICs of antibiotics did not affect bacterial agglutination of erythrocytes. Microscopic observation of S. gordonii grown at sub-MIC concentration of 0.02 ug/ml of amoxicillin revealed cell enlargement of 1.6 times those grown without the drug. When grown in the sub-MIC amount of 0.08 ug/ml of cefazolin, most S. gordonii cells were enlarged and elongated into rod-shape, resulting in 3 times the size of the cells grown without the antibiotic. The data from the fibrinogen-binding experiments showed that the binding of S. gordonii to immobilized fibrinogen was increased with all the B-lactam drugs tested; the binding of S. aureus to immobilized fibrinogen, on the other hand, was decreased with the same drugs. The results show that low concentrations of certain B-lactam antibiotics are able to cause alterations in cellular morphology of S. gordonii and affect the binding of S. gordonii and S. aureus to immobilized fibrinogen.
Agglutination ; Amoxicillin ; Anti-Bacterial Agents* ; Bacteria ; Cefazolin ; Cell Enlargement ; Erythrocytes ; Fibrinogen ; Hand ; Hemagglutination ; Staphylococcus aureus* ; Staphylococcus* ; Streptococcus gordonii* ; Streptococcus* ; Surface Properties*

BACKGROUND: Up to the present, there has been little study on chronic fatigue or chronic fatigue syndrome, and there is equally sparse relevant statistical data For this reason, we attempted to investigate the present status of fatigue, particularly its incidence and actual conditions. METHODS: The study subjects were 12,152 outpatients who visited family practice in hospitals all over Korea between July 24 and September 21, 1997. They were given a questionnaire which included questions reflecting the (U.S.) Center for Disease Control criteria defining chronic fatigue syndrome. RESULTS: Among the subjects, 861 people complained of fatigue in their response to the questionnaire and they became the focus of the study. Of this fatigue group, 426 people(49.4%) had rnanifested fatigue for more than 6 manths, and the male/female ratio was 54%/46%, respectively. People who re ported that fatigue impaired their ability to function on a daily basis made up 35.8% of the fatigue group and the percentage of people who had considered visiting a clinic duen to fatigue wasa unexpectedly high 52.8%. The reported causes of fatigue, in decreasing order, were. social interactio(mals 68.5%/ femals 45.1%); sleep disturbance(mals 26.8%/ femals 21.8%); and physical maladies(mals 24.2%/femals 26.5%). There were significant gender differences in social interaction relating to domestic problems(mals 4.7%/femals 16.7%) and emotional problems(mals 12.2%/femals 21.4%). Among 33 chronic fatigue syndrome patients who indicated what they thought were the causes of their problems, 68.8% reported physical maladies, 65.6% social life, 31.3% emotional problems, 21.9% sleep disturbance, and 21.9 % domestic problems. The associated symptoms of fatigue reported in both males and females, in decreasing order, included: myalgia, headache and neurologic symptoms. The prevalence of chronic fatigue was 0.27%. CONCLUSIONS: Our study showed that 7.1% of family practice outpatients complained of fatigue and that their daily activities or occupational life were disturbed as a result. This group demanstrates is serious need for medical assistance. Therefore, doctors should have more interest in fatigue, particularly in chronic fatigue syndrome, so as to provide real and versatile care.
Centers for Disease Control and Prevention (U.S.) ; Family Practice ; Fatigue Syndrome, Chronic ; Fatigue* ; Female ; Headache ; Humans ; Incidence ; Interpersonal Relations ; Korea ; Male ; Medical Assistance ; Myalgia ; Neurologic Manifestations ; Outpatients* ; Prevalence ; Surveys and Questionnaires

No abstract available.

Profound reduction of anterograde coronary flow with concomitant ischemia is seen occasionally during percutaneous coronary intervention despite technically successful procedure. We found interesting coronary flow pattern in a patient with acute myocardial infarction, showing angiographic no reflow phenomenon after direct PTCA. The coronary blood flow pattern of the angiographic no-reflow phenomenon in this case was characterized by minimal systolic flow and sharp deceleration of diastolic flow. Coronary flow reserve calculated by the ratio of adenosine induced maximal hyperemic velocity and basal velocity was reduced. The Dopplertipped guide wire was useful for observation of phasic coronary flow pattern of angiographic no-reflow phenomenon.
Adenosine ; Deceleration ; Humans ; Ischemia ; Myocardial Infarction* ; No-Reflow Phenomenon ; Percutaneous Coronary Intervention

Although most cases of posterior reversible encephalopathy syndrome (PRES) are reversible, irreversible lesions as a form of hemorrhage or infarction have been described. PRES as a complication of systemic lupus erythematosus (PRES-SLE) is associated with hypertension or use of immunosuppressive agents. We present a case of recurrent atypical PRES-SLE, which showed restricted diffusion in the first manifestation of SLE, resulted in parenchymal hemorrhagic transformations in the recurrent episode.
Diffusion ; Hemorrhage ; Humans ; Hypertension ; Immunosuppressive Agents ; Infarction ; Lupus Erythematosus, Systemic

PURPOSE: To report a case of Serratia marcescens endophthalmitis following phacoemulsification and posterior chamber intraocular lens implantation. CASE SUMMARY: A 64-year-old male with a history of diabetes, hypertension, cardiovascular disease was referred with right ocular pain and reduced vision 1 day after cataract surgery. On admission, hypopyon on anterior chamber by slit lamp examination and anterior vitreous was hazy according to ultrasonography. We immediately performed intravitreal antibiotics injection and microbiological analysis of anterior chamber and vitreous samples was performed. On day 3, persistent cornea stormal infiltration and cornea perforation were visible and the organism was identified as S. marcescens. Despite appropriate antibiotic treatment the eye continued to deteriorate. CONCLUSIONS: S. marcescens endophthalmitis was diagnosed and treated immediately, but rapid progression and outcome were unsatisfactory.
Anterior Chamber ; Anti-Bacterial Agents ; Cardiovascular Diseases ; Cataract* ; Cornea ; Corneal Perforation* ; Endophthalmitis* ; Eye ; Humans ; Hypertension ; Lenses, Intraocular ; Male ; Middle Aged ; Phacoemulsification ; Serratia marcescens* ; Serratia* ; Vision, Low

We analysed the optic nerve head of 151 normal eyes with 8 confocal scanning laser ophthalmoscope (TopSSTM, Laser Diagnostic Technologies, Inc.), and obtained the normal values of each parameters. As the optic disc size increases, the cup shape, effective area, 1/2 depth area, C/D ratio, neuroretinal rim area, volume above, volume below, and 1/2 depth volume also increase. Therefore we obtained the normal values of these parameters according to the optic disc size. The entire subjects were divided into four groups according to the disc area, each group of 1. 5mm2-2.0mm2, 2.0mm2-2.5mm2, 2.5mm2-3.0mm2, and 3.0mm2-3.5mm2`, respectively. The normal values of other parameters such as contour variation, rnean contour depth, average depth, maximum depth, average slope, and maximum slope which are not affected by optic disc size were obtained without grouping. This may minimize the error in evaluating the optic disc parameters and may be useful in the early detection of glaucomatous optic disc changes.
Ophthalmoscopes ; Optic Disk ; Reference Values*

Mucinous cystic neoplasms of the pancreas are uncommon and known to occur mainly in middle-aged women. Wepresent a case of pancreatic mucinous cystadeno-carcinoma in an 11-year-old girl who had a past history of bluntabdominal trauma. The tumor was initially mistaken for a traumatic pseudocyst. US and CT revealed a multiloculatedcystic mass in the pancreatic tail. The mass showed good transmission on ultrasonography (US) and had anattenuation value of 10 HU on CT. Metastatic lesions in the liver were also shown on follow-up study.
Child* ; Cystadenocarcinoma, Mucinous* ; Female* ; Follow-Up Studies ; Humans ; Liver ; Mucins* ; Pancreas ; Ultrasonography

PURPOSE: To evaluate CT findings for the differential diagnosis of mechanical bowel obstruction and paralytic ileus. MATERIALS AND METHODS: Without information relating to clinical or operative findings, we retrospectively analyzed the CT scans of 24 patients with mechanical bowel obstruction and 19 patients with paralytic ileus. Final diagnosis was confirmed by operation (n=26), or by clinical symptoms, radiologic findings and follow-up study CT findings were obtained : 1) the diameter of the most dilated part of the small bowel, and the thickness and enhancing pattern of the dilated small bowel wall; 2) the diameter of the most dilated part of the descending colon and the ratio of the diameter of the small bowel to that of the descending colon; 3) the number of transitional zones, length and thickness. and 4) associated ascites and its location. RESULTS: The mean diameters of the most dilated part of the small bowel in mechanical bowel obstruction and paralytic ileus were 3.6cm and 2.9cm, respectively. The diameter of the small bowel in mechanical bowel obstruction was significantly greater than in paralytic ileus(p< .05). The mean thickness of dilated small bowel wall was 4.0mm in mechanical bowel obstruction and 2.4mm in paralytic ielus, and target-like enhancement was prominent in mechanical bowel obstruction (46%) (p< .05). he mean diameter of the most dilated part of the descending colon was not significantly different to that of the most dilated part of the small bowel, but the ratio of the diameter of the small bowel to that of the colon was 2.9 in mechanical bowel obstruction and 1.9 in paralytic ileus, respectively, which was statistically significant (p< .05). A transitional zone was seen in 23 cases (96%) of mechanical bowel obstruction and in nine (47%) of paralytic ileus. In mechanical bowel obstruction, mean transitional zone length was 2cm, shorter than that of paralytic ileus (3.4cm) (p< .05) The thickness of transitional zone and the presence of ascites and its locations were not significantly different between mechanical bowel obstrction and paralytic ileus. CONCLUSION: In the differential diagnosis of mechanical bowel obstruction and paralytic ileus, the following CT findings were considered useful : diameter of the most dilated part of the small bowel ; thickness and target-like enhancing pattern of dilated small bowel wall ; ratio of the diameter of the small bowel to that of the descending colon ; and the number of transitional zones, and their length.
Ascites ; Colon ; Colon, Descending ; Diagnosis ; Diagnosis, Differential* ; Follow-Up Studies ; Humans ; Intestinal Pseudo-Obstruction* ; Retrospective Studies ; Tomography, X-Ray Computed

BACKGROUND: With increased prevalence of colorectal cancer, it is important to establish the risk factors of colorectal cancer. The prevalence of the metabolic syndrome (MS) is also increasing. Insulin resistance may play an important role in the pathogenesis of MS and colorectal polyps. The aim of this study was to assess the relationship between MS and colorectal polyps. METHODS: A total 558 subjects underwent colonoscopic examination from April 2004 to July 2005 at the health promotion center of Bundang CHA Hospital. According to the National Cholesterol Education Program (NCEP) Adult Treatment Panel III definition of MS, the waist circumference, blood pressure (BP), fasting blood glucose (FBG), triglyceride (TG) and HDL cholesterol were measured. Alcohol consumption, smoking and other confounding factors were assessed by a self-administered questionnaire. RESULTS: The incidence of MS and colorectal polyps was 16.3% and 33.0%, respectively. In subjects with polyps, the number of men, smokers and drinkers were higher than in subjects without polyps. In subjects with polyps, BP, FBG and TG were also higher than in subjects without polyps. After adjustment for possible confounding factors, MS was associated with increased risk of colorectal polyps (odds ratio, 1.74; 95% confidence interval, 0.94~3.22). MS strongly increased the risk of colorectal polyps in men (odds ratio 2.19; 95% confidence interval, 1.07~4.45), but not in women. CONCLUSION: We concluded that MS is a risk factor for colorectal polyps in asymptomatic Korean adults and this suggests that insulin resistance may play an important role in the development of colorectal polyps.
Adult ; Alcohol Drinking ; Blood Glucose ; Blood Pressure ; Cholesterol ; Cholesterol, HDL ; Colorectal Neoplasms ; Education ; Fasting ; Female ; Health Promotion ; Humans ; Incidence ; Insulin Resistance ; Male ; Polyps* ; Prevalence ; Risk Factors ; Smoke ; Smoking ; Triglycerides ; Waist Circumference ; Surveys and Questionnaires