Fungi have been recognized as a significant cause of external otitis and it may be the primary pathogen or be part of a mixed infection. In the immunocompromised host, fungus is capable of producing infection in inner ear or middle ear. Otomycoses are most frequently caused by Aspergillus spp. and Candida sap. There are few reports that Aspergillus species other than A. fumigatus, A. niger and f. flavus have caused chronic otitis media. We report two cases of chronic otitis media caused by Aspergillus ferrous in Korea. One case is a 7-year-old girl who had recurrent serous otorrhea and otalgia for 4 years, was reattended otolaryngology clinics with otorrhea of 3 days durations and another is a 6-year-old girl who had serous otorrhea for 2 months and 3 day fever, was attended otolaryngology clinics with them. Microscopic appearance and colony morphology from ear discharge cultures revealed A. ferrous. The infection responded well to topical ketoconazole therapy. This report should help to raise medical personnel's awareness of such human opportunistic fungal ear infections.
Aspergillus* ; Candida ; Child ; Coinfection ; Ear ; Ear, Inner ; Ear, Middle ; Earache ; Female ; Fever ; Fungi ; Humans ; Immunocompromised Host ; Ketoconazole ; Korea ; Niger ; Otitis Externa ; Otitis Media* ; Otitis* ; Otolaryngology ; Otomycosis

BACKGROUND: Neuroaxial morphine may produce nausea and vomiting due to cephalad migration. Though it improves post- operative pain, it may have serious complication delaying recovery. The aim of this study was to investigate the efficacy of prophylactic antiemetics such as conventional metoclopramide or more expensive ondansetron. METHODS: Eighty-seven patients who underwent orthopedic knee arthroscopic surgery under epidural anesthesia were randomly assigned to three groups, which are (a) normal saline intravenous injection control group (Group C), (b) metoclopramide intravenous injection and intranasal spray study group (Group M), (c) ondansetron inravenous injection group (Group O). Before the end of surgery, all patients were given 3 mg of morphine and 2 mg of butorphanol mixture via epidural catheter for postoperative pain control. The anesthesia were all standardized. Post-operative nausea and vomiting were observed and used as outcome variables and postoperative pain, itching, somnolence, dizziness, urinary retention were also observed. RESULTS: The incidence of postoperative nausea was significantly lower in Group M (P = 0.0296) and Group O (P = 0.005) compared with Group C. The incidence of postoperative vomiting was significantly lower in Group O (P = 0.01) compared with Group C. But statistically no difference was noted in vomiting between Group C and Group M (P = 0.0579). CONCLUSIONS: The results suggest that ondansetron and metoclopramide are effective in reducing the incidence of post-operative nausea. But ondansetron is more effective in reducing the incidence of post-operative morphine induced vomiting.
Anesthesia ; Anesthesia, Epidural ; Antiemetics ; Arthroscopy ; Butorphanol ; Catheters ; Dizziness ; Humans ; Incidence ; Injections, Intravenous ; Knee ; Metoclopramide* ; Morphine ; Nausea ; Ondansetron* ; Orthopedics ; Pain, Postoperative ; Postoperative Nausea and Vomiting* ; Pruritus ; Urinary Retention ; Vomiting

No abstract available.
Diffusion* ; Teicoplanin*

No abstract available.
Glaucoma* ; Manometry* ; Mass Screening*

No abstract available.
Radiation, Ionizing

PURPOSE: The aim of the present study is to detect cagA and vacA genes of Helicobacter pylori(H. pylori) strain in gastric biopsy specimens and to evaluate its association with gastric inflammation in children. METHODS: The cagA and vacA genes were detected by a direct polymerase chain reaction(PCR) assay of gastric biopsy specimens in 22 patients who were found to be H. pylori positive by histological detection with modified Giemsa stain, rapid urease test(CLO; Delta West Pty Ltd, Australia) and PCR using ureC primer in gastric biopsy specimens. RESULTS: The cagA gene was detected in 16(72.7%) of 22 patients. Eleven patients(50%) had both the cagA and vacA gene. Five patients had only the vacA gene. Twenty one patients(95.5%) had the cagA or vacA gene. The cagA gene was detected in 66.7% of gastritis and in 87.5% of peptic ulcer patients. The association of the cagA gene with peptic ulcer or the higher degree of inflammation did not reach statistical significance. The histological H. pylori density of antrum was significantly correlated with gastric inflammation(P<0.05). CONCLUSION: These findings suggest that the antral density of H. pylori was associated with the gastric inflammation. The association of the cagA gene with peptic ulcer or the higher degree of imflammation was not significant.
Azure Stains ; Biopsy* ; Child* ; Gastritis ; Helicobacter pylori* ; Helicobacter* ; Humans ; Inflammation* ; Peptic Ulcer ; Polymerase Chain Reaction* ; Urease

PURPOSE: The aim of this study was to evaluate the usefulness of PCR using ureC primer in the gastric biopsy specimens for the diagnosis of Helicobacter pylori (H. pylori) infection in children. METHODS: We have assessed prospectively 82 patients (age range 1-15 years) who underwent esophagogastroduodenoscopy (Olympus EVIS XQ 200 or p230, Japan) for 15 months. At least three biopsy specimens were taken from the antral mucosa within 2cm of the pylorus. We performed histological detection with modified Giemsa stain, CLO test (Delta West Pty Ltd, Australia) for rapid urease test and PCR using ureC primer. H. pylori positivity was defined as the concordance of two tests. The patients with only one positive test were defined as undetermined cases. RESULTS: Seventeen of the 82 patients were H. pylori positive and 52 patients were H. pylori negative by definition. Of the 17 patients, 15 were found to be positive by all three tests, 2 were found to be positive by two tests. Abnormal endoscopic findings in H. pylori positive patients (82.4%) was significantly higher than H. pylori negative patients (50.0%) (P<0.05). Diagnostic sensitivity, specificity, positive predictive value, negative predictive value and efficiency of PCR in gastric biopsy specimens were 94.1%, 100%, 100%, 98.1%, 98.7% and same as CLO test, respectively. Those of endoscopic nodularity was 58.8%, 100%, 100%, 88.1% 89.9%. CONCLUSION: These findings suggest the PCR assay using the ureC gene in gastric biopsy specimens is sensitive and rapid for the diagnosis of H. pylori infection in children. But, in this study diagnostic sensitivity and specificity of PCR assay were the same as the CLO test.
Azure Stains ; Biopsy* ; Child* ; Diagnosis* ; Endoscopy, Digestive System ; Helicobacter pylori* ; Helicobacter* ; Humans ; Mucous Membrane ; Polymerase Chain Reaction* ; Prospective Studies ; Pylorus ; Sensitivity and Specificity ; Urease

PURPOSE: The aim of this study was to evaluate the usefulness of PCR using ureC primer in the gastric biopsy specimens for the diagnosis of Helicobacter pylori (H. pylori) infection in children. METHODS: We have assessed prospectively 82 patients (age range 1-15 years) who underwent esophagogastroduodenoscopy (Olympus EVIS XQ 200 or p230, Japan) for 15 months. At least three biopsy specimens were taken from the antral mucosa within 2cm of the pylorus. We performed histological detection with modified Giemsa stain, CLO test (Delta West Pty Ltd, Australia) for rapid urease test and PCR using ureC primer. H. pylori positivity was defined as the concordance of two tests. The patients with only one positive test were defined as undetermined cases. RESULTS: Seventeen of the 82 patients were H. pylori positive and 52 patients were H. pylori negative by definition. Of the 17 patients, 15 were found to be positive by all three tests, 2 were found to be positive by two tests. Abnormal endoscopic findings in H. pylori positive patients (82.4%) was significantly higher than H. pylori negative patients (50.0%) (P<0.05). Diagnostic sensitivity, specificity, positive predictive value, negative predictive value and efficiency of PCR in gastric biopsy specimens were 94.1%, 100%, 100%, 98.1%, 98.7% and same as CLO test, respectively. Those of endoscopic nodularity was 58.8%, 100%, 100%, 88.1% 89.9%. CONCLUSION: These findings suggest the PCR assay using the ureC gene in gastric biopsy specimens is sensitive and rapid for the diagnosis of H. pylori infection in children. But, in this study diagnostic sensitivity and specificity of PCR assay were the same as the CLO test.
Azure Stains ; Biopsy* ; Child* ; Diagnosis* ; Endoscopy, Digestive System ; Helicobacter pylori* ; Helicobacter* ; Humans ; Mucous Membrane ; Polymerase Chain Reaction* ; Prospective Studies ; Pylorus ; Sensitivity and Specificity ; Urease

A 46-year-old woman received one cervical epidural injection for the management of her neck and shoulder pain. The patient was placed in the prone position without sedation. By using the "loss of resistance to injection of air" technique, the epidural space was identified at the level of C7-T1 inter-laminar space. After needle placement was confirmed by biplanar fluoroscopy and contrast dye, mixture composed of 20 mg of triamcinolone acetonide and 0.125% chirocaine (6.5 ml total volume) was injected. The patient reported no reaction or signs of spinal cord irritation during needle placement attempt. She was developed both low extremity motor weakness and the repeated MRI of the cervical spine indicated right focal cervical myelopathy. It is unknown whether the neurologic injury sustained by patient was the result of spinal cord penetration by the needle, adverse effects from neural tissue exposure to the injected drug, or a combination of both factors.
Bupivacaine ; Epidural Space ; Extremities ; Female ; Fluoroscopy ; Humans ; Injections, Epidural ; Middle Aged ; Neck ; Needles ; Prone Position ; Shoulder Pain ; Spinal Cord ; Spinal Cord Diseases ; Spine ; Triamcinolone Acetonide

BACKGROUND: Glutamate is the predominant excitatory neurotransmitter in the central and peripheral nervous system and has known to be involved in nociceptive transmission and central sensitization. It acts through ligand gated ionotropic glutamate receptors (iGluRs) and G protein-coupled metabotropic glutamate receptors (mGluRs). And mGlu 1, 5 receptors have been recognized to play a role in nociceptive processing. We want to investigate whether central mGluR1 and mGluR5 antagonists could reverse the behavioral signs of weight bearing and secondary mechanical hyperalgesia induced by chronic knee joint inflammation. METHODS: MGluR1 antagonist, (RS)-1-aminoindan-1,5-dicarboxylic acid (AIDA: 25, 50, 100 microM/10 microliter, n = 7 per group) and selective mGluR5 antagonist, 2-methyl-6-(phenylethynyl)-pyridine (MPEP: 25, 100, 200 nM/10 microliter, n = 7 per group) were injected intrathecally 5 days after Complete Freund's Adjuvant (CFA, 150 microliter) injection into knee joint and behavior signs of weight bearing and secondary mechanical hyperalgesia were observed. RESULTS: CFA significantly reduced the magnitude of right hind paw weight bearing and decreased the withdrawal threshold to mechanical stimulation compared to contralateral side. Higher dose of AIDA (100 microM) significantly reversed the reduction of weight bearing, but MPEP did not. AIDA reversed the decrease of the paw withdrawal threshold to mechanical stimulation at the dosage of 50 and 100 microM respectively. MPEP significantly increased the paw withdrawal threshold to mechanical stimulation in a dose dependent manner. CONCLUSIONS: Group I mGluRs were involved in maintenance of primary and secondary mechanical hyperalgesia.
Animals ; Arthritis ; Central Nervous System Sensitization ; Freund's Adjuvant ; Glutamic Acid ; Hyperalgesia ; Inflammation ; Knee Joint* ; Knee* ; Neurotransmitter Agents ; Peripheral Nervous System ; Rats* ; Receptors, Ionotropic Glutamate ; Receptors, Metabotropic Glutamate ; Weight-Bearing