A fixed drug eruption is a cutaneous reaction caused by various drugs, which include phenazone derivatives, barbiturates, sulfonamides, tetracyclines and phenolphthaleins. An eruption caused by piroxicam is very rare and there have been no previous reports in Korea. A 49-year-old woman was seen with mutiple erythematous patches and some bullae that appeared after oral administration of piroxicam. The patient had had two similar episodes after oral administration of piroxicam. We performed patch test with piroxicam and could confirm a fixed drug eruption caused by this durg.
Administration, Oral ; Antipyrine ; Barbiturates ; Drug Eruptions* ; Female ; Humans ; Korea ; Middle Aged ; Patch Tests ; Phenolphthalein ; Phenolphthaleins ; Piroxicam* ; Sulfonamides ; Tetracyclines

Fixed drug eruption normally presents as single or multiple sharply demarcated erythematous lesions that recur at the same location upon re-exposure to the offending agent. When the acute inflammation subsides, it often leaves residual hyperpigmentation. Commonly implicated substances are phenolphthalein, barbiturates, sulfonamides, tetracyclines, salicylates, gold and pyrazolone derivatives. Despite frequent use of acetaminophen, drug eruptions, especially fixed drug eruptions, due to acetaminophen are extrernely rare. We report here a childhood case of fixed drug eruption caused by acetaminophen, which is extensively used as an over-the-counter drug, as well as in medical therapy.
Acetaminophen* ; Barbiturates ; Drug Eruptions* ; Hyperpigmentation ; Inflammation ; Phenolphthalein ; Salicylates ; Sulfonamides ; Tetracyclines

Methoxyflurane, a new anesthetic agent, was administered to one hundred surgical patients. The following are the results of clinical observation and liver function tests. (1) Methoxyflurane is easily administered with a relatively simple vaporizer such as Heidbrink No.8 ether vaporizer in semi-closed system. (2) Blood pressure, pulse rate and cardiac rhythm are remarkably stable if deep anesthesia is avoided. (3) Excellent muscle relaxation is produced at intermediate levels of anesthesia without producing apnea. To avoid overdose it is recommended, however, to use muscle relaxants for operations which require highest degree of muscle relaxation such as upper abdominal procedures. (4) Assisted respirstion is advocated since methoxyflurane tends to depress respiration. (5) Depth of anesthesia is easily controlled with growing experience so that overdose can be avoided. (6) Analgesia extends into the recovery phase, minimizing the need for narcotics in the immediate postoperative period. (7) lnduction of and recovery from anesthesia is relatively prolonged. However, nausea, vomiting or delirium is less frequent than after ether anesthesia. (8) Hepatotoxicity, as determined by bromsulphalein, retention is of the same magnitude as that determined for diethyl ether.
Analgesia ; Anesthesia ; Apnea ; Blood Pressure ; Delirium ; Ether ; Heart Rate ; Humans ; Liver Function Tests ; Methoxyflurane* ; Muscle Relaxation ; Narcotics ; Nausea ; Nebulizers and Vaporizers ; Postoperative Period ; Respiration ; Sulfobromophthalein ; Vomiting

PURPOSE: To evaluate the clinical usefulness of the phenol red thread test as a diagnostic tool of dry eye by comparing the phenol red thread test, Schirmer's test and tear break-up time. METHODS: The present study included 30 dry eye patients belonging to dry eye workshop grade 1 or 2 and 25 normal subjects. Phenol red thread test, Schirmer's test, and tear break-up time were performed on each subject's right eye. The sensitivity, specificity and repeatability of each test were compared, and the correlations between the 3 tests were also analyzed. RESULTS: Tear break-up time was superior to the other tests in terms of sensitivity and repeatability. The phenol red thread test was better than Schirmer's test in terms of specificity and repeatability. In all 55 patients including dry eye patients and normal subjects, the phenol red thread test showed a greater correlation with tear break-up time than did Schirmer's test. In addition, in 25 dry eye patients, the correlation between the phenol red thread test and Schirmer's test increased significantly. CONCLUSIONS: The phenol red thread test is less irritating and requires a shorter testing time than Schirmer's test. Additionally, the phenol red thread test is superior to Schirmer's test in terms of specificity, repeatability, and relation to tear break-up time. In addition, the correlation between the phenol red thread test and Schirmer's test significantly increases in dry eye patients. Therefore, the phenol red thread test is a good substitute option for Schirmer's test in diagnosing dry eye.
Eye ; Humans ; Phenol ; Phenolsulfonphthalein ; Sensitivity and Specificity ; Tears

Fixed drug eruption (FDE) is an eruption, which recurs at the same site or sites on each administration of the causative drug, and heals with residual hyperpigmentation. FDE is caused by many drugs, barbiturates, tetracyclines, sulfonamide, and phenolphthalein. Salicylate and nonsteroidal anti-inflammatory drugs (NSAIDs) also cause FDE, but acetaminophen does so only rarely. A 9-year-old girl presented with a 3-year-history of symptomatic pigmented macules on her face, abdomen, and extremities. The eruption was first appeared three years ago, which was when she took medicine after she was discharged following suspicions of Kawasaki disease. Thereafter, she had the same eruption on the same sites when she took medicine for common colds including acetaminophen and ibuprofen. The oral challenge provocation test for ibuprofen was negative, whereas for acetaminophen it was positive. We report a rare case of FDE due to acetaminophen with clinical findings and results of oral challenge test.
Abdomen ; Acetaminophen* ; Barbiturates ; Child* ; Common Cold ; Drug Eruptions* ; Extremities ; Female ; Humans ; Hyperpigmentation ; Ibuprofen ; Mucocutaneous Lymph Node Syndrome ; Phenolphthalein ; Tetracyclines

The term "fixed drug eruption" was coined by Louis Brocq in 1894 to describe a special type of reaction to antipyrine. It is now known that many drugs can cause a fixed drug eruption. Notorious offenders have included phenolphthalein, quinine and barbiturates. We present a case of multiple fixed drug eruption appearing in a 20 year-old male patient who has generalized slate-blue colored pigmentation on neck, trunk and extremities. The area of total pigmented skin lesions are over 50% of body surface. We could confirm the fixed drug eruption by positive phenobarbital provocation test.
Antipyrine ; Barbiturates ; Criminals ; Drug Eruptions* ; Extremities ; Humans ; Male ; Neck ; Numismatics ; Phenobarbital ; Phenolphthalein ; Pigmentation ; Quinine ; Skin ; Young Adult

BACKGROUND: The precise identification of Enterococcus gallinarum and E. casseliflavus has assumed additional importance in clinical microbiology due to the intrinsic low-level resistance to vancomycin and the difficulty in differentiating them from E. faecium or E. faecalis, which are frequently found to be clinically significant vancomycin resistant enterococci(VRE). We evaluated the usefulness of Methyl-alpha-D-glucopyranoside(MDG) test for accurate species identification among them. METHODS: A total of 23 enterococci isolates including 18 clinical isolates of VRE from Nov 1997 to Aug 1998 and 5 VRE strains which had previously been reported as E. faecalis (2), E. faecium(2), E. avium(1) carrying vanC were tested for acidification of MDG. MDG test was done using 1% MDG in phenol red broth base and yellow coloration was interpreted as positive after 1 and 2 days of incubation at 35 degrees C. MDG results were compared with species identification by MicroScan Pos Combo type 6 (Dade, US A), motility test, pigment production, and PCR results of vanA, vanB, vanC1, vanC2/C3. RESULTS: Vancomycin resistance of 23 strains were genotyped as 7 strains of vanA, 12 strains of vanC1, 4 strains of vanC2/C3. MicroScan identified 7 vanA VRE as E. faecalis(1) and E. faecium(6), 12 VRE carrying vanC1 as E. faecalis(3), E. faecium(8) and E. avium(1), and 4 VRE carrying vanC2/C3 as E faecalis(3) and E. avium(1). Sixteen vanC VRE strains were all positive for MDG test and only 8(50%) of the 16 strains were motile. Yellow pigment were detected in all 4 vanC2/C3 VRE but only after a careful examination with a prolonged incubation. Seven vanA VRE were all negative in MDG tests, motility test and pigment production. CONCLUSIONS: MicroScan system plus motility and pigment production test was not able to differentiate reliably E. gallinarum and E. casseliflavus from E. faecalis and E. faecium. The MDG test was shown to be superior to motility test in differentiating those from E. faecalis and E. faecium. We conclude that the MDG test should be included for identifcation of VRE.
Enterococcus ; Phenolsulfonphthalein ; Polymerase Chain Reaction ; Vancomycin Resistance ; Vancomycin*

We measured the tear secretion rate in normal and dry eyes by using a cotton thread method. This new method measures basal tears by means of a yellow colored cotton thread(Hamano fiber) impregnated with phenol red. The 3mm bent end of a 70mm long thread is placed in the inferior conjunctival sac on the temporal side of the eye for 30 seconds. The length of the thread that is wet by the tears changes color soon from yellow to red as a result of the change in pH. We obtained the following results by using of Hamano thread test, as a modified Schirmer test. 1. The proper test time of this test was 30 seconds in view of the analysis of the amount of tear secretion with time. 2. Average wet lengths of normal male was 16.6mm, that of female was 15.7mm from 30 seconds test. 3. Distribution of wet lengths in 300 normal eyes were ranged from 4.0mm to 34.0mm and most of them(61%) were within 10 to 20mm. 4. Wet lengths with and without anesthesia showed no statistical significance(paired t-test, p>0.05). 5. Reproducibility of Hamano fiber test that was tested 3 times in same eye represented significance in statatics(paired t-tast, p<0.05).
Anesthesia ; Female ; Humans ; Hydrogen-Ion Concentration ; Male ; Phenolsulfonphthalein ; Tears*

To understand the ability of producing cellulolytic enzyme activity in the sapstaining fungi, four species of Ophiostoma and two species of Leptographium were investigated in the culture media containing each of cellulose substrates such as CM-cellulose, Avicel and D-cellobiose and each of chromogenic dyes such as Congo-Red, Phenol Red, Remazol Brilliant Blue and Tryphan Blue. When the fungi were grown for 5~7 days at 25degrees C, the formation of clear zone by chromogenic reaction around the margin of the fungal colony was demonstrated in all the culture media Congo-Red containing CM-cellulose. There was difference in the formation of clear zone among the dyes. Only Ophiostoma setosum and Leptographium spp. showed cellulolytic activity to the three substrates. Overall, the results of this study show that ophiostomatoid sapstaining fungi can produce cellulolytic enzymes.
Cellulose ; Coloring Agents ; Culture Media ; Fungi ; Ophiostoma* ; Phenolsulfonphthalein

To obtain basic information on the detection of cellulolytic activity in Auricularia auricula-judae, the influences of dye reagent, pH, and temperature were assessed. Chromogenic dye (congo red, phenol red, remazol brilliant blue, and trypan blue) was individually incorporated into a medium containing either carboxymethyl-cellulose, Avicel, or D-cellobiose as a polysaccharide carbon substrate. The other assessments utilized pHs ranging from 4.5 to 8.0 and temperatures from 15~35degrees C. Overall, when A. auricula-judae species were transferred onto media contained Congo red and adjusted pH 7.0 and then incubated at 25degrees C for 5 days, the clear zone indicative of cellulolytic activity was more pronounced.
Benzenesulfonates ; Carbon ; Cellulose ; Congo Red ; Diminazene ; Hydrogen-Ion Concentration ; Phenolsulfonphthalein