Morganella morganii, a gram, negative rod is often regarded as an opportunistic, secondary invader rather than a primary pathogen on the skin. It has been isolated from blood, sputa, and pus from patients with respiratory tract and wound infections or with bacteremia. A 2-year-old boy presented with erythematous ulcerative lesions on the cheeks and left knee which had a tendency to superficial scarring. The organism isolated from the ulcer displayed a biochemical char acteristics typical of Morganella morganii. The lesions responded well to systemic antibiotic therapy with amikacin and carbenicillin, which were recognized as effective drugs in in vitro sensitivity testing.
Amikacin ; Bacteremia ; Carbenicillin ; Cheek ; Child, Preschool ; Cicatrix ; Humans ; Knee ; Male ; Morganella morganii* ; Morganella* ; Respiratory System ; Skin Ulcer* ; Skin* ; Suppuration ; Trout ; Ulcer ; Wound Infection

No abstract available.
Salmonella Infections*

OBJECTIVES: This study was carried out to analyze the hearing-threshold levels and relating factors of 1,048 workers with noise-induced hearing loss(D1). METHODS: We analyzed the hearing-threshold levels and relating factors of 1,048 workers with noise-induced hearing loss(D1) examined by the summary reports of specific health examination results of industries and personal reports of specific health examination results reported by 58 specific health examination institutes and 8 secondary pneumoconiosis examination institutes in 1996. RESULTS: Among 1,048 workers at 510 workplaces, male workers were 1,009 (96.3%) and female workers were 39 (3.7%). The mean ages of workers initially exposed to noise and at present were 28.7 and 47.2, respectively. The duration of total exposure was 16.5 years. Average hearing-threshold levels analyzed by three-divided classification of the study subjects were 43.7dB(Lt) and 42.6dB(Rt). Those analyzed by six-divided classification were 50.5dB(Lt) and 48.6dB(Rt). Among workers with noise-induced shearing loss(D1), 16.3% was unilateral hearing loss and 84.6% was classified to compensation case. 8.8%(Rt) and 10.2%(Lt) of them were suspected to be conductive hearing loss by differences of air-bone hearing-threshold levels. Hearing-threshold levels of workers in manufacturing industry were significantly increased during the short exposure compared with the levels in mining industry. Among manufacturing industries, hearing-threshold levels of workers in trailer and other transportation equipment manufacturing industry were significantly increased. Age and duration of total noise exposure were not significantly related to the average hearing-threshold levels analyzed by three-divided classification. Hearing-threshold levels of female workers were significantly increased during the short exposure compared with those of male workers. Hearing-threshold levels of workers at the high risk group, ages of 20s, 30s and total exposure duration of less than 10 years, were not significantly increased compared with those of the other groups. However, they were exposed at young ages. The 3 leading industries of workers at high risk group were trailer and other transportation equipment manufacturing, automobile manufacturing and assemble-metal manufacturing industries. CONCLUSIONS: This study was the first nationwide analysis of the hearing-threshold levels and relating factors of workers with noise-induced hearing loss(D1). We found the differences of the real number by the statistics of the department of labour and the expected number of worker's compensations for occupationally-induced hearing loss estimated by this study. According to the results of this study, we should carefully examine the methods to narrow this difference.
Academies and Institutes ; Automobiles ; Classification ; Compensation and Redress ; Female ; Hearing ; Hearing Loss ; Hearing Loss, Conductive ; Hearing Loss, Noise-Induced* ; Hearing Loss, Unilateral ; Humans ; Korea* ; Male ; Mining ; Noise ; Pneumoconiosis ; Research Report ; Transportation ; Workers' Compensation

PURPOSE: To evaluate the efficacy of intravitreal injections of triamcinolone acetonide (TA) at the end of pars plana vitrectomy (PPV) for proliferative diabetic retinopathy (PDR). METHODS: We analyzed 50 patients (52 eyes) who underwent PPV for treatment of PDR and received an intravitreal injection of 4 mg TA at the end of surgery. The study group (Group 1) was compared with a control group (Group 2, 46 patients, 51 eyes) (matched with the study group for preoperative parameters) who underwent PPV without intravitreal injection of TA. RESULTS: In Group 1, the grade of anterior chamber cells at postoperative days 1 and 7 was significantly lower than that of Group 2. There was slight mean IOP elevation in Group 1 at postoperative weeks 2, 3, 4, and 8, but it was not statistically significant. Forty-four eyes (84.6%) from Group 1 showed better visual acuity at the last follow-up than at the preoperative visit (Group 1). Thirty-two eyes (62.8%) from Group 2 showed better visual acuity at the last follow-up than at the preoperative visit. The degree of visual improvement was 0.75 logMAR in Group 1 and 0.59 logMAR in Group 2. Vitreous hemorrhage occurred in 9 eyes (17.3%) from Group 1 and in 19 eyes (37.3%) from Group 2. However, the differences in the occurrence of neovascularization in iris and neovascular glaucoma between two groups were not statistically significant. CONCLUSIONS: Intravitreal TA injection at the end of PPV seems to be effective in improving visual acuity and decreasing early postoperative inflammation and the frequency of vitreous hemorrhage.
Anterior Chamber ; Diabetic Retinopathy* ; Follow-Up Studies ; Glaucoma, Neovascular ; Humans ; Inflammation ; Intravitreal Injections ; Iris ; Triamcinolone Acetonide* ; Triamcinolone* ; Visual Acuity ; Vitrectomy* ; Vitreous Hemorrhage

Eosinophilic granulomatosis with polyangitis (EGPA) should be considered in asthmatic patients who present with severe systemic symptoms and eosinophilia. Progressive renal insufficiency can occur during the acute phase of EGPA accompanied by renovascular involvement. A 58-year-old man visited local clinic with complaints of malaise, weight loss, fever, and dyspnea. Eosinophilia was revealed in peripheral blood. Pulmonary function tests were carried out, which yielded decreased lung function with positive bronchodilator response. Kidney and skin biopsies were performed, and histological examination showed acute necrotizing crescentic glomerulonephritis and leukoclastic vasculitis in the skin, which led to a diagnosis of EGPA (Churg-Strauss syndrome) associated with rapidly progressive glomerulonephritis. The patient received pulse steroid therapy with parenteral methylprednisolone, followed by oral prednisolone. Clinical and laboratory findings improved dramatically, and remission was attained rapidly. The patient continued to be in remission for 5 months. Prompt and aggressive treatment with systemic corticosteroids is mandatory to control disease activity and to achieve remission.
Adrenal Cortex Hormones ; Biopsy ; Churg-Strauss Syndrome ; Diagnosis ; Dyspnea ; Eosinophilia ; Eosinophils* ; Fever ; Glomerulonephritis* ; Humans ; Kidney ; Lung ; Methylprednisolone ; Middle Aged ; Prednisolone ; Renal Insufficiency ; Respiratory Function Tests ; Skin ; Vasculitis ; Weight Loss

Low grade lymphomas are malignancies of predominantly small lymphocytes that typically have long median survival periods due to low proliferative rates. It is considered an indolent disease, but patients with low grade lymphoma can almost never be cured with conventional treatment. New low-grade lymphoma entities have been classified by the International Lymphoma Study Group (ILSG) and are also categorized into the Revised European American Lymphoma (REAL) classification. The REAL classification utilizes a multiparameter definition of clinico-pathologic and biologic entities. According to this classification, we investigated the incidence, various clinical characteristics, treatment outcome and prognostic factors of low grade lymphoma. Many clinical characteristics of low grade lymphoma in Korea differed from those of Western countries, especially in the incidence, therapeutic outcome and prognostic factors. In Korea, although the general incidence of low grade lymphoma is relatively low, the relative number of mucosa-associated lymphoid tissue lymphoma (MALToma) is very high, and the overall survival rate is better than that reported of Western countries. Thus, further investigation on treatment outcome and prognosis of low grade lymphoma entities, other than mucosa-associated lymphoid tissue lymphoma, are warranted.
Adolescent ; Adult ; Aged ; Female ; Human ; Immunophenotyping ; Lymphoma, Low-Grade/mortality/pathology/*therapy ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Treatment Outcome

Salmonella (S.) Typhimurium and S. Enteritidis are the major causative agents of food-borne illnesses worldwide. Currently, a rapid detection system using multiplex real-time polymerase chain reaction (PCR) has been applied for other food-borne pathogens such as Escherichia coli, Staphylococcus aureus and Streptococcus spp. A multiplex real-time PCR was developed for the simultaneous detection of Salmonella spp., especially S. Typhimurium and S. Enteritidis, in beef and pork. For the specific and sensitive multiplex real-time PCR, three representative primers and probes were designed based on sequence data from Genbank. Among the three DNA extraction methods (boiling, alkaline lysis, and QIAamp DNA Mini Kit), the QIAamp DNA Mini Kit was the most sensitive in this study. The optimized multiplex real-time PCR was applied to artificially inoculated beef or pork. The detection sensitivity of the multiplex real-time PCR was increased. The specificity of the multiplex real-time PCR assay, using 128 pure-cultured bacteria including 110 Salmonella isolates and 18 non-Salmonella isolates, was 100%, 100% and 99.1% for Salmonella spp., S. Typhimurium and S. Enteritidis, respectively. The sensitivity was 100%, 100% and 91.7% for Salmonella spp., S. Typhimurium and S. Enteritidis, respectively. The multiplex real-time PCR assay developed in this study could detect up to 0.54 +/- 0.09 and 0.65 +/- 0.07 log10 CFU/ml for S. Typhimurium and S. Enteritidis for beef, 1.45 +/- 0.21 and 1.65 +/- 0.07 log10 CFU/ml for S. Typhimurium and S. Enteritidis for pork, respectively, with all conditions optimized. Our results indicated that the multiplex real-time PCR assay developed in this study could sensitively detect Salmonella spp. and specifically differentiate S. Typhimurium from S. Enteritidis in meats.
Animals ; Cattle ; DNA, Bacterial ; *Food Microbiology ; Meat/*microbiology ; Polymerase Chain Reaction/*veterinary ; Salmonella/*isolation & purification ; Sensitivity and Specificity ; Swine

High-dose intravenous immunoglobulins alter the disease activity of adult-onset Still's disease (AOSD). Because activation status of FcgammaR is possibly dependent on their genetic polymorphisms, we investigated whether the polymorphisms of FcgammaR IIa and IIIa are risk factors, and affect the clinical features of AOSD. Genomic DNA was extracted from 36 patients and from 197 healthy controls. Polymerase chain reaction for FcgammaR IIa and IIIa using the allele-specific primers and direct sequencing of FcgammaR IIIa polymorphic site were performed. The frequencies of FcgammaR IIa/IIIa genotype between patients with AOSD and controls were not different. The allelic frequencies of FcgammaR IIa/IIIa between patients with AOSD and controls were not different, either. However, the FcgammaR IIa-R/R131 genotype was associated with a higher concentration of hemoglobin (p=0.04) and stable liver function (p=0.009) than the other genotypes. The FcgammaR IIIa-F/F176 genotype was associated with significantly lower titers of serum ferritin (p=0.025), and higher serum albumin (p=0.037) and cholesterol (p=0.014) concentrations than the other genotypes. This study suggest that the FcgammaR IIa and IIIa polymorphisms might not be genetic risk factors for AOSD in Korean, but contribute to the activity of disease. FcgammaR IIa-R/R131 and IIIa-F/F176 genotypes, low-binding genotypes for IgG2a and G1, may have more protective effects in acute stage of the disease than the other genotypes.
Adult ; Antigens, CD/*genetics ; Female ; Genotype ; Humans ; Korea ; Male ; *Polymorphism, Genetic ; Receptors, IgG/*genetics ; Still's Disease, Adult-Onset/*genetics/physiopathology

The reactive airway dysfunction syndrome (RADS), a subset of irritant-induced asthma, has been described following exposure to various irritant gas. We describe a case of RADS occuring following a single exposure to high levels of chlorine gas in the workplace. No documented pre-existing respiratory illness and atopy was identified. Cough, dyspnea, and wheezing were developed with the single accidental exposure to chlorine gas and methacholine provocation test was positive. He was completely recovered with the treatment of corticosteroid and oxygen therapy.
Angioedema ; Asthma ; Cellulitis ; Chlorine* ; Cough ; Dyspnea ; Eosinophilia ; Hypereosinophilic Syndrome ; Methacholine Chloride ; Oxygen ; Respiratory Sounds

PURPOSE: Intramedullary cartilage forming tumors in the meta-diaphysis of the long bones can represent an enchondroma or a low-grade chondrosarcoma, with the latter requiring adequate surgical treatment. However, these two lesions have overlapping clinical and histological features and so they pose a diagnostic and therapeutic dilemma. The purpose of this study was to analyze the clinical outcome and to determine the relevant clinical and radiographic parameters for deciding on the treatment for these tumors. MATERIALS AND METHODS: We conducted a retrospective review of 73 patients who were treated for enchondroma or low-grade chondrosarcoma that was located in the metaphysis or diaphysis of the bones. There were 20 men and 53 women with an average age of 49 years (range: 18-80). The locations were the proximal humerus (n=34), distal femur (24), proximal femur (6), proximal tibia (3), proximal fibula (2), humerus shaft (2) and femur shaft (2). 41 patients were treated surgically and 32 patients were simply observed based on the following parameters at presentation; the presence of pain, the tumor length and radiographic evidence of endosteal erosion. RESULTS: All of the 32 patients who were initially observed had no evidence of disease progression at the last follow-up (average: 3.2 years, range: 1.0-14.9). Forty (98%) of the surgically treated patients showed no recurrence at the the last follow-up (average: 4.3 years, range: 1.0-14.0). CONCLUSION: The presence of pain, tumor length and radiographic evidence of endosteal erosion should be considered to determine the best course of treatment for intramedullary cartilage forming tumors in the meta-diaphysis of the long bones. With the appropriate selection of the patients, these tumors can be successfully treated nonoperatively.
Cartilage ; Chondroma ; Chondrosarcoma ; Decision Making ; Diaphyses ; Disease Progression ; Female ; Femur ; Fibula ; Follow-Up Studies ; Humans ; Humerus ; Male ; Recurrence ; Retrospective Studies ; Tibia