No abstract available.
Diptera*

BACKGROUND: Enterococci exhibit intrinsic resistance or high-level minimum inhibitory concentration (MIC) to beta-lactams than other streptococci. This appears to be due to low affinity of penicillin-binding proteins and rarely production of beta-lactamase, which gives the reason of testing beta-lactamase for blood and cerebrospinal fluid isolates. Ampicillin is more effective than penicillin in vitro, and MIC of ampicillin is generally 1 dilution lower than that of penicillin. The purpose of this study is to detect beta-lactamase producing enterococci an6 to compare MICs of ampicillin and penicillin by Vitek system (bioMerieux, Hazelwood, MO, USA) with those by agar dilution method. METHODS: We collected 110 isolates of Enterococcus faecalis and 51 isolates of E. faecium from clinical specimens in 1998. MICs of antibiotics were determined by agar dilution method and Vitek system. We also performed beta-lactamase test by the Cefinase (Becton Dickinson, USA) for 512 isolates of E. faecalis and 189 isolates of E. faecium collected in 1998. RESULTS: The most common sites of isolates were blood, bile, surgical/traumatic wounds, closed and open pus and urine. MICs of ampicillin were 1 to 2 dilution lower than those of penicillin for E. faecalis (P=0.03). But there were no significant differences in MICs for E. faecium (P=0.19). Five isolates (4 E. faecalis and 1 E. faecium) were susceptible to ampicillin but resistant to penicillin. There were no beta-lactamase producing enterococci among 701 isolates tested. CONCLUSIONS: MIC by Vitek system tends to be 1 to 2 dilution lower than MIC by agar dilution method to beta-lactams, and MIC of ampicillin is 1 to 2 dilution lower than MIC of penicillin, which could result in discrepancy in interpretation of susceptibilty tests. A beta-lactamase test for enterococci is not recommeneded for routine test in Korea.
Agar ; Ampicillin ; Anti-Bacterial Agents* ; beta-Lactamases ; beta-Lactams ; Bile ; Cerebrospinal Fluid ; Enterococcus faecalis ; Enterococcus* ; Korea ; Microbial Sensitivity Tests ; Penicillin-Binding Proteins ; Penicillins ; Suppuration ; Wounds and Injuries

Background: Positive end-expiratory pressure(PEEP) ventilation causes reduction in cardiac output and increase of intra-thoracic pressure, hence reduction of hepatic blood flow. The purpose of this study is to evaluate the changes of hepatic venous oxygen saturation, tension and content during increase and removal of PEEP and to evaluate hemodynamic variable which has the greatest effect on hepatic oxygenation. Method: Eight dogs were anethetised with 1.0 vol% isoflurane and 100% oxygen. After 30 minutes of stabilization of vital signs, PEEP were increased from 0 cmH2O to 5 cmH2O and 10 cmH2O and lowered to 0 cmH2O again, and hemodynamic data (heart rate, arterial blood pressure, central venous pressure(CVP), pulmonary arterial pressure, pulmonary arterial occlusion pressure and cardiac output(CO)) and hepatic venous oxygenation data (hepatic venous oxygen saturation(ShvO2), tension(PhvO2) and content(ChvO2)) were measured at each step. Results: CO, ShvO2, PhvO2 and ChvO2 decreased significantly at 10 cmH2O PEEP compared to the baseline and 5 cmH2O PEEP and CO, ShvO2 and ChvO2 increased signicantly with removal of PEEP. CVP increased significantly at 10 cmH2O PEEP and decreased significantly with PEEP removal. PEEP showed close correlationship with CO and CVP considering all steps of PEEP and PEEP removal. ShvO2 and PhvO2 showed most close correlationship with CO considering all steps of PEEP and PEEP removal. Conclusion: ShvO2 with PEEP therapy is dependent upon CO. Therefore cardiac output maintenance is essential during PEEP therapy. For exact evaluation of hepatic oxygenation, it is valuable to monitor ShvO2.
Animals ; Arterial Pressure ; Cardiac Output ; Dogs* ; Hemodynamics ; Isoflurane ; Oxygen* ; Positive-Pressure Respiration* ; Ventilation ; Vital Signs

No abstract available.
Mucocutaneous Lymph Node Syndrome* ; Thrombocytopenia*

Complicated hepatic microabscess secondary to ascending cholangitis following ERCP (Endoscopic retrograde cholangiopancreatogram) is rare, and needs to be differentiated from other microabscesses, metastasis or Caroli's disease. We experienced a case of hepatic microabscess associated with septic cholangitis following ERCP. Cholangiogram showed multiple sac-like abscess pockets with characteristic biliary communication, and CT scan revealed multiple low attenuated lesions. At the resolving stage of chotangitic microabscess, CT scan showed partial rim enhancement of the abscesses and disproportional dilatation of intrahepatic ducts. The residual parenchymal enhancement surrounding the resolved microabscess pockets and dilatated biliary ducts, however, remained even after clinical recovery.
Abscess ; Caroli Disease ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis* ; Dilatation ; Neoplasm Metastasis ; Tomography, X-Ray Computed

PURPOSE: To evaluate intrahepatic nodular lesions detected on CTAP but not on conventional contrast CT in regard to its relationship with satellite nodules or borderline malignancies. MATERIALS AND METHODS: From June 1991 to March 1994, CTAP was undertaken in 132 cases with confirmed hepatocellular carcinoma(HCC), of which 35 cases having 82 lesions were suitable for analysis(excluding the cases which had no follow-up studies, showed segmental abnormal portal perfusion, no additional lesions and, or inumerable lesions). The CTAP findings were compared with those on artery dominant imaging studies (angiography, DSA, bolus dynamic CT, arterial CT, Lipiodol CT) taken during the same period(to confirm the presence of lesions) and the findings on follow-up imaging studies(to assess the developemerit of malignancy). RESULTS: Arterial vascularity was identified in 35 of 82 lesions(42.7%) on arterial dominant imaging studies. Developement into malignancy was identified on follow-up imaging studies in 25 of remained 47 lesions(53.2%). CONCLUSION: The total positive predictive value of nodules on CTAP was 73.2%(35+25/82), but the predictive value for HCC by follow-up only was 53.2%. Given'the difficulties in detecting intranodular arterial flow and the short follow-up duration in many patients, the actual positive value might be higher.
Arteries ; Ethiodized Oil ; Follow-Up Studies ; Humans ; Perfusion

PURPOSE: To evaluate intrahepatic nodular lesions detected on CTAP but not on conventional contrast CT in regard to its relationship with satellite nodules or borderline malignancies. MATERIALS AND METHODS: From June 1991 to March 1994, CTAP was undertaken in 132 cases with confirmed hepatocellular carcinoma(HCC), of which 35 cases having 82 lesions were suitable for analysis(excluding the cases which had no follow-up studies, showed segmental abnormal portal perfusion, no additional lesions and, or inumerable lesions). The CTAP findings were compared with those on artery dominant imaging studies (angiography, DSA, bolus dynamic CT, arterial CT, Lipiodol CT) taken during the same period(to confirm the presence of lesions) and the findings on follow-up imaging studies(to assess the developemerit of malignancy). RESULTS: Arterial vascularity was identified in 35 of 82 lesions(42.7%) on arterial dominant imaging studies. Developement into malignancy was identified on follow-up imaging studies in 25 of remained 47 lesions(53.2%). CONCLUSION: The total positive predictive value of nodules on CTAP was 73.2%(35+25/82), but the predictive value for HCC by follow-up only was 53.2%. Given'the difficulties in detecting intranodular arterial flow and the short follow-up duration in many patients, the actual positive value might be higher.
Arteries ; Ethiodized Oil ; Follow-Up Studies ; Humans ; Perfusion

The author studied on the 197 cases of the pleomorphic adenoma which had been diagnosed with biopsy during the period of 1985 to 1996 at the Kyungpook National University Hospital. This study contains the statistical analysis of the clinico-pathological findings such as sex, age, location, chief complaint, duration, treatment method, size, recurrence, and treatment department in relation to anatomical location. The result were as follows : 1. The treatment department in oxter were ENT(16.2%), GS(22.8%), OMFS(18.8%), PS(12.2%). 2. The incidence of pleomorphic adenoma were parotid gland(57.8%), palatal salivary gland(20.3%), submandibular gland(17.2%), other minor salivary glands(4.5%). 3. The tumors were more common in females than males, with a male to female ratio of 1 : 1.85. 4. The peak age of ocurrence was in the forth decade. 5. The duration of the most cases were less than 5 years. 6. Although the size of the tumors was variable, the incidence was highest between 3cm and 4cm(25.4%). 7. The most prevalent chief complaint was swelling(94.9%). 8. Conservative treatment was performed 30.0%, and radical treatment was employed 70.0%. 9. The recurrence rate is 8.1%, and recurrence used to be relatively common with conservative treatment. 10. The rate of malignant transformation is 1%. 11. The anatomical location has no relationship with the factors of sex, duration, and malignant transformation. 12. There was statistical significance on the anatomical location to the treatment department, age, chief complaint, size, treatment method, recurrence (P<0.05).
Adenoma, Pleomorphic* ; Biopsy ; Female ; Gyeongsangbuk-do ; Humans ; Incidence ; Male ; Recurrence

A 70-year-old woman with Parkinson disease was admitted to the emergency department with altered consciousness, fever and convulsive movements without experiencing withdrawal from antiparkinsonian medication. Six hours after the emergency department visit, the patient had a hyperpyrexia (>40℃) and a systolic blood pressure of 40 mmHg. There was no evidence of bacterial infection based on extensive workups. The patient was discharged without aggravation of Parkinson disease symptoms after treatment that included administration of dantrolene sodium, enforcement of continuous renal replacement therapy and cooling blankets. Malignant syndrome should be suspected if high fever occurs in Parkinson disease patients without evidence of a definitive infection.
Aged ; Bacterial Infections ; Blood Pressure ; Consciousness ; Dantrolene ; Dehydration ; Emergency Service, Hospital ; Female ; Fever ; Humans ; Parkinson Disease* ; Renal Replacement Therapy

PURPOSE: This study was a qualitative research study in which focus group interviews were used to collect data on the meaning of respite for family caregivers who are taking care of elders with dementia. METHODS: The focus group interviews and participants consisted of 2 family caregiver groups, for a total of 8 people taking care of their elders and 5 professional caregivers working in a geriatrics hospital or social welfare institutions. Content analysis was used and debriefing notes were referred in order to analyze the data. RESULTS: The meaning of respite in this research was measured using 4 main categories: 'Temporary break from routine', 'direct help', 'psychological comfort', 'valuables which cannot be taken easily' and 9 subcategories: 'Temporary diversion of attention', 'temporarily free from my duty', 'taking care of oneself', 'receiving economic help', 'empathize with others', 'comfort based on trust', 'resting together with the elder', 'no time to rest', 'cannot get out of one's obligatory duty'. CONCLUSION: The findings of the study show that rest means not only a temporary relief from caretaking, but also a real respite based on the patients' stable state and comfort. These results indicate a new meaning for respite, that the first step of respite program has to begin even when the caregivers do not recognize the need for respite.
Adult ; Aged ; Caregivers/*psychology ; Dementia/*nursing ; Family ; Female ; Geriatric Nursing ; Home Nursing ; Humans ; Interviews as Topic ; Male ; Middle Aged ; Nurse-Patient Relations ; *Respite Care