No abstract available.
Denture, Complete* ; Finite Element Analysis*

Povidone-iodine(PVP-I) is a widely used antiseptic for the skin because of its low toxicity and high germieidal efficacy, Allergic contact dermatitis to PVP-I is known to be rare. Two patients who recently underwent surgical operations were referred to us due to pruritic well-demarcated eczematous skin lesions around the wounds. Their operation wounds had persisted in spite of the treatments using systemic antibiotics and topical antiseptics. Patch tests were performed with antiseptics including PVP-I, hydrogen peroxide, and benzalkonium chloride which had been used to dress their wounds. The patch tests resulted in positive reactions to PVP-I at the concentrations of 1% in one patient and 0.01% in another.
Anti-Bacterial Agents ; Anti-Infective Agents, Local ; Benzalkonium Compounds ; Dermatitis, Allergic Contact* ; Humans ; Hydrogen Peroxide ; Patch Tests ; Povidone-Iodine* ; Skin ; Wounds and Injuries

Wet cement can cause caustic ulcers due to its alkalinity. Besides caustic ulcers frequently called cement burn, allergic and irritant contact dermatitides are common in cement workers. Alkalinity of calcium hydroxide in wet cement combined with the effect of pressure and occlusion against skin may result in cement burn. We report two cases of cement burn due to their occupational exposures.
Burns* ; Calcium Hydroxide ; Dermatitis, Contact ; Occupational Exposure ; Occupations ; Skin ; Ulcer

No abstract available.
Abdomen, Acute* ; Child* ; Humans

PURPOSE: To evaluate the relationship between MR changes of the nucleus pulposus and the time interval after traumatic disc herniation. MATERIALS AND METHODS: T2-weighted MR images of 132 patients with back pain and/or sciatica were reviewed. The changes of signal intensity, central cleft and height of the nucleus pulposus were used as criteria of disc degeneration and they were graded as normal, mild, moderate and severe degrees of degeneration. Putting these criteria together we provided integrated grade of degeneration of the nucleus pulposus(grade 0-3). To get the preliminary data for normal and age-related disc degeneration, we measured the disc height by age groups and disc levels and analyzed the realtionship between the age of the patients and the signal intensity, cleft and height in normal disc levels of the 132 patients. In 68 patients of 88 levels disc herniation, we analyzed the relationship between symptom duration and the degree of degeneration. Among these 68 patients we selected 14 patients(16 levels) who were under 30 years of age and had history of recent trauma to minimize data distortion from age related degeneration and ambiguity of initiation point of degeneration. In this group we analyzed the relationship between the time period after traumatic disc herniation and the degree of degeneration. RESULTS: The age of the patient had close relationship with the grade of signal intensity, central cleft, and disc height and grade of degeneration of the nucleus pulposus in normal discs. in 88 levels of herniated discs, the duration of symptom and degree of degeneration showed moderate correlation. In 14 patients of disc herniation who were under 30 years old and had trauma history in recent 2 years, grade 1 disc degeneration occured in average 3.7 months after trauma. CONCLUSION: Although it was difficult to proceed statistical analysis in the last group because of small patients number, the degree of degeneration of nucleus pulposus had close relationship with the duration after traumas or duration of symtoms.
Adult ; Back Pain ; Humans ; Intervertebral Disc Degeneration ; Intervertebral Disc Displacement ; Sciatica

Nonpigmenting fixed drug eruption is a form of fixed drug eruption which heals without pigmentation. To leave no traces makes the diagnosis difficult. A 37-year-old man pressented the erythematous patches on both wrists and the left thigh. Several hours before the eruption, he had taken oral drugs for the treatment of osteomyelitis. He had had the same eruptions which were diagnosed as an allergic contact dermatitis, 8 months ago. The patch tests with medicated drugs were negative, but oral provocation with etodolac brought the same eruptions.
Adult ; Dermatitis, Allergic Contact ; Diagnosis ; Drug Eruptions* ; Etodolac* ; Humans ; Osteomyelitis ; Patch Tests ; Pigmentation ; Thigh ; Wrist

BACKGROUND: Carbapenem-resistant Enterobacteriaceae (CRE) with acquired metallo β-lactamase (MBL) resistance have been increasingly reported worldwide and associated with significant mortality and morbidity. Here, an outbreak of genetically related strains of Klebsiella pneumoniae producing the imipenemase (IMP)-1 MBL in a medical intensive care unit (MICU) in Korea is reported. METHODS: Since isolating carbapenem-resistant K. pneumoniae (CRKP) at the MICU of the hospital on August 10, 2011, surveillance cultures for CRE in 31 hospitalized patients were performed from August to September 2011. Carbapenem resistance was determined based on the disk diffusion method outlined in the Clinical and Laboratory Standards Institute guidelines. Polymerase chain reaction (PCR) was performed for genes coding for β-lactamase. Associations among isolates were assessed via pulsed-field gel electrophoresis (PFGE). In addition, a surveillance study of environmental cultures and health-care workers (HCWs) was conducted in the MICU during the same time frame. RESULTS: During the study period, non-duplicated CRKP specimens were discovered in four patients in the MICU, suggestive of an outbreak. On August 10, 2011, CRKP was isolated from the sputum of a 79-year-old male patient who was admitted to the MICU. A surveillance study to detect additional CRE carriers by rectal swab revealed an additional three CRKP isolates. PCR and sequencing of the four isolates identified the presence of the IMP-1 gene. In addition, PFGE showed that the four isolated strains were genetically related. CRE was not identified in specimens taken from the hands of HCWs or other environmental sources during surveillance following the outbreak. Transmission of the carbapenemase-producing Enterobacteriaceae strain was controlled by isolation of the patients and strict contact precautions. CONCLUSIONS: This study shows that rapid and systemic detection of CRE and strict infection controls are important steps in preventing nosocomial transmission.
Aged ; Clinical Coding ; Critical Care* ; Diffusion ; Disease Outbreaks ; Drug Resistance, Bacterial ; Electrophoresis, Gel, Pulsed-Field ; Enterobacteriaceae ; Hand ; Humans ; Infection Control ; Intensive Care Units* ; Klebsiella pneumoniae* ; Klebsiella* ; Korea ; Male ; Methods ; Mortality ; Pneumonia ; Polymerase Chain Reaction ; Sputum

Septic arthritis of the children's hip causes acute or chronic inflammatory change in structure about the joint, and results in serious destruction. Due to recent advance of the diagnostic technique and of the antibiotics, the incidence of it's sequelae is decreased. The management of acute stage with antibiotics and early surgical drainage has been well established in the literature, but the management of residual anatomic deformity is less documented, and little comprehensive classification or treatment program has been outlined. We experienced two patients who had sequelae induced by delayed diagnosis and improper treatment. One had a complete loss of femoral neck with femoral head remaining in the acetabulum. Femoral neck reconstruction was performed using proximal femur : i.e., Open reduction of femoral head to femur shaft with distal transfer of greater trochanter (1st stage) followed by varus osteotomy(2nd stage) and follow-up period was 3.5 years. Another had loss of femoral head and neck, dislocation of the hip, and Larsen's trochanteric arthroplasty was performed with 6 Years follow-up. Satisfactory results were obtained in both patients who had reconstructive surgery, so we report these cases with related literatures.
Acetabulum ; Anti-Bacterial Agents ; Arthritis, Infectious ; Arthroplasty ; Child ; Classification ; Congenital Abnormalities ; Delayed Diagnosis ; Dislocations ; Drainage ; Femur ; Femur Neck ; Follow-Up Studies ; Head ; Hip ; Humans ; Incidence ; Joints ; Neck

This is a report of clinical study on the 63 patients of symptomatic urinary tract infection who were hospitalized at the Department of Pediatrics in Kangnam General Hospital during the period between the May of 1989 and the September of 1992. The observation results were as follows: 1) The frequency of urinary tract infection (UTI) was the highest in children under the age of one year (66.7%). 35 patients were male, while the other 28 were female. The ratio of male and female patients was 1.25:1. 2) Fever was observed in most of the cases. Systemic nonspecific manifestation was predominant in the infancy and early childhood, whereas local symptom of UTI was predominant in the late childhood. Among the 35 male patients, 32 cases were phimoses. As for the other 3 cases, Phimoses were not identified. 3) E. coli had the most frequency (65.3%), followed by Klebsiella, Enterobacter, Pseudomonas in descending order. 4) In the vitro antimicrobial susceptibility test, Gram negative organisms such as E. coli Klebsiella, Enterobacter were sensitive to cefotaxime, amikacin, and ampicillin/sulbactam. Meanwhile, Gram positive organisms such as Staphylococcus, Enterococcus were sensitive to vancomycin and cephradine. 5) The renal ultrasonography test was performed for 59 patients, 13 cases of whom showed abnormal findings. 6 cases out of the 13 abnormal patients had hydronephrosis. 6) DMSA renal scan was performed for 40 patients within 2 months of an acute pyelonephritic attack. Signs of pyelonephritic change were found in 18 patients. DMSA scan was repeated 4~12 months later in 4 of these patients. This showed renal cortical scarring in all patients. 7) Voiding cystourethrographic findings in 38 patients showed vesicoureteral reflux in 13 patients. 8) We performed urine culture again after 48 hours from the beginning of therapy and 85.5% of the cases became sterile. 9) The recurrent percentage of UTI was 23.8% with the ratio of 1:1.5 between male and female. Most of the patients were clildren under the age of one year. 10) Operations were made on two cases showing the increase of reflux during the follow-up of unilateral Grade ll and Grade 3 reflux, respectively. Operations were also performed on other two cases with bilateral Grade IV reflux. All the cases were good after the operations. In the meantime, as for another two cases having the right reflux of Grade lland the bilateral reflux of Grade lll, the refluxes were able to be reduced by prophylaxis only, in the course of following up.
Amikacin ; Cefotaxime ; Cephradine ; Child* ; Cicatrix ; Enterobacter ; Enterococcus ; Female ; Fever ; Follow-Up Studies ; Hospitals, General ; Humans ; Hydronephrosis ; Infant* ; Klebsiella ; Male ; Pediatrics ; Phimosis ; Pseudomonas ; Staphylococcus ; Succimer ; Ultrasonography ; Urinary Tract Infections* ; Urinary Tract* ; Vancomycin ; Vesico-Ureteral Reflux

A female newborn had the following characteristics; a congenital localized absence of skin over the lower extremities; blistering of the skin or mucous membrane, incited by trauma, which heals without scarring; and congenital absence or deformity of the nails. In respect to the characteristic manifestation, clinical course and electron microscopic features, our patient seems to fit well into Bart's syndrome. The inheritance pattern appears to be autosomal dominant but, as in this report, isolated cases have been recognized. As the review of the literatures, congenital localized absence of skin has been observed in various subsets of inherited E.B. But, we believe that the term Bart's syndrome should be used to identify patients with good prognosis as the Bart's initial description To the best of our knowedge, this is the first reported case of Bart's syndrome in the korean literature.
Blister ; Cicatrix ; Congenital Abnormalities ; Female ; Humans ; Infant, Newborn ; Inheritance Patterns ; Lower Extremity ; Mucous Membrane ; Prognosis ; Skin