Metronidazole-induced encephalopathy is a very rare complication of the long standing use of metronidazole. The encephalopathy is bilateral and symmetric in nature. We report on the magnetic resonance imaging (MRI) and clinical course of metronidazole-induced encephalopathy in a 60-year-old female with a persistent anaerobic brain abscess after draining of the abscess. After 3 months of metronidazole administration, the patient complained of dysarthria, tingling sense of all extremities, and left hemiparesis. MRI revealed symmetric hyperintensity lesions in medulla, pons, dentate nuclei of cerebellum, and splenium of corpus callosum, all of which represent typical findings of metronidazole-induced encephalopathy. In addition, asymmetric lesions in midbrain, thalamus, putamen and cerebral subcortical white matter were noted. The patient recovered after discontinuation of metronidazole and the remaining abscess was successfully treated with meropenem and levofloxacine.
Abscess ; Brain ; Brain Abscess ; Brain Diseases, Metabolic ; Cerebellum ; Corpus Callosum ; Dysarthria ; Extremities ; Female ; Humans ; Magnetic Resonance Imaging ; Mesencephalon ; Metronidazole ; Middle Aged ; Ofloxacin ; Paresis ; Pons ; Putamen ; Thalamus ; Thienamycins

The authors report a rare case of neurofibroma of the oculomotor nerve combined with the bilateral intracavernous aneurysms of the internal carotid artery. A 38-year-old female presented with a 2 month history of ocular pain and ptosis on the left side. Computed tomogram and magnetic resonance image showed a parasellar enhancing mass. Angiogram revealed bilateral intracavernous aneurysm of the internal carotid artery and multiple beaded appearance of the internal carotid artery. The tumor was completely removed via left Dolenc approach and the oculomotor nerve was reconstructed by end-to-end anastomosis, with the sural nerve. Ipsilateral intracavernous aneurysm was clipped using an encircling clip.
Adult ; Aneurysm* ; Carotid Artery, Internal ; Cavernous Sinus ; Female ; Humans ; Neurofibroma* ; Oculomotor Nerve* ; Sural Nerve

BACKGROUND: The proper use of disinfectants has been a major issue in infection control programs. We performed a survey to evaluate the current usage of disinfectants in Korea. METHODS: A questionnaire was e-mailed to 95 hospitals that had infection control programs and data were collected between 10 and 28 October 2005. The questionnaire included questions about whether the hospital had official procedures for selection and use of disinfectants and an education program for proper use; also included were questions about the general characteristics of the hospitals. The types of disinfectants consisted of antiseptics and disinfectants for medical devices, endoscopes, and environments. The questionnaire was analyzed using SPSS 12.0 program. RESULTS: Thirty-nine (41.1%) of the 95 hospitals responded to the questionnaire. Thirty-six hospitals (84.6%) had an official decision making process in selecting disinfectants in their hospitals. Ten percent povidone iodine (PVI) (94.9% for central line) and alcohol (92.3% for peripheral line) were commonly used for skin preparation for intravenous catheterization. Most hospitals used 10% PVI for clean wound (97.4%), dirty/infected wound (94.8%) and sore wound (61.5%); 3% H2O2 (43.6%) for dirty/infected wound; and saline (25.6%) for sore wound. Waterless alcohol handrubs were used in general ward (92.3%), ICU (97.4%), and OR (43.6%). Over the 60% of the hospitals used sodium hypochlorites for cleansing the floors and bathrooms of patients' rooms. As a disinfectant for endoscopes, peracetic acid (40-60%) was used the most frequently, followed by orth-pthalaldehyde (25-36%), and superoxidized water (8-23%). Most hospital followed the manufactures' guidelines on the exposure time of gastroscopes to disinfectants such as orth-pthalaldehyde (100%) and peracetic acid (96%). But, some hospitals re-used peracetic acid (12.0%) and superoxidized water (28.6%) for a longer duration than was recommended by the manufacturers. Fifty to eighty percents of the hospitals used tap water for rinsing endoscopes after disinfection, and only about 80% of these dried with alcohol after rinsing. Most hospitals (84.6%) had teaching sessions for the proper use of disinfectants more than once a year. CONCLUSION: The current use of disinfectants has been improved since 1999 in its suitability and appropriateness Proper use of disinfectants ensures the safety of invasive and non-invasive medical processes; therefore, the current guidelines for disinfection should be strictly followed by the hospital. And continuous staff education will facilitate the correct use of disinfectants.
Anti-Infective Agents, Local ; Catheterization ; Catheters ; Decision Making ; Disinfectants* ; Disinfection ; Education ; Electronic Mail ; Endoscopes ; Gastroscopes ; Infection Control ; Korea* ; Patients' Rooms ; Peracetic Acid ; Povidone-Iodine ; Skin ; Sodium ; Water ; Wounds and Injuries ; Surveys and Questionnaires

Objective: To investigate the clinical factors associated with successful gastrostomy tube weaning in patients with prolonged dysphagia after stroke. Methods: This study involved a retrospective medical chart review of patients diagnosed with prolonged dysphagia after stroke who underwent gastrostomy tube insertion between May 2013 and January 2020. Forty-seven patients were enrolled and consequently divided into gastrostomy tube sustaining and weaning groups. The numbers of patients in the sustaining and weaning groups were 31 and 16, respectively. The patients’ demographic data, Korean version of Mini-Mental State Examination (K-MMSE) score, Korean version of the Modified Barthel Index (K-MBI), Functional Dysphagia Scale (FDS) score, and Penetration-Aspiration Scale (PAS) score were compared between the two groups. A videofluoroscopic swallowing study was performed before making the decision of gastrostomy tube weaning. The clinical factors associated with gastrostomy tube weaning were then investigated. Results: There were significant differences in age; history of aspiration pneumonia; K-MMSE, FDS, and PAS scores; and K-MBI between the groups. In the multiple logistic regression analysis, the FDS (odds ratio [OR]=0.791; 95% confidence interval [CI], 0.634–0.987) and PAS scores (OR=0.205; 95% CI, 0.059–0.718) were associated with successful gastrostomy tube weaning. In the receiver operating characteristic curve analysis, the FDS and PAS were useful screening tools for successful weaning, with areas under the curve of 0.911 and 0.918, respectively. Conclusion In patients with prolonged dysphagia, the FDS and PAS scores are the only factors associated with successful gastrostomy tube weaning. An evaluation of the swallowing function is necessary before deciding to initiate gastrostomy tube weaning.

Fibrosing mediastinitis is a rare benign disorder characterized by the proliferation of dense fibrous tissue within the mediastinum. It typically manifests as localized or infiltrative soft-tissue masses in the middle mediastinum or hilar area, which cause compression and encasement of adjacent mediastinal structures, such as the vessels or airway. Here, we report a rare case of fibrosing mediastinitis in a 13-year-old girl that presented as a middle mediastinal mass lesion on CT scan with obliterating left lower lobar bronchus. The patient’s symptoms and follow-up chest CT showed significant improvement following systemic corticosteroid treatment. As fibrosing mediastinitis can improve with systemic steroid therapy, radiologists must be aware of its radiologic findings when discriminating between infiltrating soft tissue lesions in the mediastinum.

Nodular scabies is a clinical variant of classic scabies with uncertain cause. The cutaneous manifestations consist of firm, erythematous nodules focally affecting genitalia, groin and axillae, and no case of generalized involvement has been reported in the literature. On histopathologic examination, mites and excretas were known to be seldom found in the stratum corneum, but if serial sections are studied, they can be seen in as much as 20% of the cases. The dermis shows dense superficial and deep perivascular mixed cell infiltration composed of lymphocytes, histiocytes, plasma cells, eosinophils, and atypical mononuclear cells, which should be distinguished from many types of lymphomas. We herein report a case of nodular scabies that clinically affected whole body and histopathologically revealed mite and eggshells in the stratum corneum and perivascular mixed cell infiltration throughout the dermis.

Scientific information databases produce insufficient and unsatisfactory levels of data for the specialized needs of researchers. Especially in the health and medical areas, researchers are looking for a measurement tool on the web that allows interaction between the database and the researcher for the production of new information through searching, accumulating, modifying, and deleting data. In this research paper, first a concrete explanation of the informational items in databases such as the types of measurement tool in the health and medical areas, their usage methods, their reliability and validity. Secondly, this report developed the service system of the measurement tool in the health and medical areas including functions of searching and answers of measurement information, functions in writing up information measurements from the web, and the user's friendly system according to their accessing levels. This measurement tool system can be applied for digital data collection and analysis rapidly via the web.
Data Collection ; Information Systems ; Internet* ; Reproducibility of Results ; Writing

BACKGROUND: Androgenetic alopecia (AGA) is characterized by the structural miniaturization of androgen-sensitive hair follicles in susceptible individuals and is anatomically defined within a given pattern of the scalp. Oral finasteride and topical minoxidil are the only drugs whose effect and safety were demonstrated and approved by the FDA. However, the treatment result of these medications are not always satisfactory. Here, we report the result of a clinical trial of the new topical agent, Scalp med(R) to patients with AGA. OBJECTIVE: The goal of this study was to test Scalp med(R), the solution including minoxidil, retinol, polysorbate 80 and phytosterol in the treatment of AGA. METHODS: Included in this study were males between the ages of 20 and 60 years, in good health, with mild to moderate AGA. Efficacy was evaluated by terminal hair count per 1 cm2 and hair thickness. RESULTS: The results of this clinical trial showed a highly positive response to treatment. After 24 weeks of treatment, a significant improvement in hair count and hair thickness was demonstrated in all the patients. CONCLUSION: This clinical study establishes the effectiveness and safety of Scalp med(R) in the treatment of AGA.
Alopecia ; Finasteride ; Hair ; Hair Follicle ; Humans ; Male ; Miniaturization ; Minoxidil ; Polysorbates ; Scalp ; Vitamin A

BACKGROUND: Early detection and surgical resection offer the most advantage out of all cures for lung cancer. Elderly patients may fail to benefit maximally from these interventions because of their general condition and residual lung function. To study the impact of age on stages, histology, symptoms, and treatments of the patients with non-small cell lung cancer, we undertook a retrospective review. MATERIAL AND METHOD: Two hundred eleven patients with non-small cell lung cancer were operated on at Samsung Seoul hospital between October 1994 and June 1997. Patients were arbitrarily arbitrarily by age less than 70 years(176 patients) and 70 years or more(35 patients), and their medical records were reviewed. RESULT: There were no differences in pathologic staging and diagnosis. But there were differences in surgical methods, complications, and mortality rates between the two groups. There were much more complications in the 70 years or more group(p=0.02). We chose less invasive surgical methods in the 70 years or more group. CONCLUSION: More complications were experienced in the 70 years or more group. Although thoracic operation imparts the greatest survival advantage, this benefit is diminished in elderly patients because of their high complications and mortality rate. We recommend serious consideration of surgical indications and operative methods.
Aged* ; Carcinoma, Non-Small-Cell Lung ; Diagnosis ; Humans ; Lung Neoplasms* ; Lung* ; Medical Records ; Mortality ; Neoplasm Metastasis ; Retrospective Studies ; Risk Factors* ; Seoul

PURPOSE: This study was designed to identify creation of intellectual capital and factors influencing the creation of intellectual capital in hospital organizations. METHODS: A cross-sectional design was used, with a convenience sample of 300 nurses from three general hospitals in Gwangju and South Cholla province. The tools used for this study were scales measuring creation of intellectual capital (8 items), social capital (20 items), knowledge management (8 items). Data was analyzed with descriptive statistics, Pearson's correlation coefficient and regression using the SPSS WIN 18.0 program. RESULTS: There were significantly positive relationships between social capital and knowledge management with creation of intellectual capital. The mean score for creation of intellectual capital in hospital organizations was 4.59 points. Factors influencing creation of intellectual capital in hospital organization were identified as knowledge management (beta=.625), shared values & action (beta=.166), and participation in civic activities (beta=.118). These factors explained 59.3% of the variance in creation of intellectual capital in hospital organizations. CONCLUSION: The results indicate which factors are major factors influencing creation of intellectual capital and therefore, serve as predictors of creation of intellectual capital in hospital organizations.
Hospitals, General ; Knowledge Management ; Regression Analysis ; Weights and Measures