BACKGROUND: Candida species are one ol the major pathogens causing opportunistic infection. The need for a standardized. and clinically relevant method for antifungal susceptibility testing has become more increased because resistance to antifungal agents is now being reported with increasing frequency. The purposes of this study were to measure the minimal inhibitory concentrations actions amphotericin B, flucytosine and fluconazole of clinical isolates of Candida species, and to evaluate broth microdilution method as a more efficient test method, compared with NCCLS standard broth macrodilution. METHODS: The minlmal Inhibitory concentrations of C. parapsilosis ATCC 90018, C, albicans ATCC 90028 and 32 Candida isolates from Korea University Hospital were evaluated against amphotericin B, flucytosine and fluconazole by broth macrodilution and microdilution methods. RESULTS: The minimal inhibitory concentrations of Candida species ranged 0.25 to 1.0 microgram/mL for amphotericin B, 0.125 to 2.0 microgram/mL for flucytosine and 0.125 to 64 microgram/mL for fluconazole. The percent of agreement between NCCLS standard broth macrodilution and microdilution was highest when inoculum size was 0.5-2.5x103 CFU/mL and incubation time was 48 hours, and one fold dilution agreement was 100% for amphotericin B, 100% for flucytosine and 88-96% for fluconazole. CONCLUSIONS: This study showed good agreement of results of broth microdilution test with those of macrodilution, and suggested that broth microdilution method is an accessible and useful method and can be substituted for broth macrodilutlon method with the expectation of good results.
Amphotericin B ; Antifungal Agents ; Candida* ; Fluconazole ; Flucytosine ; Korea ; Opportunistic Infections

Solitary morphea profunda is a rare form of scleroderma, characterized clinically by a solitary sclerotic plaque, and histologically by marked dermal and subcutaneous fibrosis with an inflammatory infiltrate. We describe another case of this entity presented with an ulcerative, indurated plaque on the left iliac crest, which histologically revealed a focal incidental acantholysis in the overlying epidermis and a marked eosinophilic infiltration through the dermis to the sub-cutaneous tissue.
Acantholysis* ; Dermis ; Eosinophils ; Epidermis ; Fibrosis ; Scleroderma, Localized* ; Ulcer

It is well known that the incidence of revision arthroplasty for the loosened total hip has been progressively increasing recently. And the problem is that the loosening rate of revision arthroplasty for the failed total hip replacement is much higher as compared with that of primary total hip replacement. In revision arthroplasty, Amstutz, in 1982, reported 9% incidence of mechanical failure and 43% incidence of femoral and 61% incidence of acetabular progressive radiolucencies with follow-up for an average of 2.1 years, and Pellicci, in 1985, reported 29% incidence of failure for total hip replacement that have been revised once in the radiolucent zone with the follow-up for an average 8.1 years, and Kavanagh, in 1985, reported that probable loosening occurred in 25% of revised acetabular components with follow-up for an average of 4.5 years. Cementless total hip replacement is successful in more than 90 of the primary cases for the last 5 years in our department. Therefore, not only in primary total hip replacement but also in the revision, it seems to be reasonable to perform the cementless total hip replacement as an alternative, particularlly, in young age group. During the period from April 1982 to December 1984, we have revised 12 loosened total hip replacement with cementless type. Average follow up was 1 year and 7 months. The age range of the patients was 23 to 64. The results are very promising without any evidence of loosening in all cases.
Acetabulum ; Arthroplasty ; Arthroplasty, Replacement, Hip ; Follow-Up Studies ; Hip ; Humans ; Incidence

One hundred eighty-eight patients with avascular necrosis of the femoral head in adults, who were admitted and treated in Department of Orthopedic Surgery, Seoul National University Hospital between January of 1965 and May of 1985 are investigated in terms of the history, clinical data and laboratory examinations. And, the following results were obtained. 1. The incidence was higher in the 5th decade and the sex ratio between male and female was 3.3:l. 2. 106 cases (56%) had the bilateral hip involvement. 3. The most frequent etiological factor was alcohol (72 cases, 38%), followed by trauma (35 cases, 19 %), and steroid (32 cases, 17%). 4. Underlying diseases in steroid-induced avascular necrosis of the femoral head were dermopathy (9 cases), nephropathy (4 cases), pain over other joints (5 cases), systemic lupus erythematosus (2 cases), etc. 5. The time intervals between etiological events and appearances of clinical symptoms were 2 years and 3 months in the steroid induced cases, 1 year and 1 month in trauma induced ones, 2 years and 1 month in femur neck fracture cases, 2 years and 2 months in Caissons disease, and 3 years in post-irradiation 6. Bone scan was valuable in the early diagnosis of avascular necrosis of the femoral head. 7. Selective femoral head angiography show narrowing of lateral femoral circumflex artery, narrowing or obstruction of medical femoral circumflex artery, and obstruction of superior retinacular artery. 8. It is suggested that minor trauma and osteoporosis could make micro-fracture, resulting avascular necrosis of the femoral head, and the vascular change is secondary to the avascular necrosis.
Adult ; Angiography ; Arteries ; Early Diagnosis ; Female ; Femoral Neck Fractures ; Femur ; Head ; Hip ; Humans ; Incidence ; Joints ; Lupus Erythematosus, Systemic ; Male ; Necrosis ; Orthopedics ; Osteoporosis ; Seoul ; Sex Ratio

The index on myocardial contractility of pure mitral regurgitation(MR) after mitral valve replacement is believed to be useful in determining proper operation time before irreversible myocardial damage by volume overload. Thus the authors examined pre and post-operative echocardiographic results of 20 cases of pure MR patients who had been admitted to Pusan National University hospital and compared the usefulness of each index. Pre and post-operative echocardiographic results were as follows respectively ; 1) Left ventricular internal dimension in diastole(LVIDd) were 6.49+/-0.19cm and 5.51+/-0.17cm. 2) Left ventricular internal dimension in systole(LVIDs) were 4.26+/-0.12 and 3.79+/-0.18cm. 3) Ejection fraction were 71.28+/-1.57% and 59.24+/-3.05%. 4) Fractional shortening(FS) were 34.09+/-1.18% and 27.21+/-1.84%. 5) Mean Vcf were 1.53+/-0.08cm/sec and 1.18+/-0.09cm/sec. 6) Left ventricular end-diastolic volume index(EDVI) were 196.35+/-18.33cc/m2 and 98.46+/-9.96cc/m2. 7) Left ventricular end-systolic volume index(ESVI) were 55.28+/-5.12cc/m2 and 41.88+/-6.07cc/m2. 8) Left ventricular end-systolic wall stress/ESVI(ESS/ESVI) were 2.3+/-0.21 and 3.91+/-0.83. ESS/ESVI showed significantly(p<0.05) elevated postoperative change, LVIDd, LVIDs, EF, FS, EDVI, ESVI revealed significantly(p<0.05) reduced postoperative change whereas Mean Vcf had no postoperative change. After examining correlation between preoperative and postoperative results of each index, it is believed that LVIDd, LVIDs, and ESS/ESVI were useful prognostic indices but were unrelated to postoperative ejection phase indices such as EF, FS, and MEan Vcf. Especially in case of LVIDd>6cm, LVIDs>4cm, and ESS/ESVI<2, the prognosis was poor due to myocardial damage by mitral regurgitation.
Busan ; Echocardiography ; Humans ; Mitral Valve Insufficiency* ; Mitral Valve* ; Prognosis ; Stroke Volume

No abstract available.
Hepacivirus* ; Hepatitis C Antibodies* ; Hepatitis C* ; Hepatitis* ; Prevalence*

No abstract available.
Child* ; Humans ; Tuberculosis*

The most important prognostic factor of breast cancer is the status of lymph node or distant metastasis, which is resisted by basement membrane and stromal matrix. MMP (matrix metalloproteinase)-2 is a 72-kilodalton type IV collagenase/ gelatinase and degrades the type IV collagen which is a main component of the basement membrane. Therefore, MMP-2 is believed to be one of the key molecule for cancer invasion and metastasis. Enzymatic activity of MMP is inhibited by TIMPs (tissue inhibitors of metalloproteinase). TIMP-2 forms a complex with latent pro-MMP-2 and inhibits the active forms of MMP-2. The balance of MMPs and TIMPs is suspected as the important factor of invasion and metastasis of the tumor cells. We studied the association between the expression of MMP-2/TIMP-2 and growth pattern of tumor border, lymph node metastasis, and estrogen receptor expression in the 57 cases of invasive ductal carcinoma of the breast using immunohistochemical staining methods. The results revealed increased expression of MMP-2 in the infiltrating tumor border and tumors with positive lymph node metastasis and negative estrogen receptor with no statistical significance (p>0.05). But the expression of TIMP-2 was increased in expanding tumor border and tumors with positive lymph node metastasis and negative estrogen receptor without statistical significance (p>0.05).
Basement Membrane ; Breast Neoplasms ; Breast* ; Carcinoma, Ductal* ; Collagen Type IV ; Estrogens* ; Gelatinases ; Lymph Nodes* ; Matrix Metalloproteinases ; Neoplasm Metastasis* ; Tissue Inhibitor of Metalloproteinase-2*

We herein report three caes of xanthogranuloma occurring in aduls representing solitary nodule or multiple papules. Blood lipid substances such as cholesterol and triglyceride were normal and extracutaneous manifestatioiis were not found in all cases. Histopathorogic findings commonly revealed a granulomatous infiltrate c(intaining foam cells, foreign body gianf. cells and Touton giant cells as well as histiocytes and lymphocytes.
Adult* ; Cholesterol ; Foam Cells ; Foreign Bodies ; Giant Cells ; Histiocytes ; Humans ; Lymphocytes ; Triglycerides

Gastrointestinal angiodysplasia is a distinct disease entity which causes frequent gastrointestinal bleeding. It predominantly arises at the stomach and duodenum in the upper gastrointestinal tract and cecum and ascending colon in the lower gastrointestinal tract. The general histological finding of the angiodysplasia is a submucosal vascular ectasia and tortuosity. We have experienced two cases of the intestinal angiodysplasia. The first case occurred on a jejunum in a 22-year-old woman who had anemia. The second case occurred on a sigmoid colon in a 59-year-old man who had constipation. In addition to the general histologic finding of the angiodysplasia, the microscopic findings of the first case revealed some capillary hemangioma-like areas; and in the second case, there was a marked ischemic change and the thickening of the wall.
Anemia ; Angiodysplasia* ; Capillaries ; Cecum ; Colon, Ascending ; Colon, Sigmoid ; Constipation ; Dilatation, Pathologic ; Duodenum ; Female ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Jejunum ; Lower Gastrointestinal Tract ; Middle Aged ; Stomach ; Upper Gastrointestinal Tract ; Young Adult