Change of Antibiotic Sensitivities to Causative Organisms of Urinary Tract Infection in Out Patients 2 years Before and After the Separation of Prescription and Dispensing Medicines

BACKGROUND: The overuse and misuse of antimicrobial agents and their resultant emergence of resistant microorganisms have made choices regarding antimicrobial therapy more difficult .Therefore,a new system that separated prescribing and dispensing medicine began on July 1,1997 to prevent overuse and misuse of medicine.We studied to evaluate changes of antibiotic sensitivities to causative microorganisms of urinary tract infection 2 years before and after the new medical system. METHODS: During each 2 years before and after the new medical system,we analyzed antibiotic sensitivities of causative microorganisms for urinary tract infection among the 447 out-patients who visited a hospital in GangNeung.The diagnosis of urinary tract infection was based on greater than 105 CFU (Colony For Unit)per ml.urine. RESULTS: The most common pathogenic microorganisms as E.coli (76.5%),followed by Klebsiella pneumoniae (5.1%),and Proteus mirabilis (3.6%)in urine culture. A first generation cephalosporin,cephalothin,against E.coli, had more significant sensitivity after the introduction of the new medical system (52.6%)than before (33.9%),especially in the 80th decade (P=0.023) and in females (P<0.001).Also,trimethoprim/sulfamethoxazole against E.coli showed signifcant improving sensitivity (P=0.025). CONCLUSION: There was little change of antibiotic sensitivity of urinary tract infection in out-patients before and after the new medical system in cephalothin and trimethoprim/sulfamethoxazole against E.coli. The change of antibiotic sensitivities will require further observation for a longer term after the introduction of the new medical system.

Secretion and Excretion of Tears in Normal Eyes of Korean

The complaint of tearing may be due to 1) partial or complete obstruction of the excretory mechanism, 2) increased lacrimal secretion, or 3) decreased basic lacrimal secretion. So the physician should ascertain whether an excess of tears or obstruction of excretory mechanism is present. The most widely used tests for this purpose are the Schirmer test, Jones test and fluorescein dye disappearance test. The Jones test consist of Jones I test and Jones II test, which determine the functional and anatomical integrity of the lacrimal excretory system. In this study, Schirmer test, Jones test and fluorescein dye disappearance test were performed on 400 normal and 100 abnormal eyes to determine the secretion and excretion of tears.

A Case of the Tolosa-Hunt Syndrome

Painful ophthalmoplegia due to idiopathic granulomatous inflammation of the cavernous sinus or superior orbital fissure has been termed Tolosa-Hunt syndrome. We have experienced a case of Tolosa-Hunt syndrome in an 11 year old boy who has diagnosed with several clinical signs and symptoms such as severe ocular pain, headache, ptosis, proptosis, slight limitation of eyeball motion, nausea and vomiting, and the brain and orbital C-T scan which shows the right ethmoid and sphenoid sinusitis and inflammatory thickening of dura an the planum spenoidale.

A Case of Conjunctival Aspergillosis

Conjunctival aspergillosis refers to the infectious process of conjunctiva caused by one of the numerous members of the genus Aspergillus. A 4 year old Korean boy was brought to our hospital due to localized injection and edema of the left temporal bulbar conjunctiva which did not respond to the systemic and topical antibiotics for about 2 weeks. Clusters of the Aspergillus element was identified by the conjunctival biopsy and the diagnosis was made.