Molecular Epidemiologic Analysis of Enterobacter Isolated from Clinical Specimen

Eighty-nine isolates of Enterobacter spp. from two university hospitals were analyzed by phenotypic and genotypic characteristics for epidemiologic investigation. Most strains were isolated from sputum, urine, wound, pus and catheter tip. Most isolates of Enterobacter spp. were resistant to ampicillin, cefazolin and cefoxitin and 39% of E. cloacae isolates were also resistant to other cephalosporins and aminoglycoside antibiotics except amikacin but all strains were highly susceptible to imipenem and ciprofloxacin. Twenty-six antimicrobial resistance patterns were obtained from E. clacae, but E. aerogenes showed only 4 patterns. Fourty-two plasmid profiles were identified, but plasmid was not detected from 28.4% of E. cloacae and 58% of E. aerogenes. Six biotypes from E. cloacae and three biotypes from E. aerogenes were obtained by carbohydrate metabolism. Fourteen strains of E. cloacae carried conjugative R plasmids and these plasmids were further analyzed. Among them, ten plasmids showed identical antibiogram, molecular weight, and pI value by isoelectric focusing and nearly identical restriction endonuclease fragment pattern. Their parental strains had identical antibiogram, biotype, plasmid profile, and were isolated from 4 different specimens including 6 catheter tips of different patients. But most clinical isolates showed various types of combination and seemed to be different strains. These results indicate that the epidemic strain were present in this hospital and the combination of antibiogram and plasmid analysis can be used to discriminate the epidemic strains of multi-resistant E. cloacae.

Treatment of Erythrodermic Psoriasis with Etretinate

We have investigated the clinical response of 12 patients with erythrodermic psoriasis to therapy with etretinate. Initial dosage of etretinate was 20-60mg/day. The time for complete disappearance of scales averaged 19.9 days. In 10 of 12 patients(83.3%) satisfactory results were obtained after 2 to 11 months of treatment. Cheilitis was the most common side effect. Three patients had mild elevation of blood lipids, which was corrected by dose reduction. Remission period, of ten patients who showed good result, averaged 4.2 months.

A Study of the Effect of Nicotinic acid and Its Substitutes on Cutaneous Blood Flow / 대한피부과학회지

The ability of nicotinic acid and its substitutes to increase cutaneous blood flow has been measured by laser Doppler flowmeter in 30 healthy human volunteers. We applied nicotinarnide, nicotinic acid ethyl ester, nicotinic acid methyl ester, hexyl nicozinate each in an acqeous solution at a concentration of 10 mM/liter for 10 minutes occlusion on the forearm. The change of blood flow was serially checked at 5 to 10 minutes intervals for one hour. The study results were as follows : l. The relative maximum cutaneous blood flow response was in following order nicotinic acid methyl ester(100%), nicotinic acid ethyl ester(98%), hexyl nicotinate (84%) and nicotinic acid(63%). However, there was no statistically significant difference(p>0.05) between each drug. There was statististically significant difference between nicotinamide and all other nicotinic acid substitutes(p<0.05). 2. The time required to reach maximum blood flow response was 6.7 minutes for hexyl nicotinste, 10 minutes for nicotinic acid ethyl ester, 12.5 minutes for nicotinic acid methyl ester and 20 minutes for nicotinic acid. However, there was statistically significant difference between hexyl nicotinate and nicotinic acid only(p<0.05). 3. Significant decrease of cutaneous blood flow was observed one hour after the removal of the patches in all drugs.

A Case of Lupus Pernio / 대한피부과학회지

A 36-year-old female patient with sarcoidosis is presented showing lupus pernio, papular skin lesions, cervical lymph node enlargement and lung lesions. Diagnosis was confirmed by characteristic histologic findings of noncaseating granulomas in skin and cervical lymph node, supported by compatible clinical and laboratory features. Methatrexate was administered orally, which resulted in considerable improvement of skin lesions.

Quantitation of Sunburn Cell Production and Ear Swelling Reaction in Mouse Skin by PUVA Treatment / 대한피부과학회지

This study was undertaken to investigate the quantitative change of sunburn cell(FiBC)production and ear swelling reaction(ESR)aecording to the UVA radiation dose and time course sfter PUVA treatment. A total of 75 ICR male albino haired mice were used as subjects. The results were as follows : 1. At 24 hours after PUVA treatment, the mean SBC numbers per cm length of epidermis were 29.1+13.6 with 1J/cm, 48.8+19.5 with 5J/cm, and 51.6+14. 8 with 10J/cm of UVA irradiation. SBC production was dose related with respect to radiation dose, but the increment was not so remarkable with more than 5J /cm of UVA irradiation. 2. [n PUVA treatment using 5J/cm of UVA, the mean SBC numbers per cm length of epiderrnis were 48.8+19.5 after 24 hours, 63.8+18.3 after 48 hours. SBC numbers rose to a maximum at 48 hours, but epidermal damage precludecl SBC counting after this. 3. At, 24 hours after PUVA treatment, no significant ESR was observed with 1 an3 5J/cm of UVA. In PUVA treatment using lOJ/cm of UVA, the mean ear thickness was 20.6+1.7( x 10mm) before treatment and 30.1+3.3( x 10mm') at 2h: hours after treatment, which showed significa.nt change(p<0.05). 4. In PUVA treatment using 5J(cm of UVA, ESR showed significant change at 43hours reaching a maximum at 72 hours. After 7 days, ESR was not measurable due to ear necrosis.

A Clinical and Histopathologic Study of Thirteen Cases of Phenytoin Induced Drug Eruption / 대한피부과학회지

The study comprises 13 cases of phenytoin induced drug eruption admitted and treated at Seoul National University Hospital during a 6-year period (1981-1986). The summaries are as follows : 1. The skin lesions were usually pruritic morbilliform maculopapular eruptions on face, trunk, extremites, including palms and soles. However, erythema multiform was observed in one case. 2. Hiistopathologically, the dermis showed perivascular accumulation of mononuclear cells with occasional eosinophils. In some cases, the epidermis showed vacuolar alteration of basaI layer, necrotic keratinocyte with dermal perivascular mononuclear cell infiltrations. 3. The frequencies of the associated features were as follows : fever(61.5%), lymphadenopathy(23.1%), leukocytosis(45.5%), esinophilia(72.7%), and liver function abnormalities(63.6%)

Histology of Nevus Flammeus Following Argon Laser Treatment / 대한피부과학회지

We observed the histopathological findings in 16 patients with nevus flammeus according to the time sequence after argon laser therapy. The results were as follows : 1. Immediately after treatment There was nonspecific damage to the epidermis, upper part of the dermis and upper portion of the pilosebaceous unit to a depth of 0.4~0.5mm depth. The specific damage to the vessels, which showed thrombi formation and partial disruption of the vessel walls was seen to a depth of 0.8~0.9mm. 2. One week after treatment Crust was formed and the epidermis regenerated almost completely. The thrombi still persisted and there was partial disappearance of the vessel walls. 3. Four to 10 months after treatment The epidermis appeared normal except the rete ridge flattening. The upper dermis was diffusely fibrotic, with relatively few residual vessels, many of them with slit-like contour.

Histopathologic Study of Drug - Induced Morbiliform Eruption and Erythema Multiforme / 대한피부과학회지

A histopathological observation of drug-induced morbilliform eruption and erythema multiforme was made on 32 patients with drug eruption, We found that many histopathologic features of drug-induced morbilliform eruption of basal cell layer with infiltration of derrnoepidermal junction and necrosis of epidermal keratinocyte were similar to those of drug induced erythema multiforme. Therefore, it seems possible to regard the histopathologic features of druginduced morbilliform eruption and erythema multiforrne as a cornmon tissuc reaction with spectral expression.

Clinical Study of Hospitalized Patients with Drug Eruption During a 10-Year Period (1976~1985) / 대한피부과학회지

The study comprises 127 inpatients with drug eruption, treated at the Department of Dermatology, Seoul National University Hospital, during a 10-year period. The results are summarized as follows: 1. Out of 1,434 dermatologic inpatients, 127(8. 9%) patients were diagnosed as drug eruption. 2. The cutaneous manifestations of drug eruptions in the order of frequency were as follows: exanthematous eruption, urticaria, erythema multiforme, Stevens Johnson syndrome, TEN, exfoliative dermatitis, fixed drug eruption and purpura. 3. Antibiotics and antimicrobials were the most common causative agents followed by antipyretics and analgesics, CNS depressant drugs and herb drugs. 4. The 5 most common drugs causing drug eruptions were ampicillin, acetyl salicylic acid, diphenylhydantoin, sulfonamide and phenacetin.