No abstract available.

No abstract available.
Adolescent* ; Arteries* ; Humans ; Male*

BACKGROUND: Healthcare-associated infections (HAIs) are among the most important threats to patient safety. When hospitalized children face these threats, there is morbidity, mortality, prolonged hospitalization, and increased healthcare costs. Research on local healthcare epidemiology is necessary to enhance collective knowledge and evidence formanaging this problem. METHODS: We performed a retrospective analysis of databases of patients who were diagnosed with HAIs at Chung-Ang University Hospital (CAUH) from 2007 through 2011. Cases were selected from the microbiology registry databases. The data on prevalence of HAIs in various wards and its annual trends were compared to previously reported nationwide data. Moreover, we analyzed the patterns of antibiotic susceptibility results for HAI pathogens. RESULTS: A total of 181 HAIs were identified in 122 patients. The HAI rate among pediatric patients at CAUH was 2.4/1,000 person-hospital days. Urinary tract infections (UTIs) (53 episodes, 29.3%) were the most common, followed by pneumonia (33 episodes, 18.2%). Staphylococcus aureus was found to be the most common gram-positive organism, whereas Escherichia coli was the most common gram-negative organism. Methicillin-resistant S. aureus (MRSA) comprised 84% of the S. aureus infections. Imipenem resistance was detected in 58.8% and 55.0% of Acinetobacter baumannii and Pseudomonas aeruginosa isolates, respectively. CONCLUSION: Between 2007 and 2011, UTIs were the most common type of HAIs, and MRSA was the most common pediatric HAI pathogen, both in the general ward and intensive care unit at the CAUH. Further research on the epidemiology and pathogenesis of HAIs is necessary and prevention measures should be implemented to prevent HAIs in children.
Acinetobacter baumannii ; Child ; Child, Hospitalized ; Delivery of Health Care ; Escherichia coli ; Health Care Costs ; Hospitalization ; Humans ; Imipenem ; Intensive Care Units ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Microbial Sensitivity Tests ; Patient Safety ; Patients' Rooms ; Pneumonia ; Prevalence ; Pseudomonas aeruginosa ; Retrospective Studies ; Staphylococcus aureus ; Urinary Tract Infections

Despite significant advances in dialysis technology, kidney transplantation is accepted today as the optimal available treatment for end-stage renal disease (ESRD) in children and adolescents. Children undergoing renal transplantation pose many challenges to the anesthesiologist because ESRD has such adversely affects on the entire vital organ system as hypotension, hypovolemia, acidosis, atelectasis and pulmonary edema. Most importantly, hypotension and hypovolemia as results of large kidney transplantation should be corrected for normal renal function. In addition, ESRD alters the effects of various drugs used in anesthetic practice. We experienced 4 cases of general anesthesia for renal transplantation in children. Careful preoperative evaluation and preparation of the patients, as well as a knowledge of altered dry responses are essential in planning and managing anesthesia.
Acidosis ; Adolescent ; Anesthesia* ; Anesthesia, General ; Child* ; Dialysis ; Humans ; Hypotension ; Hypovolemia ; Kidney Failure, Chronic ; Kidney Transplantation* ; Pulmonary Atelectasis ; Pulmonary Edema

PURPOSE: Epileptic patients have a increasing tendency to develop seizure attack in high temperature. This finding suggests that high temperature may have an effect on neuronal hyperexcitability and injury of epileptic brain. Therefore, the influence of high temperature on normal and epileptic brain was studied in organotypic explant cultures of rat. METHODS: Fourteen days-in-vitro cultures from 8 day-old rat pups were perfused with standard aCSF bubbled with 95%/5% O2/CO2 in a microchamber. Stimulus train(0.3 sec, 60 Hz) was applied to Schaffer collaterals in CA3 and extracellular field potential was recorded in the CA1 pyramidal layer. At 36degrees C initially, AD was evoked. In high temperature(HT) group, the cultures were subjected to 39degrees C for a period of 8 min before the second stimulus train was applied. They were then restored to 36degrees C for 10 min. In normal temperature group, temperature was maintained at 36degrees C for the second stimulus train. The cultures were returned to the incubator and observed serially for neuronal damage. Intensity of propidium iodide fluorescence indicative of neuronal injury was quantitated by digital image analysis. The cultures on the same insert that were not stimulated served as the unstimulated groups. RESULTS: There was not a statistically significant difference in neuronal damage between the unstimulated high-temperature(HT) and normal-temperature(NT) group. In CA1 sector, % damage(mean+/-SEM) was 0.42+/-0.20 vs 0.27+/-0.05 at 24 hrs(HT vs NT group, n=16 each, P>0.05, Student t-test); 1.81+/-0.79 vs 1.43+/-0.27 at 48 hrs(P>0.05); 3.50+/-1.32 vs 3.35+/-0.56 at 72 hrs(P>0.05). In CA3 sector, % damage was 0.34+/-0.10 vs 0.20+/-0.03 at 24 hrs(P>0.05); 0.99+/-0.20 vs 0.83+/-0.23 at 48 hrs(P>0.05); 2.00+/-0.38% vs 2.26+/-0.35% at 72 hrs(P>0.05). Neuronal damage on AD induced cultures during febrile setting(n=16) was significantly higher than in nonfebrile setting(n=16). In CA1 sector, % damage was 6.63+/-2.56 vs 0.92+/-0.45 at 24 hrs(febrile setting vs nonfebrile setting, P= 0.036); 26.37+/-7.44 vs 4.99+/-2.23 at 48 hrs(P=0.010); 38.59+/-9.63 vs 6.48+/-2.30 at 72 hrs (P=0.003). In CA3 sector, % damage was 1.23+/-0.48 vs 3.91+/-2.37 at 24 hrs(P=0.277); 13.09+/-5.75 vs 5.93+/-3.27 at 48 hrs(P=0.288); 27.86+/-8.68 vs 7.54+/-3.74 at 72 hrs(P=0.04). CONCLUSION: At high temperature, seizures in epileptic brain may be more injurious than seizures in normal temperature.
Animals ; Brain ; Fluorescence ; Hippocampus* ; Humans ; Incubators ; Neurons* ; Propidium ; Rats* ; Seizures

PURPOSE: To evaluate changes in corneal keratometry, high-order aberrations (HOAs), and anterior chamber parameters after trabeculectomy using Pentacam(R) (Oculus Inc., Dutenhofen, Germany). METHODS: Forty eyes of 40 patients who underwent limbal-based trabeculectomy or fornix-based trabeculectomy between July 2011 and May 2012 were retrospectively reviewed. Intraocular pressure (IOP), corneal keratometry, central corneal thickness, anterior chamber depth, anterior chamber volume, and HOAs were measured using Pentacam(R) preoperatively and at 3 months postoperatively. RESULTS: The mean age of patients who underwent trabeculectomy was 58.26 +/- 16.28 years. IOP showed significant decrease after surgery in both groups compared to preoperative values (p < 0.05). There were no significant differences in corneal keratometry, anterior chamber depth, anterior chamber volume, central corneal thickness, total root mean square (RMS), trefoil, and coma after surgery (p > 0.05). CONCLUSIONS: Postoperative corneal keratometry and anterior chamber parameters did not change significantly compared to preoperative values in glaucoma patients after performing trabeculectomy. Most HOAs that affected quality of vision were not changed in the limbal-based trabeculectomy or fornix-based trabeculectomy.
Anterior Chamber* ; Coma ; Cornea ; Glaucoma ; Humans ; Intraocular Pressure ; Lotus ; Retrospective Studies ; Trabeculectomy*

PURPOSE: To evaluate changes in corneal keratometry, high-order aberrations (HOAs), and anterior chamber parameters after trabeculectomy using Pentacam(R) (Oculus Inc., Dutenhofen, Germany). METHODS: Forty eyes of 40 patients who underwent limbal-based trabeculectomy or fornix-based trabeculectomy between July 2011 and May 2012 were retrospectively reviewed. Intraocular pressure (IOP), corneal keratometry, central corneal thickness, anterior chamber depth, anterior chamber volume, and HOAs were measured using Pentacam(R) preoperatively and at 3 months postoperatively. RESULTS: The mean age of patients who underwent trabeculectomy was 58.26 +/- 16.28 years. IOP showed significant decrease after surgery in both groups compared to preoperative values (p < 0.05). There were no significant differences in corneal keratometry, anterior chamber depth, anterior chamber volume, central corneal thickness, total root mean square (RMS), trefoil, and coma after surgery (p > 0.05). CONCLUSIONS: Postoperative corneal keratometry and anterior chamber parameters did not change significantly compared to preoperative values in glaucoma patients after performing trabeculectomy. Most HOAs that affected quality of vision were not changed in the limbal-based trabeculectomy or fornix-based trabeculectomy.
Anterior Chamber* ; Coma ; Cornea ; Glaucoma ; Humans ; Intraocular Pressure ; Lotus ; Retrospective Studies ; Trabeculectomy*

PURPOSE: To report the long-term follow-up results after cyclocryotherapy, applied to the 3-o'clock and 9-o'clock positions in blind refractory glaucoma patients. METHODS: We retrospectively reviewed the charts of 19 blind patients, and a total of 20 eyes with refractory glaucoma who were treated with cyclocryotherapy. Cyclocryotherapy treatments were performed using a retinal cryoprobe. The temperature of each cyclocryotherapy spot was -80degrees C and each spot was maintained in place for 60 seconds. Six cyclocryotherapy spots were placed in each quadrant, including the 3-o'clock and 9-o'clock positions. RESULTS: The mean baseline pretreatment intraocular pressure (IOP) in all eyes was 50.9 ± 12.5 mmHg, which significantly decreased to a mean IOP at last follow-up of 14.1 ± 7.1 mmHg (p < 0.001). The mean number of antiglaucoma medications that patients were still taking at last follow-up was 0.3 ± 0.6. Devastating post-procedure phthisis occurred in only one eye. CONCLUSIONS: Cyclocryotherapy, performed at each quadrant and at the 3-o'clock and 9-o'clock position, is an effective way to lower IOP and, thus, is a reasonable treatment option for refractory glaucoma patients who experience with ocular pain and headaches.
Adult ; Aged ; Aged, 80 and over ; Blindness/etiology/*surgery ; Cryosurgery/*methods ; Female ; Follow-Up Studies ; Glaucoma/complications/physiopathology/*surgery ; Humans ; Intraocular Pressure/*physiology ; Male ; Middle Aged ; Retrospective Studies ; Time Factors ; Treatment Outcome ; *Visual Acuity

BACKGROUND: Mutated or deregulated expression of C-erbB-2 causes this gene to function as a potent oncogene. Vascular endothelial growth factor (VEGF) is a crucial angiogenic molecule in lung cancer. Both C-erbB-2 and VEGF can promote growth, proliferation and metastasis in non-small cell lung cancer (NSCLC). The purpose of this study was to investigate evaluate the relationship between the expressions of the C-erbB-2 and VEGF genes using immunohistochemistry. MATERIALS AND METHODS: Ninety-five patients with NSCLC were involved (60 squamous cell carcinoma and 35 adenocarcinoma). The formalin-fixed paraffin embedded specimens were immunohistochemically stained for C-erbB-2 and VEGF using the avidin-biotin complex method. RESULTS: Positive C-erbB-2 expression was observed more often in adenocarcinomas than squamous cell carcinomas (p<0.05). Although the immunohistochemical expressions of C-erbB-2 and VEGF in non-small-cell lung cancer showed increased tendencies at an advanced stage, the correlation between early and advanced cancers was insignificant. In adenocarcinomas, the expressions of VEGF and C-erbB-2 were significantly (p<0.05). CONCLUSION: The overexpression fo C-erbB-2 was significantly higher in adenocarcinomas than squamous cell carcinomas, and correlated with the expression of VEGF in adenocarcinomas of the lungs.
Adenocarcinoma ; Carcinoma, Non-Small-Cell Lung* ; Carcinoma, Squamous Cell ; Humans ; Immunohistochemistry ; Lung ; Lung Neoplasms ; Neoplasm Metastasis ; Oncogenes ; Paraffin ; Vascular Endothelial Growth Factor A*

PURPOSE: To evaluate the accuracy of T2-weighted imaging and MR cholangiopancreatography using the single shot fast spin-echo technique for evaluating pancreaticobiliary disease. MATERIALS AND METHODS: B e t ween March and July 1997, axial and coronal T2-weighted images ( T E : 8 0 -2 00 msec) and MR cholangiopancreatograms(TE:800 -1 2 00 msec) were obtained in two ways [single slab (thickness:30 -50 mm) and multislice acquisition under chemical fat saturation] using SSFSE pulse sequencing in 131 cases of suspected pancreati-cobiliary disease. The accuracy of SSFSE MR imaging was assessed in 89 lesions of 74 patients [male,48; female,26; age range, 3 0 -86 (mean,59)years] confirmed surgicopathologically(50 lesions in 39 patients) and clinically (39 lesions in 35 patients). Two radiologists reviewed the MR images and diagnosis was determined by consensus. RESULTS: Correct diagnosis was confirmed in 84 of 89 lesions (94 %). Seven lesions were falsely interpreted, false positive and false negative results accounting for two and five cases, respective l y. Two pancreatic cancers were misdiagnosed as pancreatitis and a cancer of the proximal common bile duct(CBD) was interpreted as a distal CBD cancer. The sensitivity of SSFSE MR imaging for malignancy was 93 %. One CBD stone revealed by endoscopic retrograde cholangiopancreatography (ERCP) was not detected on MR images. In contrast, a stone in the CBD seen on MR images was not apparent on subsequent ERC P. Sensitivity and specificity for calculous disease were 96 % and 99.7 %, respective l y. A benign stricture of the ampulla of Vater was falsely interpreted as normal, and correct diagnosis was possible in two falsely diagnosed cases when MR images were rev i ewed retrospectively. CONCLUSION: The combination of T2-weighted and cholangiographic images using SSFSE is an accurate method for diagnosing pancreaticobiliary diseases.
Ampulla of Vater ; Bile ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangiopancreatography, Magnetic Resonance* ; Consensus ; Constriction, Pathologic ; Diagnosis ; Humans ; Magnetic Resonance Imaging ; Pancreatic Neoplasms ; Pancreatitis ; Retrospective Studies ; Sensitivity and Specificity