BACKGROUND/AIMS: Multidrug-resistant tuberculosis (MDR-TB) is an important public health problem in South Korea. MDR-TB is difficult to control, and treatment is less effective than for drug-sensitive tuberculosis. The aim of this report is to determine the risk factors for poor outcomes for MDR-TB. METHODS: We retrospectively and consecutively analyzed the clinical outcomes of MDR-TB patients registered at a single tuberculosis-specialized hospital in South Korea from January 2005 to February 2011. We used standard treatment outcome definitions for MDR-TB and used the combination of “defaulted”, “treatment failed”, and “died” as a composite poor outcome variable. We analyzed the risk factors associated with poor outcome. RESULTS: Among the 258 patients sampled, 91 (35.3%) had MDR-TB on their first tuberculosis infection, while 167 patients (64.7%) who had previously been treated for tuberculosis had MDR-TB over the study period. Treatment outcomes revealed that 207 patients (80.2%) were cured of their infection, 15 (5.8%) completed their treatment, one (0.4%) defaulted treatment, 6 (2.3%) died, and treatment failed for 29 patients (11.3%). Multivariate Cox proportional-hazards regression analysis found that poor outcome were associated with a body mass index <18.5 kg/m2 (hazard ratio [HR]: 2.57; 95% confidence interval [CI]: 1.28-5.15, p = 0.008), being susceptible to four or fewer drugs at the start of treatment (HR: 3.89; 95% CI: 1.38-10.96, p = 0.01), and ofloxacin resistance (HR: 2.49; 95% CI: 1.06-5.81, p = 0.035). CONCLUSIONS: Being underweight, susceptibility to four or fewer drugs, and ofloxacin resistance are independent prognostic factors of poor outcome for MDR-TB patients.
Body Mass Index ; Humans ; Korea* ; Ofloxacin ; Public Health ; Retrospective Studies ; Risk Factors* ; Thinness ; Treatment Outcome ; Tuberculosis ; Tuberculosis, Multidrug-Resistant*

BACKGROUND/AIMS: Multidrug-resistant tuberculosis (MDR-TB) is an important public health problem in South Korea. MDR-TB is difficult to control, and treatment is less effective than for drug-sensitive tuberculosis. The aim of this report is to determine the risk factors for poor outcomes for MDR-TB. METHODS: We retrospectively and consecutively analyzed the clinical outcomes of MDR-TB patients registered at a single tuberculosis-specialized hospital in South Korea from January 2005 to February 2011. We used standard treatment outcome definitions for MDR-TB and used the combination of “defaulted”, “treatment failed”, and “died” as a composite poor outcome variable. We analyzed the risk factors associated with poor outcome. RESULTS: Among the 258 patients sampled, 91 (35.3%) had MDR-TB on their first tuberculosis infection, while 167 patients (64.7%) who had previously been treated for tuberculosis had MDR-TB over the study period. Treatment outcomes revealed that 207 patients (80.2%) were cured of their infection, 15 (5.8%) completed their treatment, one (0.4%) defaulted treatment, 6 (2.3%) died, and treatment failed for 29 patients (11.3%). Multivariate Cox proportional-hazards regression analysis found that poor outcome were associated with a body mass index <18.5 kg/m2 (hazard ratio [HR]: 2.57; 95% confidence interval [CI]: 1.28-5.15, p = 0.008), being susceptible to four or fewer drugs at the start of treatment (HR: 3.89; 95% CI: 1.38-10.96, p = 0.01), and ofloxacin resistance (HR: 2.49; 95% CI: 1.06-5.81, p = 0.035). CONCLUSIONS: Being underweight, susceptibility to four or fewer drugs, and ofloxacin resistance are independent prognostic factors of poor outcome for MDR-TB patients.
Body Mass Index ; Humans ; Korea* ; Ofloxacin ; Public Health ; Retrospective Studies ; Risk Factors* ; Thinness ; Treatment Outcome ; Tuberculosis ; Tuberculosis, Multidrug-Resistant*

While maternal mortality rates due to obstetric causes have declined in recent years, maternal mortality rates due to non-obstetric causes have relatively increased. Among these, pregnancy related stroke is significant because it has the worst impact on both mother and the fetus. Stroke is the state of necrosis in brain tissues caused by perfusion disorder in the cerebral blood flow and pregnant or puerperal women are reported to have about 13-fold more risk of stroke compared to non-pregnant women. Pregnancy-related stroke must be differentiated from stroke in elderly patients, because it is different in pathophysiological etiologies and recurrence rates and also diagnostic and therapeutic methods may affect the fetal health status. In this article, we experienced one case of hemorrhagic stroke occurred in a normal pregnant woman with gestational age of 40 weeks and the other case with ischemic stroke in 33 gestational weeks, those both without any manifestation of preeclampsia or eclampsia.
Aged ; Brain ; Cerebral Hemorrhage* ; Cerebral Infarction* ; Eclampsia* ; Female ; Fetus ; Gestational Age ; Humans ; Maternal Mortality ; Mothers ; Necrosis ; Perfusion ; Postpartum Period* ; Pre-Eclampsia* ; Pregnancy ; Pregnant Women* ; Recurrence ; Stroke*

Basaloid squamous cell carcinoma occurs in various organs including the upper respiratory tract, the base of the tongue, pharynx, larynx, breast, uterine cervix and anus. It is a rare tumor, but it must be distinguished from other malignancies because of its aggressive clinical behavior. Many cases present in the advanced stage at the time of diagnosis. We present here a case of esophageal basaloid squamous cancer that was diagnosed in 75-year-old male patient who had dysphagia and throat pain, and this was accompanied by squamous cell cancer of the tongue base, as was determined by laryngoscopic and esophagogastroscopic examination.
Aged ; Anal Canal ; Breast ; Carcinoma, Squamous Cell* ; Cervix Uteri ; Deglutition Disorders ; Diagnosis ; Esophagus ; Female ; Head and Neck Neoplasms ; Humans ; Larynx ; Male ; Neoplasms, Squamous Cell ; Pharynx ; Respiratory System ; Tongue*

Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) serves as an extracellular signal triggering apoptosis in tumor cells. To characterize the molecular events involved in TRAIL-induced apoptotic signaling, we investigated the role of extracellular signal-regulated kinase 1/2(ERK1/2) in the apoptosis using HeLa cells. Here we show that TRAIL pronounced ERK1/2 activation through a tyrosine kinase-dependent mechanism, subsequently elevated anti-apoptotic Bcl-2 protein levels. Pretreatment with Genistein, an inhibitor of tyrosine kinase, significantly attenuated ERK1/2 activation and enhanced cell death. Moreover, inhibition of ERK1/2 with PD98059 promoted apoptotic cell death through the down-regulation of ERK1/2 activity and Bcl-2 protein levels. Taken together, our results suggest that the activation of ERK1/2 via tyrosine kinase pathway plays a protective role as the mechanism of cellular defense through the up-regulation of Bcl-2 protein levels in TRAIL-induced apoptosis.
Apoptosis* ; Cell Death ; Down-Regulation ; Genistein ; HeLa Cells* ; Humans ; Necrosis ; Phosphotransferases ; Protein-Tyrosine Kinases* ; Tyrosine* ; Up-Regulation