BACKGROUND: Several antibiotics can be used to treat ventilator-associated pneumonia caused by carbapenem-resistant A. baumannii (CRAB-VAP) including high-dose sulbactam. However, the effectiveness of high-dose sulbactam therapy is not well known. We report our experience with high-dose sulbactam for treatment of CRAB-VAP. METHODS: Medical records of patients with CRAB-VAP who were given high-dose sulbactam between May 2013 and June 2015 were reviewed. RESULTS: Fifty-eight patients with CRAB-VAP were treated with high-dose sulbactam. The mean age was 72.0 ± 15.2 years, and the acute physiology and chronic health evaluation II (APACHE II) score was 15.1 ± 5.10 at the time of CRAB-VAP diagnosis. Early clinical improvement was observed in 65.5% of patients, and 30-day mortality was 29.3%. Early clinical failure (odds ratio [OR]: 8.720, confidence interval [CI]: 1.346-56.484; p = 0.023) and APACHE II score ≥ 14 at CRAB-VAP diagnosis (OR: 10.934, CI: 1.047-114.148; p = 0.046) were associated with 30-day mortality. CONCLUSIONS: High-dose sulbactam therapy may be effective for the treatment of CRAB-VAP. However, early clinical failure was observed in 35% of patients and was associated with poor outcome.
Acinetobacter baumannii* ; Acinetobacter* ; Anti-Bacterial Agents ; APACHE ; Diagnosis ; Humans ; Medical Records ; Mortality ; Pneumonia, Ventilator-Associated* ; Sulbactam*

No abstract available.
Thyroid Gland* ; Thyroid Nodule*

BACKGROUND: Some research viewed that effective dietary therapy was enough to control proper blood glucose level, but in the most patient, dietary therapy was not practiced and the most difficult part of managing their diabetes. The purpose of this research study was to investigate dietary practice adherence and perceived barriers among the elderly diabetes. METHODS: The survey was mailed to 852 persons with diabetes member via diabetic educator of 156 hospitals or clinics and 24 health centers. Questionnaire had background information of patients, meal regularity, food intake as a dietary practice adherence, barriers of 36 items which have 3 areas such as motive/attitude, knowledge, authority/resource. We asked the person with diabetes to rate barrier to dietary practice adherence. 432 questionnaire were returned the response. we selected 69 persons who were over 65 year old. RESULTS: 1) meal regularity was more satisfactory than food intake. 2) deficit of meal regularity were evening snack and resonable spacing between evening meal and evening snack. 3) deficit of food intake was serving of milk. 4) main barrier to dietary practice adherence was that of knowledge. CONCLUSION: For practice effectively dietary therapy to elderly diabetes, individual consultation or small group education must be pursued and more easily educational skills should be required.
Aged* ; Blood Glucose ; Eating ; Education ; Humans ; Meals ; Milk ; Postal Service ; Surveys and Questionnaires ; Snacks

Color developers(CD) have been noted to produce lichen planus like eruption as well as eczematous contact dermatitis. The chemicals involved are derivatives of paraphenylenediamine or aniline, i. e., Kodak CD 2, Kodak CD 3, Agfa TSS. We report a 28-year-old male who showed a feature of lichenoid contact dermatitis after exposure to color developer. Patch test revealed positive reactions to CD2, CD3 and CD4. Skin biopsy from a patch site showed lichen planus-like tissue reaction.
Adult ; Biopsy ; Dermatitis ; Dermatitis, Contact* ; Humans ; Lichen Planus ; Lichens ; Male ; Patch Tests ; Skin

OBJECTIVES: Chromosomal anomalies are common disease entity among genetic diseases. But there are scanty reports about the status of chromosomal abnormalities in Korean. In addition, the comprehensive multi-center study of chromosomal abnormalities in Korean has never been performed. METHODS: We have collected 1,793 cases (394 abortuses; 198 chorionic villi; 1,060 amniotic fluid cells; 141 fetal blood), which showed abnormal karyotype results from twenty three cytogenetic centers in Korea from the year of 1977 to 1999. RESULTS: In abortuses, numerical chromosomal abnormalities was 85%, and structural abnormalities was 13% and the most frequent anomaly was trisomy 16. In chorionic villi, numerical anomaly was 60.0% and structural anomaly was 31.3% and the most frequent karyotype was Down syndrome. In amniotic fluid cells, structural anomaly exceeded the number of numerical anomaly and the most frequent anomaly was Down syndrome. In fetal blood, numerical anomaly was 63.8% and the most frequent karyotype was trisomy 18 (23.4%) CONCLUSIONS: This may be the first comprehensive and multi-center study in Korea. The proportion of the abnormal karyotypes in each specimens was different from each other. Based on this study, the more comprehensive study should be performed to all the Korean population.
Abnormal Karyotype ; Amniotic Fluid ; Chorion* ; Chorionic Villi* ; Chromosome Aberrations ; Cytogenetics ; Down Syndrome ; Female ; Fetal Blood* ; Karyotype ; Korea ; Trisomy

Over 60 different types of human papillomavirus (HPV) have been identified, and they are classified into high and low risk groups based on the risk for malignant progression of HPV associated lesions. HPVs belonging to a high risk group have been shown to express two major transforming proteins, E6 and E7. With respect to the transforming activity of these proteins, many investigators have reported the location of these proteins in the cell, but their results are still controversial. In the present study, HPV type 16 E6 or E7 open reading frame (ORF) proteins were expressed and localized in human epidermal keratinocytes (RHEK-1) using the vaccinia virus as an expression vector. Immunofluorescence detection using monoclonal antibodies against E6 or E7 ORF proteins revealed that E6 or E7 proteins of HPV type 16 were located in the cytoplasm of RHEK-1 cells. These results suggest that E6 and E7 proteins bind to the tumor suppressor counterparts, thereby preventing transport of these proteins into the nucleus. These antioncogene products that fail to be rapidly transported out of the cytosol may be degraded by certain proteases such as the ubiquitin dependent system. In this way, the precise function of antioncogene products in the regulation of cell growth could be destroyed, and abnormal cell growth could occur.
Animal ; Base Sequence ; Cell Line ; Fluorescent Antibody Technique ; Haplorhini ; Human ; Keratinocytes/metabolism ; Molecular Sequence Data ; Oncogene Proteins, Viral/*biosynthesis ; Open Reading Frames/*physiology ; Papillomavirus, Human/*chemistry ; Plaque Assay ; Polymerase Chain Reaction ; Recombinant Proteins/biosynthesis ; Support, Non-U.S. Gov't ; Vaccinia virus/genetics

Dysphagia can be caused by various mechanisms such as impaired tongue movement, delayed swallowing reflex, decreased pharyngeal peristalsis, incomplete closure of epiglottis and cricopharyngeal dysfunction. Cricopharyngeal muscle, forming the upper esophageal sphincter, acts as a muscular sling between the pharynx and the esophagus. Normally, it closes constantly at rest and opens during laryngeal elevation through active relaxation on the one hand and passive traction by the antero-cephalad laryngeal movement on the other. If its incoordination or hypertonicity happens, dysphagia can develop. Cricopharyngeal muscle dysfunction is caused by various situations such as neuromuscular diseases, postoperative changes and stroke, particularly after brainstem stroke. We report a case of isolated dysphagia caused by failure of active relaxation of cricopharyngeal muscle without aspiration after left lateral medullary lacunar infarction.
Ataxia ; Brain Stem Infarctions ; Deglutition ; Deglutition Disorders ; Epiglottis ; Esophageal Sphincter, Upper ; Esophagus ; Hand ; Muscle Relaxation ; Muscles ; Neuromuscular Diseases ; Peristalsis ; Pharynx ; Reflex, Abnormal ; Relaxation ; Stroke ; Tongue ; Traction

Xanthogranulomatous cholecystitis is an extremely rare benign inflammatory disease of the gall bladder characterized by yellowish focal nodular appearance with tissue necrosis and lipid-containing histiocyte (xanthomacell). Recently, we experienced a case of xanthogranulomatous cholecystitis. A 71-year old woman was admitted with the complaints of RUQ pain for 1 month. On abdominal ultrasound examination, there were diffuse gallbladder wall thickening, echogenic nodule with acoustic shadow, the calculous cholecystiti and the gall badder cancer were strongly suspected and the operation was performed. At operation the gall bladder was marked enlarged and wall thickening with two brownish, oval shaped, smooth surfaced stones. The specimen was revealed a xanthogranulomatous cholecystitis by the pathology.
Acoustics ; Aged ; Cholecystitis* ; Female ; Gallbladder ; Histiocytes ; Humans ; Necrosis ; Pathology ; Ultrasonography ; Urinary Bladder

The calcifying odontogenic cyst (COC) is a rare disorder of the jaws and shows various radiographic features. The purpose of this study is to describe the different radiographic appearances of 2 cases of COC. Case 1 was located in the posterior maxilla extending into maxillary sinus, showing unilocular radiolucency with a well-defined margin. Cortical bone expansion and thinning were prominent. Root resorption of adjacent teeth was apparent. Case 2 showed unilocular radiolucency with a calcified material. Calcification was supposed to be dystrophic dental hard structures, detected at the periphery of the lesion. Ghost cell and proliferation of ameloblastoma-like tissues were common features for these two lesions on histopathological findings. This reports presented common and atypical radiographic features of the COC.
Jaw ; Maxilla ; Maxillary Sinus ; Odontogenic Cyst, Calcifying ; Root Resorption ; Tooth

BACKGROUND/AIMS: We analyzed patients with abdominal pain of undetermined etiology, referred to physiatrists by gastroenterologists, and determined the clinical features of patients with abdominal wall pain. METHODS: A retrospective chart review of 100 patients referred by gastroenterologists over 4 years was performed. A visceral etiology of abdominal pain was excluded by the gastroenterology work-up using radiologic and endoscopic studies, and medical treatment. The clinical features and outcomes of abdominal wall pain were examined. We determined the long-term outcome by telephone. RESULTS: Of 100 patients with abdominal pain of undetermined etiology, 89% of the patients were identified as having pain arising in the abdominal wall, and the right flank area was the most common site of pain. The pain had a musculoskeletal origin in 90.4% of the patients and a neurogenic origin in 9.6%. Treatment by the physiatrists resulted in complete or partial pain relief in 73% of the patients. The diagnosis remained unchanged after a mean of 22.67 (range 6.5-55) months in 95.5% of the patients. Long-term effects of management were seen in 73.6% of the patients. CONCLUSIONS: In a small group of patients with abdominal pain of unknown etiology, the source of pain could be in the abdominal wall. Recognizing abdominal wall pain could lead to an accurate diagnosis, reduced medical costs and effective treatment.
Abdominal Pain ; Abdominal Wall ; Gastroenterology ; Humans ; Retrospective Studies