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.
Pilomatrixoma* ; Vaccination*

The most common adverse effect of intravenous heparin is hemorrhage. Of the these, retroperitoneal hemorrhage and femoral neuropathy secondary to heparin anticoagulation has reported in 1966 for the first time by DeBolt and Jordan. We experienced a case of spontaneous retroperitoneal hemorrhage due to iliopsoas muscle hematoma in patient with myocardial infarction receiving intravenous heparin for a 3 days in therapeutic doses. The pathophysiology of iliopsoas muscle hematoma has not yet been cleared. But because of the possibility of large amount in volume, retroperitoneal hemorrhage has been known as a serious adverse effect that leads to the hypovolemic shock and death. In this article, we described the clinical manifestation, the importance of the early diagnosis and diagnostic clues and associated factors of the retroperitoneal hemorrhage in patient receiving intravenous heparin.
Early Diagnosis ; Femoral Neuropathy ; Hematoma* ; Hemorrhage* ; Heparin* ; Humans ; Jordan ; Myocardial Infarction* ; Shock

Endometriosis is defined as the presence of endometrial tissue(gland and stroma) outside the uterus. The incidence of scar endometriosis is quite rare, and must differentiate with cellulitis and abscess. We have experienced one case of perineal endometriosis and one case of abdominal wall endometriosis at the site of postoperative wound scar. The possible pathogenesis of endometriosis and treatment were discussed.
Abdominal Wall ; Abscess ; Cellulitis ; Cicatrix* ; Endometriosis* ; Female ; Incidence ; Uterus ; Wounds and Injuries

Background: Mobile applications are useful in the field of dermatology as diagnosis and treatment are based on visual inspection. However, in Korea, dermatology-related applications have not been developed effectively despite the high rate of mobile internet usage. In addition, there is no report on the current trends of dermatology-related mobile application. Objective: This study aimed to identify and categorize the available dermatology-related mobile application and compare the current trends in Korea with those in the US. Methods: Eight dermatologic terms were queried in two mobile platforms, Android and iOS. Applications were categorized by function based on their description. The number of reviews, rating, provider, target audience, and price of applications were recorded. Results: A total of 213 dermatology-related applications were identified. Approximately 10.8% of the applications were related to skin diseases, 23.5% were related to skin care, and 65.7% were others. Among the applications related to skin diseases, 4.2% were self-surveillance/diagnosis apps, 3.3% were disease guide and reference apps, and 1.4% were dermoscopy apps. No applications were related to educational aid and photography search. Among the applications related to skin care, 12.7% were self-surveillance/diagnosis apps used for general skin care, 3.8% were skin care apps, and 2.8% were cosmetics apps. Other categories included shopping (24.9%), advertisements (15.0%), and hospital searches (15.0%). Conclusion The development and use of dermatology mobile applications can contribute to the efficient delivery of accurate information to patients, educate patients, and further reduce the prevalence of skin diseases. Therefore, dermatologists should play a leading role in presenting the direction for dermatology-related mobile application development.

Acute gluteal compartment syndrome (AGCS) is a rare condition associated with trauma, drug abuse, alcohol intoxication, prolonged immobilization, hip arthroplasty and epidural anesthesia. We report the case of a 42-year-old woman presenting severe buttock pain following decreased lower extremity motor function after an incident whereby she rolled down a flight of stairs. We performed fasciotomy of the gluteal fascia in order to provide relief from acute gluteal compartment syndrome. At the 2 month follow up visit her sensory and motor function had improved. Acute gluteal compartment syndrome is a rare condition which can result in misdiagnosis or delayed diagnosis. Careful consideration is needed for patients suffering severe buttock pain.
Adult ; Anesthesia, Epidural ; Arthroplasty ; Buttocks ; Compartment Syndromes ; Delayed Diagnosis ; Diagnostic Errors ; Fascia ; Female ; Follow-Up Studies ; Hip ; Humans ; Immobilization ; Lower Extremity ; Sciatic Nerve ; Stress, Psychological ; Substance-Related Disorders

Acute gluteal compartment syndrome (AGCS) is a rare condition associated with trauma, drug abuse, alcohol intoxication, prolonged immobilization, hip arthroplasty and epidural anesthesia. We report the case of a 42-year-old woman presenting severe buttock pain following decreased lower extremity motor function after an incident whereby she rolled down a flight of stairs. We performed fasciotomy of the gluteal fascia in order to provide relief from acute gluteal compartment syndrome. At the 2 month follow up visit her sensory and motor function had improved. Acute gluteal compartment syndrome is a rare condition which can result in misdiagnosis or delayed diagnosis. Careful consideration is needed for patients suffering severe buttock pain.
Adult ; Anesthesia, Epidural ; Arthroplasty ; Buttocks ; Compartment Syndromes ; Delayed Diagnosis ; Diagnostic Errors ; Fascia ; Female ; Follow-Up Studies ; Hip ; Humans ; Immobilization ; Lower Extremity ; Sciatic Nerve ; Stress, Psychological ; Substance-Related Disorders

BACKGROUND/AIMS: Gastric stasis in migraineurs remains controversial. The aim of this study is to investigate gastric emptying (GE) time, and any associations between GE parameters and dyspeptic symptoms among patients with functional dyspepsia (FD) and migraine without any gastrointestinal symptoms during the interictal period. METHODS: We enrolled 27 migraine patients, 32 FD patients and 12 healthy people as controls, and performed GE scintigraphy as gastric function test. Gastrointestinal symptoms were evaluated in the FD and migraine. RESULTS: The age-adjusted mean gastric half-emptying time in FD (125.51 +/- 52.55 minutes) patients was longer than in migraineurs (100.82 +/- 23.94 minutes, P = 0.035) and controls (95.25 +/- 23.29 minutes, P = 0.021). The percentage of gastric retention was higher in FD than in migraine. However, migraineurs did not show an obvious delayed gastric emptying or an increase of gastric retention when compared to the normal controls. The association between each dyspeptic symptom and GE parameters was not significant, but postprandial fullness and early satiety showed a tendency of delayed GE. In migraineurs, GE time did not show significant association with nausea and vomiting during interictal periods. CONCLUSIONS: Delayed GE does not appear to be a mechanism that patients with FD and migraine have in common. Migraineurs without dyspepsia during interictal period had normal GE, and further study for association with FD should be investigated.
Dyspepsia ; Gastric Emptying ; Gastroparesis ; Humans ; Migraine Disorders ; Nausea ; Retention (Psychology) ; Vomiting

Since 1990 when Wolff and co-authors proved that both RNA and DNA expression vectors containing interest gene were directly injected into mouse muscle and expressed the protein in vivo, the concept of gene vaccine has been broadly tested in the vaccine field. However, due to the limitations of technology and the misconception about RNA, most previous studies have focused on the DNA vaccine. Recently, the RNA vaccine has emerged as a new game-changing disruptive innovation technology in the vaccine field. This review has covered the characteristics of the RNA vaccine, including its strengths and weaknesses. Finally, we have suggested future directions for the RNA vaccine.
Animals ; DNA ; Mice ; RNA*

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