Some species of mesophilic bacteria in the genus Aeromonas were isolated from a snakehead (Channa argus) culture-pond in the Myung-Ji area, a freshwater culture-pond in Pukyung National University, and seawater near the sewage treatment plant in Kwang-An Beach in Pusan. They were identified by biological characteristics, and their susceptibility to ten antibiotics including ampicillin, cefoxitin, ceftazidime cephalothin, cefotiam, chloramphenicol, nalidixic acid, rifampin, cefoperazone-sulbactam, and imipenem, was also studied. Four species in the genus Aeromonas, A. veronii biovar sobria (27 strains), A. caviae (14 strains), A. trota (1 strain), and A. schubertii (1 strain) were identified. A. trota, an unrecorded species in Korea, is reported for the first time in this study. Three strains of A. veronii biovar sobria showed multiple resistance to three kinds of antibiotics and one strain to four drugs. All strains of A. caviae were resistant to more than three drugs and seven strains to four drugs. A. trota was resistant to cephalothin and rifampin, but A. schubertii showed multiple resistance to ampicillin, nalidixic acid, and rifampin.
Aeromonas* ; Ampicillin ; Animals ; Anti-Bacterial Agents ; Bacteria ; Busan ; Cefotiam ; Cefoxitin ; Ceftazidime ; Cephalothin ; Chloramphenicol ; Drug Resistance, Microbial* ; Fresh Water* ; Guinea Pigs ; Imipenem ; Korea* ; Nalidixic Acid ; Plants ; Population Characteristics ; Rifampin ; Seawater* ; Sewage

BACKGROUND: In Korea, private health insurance has neglected to induce externality on national health insurance by moral hazard. Therefore, we conducted this study in order to explore the influence of private health insurance on unnecessary medical utilization among patients with cervical or lumbar sprain. METHOD: The study examined a population of 449 patients (admission, 384; out-patient; 85) diagnosed with simple cervical or lumbar sprain without neurological symptoms at 20 small hospitals or clinics in Gwangju and Jeollanam provinces from Jul. 1 to Aug. 31 2008. The data were collected using structured, self-administrated questionnaire which collected information such as whether or not the patient was admitted (as a dependent variable), whether or not they had private health insurance (as a independent variable), and covariates such as socio-demographic characteristics, the factors related to the sprain, and characteristics of the insurance provider. RESULTS: From hierarchical multiple logistic regression analysis, it was found that the admission rate of patient with private health insurance was higher than that those without it (Odds ratio=3.31, 95% Confidence interval; 1.14-9.58), meaning that private health insurance was an independent factor influencing the admission of patients with these conditions. Other determinants of admission were patient age and physician referral. CONCLUSIONS: This study is the first empirical study to explore the influence of private health insurance on inducing moral hazard in admission services, specifically among patients with cervical or lumbar sprain. Regulation of benefits provided by private health insurance may be necessary, as the effect of this moral hazard may mean existence of externality.
Humans ; Insurance ; Insurance, Health ; Korea ; Logistic Models ; National Health Programs ; Sprains and Strains ; Surveys and Questionnaires

BACKGROUND: The antihypertensive agents such as verapamil and esmolol are well known about effects of hemodynamic stabilization to tracheal intubation. The aim of the present study was to compare and evaluate the efficacy of those for controlling hemodynamic responses to tracheal intubation. METHODS: Thirty six patients, ASA physical status I or II, were randomly assigned to one of three groups (n=12 each): saline (control), verapamil 0.1 mg/kg and esmolol 1 mg/kg. Anesthesia was induced with thiopental 5 mg/kg intravenously, and then saline, verapamil and esmolol were administered as an intravenous bolus, and immediately followed by succinylcholine 1.5 mg/kg. Tracheal intubation was done 60 s and 90 s after intravenous injection of verapamil and esmolol, respectively. Systolic and diastolic blood pressure and heart rate were measured before induction and every min for 5 minutes after tracheal intubation. RESULTS: There was a significant attenuation in systolic and diastolic arterial pressure after tracheal intubation in verapamil group compared to control group. Heart rate was significantly lower in esmolol group than in verapamil group after tracheal intubation. CONCLUSIONS: Verapamil 0.1 mg/kg and esmolol 1 mg/kg attenuated the increases in blood pressure and heart rate after tracheal intubation, respectively.
Anesthesia ; Antihypertensive Agents ; Arterial Pressure ; Blood Pressure* ; Heart Rate* ; Heart* ; Hemodynamics ; Humans ; Injections, Intravenous ; Intubation ; Succinylcholine ; Thiopental ; Verapamil*

OBJECTIVE:To evaluate the biodurability of the covering material in retrievable metallic stents covered with polycarbonate polyurethane. MATERIALS AND METHODS: Using a peristaltic pump at a constant rate of 1ml/min, bile was recirculated from a reservoir through a long tube containing four stents. Each of these was removed from the system every two weeks and a radial tensile strength test and scanning electron microscopy (SEM) were performed. Each stent, removed at 2, 4, 6 and 8 weeks, was compared with a control stent not exposed to bile juice. RESULTS: Gross examination showed that stents were intact at 2 weeks, but at 4, 6 and 8 weeks cracks were observed. The size of these increased gradually in accordance with the duration of exposure, and at 8 weeks several large holes in the polyurethane membrane were evident. With regard to radial tensile strength, extension and peak load at break were 84.47% and 10.030 N/mm, 54.90% and 6.769 N/mm, 16.55% and 2.452 N/mm, 11.21% and 1.373 N/mm at 0, 2, 4 and 6 weeks, respectively. Scanning electron microscopy at 2 weeks revealed intermittent pitting and cracking, and examination at 4, 6 and 8 weeks showed that the size of these defects was gradually increasing. CONCLUSION: When the polyurethane membrane was exposed to bile, biodegradation was first observed at week two and increased gradually according to the duration of exposure.
Bile Acids and Salts/physiology ; Biodegradation ; Hydrogen-Ion Concentration ; Microscopy, Electron, Scanning/*instrumentation ; Phantoms, Imaging ; *Polyurethanes ; *Stents ; Support, Non-U.S. Gov't ; Tensile Strength ; Time Factors

Hyper-activated depressor septi nasi is an important factor caused a nasal tip drooping and many studies have been carried out, however it still remains controversial. This study presents a surgical modality for its intervention, based on the anatomical study. Eleven fixed and six fresh cadavers were used for the study. We found that the depressor septi nasi was consisted of three fascicles. Medial fascicles were inserted into the dermocartilaginous ligament, and deep fibers of the medial fascicles were attached to the anterior nasal spine. After superficial fibers were interdigitated with the orbicularis oris, they were attached to the alveolar bone. Intermedial fascicles were inserted to the footplates of the medial cruses and the caudal septum. After they were interdigitated with the medial fascicle and the orbicularis oris, they were attached to the alveolar bone. From April to August 2008, five patients had surgical intervention for hyper-activated depressor septi nasi. Medial and intermedial fascicles were detached completely from the anterior nasal spine and the septum through intranasal approach. Tip droopings were improved in all cases. Specific complications were not found. We believe that surgical intervention through intranasal approach is a useful method for correction of tip drooping.

Fibromyxomatous lesions of the maxilla are rare. Although other locations are also uncommon, this tumor can occasionally be found in jawbone. They are slow-growing, which result in expansion of the surrounding bony cortices. Maxillary and man-dibular myxomas are locally aggressive neoplasms that are thought to arise from fibroblasts of the dental papilla or sinonasal mucosa. The precise origin of these tumors, however, remains controversial. When present in the maxilla, they can extend into the maxillary sinus, the nose, or the orbit. The differential diagnosis should be made from neoplasms in which myxomatous change can be a prominent secondary feature such as liposarcomas, chondrosarcomas, and neurofibromas. We report a case with a large maxillary mass occluding the nasal cavity and expanding hard palate and gingivobuccal area. The histopathologic diagnosis was odontogenic fibromyxoma originating from canine tooth. The treatment was medial maxillectomy.
Chondrosarcoma ; Cuspid ; Dental Papilla ; Diagnosis ; Diagnosis, Differential ; Fibroblasts ; Fibroma* ; Liposarcoma ; Maxilla* ; Maxillary Sinus ; Mucous Membrane ; Myxoma ; Nasal Cavity ; Neurofibroma ; Nose ; Orbit ; Palate, Hard

BACKGROUND AND OBJECTIVES: Microphones designed to measure otoacoustic emissions (OAEs) from the human ear canal typically sample the sound field in the canal some 15-20 mm away from the tympanic membrane. Discrepancies inevitably arise at high frequencies between the sound pressure at the tympanic membrane and at the entrance to the emission probe from sound reflected by the tympanic membrane due to incomplete absorption. A previous work on the ear canal acoustics suggests the emission probe underestimate the sound pressure level of the stimulus at the tympanic membrane by as much as 15-20 dB for the stimulus frequencies near 5-7 KHz. Materials and Method: This study checked the variation of transiently evoked otoacoustic emissions (TEOAEs) and distorsion product otoacoustic emissions (DPOAEs) for the situations of probe which were controlled by ear canal volume. RESULTS: All mean values on TEOAEs (stimulus level, echo response, reproducibility) significantly increased (p 0.05) as the ear canal volume decreased. The mean amplitude of DPOAEs significantly increased at 1.6, 2, 25, 3.2, 4 (F2 frequency) and the variation of the mean noise level was statistically significant at 1, 2, 4 KHz (F2 frequency). The mean signal to noise ratio on DPOAEs significantly increased at 1, 2, 3.2, 4, 6.3 KHz (F2 frequency). CONCLUSION: These results suggest that the reliability of measurements of otoacoustic emissions should be improved when the probe is located nearer to the tympanic membrane.
Absorption ; Acoustics ; Ear Canal ; Humans ; Noise ; Signal-To-Noise Ratio ; Tympanic Membrane

BACKGROUND: We investigated the surgical outcomes of patients who underwent therapeutic surgery for malignant pleural mesothelioma (MPM) at a single center. METHODS: A retrospective review of 21 patients who underwent therapeutic surgery for MPM from January 2001 to June 2015 was conducted to assess their outcomes. The patients' characteristics and postoperative course, including complications, mortality, overall survival, and recurrence-free survival, were analyzed. RESULTS: Of the 21 patients who underwent therapeutic surgery, 15 (71.4%) underwent extrapleural pneumonectomy, 2 pleurectomy (9.5%), and 4 excision (19.1 %). The median age was 57 years (range, 32–79 years) and 15 were men (71.4%). The mean hospital stay was 16 days (range, 1–63 days). Median survival was 14.3 months. The survival rate was 54.2%, 35.6%, and 21.3% at 1, 3, and 5 years, respectively. In patients' postoperative course, heart failure was a major complication, occurring in 3 patients (14.3%). The in-hospital mortality rate was 2 of 21 (9.5%) due to a case of severe pneumonia and a case of acute heart failure. CONCLUSION: A fair 5-year survival rate of 21.3% was observed after surgical treatment. Heart failure was a major complication in our cohort. Various surgical methods can be utilized with MPM, each with its own benefits, taking into consideration the severity of the disease and the comorbidities of the patient. Patients with local recurrence may be candidates for surgical intervention, with possible satisfying results.
Cohort Studies ; Comorbidity ; Heart Failure ; Hospital Mortality ; Humans ; Length of Stay ; Male ; Mesothelioma* ; Mortality ; Pneumonectomy ; Pneumonia ; Recurrence ; Retrospective Studies ; Survival Rate

It has been hypothesized that jobs that have both high psychological demands and low decision latitude ('job strain") can lead to musculoskeletal disorder. The objective of this study was to test whether job strain was correlated with the presence of work-related musculoskeletal disorder, especially myofascial pain syndrome (MPS). Information on demographic factors, confounders such as household load and taking care of children or not, and scores for decision latitude, job demand, and social support was obtained by self-administered questionnaire, which had been developed in Korean language, by adopting NIOSH instrument and Extended Karasek Model (16 items). All subjects were also examined by rehabilitation medicine specialists for musculoskeletal disorders. Subjects (n=370) could be categorized into 4 groups, these were, housewives(n=89), shipyard CAD workers(n=89), general female workers(n=79; nurses, insurance counselors, public officials, clerks, etc), and telephone directory assistance operators(n=113). Results from univariate analyses indicated that all demographic factors, all confounders, scores for decision latitude and social support were not associated with the risk of musculoskeletal disorder. However, score for job demand was higher in musculoskeletal disorder cases than others. In subgroup analysis, this association was convinced again, in telephone directory assistance operators. Job strain model showed that the group of telephone directory assistance operators was high-strain group, and OR of musculoskeletal disorder was 2.446 (95% C.I. : 1.174, 5.096), when comparing this with the low strain group. In conclusion, job strain is a risk factor for work-related musculoskeletal disorder.
Child ; Counseling ; Demography ; Family Characteristics ; Female ; Humans ; Insurance ; Myofascial Pain Syndromes ; National Institute for Occupational Safety and Health (U.S.) ; Questionnaires ; Rehabilitation ; Risk Factors ; Specialization ; Telephone

BACKGROUND: Although, its efficacy is unclear, the application of complementary and alternative medicine (CAM) is increasing among patients worldwide. The physician's role is very important to help patients understand and use CAM properly. The aim of this study is to examine the perceptions, attitudes and physician-patient communication of about CAM in two distinguished specialty physicians. METHODS: A web-based survey was performed to list oncologists and family physicians in Korea between May 2007 and July 2007. E-mails were sent to total of 5,429 physicians and 547 physicians replied on survey (response rate: 10.1%). Of them, 500 participants comprising 174 clinical oncologists and 326 family physicians were involved in this study. The study questionnaire consisted of 26 questions including questions about general characteristics of CAM and intentions of introduction and education to their patients. RESULTS: Of 500 physicians, males were 73.4%, and 82.0% were middle-aged 30-49. Family physicians had more interest than oncologists about CAM (79.5% and 57.5%, respectively). In addition to, family physicians preferred introducing CAM to their patients than oncologists (34.1% and 18.4%, respectively). Almost 85% of the oncologists and family physicians thought that it was necessary to introduce CAM to their patients. However, 60.2% of them had hesitated their practice because 70.3% of them did not have sufficient knowledge in CAM. Both specialty physicians responded that usefulness of CAM information when regarding practice, should contain evidence-based evaluation (59.2%) and consensus guideline (37.0%). CONCLUSION: The results of this study showed that most physicians did not have sufficient information regarding CAM (87.2%). The result implies that evidence based information on complementaryand alternative medicine should be offered in the national level to improve communication between physicians and patients.
Complementary Therapies ; Consensus ; Electronic Mail ; Humans ; Intention ; Korea ; Male ; Physician's Role ; Physicians, Family ; Surveys and Questionnaires