No abstract available.

BACKGROUND: The aim of the study was to determine prevalence of potential heterogeneous vancomycin-resistant Staphylococcus aureus (h-VRSA) among methicillin-resistant S. aureus (MRSA) isolated in Korea by using Mu-3 agar and to determine the effect of in vitro vancomycin exposure on the resistance. METHODS: MRSAs isolated in 1980-1999 were screened for the presence of VISA or h-VRSA using Mu-3 agar. MIC of vancomycin was tested by NCCLS agar dilution and broth microdilution tests. Suspected h-VRSA were selected by vancomycin-containing media and change of resistance was determined by population analysis. A strain with Mu50 type growth was serially exposed to 8 pg/ml of vancomycin containing media and change of the vancomycin resistance was determined. RESULTS: Among the 455 MRSA isolates, 18 (3.9 %) grew on selective brain heart infusion agar (BHIA), and 354 (77,8%) on Mu-3 agar, 66 (14.5%) with Mu3 type growth and 78 (17.1%) with Mu50 type growth. MIC of vancomycin was 11 pg/ml for some of the isolates when inocula were approximately 10' CFU, but VISA was not present when tested by NCCLS broth microdilution test. Exposure of the isolates to van-cornycin raised the MIC. Serial exposure once to 8 pg/ml of vancomycin resulted in significant decrease of cells susceptible to 8-12 pg/ml of vancomycin. CONCLUSION: VISA was not present among the test isolates, but 34.2% were suspected to be potential h-VRSAs, suggesting possible emergence of VISA if vancomycin was administered prolonged period. It is considered that suitable screening media are vancomycin containing BHIA for VISA and Mu-3 agar for h-VRSA. The isolates showing Mu50 type growth on Mu-3 agar are not always VISA, but rather h-VRSA.
Agar* ; Brain ; Heart ; Korea ; Mass Screening ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Prevalence ; Staphylococcus aureus* ; Staphylococcus* ; Vancomycin Resistance ; Vancomycin*

Two patients with cutaneous leishmaniasis were treated with itraconazole. One patient was a 24-year-old man who had several erythematous papulonodules on the extremities for 1 month, which revealed cutaneous leishmaniasis, histopathologically. He was treated with itraconazole (200 mg/day) for 2 months. After treatment he showed clinical healing and the biopsy specimens no longer showed leishmania organisms. The other patient was a 27-year-old female who had several erythematous papulonodules on the face and neck for 3 months. The skin lesions revealed leishmania organisms in the tissue sections and culture media. She was also treated with itraconazole (200 mg/day) for 2 months. After treatment she also showed satisfying clinical healing and the biopsy specimens revealed no leishmania organisms. No specific side effects were encountered in both patients during the treatment. From these results, itraconazole is considered to be one of the promising anti-leishmanial drugs.
Adult ; Biopsy ; Culture Media ; Extremities ; Female ; Humans ; Itraconazole* ; Leishmania ; Leishmaniasis, Cutaneous* ; Neck ; Skin ; Young Adult

BACKGROUND: Epidermal growth factor (EGF) , a potent stimulant of epithelialization, has been noted to increase the tickness of the epidermis, increase the epithelial cell proliferartion and keratinization, and accelerate wound contraction. OBJECTIVE: Our purpose was to evaluate the efficacy of topical application of recombinant human epidermal growth factor (rhEGF) in the healing of full-thickness excision and burn wound. METHODS: Full-thickness excision and burn wound were made on the back of the male Wistar rat. Recombinant human epidermal growth factor was applied twice a day and the size of the wound was measured with planimetry every other day for 21 days. The keratinocytes of the circumcised foreskin were cultured in different concentrations of recombinant human epidermal growth factor and proliferation of the keratinocytes was evaluated. RESULTS: 1. Regardless of wound types or base types, wound healing in the experimental groups (rhEGF 10, 30, 50g/g) was generally better than that in the control or vehicle group. 2. The duration of wound healing was decreased as follows in order; in full-thickness excision wound, rhEGF 50 g/g group, rhEGF 30 g/g group, rhEGF 10 g/g group, vehicle group, and control group and in full-thickness burn wound, rhEGF 30 g/g group, rhEGF 50g/g group, rhEGF 10g/g group, vehicle group, and control group. 3. In the biopsy specimen taken from the wound at 9th and 13th day, neodermis, neovascularization, the thickness and maturation of the collagen bundles, and reepithelithelialization were more increased in the experimental groups than in the control or vehicle group. 4. In vitro culture of epidermal cells showed similar proliferation in the concentration of rhEGF higher than 10 ng/ml. CONCLUSION: these findings suggest that topical application of recombinant human epidermal growth factor in the healing of full-thickness excision and urn wound.
Animals ; Biopsy ; Burns ; Collagen ; Epidermal Growth Factor* ; Epidermis ; Epithelial Cells ; Foreskin ; Humans ; Keratinocytes ; Male ; Rats ; Ticks ; Wound Healing* ; Wounds and Injuries*

OBJECTIVE: In recent years, the neurosurgeon's role in managing cerebrovascular diseases (CVD) has becomes rapidly challenged and overlapped with other specialists. Furthermore, the patterns of CVD and patient recruitment have also changed. We conducted a retrospective study regarding the practical trends of CVD with reference to the management paradigms at our institute. METHOD: We reviewed all the available data, including the annual reports, the daily department records, the medical records and the radiographic films of the CVD patients who had been admitted to our Neurosurgery Department during the five years between Jan. 2004 and Dec. 2008. RESULTS: The total numbers of CVD operations showed a slight initial increase, but then they remained steady for the latter 3 years. The number of cases of non-angiomatous hemorrhage has been relatively steady, regardless of surgery. The total numbers of treated aneurysms increased, but the main body of this increment was attributed to the initiation of endovascular treatment and increased identification of unruptured vascular lesions. Vascular malformations were sustained with a small number of cases due to referring them to other institutes for radiosurgery, except for the cases that required urgent hemorrhagic evacuation. CONCLUSION: Hemorrhagic CVDs tended to decrease either due to increasing identification before rupture or shifting such patients into a large volume hospital. The increasing awareness of ischemic CVD, the early detection of unruptured aneurysms, and the separation of medical responsibilities from neurologists have all pushed neurosurgeons to make treatment plans in a more cooperative fashion, instead of a competitive way. Neurosurgeons should be furnished with several revolutionary surgical options to widen their scope of managing patients with CVD.
Academies and Institutes ; Aneurysm ; Hemorrhage ; Humans ; Infarction ; Intracranial Aneurysm ; Medical Records ; Neurosurgery ; Patient Selection ; Radiosurgery ; Retrospective Studies ; Rupture ; Specialization ; Subarachnoid Hemorrhage ; Vascular Malformations ; X-Ray Film

Down syndrome is the most common autosomal syndrome in man. The incidence of trisomy 21 due to translocation is about 3.5-5%. Translocations are usually centric fusions between a 21 and a D group (54.2%) or a G group (40.9%) chromosome. Since the short arm of 21 carries no phenotypically active genes, even if the short arm of 21 is lost, usually there is no imbalance with clinical significance. Rare translocations in Down syndrome may also occur between a 21 and other chromosomes (4.9%). We experienced a case of unusual (1q;21q) translocation Down syndrome inherited from a t (1q;21q) balanced carrier mother. The segmental trisomy was confirmed by FISH analysis. This is the first case of a familial Down syndrome with t (1q;21q) in Korea.
Arm ; Down Syndrome* ; Humans ; Incidence ; Korea ; Mothers* ; Trisomy

BACKGROUND: Group B Streptococcus (GBS) is known to be the leading cause of severe neonatal infections and also causes infections in pregnant women and adults with chronic underlying diseases. The frequency of GBS infections has increased recently. This study was aimed to determine the cultural results of beta-hemolytic streptococci and the clinical significance of the patients who had GBS infections during recent years. METHODS: This study has analyzed the isolation results and clinical importance of beta-hemolytic streptococci and GBS isolated from clinical specimens, except for stools, obtained from the patients in the Severance Hospital in Seoul from 1991 to 1999. RESULTS: Of 2,242 isolated beta-hemolytic streptococci, clinical records of 2,078 were available. GBS was found in 790 cases (38.0%). The isolation rate of group A Streptococcus was considerably high in pus and respiratory specimens while GBS was most commonly isolated from urogenital specimens. The isolation rate of GBS was much higher in females than males. GBS was the most common in patients under the age of one year or over age twenty. Especially, in newborn babies, GBS accounted for 72.7% of the total isolates. Of the 790 GBS isolates, 35.6% were considered to have definite infections. Of the 283 GBS infected patients, 56.2% had chronic diseases such as diabetes and malignancies. CONCLUSIONS: GBS is, two-fold, more commonly isolated than group A Streptococcus and the isolation rate is on the rise. GBS is more common in adult patients with chronic underlying diseases and remarkably high in newborn babies and the neonatal infections are severe. Therefore, microbiological diagnosis of GBS infections is necessary for proper treatment.
Adult ; Chronic Disease ; Diagnosis ; Female ; Humans ; Infant, Newborn ; Male ; Pregnant Women ; Seoul ; Streptococcus agalactiae ; Streptococcus* ; Suppuration

Familial adenomatous polyposis(FAP) is a hereditary disorder characterized by the development in adolescence or early adult life of multiple adenomatous polyps throughout the colon and rectum. The risk of malignant transformation is so high as to virtually 100 per cent if the patient lives long enough. Gardner's syndrome, a variant of familial adenomatous polyposis, is characterized by colorectal adenomas, multiple osteomas and variety of soft tissue lesions, including sebaceous cysts, fibromas, lipomas, and desmoid tumors. The recent study show that this group of diseases are caused by different mutations of the same gene located on the long arm of chromosome 5. All family members at risk of inheriting this gene need frequent surveillance of the colon. This should start between the ages of 8 and 12 years and should be continued at regular intervals. Prompt colectomy is indicated at the time the diagnosis is made. We experienced a case of Gardner's syndrome, which had typical extracolonic manifestations. Herein, we report this case with a review of the literature.
Adenoma ; Adenomatous Polyposis Coli ; Adenomatous Polyps ; Adolescent ; Adult ; Arm ; Chromosomes, Human, Pair 5 ; Colectomy ; Colon ; Diagnosis ; Epidermal Cyst ; Fibroma ; Fibromatosis, Aggressive ; Gardner Syndrome* ; Humans ; Lipoma ; Osteoma ; Rectum

BACKGROUND: Increased serum ferritin and decreased vitamin D levels associated with nonalcoholic fatty liver disease (NAFLD). However, their association with the severity of NAFLD has not been fully evaluated. The aim of this study was to compare the association of serum ferritin and 25(OH)D3 levels with the severity of ultrasonographically detected NAFLD (US-NAFLD) and hepatic steatosis defined by fatty liver index (FLI) in Korean adults. METHODS: A cross-sectional analysis of clinical and anthropometric data, including serum ferritin and 25(OH)D3, from men (n=295) and women (n=263) who underwent a routine health check-up in 2012. RESULTS: In men, with an increase in the quartile of serum ferritin level, the incidences of subjects with metabolic syndrome (P=0.002), US-NAFLD (P=0.041), and FLI > or =60 (P=0.010) were significantly elevated. In women, the incidence of subjects with US-NAFLD was also significantly elevated with increases in the serum ferritin quartile (P=0.012). Regarding 25(OH)D3, no statistical differences were observed among the different quartiles in either gender. Serum ferritin level significantly increased as the severity of US-NAFLD increased (P<0.001); however, no significant differences in 25(OH)D3 level were observed in men. No significant differences in either serum ferritin or 25(OH)D3 level were observed among women with different levels of severity of US-NAFLD. CONCLUSION: Increased serum ferritin level showed a closer association with severity of NAFLD compared with level of serum vitamin D, suggesting that serum ferritin level may be a better marker than vitamin D level for predicting the severity of US-NAFLD and hepatic steatosis in a clinical setting.
Adult* ; Cross-Sectional Studies ; Fatty Liver* ; Female ; Ferritins* ; Humans ; Incidence ; Male ; Vitamin D*

STUDY DESIGN: Prospective randomized noninferiority trial. PURPOSE: To evaluate whether the union rate of anterior cervical discectomy and fusion (ACDF) using a polyetheretherketone (PEEK) cage filled with a mixture of hydroxyapatite (HA) and demineralized bone matrix (DBM) is inferior to that of a mixture of beta-tricalcium phosphate (beta-TCP) and HA. OVERVIEW OF LITERATURE: There have been no clinical trials investigating the outcomes of a mixture of HA and DBM in a PEEK cage in ACDF. METHODS: Eighty-five eligible patients were randomly assigned to group B (n=43), in which a PEEK cage with a mixture of HA and DBM was used, or group C (n=42), in which a PEEK cage with a mixture of HA and beta-TCP was used. The primary study endpoint was the fusion rate, which was assessed with dynamic radiographs and computed tomography (CT) scans. Secondary endpoints included pain intensity using a visual analogue scale, functional outcome using a neck disability index score, laboratory tests of inflammatory profiles, and the infection rate. RESULTS: Seventy-seven patients (38 in group B and 39 in group C) were included in the final analysis. One year postoperatively, bone fusion was achieved in 87% of group B patients and 87% of group C patients on dynamic radiographs, and 87% of group B patients and 72% of group C patients on CT scans (p=1.00 and 0.16, respectively). There were also no between-groups differences with respect to the secondary endpoints. CONCLUSIONS: A HA/DBM mixture inside a PEEK cage can provide noninferior outcomes compared to a HA/TCP mixture in ACDF.
Bone Matrix* ; Diskectomy* ; Durapatite ; Humans ; Hydroxyapatites ; Neck ; Prospective Studies* ; Tomography, X-Ray Computed