PURPOSE: Haemophilus influenzae, one of the normal flora of the upper respiratory tract, can cause such infections as otitis, sinusitis, pneumonia, and meningitis in children. The oropharyngeal flora has therefore mainly been analyzed as a reservoir for pathogens. This study was performed to reveal the colonization rate of H. influenzae in the upper respiratory tract, their biotypes, their antimicrobial resistance and production of beta-lactamase in healthy children. METHODS: The specimens for H. influenzae were obtained through oropharyngeal swab from 209 healthy children, younger than 5 years of age in 4 day care centers from March 1998 to June 1998. These isolates of H. influenzae were tested for their biotypes, in vitro susceptibility to seven antimicrobial agents(ampicillin, ampicillin/sulbactam, aztreonam, chloramphenicol, cefotaxime, tetracycline and trimethoprim-sulfamedoxazole) by disc diffusion method and production of beta- lactamase. RESULTS: The carriage rate of H. influenzae in the day care center children was 13.4%(28/209). Of 24 isolates, 8 isolates(33%) were biotype II and 6 isolates(25%) were biotype I. The overall rates of resistance of 15 isolates are as follows; ampicillin 46.7%, tetracycline 28.6%, trimethop rim-sulfamedoxazole 14.3%, ampicillin/sulbactam 6.7%. The prevalence of beta-lactamase producing isolates was 65.2%. All beta-lactamase producing isolates were resistant to ampicillin. The resis tance rates of beta-lactamase producing isolates to tetracycline, trimethoprim-sulfamedoxazole, and ampicillin/sulbactam were 44.4%, 25.0%, and 11.1%, respectively. CONCLUSION: Children in day care centers in Seoul have high rates of H. influenzae carriage. The antimicrobial resistance of H. influenzae from the oropharyngeal specimens of healthy children was higher than expected.
Ampicillin ; Aztreonam ; beta-Lactamases ; Cefotaxime ; Child* ; Chloramphenicol ; Colon ; Day Care, Medical ; Diffusion ; Haemophilus influenzae* ; Haemophilus* ; Humans ; Influenza, Human ; Meningitis ; Otitis ; Pneumonia ; Prevalence ; Respiratory System ; Seoul ; Sinusitis ; Tetracycline

PURPOSE: Many different scoring systems have been proposed for assessing the severity of atopic dermatitis. The SCORAD (SCORing Atopic Dermatitis) is one of the best validated systems, but is too complicated and time-consuming for routine clinical use. The aim of this study is to evaluate the Three Item Severity (TIS) score in routine clinical practice and to investigate the correlation with SCORAD and quality of life. METHODS: The study was done on 69 cases of atopic dermatitis randomly selected by SCORAD severity in Kangdong Sacred Heart Hospital pediatric allergy clinic from March 2003 to August 2003. Patients were from three months old to 15 years old. A trained pediatrician assessed the TIS score and simultaneous 10 item questionnaire about quality of life (QOL) was checked. RESULTS: According to the SCORAD, there were 21 (30.4%) mild cases, 26 (37.7%) moderate cases and 22 (31.9%) severe cases out of total 69 patients. According to the TIS score, 21 (30.4%) cases were 0-2 point, 16 (23.2%) were 3 point, 11 (16.0%) were 4-5 point and include 21 (30.3%) were 6-9 point. In QOL score, 21-30 points were most common (36.2%). There was significant positive correlation between TIS score and SCORAD (Spearman's rs= 0.86, P< 0.01). There was significant positive correlation between TIS score and QOL (Spearman's rs=0.89, P< 0.01). CONCLUSION: The TIS score is a reliable and simple scoring system for atopic dermatitis. It is particularly suitable in general practice, for routine clinical use.
Adolescent ; Child* ; Dermatitis, Atopic* ; General Practice ; Heart ; Humans ; Hypersensitivity ; Quality of Life ; Surveys and Questionnaires

Nail-patella syndrome is a relatively rare autosomal dominant disorder characterized by dysplastic nail, hypoplastic or absent patella, and dislocation of radial head and iliac horns. In addition, renal abnormalities have been reported. The usual clinical signs of the renal involvement are asymptomatic proteinuria, microscopic hematuria, and in some cases progression to end stage renal disease. We present the case of adult with nail-patella syndrome, who developed proteinuria. Electron microscopy revealed irregular thickening of the glomerular basement membrane with areas of rarefaction, giving rise to a pathognomonic "moth-eaten" appearance.
Adult ; Animals ; Dislocations ; Glomerular Basement Membrane ; Head ; Hematuria ; Horns ; Humans ; Kidney Failure, Chronic ; Microscopy, Electron ; Nail-Patella Syndrome* ; Patella ; Proteinuria

PURPOSE: We aimed to compare the detection of breast cancer using full-field digital mammography (FFDM), FFDM with computer-aided detection (FFDM+CAD), ultrasound (US), and FFDM+CAD plus US (FFDM+CAD+US), and to investigate the factors affecting cancer detection. METHODS: In this retrospective study conducted from 2008 to 2012, 48,251 women underwent FFDM and US for cancer screening. One hundred seventy-one breast cancers were detected: 115 invasive cancers and 56 carcinomas in situ. Two radiologists evaluated the imaging findings of FFDM, FFDM+CAD, and US, based on the Breast Imaging Reporting and Data System lexicon of the American College of Radiology by consensus. We reviewed the clinical and the pathological data to investigate factors affecting cancer detection. We statistically used generalized estimation equations with a logit link to compare the cancer detectability of different imaging modalities. To compare the various factors affecting detection versus nondetection, we used Wilcoxon rank sum, chi-square, or Fisher exact test. RESULTS: The detectability of breast cancer by US (96.5%) or FFDM+CAD+US (100%) was superior to that of FFDM (87.1%) (p=0.019 or p<0.001, respectively) or FFDM+ CAD (88.3%) (p=0.050 or p<0.001, respectively). However, cancer detectability was not significantly different between FFDM versus FFDM+CAD (p=1.000) and US alone versus FFDM+CAD+US (p=0.126). The tumor size influenced cancer detectability by all imaging modalities (p<0.050). In FFDM and FFDM+CAD, the nondetecting group consisted of younger patients and patients with a denser breast composition (p<0.050). In breast US, carcinoma in situ was more frequent in the nondetecting group (p=0.014). CONCLUSION: For breast cancer screening, breast US alone is satisfactory for all age groups, although FFDM+ CAD+US is the perfect screening method. Patient age, breast composition, and pathological tumor size and type may influence cancer detection during screening.
Breast Neoplasms* ; Breast* ; Carcinoma in Situ ; Consensus ; Diagnosis, Computer-Assisted ; Early Detection of Cancer ; Female ; Humans ; Information Systems ; Mammography* ; Mass Screening* ; Methods ; Retrospective Studies ; Ultrasonography* ; Ultrasonography, Mammary

BACKGROUND: IgA nephropathy (IgAN) is the most frequent primary glomerulonephritis in the world. Despite 20 years of research into this condition, much remains unknown about its pathogenesis and therapy. One major problem is that the prognostic evaluation and renal survival of IgAN is unreliable. METHODS: A retrospective study was performed to clarify the prognostic factors and the long-term renal survival rates of this disease. RESULTS: One hundred fifty-two patients with IgAN who followed-up at least 3 years after renal biopsy were included in this study. During a mean followed-up of 9.3 years after their renal biopsy (range:36-215 months), 33 of them (21.7%) had progressed to end-stage renal disease (ESRD). The actuarial renal survival rate was 97% at 5 years, and 85% at 10 years. Using univariate analysis, 5 risk factors for developing ESRD were identified:male sex, hypertension, heavy proteinuria, renal insufficiency at the time of biopsy, severe histopathologic findings such as subclass IV/V lesions by Haas' subclassification were associated with significant risk factors for developing ESRD. In multivariate regression analysis, only Haas' subclass IV/V lesions and renal insufficiency at the time of biopsy were the independent prognostic factors of IgAN. CONCLUSION: In conclusion, further long-term prospective study with larger number of patients would be necessary to assess the prognostic factors in IgAN.
Biopsy ; Glomerulonephritis ; Glomerulonephritis, IGA ; Humans ; Hypertension ; Immunoglobulin A* ; Kidney Failure, Chronic ; Prognosis* ; Proteinuria ; Renal Insufficiency ; Retrospective Studies ; Risk Factors ; Survival Rate

PURPOSE: Tacrolimus (FK-506) represents a major advance in the prevention of rejection following solid organ transplantation. Previous clinical trials in Japan, Europe, and the US suggest that tacrolimus is an effective primary immunosuppressive agent in kidney transplantation. This prospective, non-randomized single center study was done to confirmed the efficacy of tacrolimus in kidney transplantation. METHODS: A total of 50 renal transplant recipients who followed-up at least one year after transplantation was included in this study. Thirty six cases (72%) recived triple drug therapy consists of tacrolimus, mycophenolate mofetil (MMF), and low dose steroid. RESULTS: The overall incidence of acute rejection was 10%, all episodes of rejection were treated effectively with steroid pulse therapy. The incidence of treatment failure was six percent. One and two year graft survival were 98% and 96%, respectively. Adverse effects of tacrolimus therapy included tremor of the hand (56%), diarrhea (34%), alopecia (26%), hyperkalemia (22%), nephrotoxicity (18%), post transplant diabetes mellitus (14%), hypertension (14%), and hypercholesterolemia (10%). However, the incidence of gum hypertrophy and hirsutism were 6% and 2%, respectively. CONCLUSION: This short-term study indicates that tacrolimus appears to provide safe and effective primary immunosuppression in kidney transplantation.
Alopecia ; Diabetes Mellitus ; Diarrhea ; Drug Therapy ; Europe ; Gingiva ; Graft Survival ; Hand ; Hirsutism ; Hypercholesterolemia ; Hyperkalemia ; Hypertension ; Hypertrophy ; Immunosuppression* ; Incidence ; Japan ; Kidney Transplantation* ; Organ Transplantation ; Prospective Studies ; Tacrolimus* ; Transplantation ; Transplants ; Treatment Failure ; Tremor

Clear cell acanthoma is a rare, benign tumor of epidermal origin, with distinct histolopathological features which usually includes solitary or rarely multiple tumors, often localized on the lower legs of middle-aged or elderly people. It presents as a flat or dome-shaped, sharply-demarcated papule or nodule, sometimes with a keratotic scale of bright red or pink color. Histopathological findings include clear cells within sharply-demarcated area of the epidermis. We report a case of clear cell acanthoma which developed on the lateral side of the right foot of an 82-year-old man.
Acanthoma* ; Aged ; Aged, 80 and over ; Epidermis ; Foot* ; Humans ; Leg

Malignant mixed Mullerian tumors (MMMT) are rare aggressive tumors that typically arise fromthe female genital tract. This malignancy has an extremely poor prognosis due to its rapid growthand the high associated incidence of both local recurrence and distant metastases. Althoughintraperitoneal metastasis from MMMT is relatively common, no reports exist regarding theradiologic findings of intestinal metastasis from MMMT. Here, we report a case of MMMT withsecondary small bowel metastasis and the associated radiologic findings.
Female ; Humans ; Incidence ; Neoplasm Metastasis ; Prognosis ; Recurrence

PURPOSE: The purpose of this study is to examine and share experiences of male nurses who have been rejected during their nursing practice by their patients. METHODS: The participants were 12 male nurses who have worked in several hospitals. Data were collected through personalized in-depth interviews. Collected data were analyzed with the content analysis method. RESULTS: The results can be categorized into three main themes. 1. Rejection based on gender stereotypes of nurses' roles. 2. Nurses' reactions when nursing was rejected 3. Reestablishing the role as a nurse. The results of this study showed that male nurses were struggling to maintain their own positions as professional nurses. They were refused by their patients and they experienced a lack of skill and knowledge in nursing practice. They were harmed physically and psychologically from being turned down, and sometimes they had serious conflicts with female nurses. Meanwhile, the male nurses tried to be faithful to their role as professional nurses. CONCLUSION: The results of this study show the following findings. 1. The male nurses' experiences where mostly ones of understanding and cooperation with patients' caregivers. 2. The need for public relations advertising and systematic support from the media. 3. The need for improving gender equality for nurses. 4. Strengthening male nursing students' endeavors for sound nursing professionalism.
Caregivers ; Female ; Humans ; Male ; Methods ; Nurses, Male ; Nursing ; Professionalism ; Public Relations ; Qualitative Research