BACKGROUND: This study was performed to evaluate the results of intervention activities on the management of steam sterilizers and sterile items in out-patient clinics and clinical laboratories. METHODS: A checklist was developed and used to monitor and evaluate the adequacy of sterilizers and sterilized items at out-patient clinics and clinical laboratories in a tertiary-care hospital. The checklist consisted of 7 items: condition of the material used for packaging sterile items, maintenance of shelf-life records, sterilizer cleanliness, maintenance of expiry date details of sterilized items, sterilization conditions, use of chemical indicators, and the results of biological indicators. Monitoring and additional intervention activities were carried out once every week for 53 weeks from August 2007 to July 2008. The study period was divided into 2 terms, early and late intervention; the duration of each term was 6 months, and we compared the ratio of adequacy of management of sterilizer and sterilized items between the 2 terms. RESULTS: There were a total of 795 observations from 15 departments in 1 year. Sterility of the materials used for packaging increased from 87.4% in the first 6-month term to 97.9% in the second 6-month term. Records for shelf-life increased from 89.6% to 98.5% in the same period, while the figures for maintaining expiry date details of sterilized items and for steam sterilizer cleanliness increased from 92.6% to 99.2%, and from 91.9% to 98.5 (P<0.05), respectively. CONCLUSION: Our intensive checklist-based intervention was effective in improving the management of steam sterilizers and sterile items in out-patient clinics and clinical laboratories.
Ambulatory Care Facilities ; Checklist ; Humans ; Infertility ; Organothiophosphorus Compounds ; Outpatients ; Product Packaging ; Steam ; Sterilization

PURPOSE: The purpose of this study is to analyze left ventricular (LV) radial strain (S) and strain rate (SR) in children with dilated cardiomyopathy (DCM) and to evaluate whether the impairment of global radial wall motion correlates with global ventricular dysfunction in DCM. METHODS: In 10 DCM patients (range 0.6-15 years, median age 6.5 years, 3 females) and 17 age and sex matched normal controls (range 0.5-14 years, median age 5 years, 5 females) conventional echocardiography and real time tissue Doppler imaging analysis were performed. Using an automatic two dimensional speckle tracking imaging (STI) method radial S and SR were calculated for each LV segment in 18 segment model. To evaluate the correlation between the impairment of radial motion and LV global function, the average values of radial S and SR of each LV level were obtained, and defined as global (G) S or SR. RESULTS: LV radial S and SR were markedly heterogeneous and decreased in almost all segments of LV in DCM. Impaired radial S and SR were associated with global LV dysfunction. CONCLUSION: In DCM, decreased and disorganized radial S and SR contribute to LV dysfunction. Analysis of radial S and SR with STI method can give further information on LV function in DCM.
Cardiomyopathy, Dilated* ; Child* ; Echocardiography ; Humans ; Ventricular Dysfunction

PURPOSE: This study was to evaluate the effect of repeated ultrasonic scaling and surface polishing with intraoral polishing kits on the surface roughness of three different restorative materials. MATERIALS AND METHODS: A total of 15 identical discs were fabricated with three different materials. The ultrasonic scaling was conducted for 20 seconds on the test surfaces. Subsequently, a multi-step polishing with recommended intraoral polishing kit was performed for 30 seconds. The 3D profiler and scanning electron microscopy were used to investigate surface integrity before scaling (pristine), after scaling, and after surface polishing for each material. Non-parametric Friedman and Wilcoxon signed rank sum tests were employed to statistically evaluate surface roughness changes of the pristine, scaled, and polished specimens. The level of significance was set at 0.05. RESULTS: Surface roughness values before scaling (pristine), after scaling, and polishing of the metal alloys were 3.02±0.34 µm, 2.44±0.72 µm, and 3.49±0.72 µm, respectively. Surface roughness of lithium disilicate increased from 2.35±1.05 µm (pristine) to 28.54±9.64 µm (scaling), and further increased after polishing (56.66±9.12 µm, P<.05). The zirconia showed the most increase in roughness after scaling (from 1.65±0.42 µm to 101.37±18.75 µm), while its surface roughness decreased after polishing (29.57±18.86 µm, P<.05). CONCLUSION: Ultrasonic scaling significantly changed the surface integrities of lithium disilicate and zirconia. Surface polishing with multi-step intraoral kit after repeated scaling was only effective for the zirconia, while it was not for lithium disilicate.
Alloys* ; Ceramics* ; Lithium ; Microscopy, Electron, Scanning ; Ultrasonics*

Zearalenone (ZEA), a nonsteroidal estrogenic mycotoxin, is known to cause testicular toxicity in animals. In the present study, the effects of ZEA on spermatogenesis and possible mechanisms involved in germ cell injury were examined in rats. Ten-week-old Sprague-Dawley rats were treated with 5 mg/kg i.p. of ZEA and euthanized 3, 6, 12, 24 or 48 h after treatment. Histopathologically, spermatogonia and spermatocytes were found to be affected selectively. They were TUNEL-positive and found to be primarily in spermatogenic stages I-VI tubules from 6 h after dosing, increasing gradually until 12 h and then gradually decreasing. Western blot analysis revealed an increase in Fas and Fas ligand (Fas-L) protein levels in the ZEA-treated rats. However, the estrogen receptor (ER)alpha expression was not changed during the study. Collectively, our data suggest that acute exposure of ZEA induces apoptosis in germ cells of male rats and that this toxicity of ZEA is partially mediated through modulation of Fas and Fas-L systems, though ERalpha may not play a significant role.
Animals ; Antigens, CD95/*immunology ; Apoptosis/*drug effects/immunology ; Estrogens, Non-Steroidal/*toxicity ; Fas Ligand Protein/*immunology ; Histocytochemistry ; Immunoblotting ; In Situ Nick-End Labeling ; Male ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Spermatocytes/cytology/*drug effects/immunology ; Spermatogenesis/drug effects/immunology ; Spermatogonia/drug effects/immunology ; Testis/cytology/*drug effects/immunology ; Zearalenone/*toxicity

Folliculosebaceous cystic hamartoma (FSCH) is a rare cutaneous hamartoma composed of dilated folliculosebaceous units and mesenchymal elements. It presents as a papule or nodule usually on the face and scalp, rarely on the genital or trunk area. Histologically, FSCH shares several similar features to sebaceous trichofolliculoma. We report one case of FSCH misdiagnosed as a neurofibroma. He was a 38-year-old man with a neurofibromatosis type I and a nodule on his left earlobe was excised under the impression of neurofibroma. Pathological examination revealed FSCH. Although FSCH is clinically not distinctive, awareness of the lesion is important to differentiate papulonodular or cyst-like cutaneous lesions.
Adult ; Follicular Cyst ; Hamartoma ; Humans ; Neoplasms, Basal Cell ; Neurofibroma ; Neurofibromatoses ; Neurofibromatosis 1 ; Scalp ; Skin Neoplasms

BACKGROUND: The number of internet users is increasing rapidly and internet addiction among adolescents has become a serious public health problem in Korea. In the light of behavioral addiction, this study was aimed to identify the associations between the risk of internet addiction and other problem behaviors which can lead to addiction, such as cigarette smoking, alcohol drinking, drug abuse, and sexual intercourse among a nationally representative sample of Korean adolescents. METHODS: Data from the 2010 Korean Youth Risk Behavior Web-based Survey (respondents, 73,238) were analyzed. Risk of internet addiction was assessed by the 'Korean Internet Addiction Proneness Scale for Youth-Short Form: Self Report' which was developed by the Korean National Information Society Agency in 2008. Multiple logistic regression analysis was used to calculate the odds ratios of problem behaviors among adolescents at high risk for internet addiction and adolescents at low risk for internet addiction. RESULTS: The odds of smoking experience, drug abuse experience, and sexual intercourse experience were significantly higher among boys at high risk for internet addiction compared to boys at low risk for internet addiction. Among girls at high risk of internet addiction, the odds of smoking experience, drinking experience, and drug abuse experience were significantly higher compared with girls at low risk of internet addiction. CONCLUSION: The risk of internet addiction was associated with cigarette smoking, alcohol drinking, drug abuse, and sexual intercourse experience among Korean adolescents.
Adolescent ; Alcohol Drinking ; Behavior, Addictive ; Coitus ; Drinking ; Humans ; Internet ; Korea ; Light ; Logistic Models ; Odds Ratio ; Public Health ; Risk-Taking ; Sexual Behavior ; Smoke ; Smoking ; Substance-Related Disorders

BACKGROUND AND PURPOSE: Little is known about the relationships between provoking risk factors, prognosis, and optimal duration of anticoagulation in patients with cerebral venous thrombosis (CVT), especially in Asians. We aimed to investigate whether the prognosis and required duration of anticoagulation in CVT patients differ according to the provoking risk factors. METHODS: Prospectively recorded data from a tertiary medical center in South Korea were retrospectively reviewed. CVTs were categorized into three groups: unprovoked, those with possibly resolved provoking factors (PR), and those with persistent provoking factors (PP). The baseline characteristics, treatment, and prognosis of patients in these three groups were analyzed. RESULTS: From 2000 to 2015, 61 patients presented with CVT: 19 (31.1%) unprovoked, 11 (18.0%) with PR, and 31 (50.9%) with PP. The patients in our cohort had a slight female predominance and lower frequency of oral contraceptive use compared to Western cohorts. Median follow-up and duration of anticoagulation were 35 and 8 months, respectively. Despite the similarities in baseline characteristics, deaths (n=3; P=0.256) and recurrences (n=7; P=0.020) were observed only in the PP group. The median intervals to death and recurrence were 9 and 13 months, respectively. Death was associated with underlying disease activity, not with CVT progression. Recurrences in the PP group were associated with lack of anticoagulation (P=0.012). CONCLUSIONS: Although the prognosis of CVT is generally benign in Koreans, recurrence and death were observed in patients with persistent risk factors, suggesting their need for long-term treatment with anticoagulants.
Anticoagulants ; Asian Continental Ancestry Group ; Cohort Studies ; Female ; Follow-Up Studies ; Humans ; Korea ; Prognosis* ; Prospective Studies ; Recurrence ; Retrospective Studies ; Risk Factors* ; Venous Thrombosis*

Background: and Purpose: The expression of the 18-kDA mitochondrial translocator protein (TSPO) in the brain is an attractive target to study neuroinflammation. However, the binding properties of TSPO ligands are reportedly dependent on genetic polymorphism of the TSPO gene (rs6971). The objective of this study is to investigate the rs6971 gene polymorphism in the Korean population. Methods: We performed genetic testing on 109 subjects including patients with mild cognitive impairment, Alzheimer’s disease (AD) dementia, non-AD dementia, and cognitively unimpaired participants. Magnetic resonance imaging scans and detailed neuropsychological tests were also performed, and 29 participants underwent 18 F-DPA714 PET scans. Exon 4 of the TSPO gene containing the polymorphism rs6971 (Ala or Thr at position 147) was polymerase chain reaction amplified and sequenced using the Sanger method. The identified rs6971 genotype codes (C/C, C/T, or T/T) of the TSPO protein generated high-, mixed-, or lowaffinity binding phenotypes (HABs, MABs, and LABs), respectively. Results: We found that 96.3% of the study subjects were HAB (105 out of 109 subjects), and 3.7% of the subjects were MAB (4 out of 109 subjects). 18 F-DPA-714 PET scans showed nonspecific binding to the thalamus and brainstem, and increased tracer uptake throughout the cortex in cognitively impaired patients. The participant with the MAB polymorphism had a higher DPA714 signal throughout the cortex. Conclusions The majority of Koreans are HAB (approx. 96%). Therefore, the polymorphism of the rs6971 gene would have a smaller impact on the availability of second-generation TSPO PET tracers.

BACKGROUND AND OBJECTIVES: Multifocal atrial tachycardia (MAT), in general, has a favorable outcome. However, there are insufficient data regarding MAT in a pediatric population. This study sought to determine the clinical course of MAT and identify potential prognostic factors. METHODS: The medical records of MAT patients from 1997–2015 were reviewed. The arrhythmia control rate and factors for unfavorable outcomes were assessed and compared to those in the literature. RESULTS: Of the 33 included patients (19 boys and 14 girls), 27 were infants less than 1 year of age. The median age at diagnosis was 1.7 months (range, 0 day to 14 years). Fourteen (42%) patients had structural heart disease. Eight (24%) patients had lung disease and 6 (18%) had a syndromic diagnosis belonging to RASopathy. Two patients developed polymorphic ventricular tachycardia, in whom genetic analysis confirmed the presence of the RyR2 mutation several years later. MAT was controlled in 26 patients (84%) within 3.9 months (median; range, 16 days–18.4 years) using an average of 2.4 medications. There were 3 cases of cardiopulmonary mortality. The arrhythmia control rate was higher in the infant group (85%) than in the non-infant group (67%), although this trend was not statistically significant. There was a significantly lower rate of unfavorable outcomes in the idiopathic infant group (n=11) than in the other groups (p=0.008). Considering the findings of previous studies, the mortality rate was significantly higher in patients with structural heart disease than in patients without (21% vs. 5%, p=0.01). CONCLUSIONS MAT usually affects infants and has a favorable prognosis, particularly in the idiopathic infant group. However, in the presence of other comorbidities, MAT may have a variable clinical course.

BACKGROUND AND OBJECTIVES: Multifocal atrial tachycardia (MAT), in general, has a favorable outcome. However, there are insufficient data regarding MAT in a pediatric population. This study sought to determine the clinical course of MAT and identify potential prognostic factors. METHODS: The medical records of MAT patients from 1997–2015 were reviewed. The arrhythmia control rate and factors for unfavorable outcomes were assessed and compared to those in the literature. RESULTS: Of the 33 included patients (19 boys and 14 girls), 27 were infants less than 1 year of age. The median age at diagnosis was 1.7 months (range, 0 day to 14 years). Fourteen (42%) patients had structural heart disease. Eight (24%) patients had lung disease and 6 (18%) had a syndromic diagnosis belonging to RASopathy. Two patients developed polymorphic ventricular tachycardia, in whom genetic analysis confirmed the presence of the RyR2 mutation several years later. MAT was controlled in 26 patients (84%) within 3.9 months (median; range, 16 days–18.4 years) using an average of 2.4 medications. There were 3 cases of cardiopulmonary mortality. The arrhythmia control rate was higher in the infant group (85%) than in the non-infant group (67%), although this trend was not statistically significant. There was a significantly lower rate of unfavorable outcomes in the idiopathic infant group (n=11) than in the other groups (p=0.008). Considering the findings of previous studies, the mortality rate was significantly higher in patients with structural heart disease than in patients without (21% vs. 5%, p=0.01). CONCLUSIONS: MAT usually affects infants and has a favorable prognosis, particularly in the idiopathic infant group. However, in the presence of other comorbidities, MAT may have a variable clinical course.
Arrhythmias, Cardiac ; Atrial Fibrillation ; Atrial Flutter ; Comorbidity ; Diagnosis ; Heart Diseases ; Humans ; Infant ; Lung Diseases ; Medical Records ; Mortality ; Prognosis ; Ryanodine Receptor Calcium Release Channel ; Tachycardia ; Tachycardia, Supraventricular ; Tachycardia, Ventricular