OBJECTIVES: This study was conducted to find the relationship between oral health conditions of elderly people and closures of public dental health clinics in rural areas. METHODS: Oral examinations and surveys were conducted in 2011 from May 11 through November 4 on 383 seniors over 65-years and under 74 years old. RESULTS: The results of this study were as follows: 1. The results of comparative analysis of the usage behaviors of health clinics of subjects in relation to the closures of public dental clinics within the area showed that the usage level and frequency of public health agencies in areas with public dental clinics were high, and that the trend of influence on personal oral health conditions and improvement in prevention was high. When compared to 3 years ago, there was an 11.6 percentage point reduction in areas without public dental clinics (24.4%) compared to areas with public dental clinics (12.8%). 2. The results of comparative analysis of the oral health conditions and behaviors of subjects in relation to the closures of public dental clinics showed that the level of dental caries was high in areas with no public dental clinics, and the number of toothbrush usage and oral health supplemental product usage were shown to be high in areas with public dental clinics. CONCLUSION: The closures of public dental clinics were found to affect oral health behavior and conditions of elderly people in rural areas.
Aged* ; Dental Care for Aged ; Dental Caries ; Dental Clinics* ; Diagnosis, Oral ; Humans ; Oral Health* ; Public Health* ; Rural Health Services

The Apolopoprotein E type 4 allele (ApoE epsilon 4) is genetically associated with the common late anset familial and sporadic forms of Alzheimer's disease. The BchE-k variant, which is the common varant of the BchE gene, has been reported to show allelic association with AD in subjects who are also carriers of the epsilon 4 allele of the ApoE, especially in subjects over the age of 75. This study was performed to evaluate the distribution of the ApoE and the BchE genotypes in the healthy and AD groups and to evaluate the synergy between the BchE-k variant and the ApoE epsilon 4 in AD. The ApoE and the BchE genotypes were determined in DNA samples from 610 healthy people and 60 LOAD patients by using ARMS by standard agarose gel electrophoresis. The effect of the ApoE epsilon 4 was closely related to AD(p<0.05). A comparison between the AD patients and the healthy individuals, both with the epsilon 4 allele, indicated an interaction between the BchE-k and the ApoE epsilon 4(p<0.05)/ The association of the BchE-k with AD was limited to carriers of the ApoE epsilon4 allele, among whom the presence of the BchE-k gave an odds ratio of AD 3.48 (95% C.I. 1.3-9.2). Therefore, these results suggested that further evidence of an association between the ApoE epsilon 4 and LOAD, and the BchE-k acts in synergy with the ApoE epsilon 4 as a susceptibility gene for AD.
Alleles ; Alzheimer Disease ; Apolipoproteins E* ; Arm ; Dementia* ; DNA ; Electrophoresis, Agar Gel ; Genotype ; Humans ; Odds Ratio

Isoniazid is one of the most commonly used antituberculosis drug. Acute into xication is characterized by repetitious convulsions, high anion gap metabolic a cidosis and coma. The basis of theraphy consists of parental pyridoxine admi nistration in a dose equivalent to that of isoniazid ingested. Here we present a case of seizure and metabolic acidosis due to only renal adjustment dosage of Isoniazid in an elderly woman.
Acid-Base Equilibrium ; Acidosis* ; Aged* ; Coma ; Female ; Humans ; Isoniazid* ; Parents ; Pyridoxine ; Seizures*

BACKGROUND: The control of multidrug-resistant microorganisms (MDROs) is important in preventing healthcare-associated infections. We performed a survey to evaluate the current system for control of MDROs in general hospitals in Korea. METHODS: A questionnaire consisted of queries about infection control systems, personnel, antibiotic use monitoring systems, isolation and barrier precautions, and obstacles to and opinions about MDROs. The questionnaire was mailed to 145 hospitals with more than 300 beds in November 2005. RESULTS: One hundred and two of the 145 (70.3%) hospitals responded; 65.3% of the responded hospitals had antibiotics control programs and 96.0% of those had control programs for MDROs. Surveillance cultures for vancomycin-resistant enterococcus (VRE) and methicillin-resistant Staphylococcus aureus (MRSA) were taken in 21.6% and 16.7% of the hospitals, respectively. Over 90% of the hospitals had guidelines with respect to wearing gloves, collecting infectious wastes, and cleaning the environment for MRSA and VRE, but less than a half of the hospitals had the same standard for extended-spectrum beta-lactamase-producing gram-negative bacteria and carbapenem-resistant gram-negative bacteria. Most hospitals recommended gowning when contamination or invasive procedures were anticipated, but for VRE patients, gowns were used more strictly whenever there was contact with MDROs. Major obstacles related to isolation of patients infected or colonized with MDROs were the cost for isolation rooms (37.3%), and proposed solutions were reimbursement from the medical insurance company (86.3%), construction of a nationwide management system (61.8%), and effort by individual hospitals (58.8%) for MDROs infection control. CONCLUSION: Most of the hospitals have adopted control programs, but more needs to be done. Further efforts, including periodic reporting of antibiotic resistance, sufficient cost reimbursement, and providing education and increased awareness are urgently needed.
Anti-Bacterial Agents ; Colon ; Drug Resistance, Microbial ; Education ; Enterococcus ; Gram-Negative Bacteria ; Hospitals, General* ; Humans ; Infection Control* ; Insurance ; Korea* ; Methicillin-Resistant Staphylococcus aureus ; Postal Service ; Surveys and Questionnaires

PURPOSE: This study was conducted to adapt the standardized evidence-based nursing protocol using the IPC (intermittent pneumatic compression) intervention to prevent venous thromboembolism in surgical patients. Further, an investigation was done to measure knowledge on prevention of venous thromboembolism, surrogate incidence of venous thromboembolism and to assess IPC compliance in the study patients compared with those in surgical patients who underwent IPC intervention due to previous clinical experience. METHODS: An analysis was done of the nine modules suggested by National Evidence-based Healthcare Collaborating Agency (NECA) in the adaptation manual of the clinical practice guideline for protocol adaptation. A nonequivalent control group post test design as a quasi-experiment was used to verify the effect of the IPC protocol. RESULTS: There was a significant difference in knowledge of prevention of venous thromboembolism, IPC application time after intervention and the number of IPC applications between the experimental group (n=50) using the IPC nursing protocol and the control group (n=49). However, the symptoms of deep vein thrombosis and pulmonary thromboembolism were not observed in either the experimental group or the control group after the intervention. CONCLUSION: Results confirm that the standardized IPC nursing protocol provides effective intervention to prevent venous thromboembolism in surgical patients.
Compliance ; Evidence-Based Nursing ; Evidence-Based Practice ; Humans ; Incidence ; Intermittent Pneumatic Compression Devices ; Nursing Assessment* ; Nursing* ; Pulmonary Embolism ; Venous Thromboembolism* ; Venous Thrombosis

BACKGROUND: Nucleoplasty is a minimally invasive spinal surgery using a Coblation(R) technique that creates small voids within the disc. The purpose of this study was to evaluate the efficacy of cervical nucleoplasty in patients with cervical disc disorder. METHODS: Between March 2008 and December 2009, 22 patients with cervical disc disorders were treated with cervical nucleoplasty after failed conservative treatment. All procedures were performed under local anesthesia, and fluoroscopic guidance and voids were created in the disc with the Perc(TM) DC Spine Wand(TM). Clinical outcomes were evaluated by the Modified Macnab criteria and VAS score at preprocedure, postprocedure 1 month, and 6 months. RESULTS: Six patients had one, eight patients had two and eight patients had three discs treated; a total of 46 procedures was performed. Mean VAS reduced from 9.3 at preprocedure to 3.7 at postprocedure 1 month and to 3.4 at postprocedure 6 months. There was no significant complication related to the procedure within the first month. Outcomes were good or excellent in 17/22 (77.3%) cases. Postprocedure magnetic resonance imaging was acquired in two patients after two months showing morphologic evidence of volume reduction of protruded disc material in one patient but not in the other. CONCLUSIONS: Percutaneous decompression with a nucleoplasty using a Coblation(R) technique in the treatment of cervical disc disorder is a safe, minimally-invasive and less uncomfortable procedure, with an excellent short-term clinical outcome.
Anesthesia, Local ; Decompression ; Diskectomy ; Humans ; Magnetic Resonance Imaging ; Retrospective Studies ; Spine

BACKGROUND: Nucleoplasty is a minimally invasive spinal surgery using a Coblation(R) technique that creates small voids within the disc. The purpose of this study was to evaluate the efficacy of cervical nucleoplasty in patients with cervical disc disorder. METHODS: Between March 2008 and December 2009, 22 patients with cervical disc disorders were treated with cervical nucleoplasty after failed conservative treatment. All procedures were performed under local anesthesia, and fluoroscopic guidance and voids were created in the disc with the Perc(TM) DC Spine Wand(TM). Clinical outcomes were evaluated by the Modified Macnab criteria and VAS score at preprocedure, postprocedure 1 month, and 6 months. RESULTS: Six patients had one, eight patients had two and eight patients had three discs treated; a total of 46 procedures was performed. Mean VAS reduced from 9.3 at preprocedure to 3.7 at postprocedure 1 month and to 3.4 at postprocedure 6 months. There was no significant complication related to the procedure within the first month. Outcomes were good or excellent in 17/22 (77.3%) cases. Postprocedure magnetic resonance imaging was acquired in two patients after two months showing morphologic evidence of volume reduction of protruded disc material in one patient but not in the other. CONCLUSIONS: Percutaneous decompression with a nucleoplasty using a Coblation(R) technique in the treatment of cervical disc disorder is a safe, minimally-invasive and less uncomfortable procedure, with an excellent short-term clinical outcome.
Anesthesia, Local ; Decompression ; Diskectomy ; Humans ; Magnetic Resonance Imaging ; Retrospective Studies ; Spine

OBJECTIVE: Although marker chromosome is defined as an abnormal chromosome in which no part can be identified, derivative chromosomes with structural abnormalities of unknown origin are also called as marker chromosomes conventionally. The clinical significance of a marker chromosome is determined according to the origin of marker chromosome. In this study reverse painting fluorescence in situ hybridization (FISH), and comparative genomic hybridization (CGH) methods were employed to elucidate the origin of marker chromosomes in 5 clinical cases. METHODS: Reverse painting probes were generated from five copies of each marker chromosomes microdissected with micromanipulator, amplified with DOP-PCR, and labeled with fluorochromes. The probes were hybridized to normal metaphases. For CGH, normal control and patients' DNA were directly labeled with spectrum-red-dUTP and spectrum-green-dUTP by CGH nick translation kit, and hybridized to normal reference metaphases. The CGH images were captured with a computer controlled fluorescence microscope equipped with a CCD camera and analyzed by Cytovision workstation. RESULTS: Five marker chromosomes were identified as follows (1) derivative chromosome 15 inducing partial trisomy of 15pter->q21, (2) isochromosome of 18p causing 18p tetrasomy, (3) short arm of chromosome 5 causing 5p trisomy (4) small accessory chromosome originated from centromeric region of chromosome Xq11->q12 (5) der(17) with inverted duplication of the short arm of chromosome 17. In all cases the origin of each marker chromosomes were identified successfully with reverse painting FISH, and these results were concordant with the CGH profiles. CONCLUSION: Our results indicate that combined reverse painting FISH and CGH is a rapid, convinient and powerful tool to identify the origin of marker chromosomes and derivative chromosomes caused by various chromosome abnormalities such as translocation, duplication, deletion.
Arm ; Chromosome Aberrations ; Chromosomes, Human, Pair 15 ; Chromosomes, Human, Pair 17 ; Chromosomes, Human, Pair 5 ; Comparative Genomic Hybridization* ; DNA ; Fluorescence* ; Fluorescent Dyes ; In Situ Hybridization* ; Isochromosomes ; Metaphase ; Paint* ; Paintings* ; Tetrasomy ; Trisomy

PURPOSE: Group B streptococcal (GBS) meningitis is the leading cause of mortality and morbidity in neonates. There are limited current data regarding outcomes from GBS meningitis and factors that predict an adverse outcome. METHODS: Twenty-three cases of GBS meningitis that were proven by cerebrospinal fluid culture from 2000 to 2010 were retrospectively reviewed. RESULTS: All GBS meningitis cases occurred in young infants less than 3 months and were late-onset (> or =7 days). Four infants (17.4%) died, and three (13.0%) were neurologically impaired at hospital discharge. Compared to the 16 infants with normal neurologic examinations, the 7 infants who died or had adverse outcomes at hospital discharge were more likely to present with seizures within hours of admission, have coma, require pressor support or ventilator support, have an initial peripheral blood leukocyte count less than 4,000/mm3 or neutrophil count less than 1,000/mm3, and have ampicillin resistance on culture. CONCLUSION: Despite advances in intensive care, 30.4% of infants with GBS meningitis die or have neurologic impairment at hospital discharge. Poor outcome can be predicted in cases that have seizures, coma, peripheral leukopenia, or require ventilator or pressor support on initial presentation. These cases show a tendency toward resistance to ampicillin, so vancomycin can be tried initially.
Ampicillin ; Ampicillin Resistance ; Coma ; Humans ; Infant ; Infant, Newborn ; Critical Care ; Leukocyte Count ; Leukopenia ; Meningitis ; Neurologic Examination ; Neutrophils ; Prognosis ; Retrospective Studies ; Seizures ; Streptococcus agalactiae ; Vancomycin ; Ventilators, Mechanical

Thyroid antibodies are frequently observed in urticaria patients, but their roles in urticaria are not clearly elucidated. We investigated the role of serum specific IgE to thyroid peroxidase (TPO) in patients with aspirin intolerant acute urticaria (AIAU) and aspirin intolerant chronic urticaria (AICU). We recruited 59 AIAU and 96 AICU patients with 69 normal controls (NC). Serum specific IgE to TPO was measured by manual direct ELISA, and CD203c expressions on basophil with additions of TPO were measured to prove a direct role of TPO in effector cells. The prevalences of serum specific IgE to TPO were significantly higher in AIAU (15.2%) and AICU groups (7.5%) compared to NC (0%, P=0.018: P=0.013, respectively). Flow cytometry showed CD203c induction in a dose dependent manner with serial additions of TPO in some AIAU and AICU patients having high specific IgE to TPO. Our findings show that the prevalence of serum specific IgE to TPO was significantly higher in both AIAU and AICU patients than in NC. It is suggested that specific IgE to TPO play a pathogenic role in AIAU and AICU.
Adult ; Anti-Inflammatory Agents, Non-Steroidal/adverse effects ; Aspirin/*adverse effects ; Autoantibodies/immunology ; Basophils/drug effects/*immunology ; Humans ; Immunoglobulin E/blood/*immunology ; Iodide Peroxidase/blood/*immunology ; Urticaria/*chemically induced/*immunology/pathology