No abstract available.
Delivery of Health Care* ; Family Practice* ; Humans ; Inpatients* ; Insurance* ; Korea*

The lack of specificity of an abnormal findings visualized on a conventional radiocolloid liver imaging remains a significant limitation of the examination. The purpose of this investigation is to clarify an equivocal abnormal finding visualized on a conventional liver and spleen imaging by using combination of scintiangiography and histogram as a quantiative assessment. Histo-analysis of peak colloidal distribution in the liver and spleen was undertaken as a complement of conventional liver imaging. The following useful patterns was emerged: 1. In hepatitis, the splenic uptake was slightly higher than in normal group. This change was usually not recognized in conventional imaging. 2. In liver cirrhosis, the liver uptake was markedly low whilst splenic uptake was very high, resulting in splenic shift and very low liver-spleen uptake ratio. 3. In hepatoma, the liver uptake was not definitely changed but splenic uptake was considerably high, so that the liver-spleen uptake ratio was very low. 4. In liver metastasis, both liver and splenic uptakes were within normallimits and the liver-spleen uptake ratio was not changed.
Carcinoma, Hepatocellular ; Colloids ; Complement System Proteins ; Evaluation Studies as Topic ; Hepatitis ; Liver ; Liver Cirrhosis ; Neoplasm Metastasis ; Radionuclide Imaging ; Sensitivity and Specificity ; Spleen

PURPOSE: We present a case of uneventful cataract surgery in an idiopathic true exfoliation patient with areas of capsular delamination based on scanning electron microscope and transmission electron microscope results. CASE SUMMARY: A 77-year-old male presented with gradual deterioration of vision over 1 year in duration. Slit lamp examination revealed bilateral nuclear sclerotic cataracts with ring-shaped fibrous membrane floating within the anterior chamber in the right eye. In addition, the patient was diagnosed with cataract and true exfoliation of the right eye. He underwent uneventful phacoemulsification and posterior chamber intraocular lens implantation by placing capsulorrhexis outside the delaminated capsule margin. At 6 months after cataract surgery, the patient showed favorable visual outcome with uncorrected vision of 20/20 and intraocular pressure of 18 mm Hg in the right eye.
Aged ; Anterior Chamber ; Capsulorhexis ; Cataract* ; Humans ; Intraocular Pressure ; Lens Implantation, Intraocular ; Male ; Membranes ; Phacoemulsification

BACKGROUND: Extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae are resistant to most β-lactam antibiotics except carbapenems. In recent years, infrequently isolated Enterobacteriaceae that produce carbapenemase pose a serious threat in the selection of appropriate therapeutic antibiotics. The rapid detection method of carbapenemase-producing Enterobacteriaceae (CPE) is necessary to prevent the spread of CPE into healthcare facilities. METHODS: One hundred clinical Enterobacteriaceae isolates (Klebsiella pneumoniae 40, Escherichia coli 40, others 20) showing susceptibility to carbapenems and positivity in the CLSI ESBL phenotypic test from November 2015 to March 2016 and 59 stocked Enterobacteriaceae isolates harboring resistance genes producing carbapenemase (K. pneumoniae 56, Enterobacter cloacae 2, E. coli 1; types of CPE: KPC 36, GES 12, NDM 6, VIM 2, OXA 2, IMP 1) were subjected to the RAPIDEC CARBA NP test (bioMérieux, France) and CPE phenotypic test using the modified Hodge test (MHT) and carbapenemase inhibition test. RESULTS: All of the 100 Enterobacteriaceae isolates with carbapenem susceptibility and ESBL positivity were negative on the RAPIDEC CARBA NP test and CPE phenotypic test. Of 59 stock CPE isolates, 53 and 42 showed positive results to the RAPIDEC CARBA NP test and MHT, respectively. The sensitivity and specificity of the RAPIDEC CARBA NP test for detecting CPE were 89.8% and 100%, respectively. CONCLUSION: The RAPIDEC CARBA NP test is simple and produces a result within 3 hr. In conclusion, the test is a useful screen for detecting CPE because it shows high sensitivity and specificity for CPE detection.
Anti-Bacterial Agents ; Carbapenems ; Delivery of Health Care ; Enterobacter cloacae ; Enterobacteriaceae* ; Escherichia coli ; Methods ; Pneumonia ; Sensitivity and Specificity

Spontaneous subcapsular hematoma of the kidney is an uncommon, but there are only few reports on bilateral subcapsular hematoma associated with non-traumatic origin in the world. Several commonest causes for this phenomenon have been described : including disease of the kidney , nephritis, tumor, hydronephrosis, infection, tuberculosis. lithiasis and cystic disease, blood vessel disease ; arteriosclerosis, aneurysm, periarteritis nodosa and renal infarcts, blood dyscrasia. No definite causative factor was found in this case : that a 49-year-old woman was done the decortication of left kidney and hematoma remove, due to no specific abnormality in preoperative coagulation test, 24hr urine AFB stain, immunoserologic test and renal angiography.
Aneurysm ; Angiography ; Arteriosclerosis ; Female ; Hematologic Diseases ; Hematoma* ; Humans ; Hydronephrosis ; Kidney* ; Lithiasis ; Middle Aged ; Nephritis ; Polyarteritis Nodosa ; Tuberculosis

In many aging individuals, dermatochalasis and involutional ptosis appear together. Therefore, for functional and aesthetic purposes, ptosis correction and upper blepharoplasty are performed together. The aim of this article is to investigate factors that should be considered in order to achieve good results when simultaneously performing involutional ptosis correction and upper blepharoplasty in aging patients. Involutional ptosis is usually corrected through aponeurosis advancement in mild cases. In moderate or severe ptosis, the Muller muscle and aponeurosis are used together to correct ptosis. Using the two muscles together has the advantages of reducing lagophthalmos and increasing the predictability of outcomes after surgery. Broadly speaking, the surgical method used for involutional ptosis varies depending on the specific case, but unlike congenital ptosis, it is often not necessary to perform overcorrection. In particular, if there are problems such as severe dry-eye symptoms or risk of lagophthalmos, undercorrection should be considered. When performing ptosis correction, the surgeon should be careful not to overdo skin excision; instead, limited excision should be performed. After ptosis surgery, the brow may descend and the double fold may look too small. However, in order to make the double eyelids look larger, the surgeon should consider making the double eyelid design high rather than excising an excessive amount of skin. In some cases, to obtain more natural double eyelids and favorable results, it may be necessary to perform a sub-brow lift or forehead lift before or after involutional ptosis surgery.

BACKGROUND AND OBJECTIVES: Mechanisms of restenosis following successful coronary angioplasty (PTCA) are knownasvascularsmoothmuscle cells(VSMCs)proliferationandmigration, elastic recoil or vascular wall remodeling. Paclitaxel whose effect on the stabilization of microtubles leads to cell death is highly lipophilic, permitting easy pass through cell membrane, and has a long-term antiproliferative effect. This study was performed to evaluate effect of paclitaxel on VSMCs proliferation and whether locally delivered paclitaxel can prevent stenosis and neointimal formation in rat carotid artery injury model. MATERIALS AND METHODS: Cultured VSMCs were exposed to sequential concentrations of paclitaxel in vitro, and proliferation inhibition was analyzed with 3H-thymidine incorporation. Paclitaxel of a suitable concentration was applied to the endothelium-denuded carotid artery of Fisher 344 inbred rats for 20 minutes. Angiogram and morphometric analysis of carotid artery was performed after 2 weeks. RESULTS: 3H-thymidine incorporation in cultured VSMCs was decreased dose-dependently from the concentration of 0.1 micromol/L (2,454+/-149cpm/ microgram protein) to 100 micromol/L (1,323+/-69cpm/ microgram protein) of paclitaxel by single and 20-minute exposure in the presence of platelet-derived growth factor (p<0.005). In the absence of platelet-derived growth factor, the decrement of 3H-thymidine incorporation was evident above the concentration of 5 micromol/L of paclitaxel. To evaluate in vivo effect, paclitaxel (0.1 or 1 micromol/L) was administered into the endothelium-denuded carotid artery by balloon injury and incubated for 20 minutes. Percent stenoses (32.2+/-9.8%) of paclitaxel-treated group was less than those (46.3+/-7.5%) of control group on histologic analysis (p<0.01). Paclitaxel-treated group also had wider lumen on carotid angiogram and less neointimal thickening than control on histologic examination (p<0.005). CONCLUSION: Proliferation of VSMCs was effectively inhibited and neointimal formation and luminal stenosis was prevented in rat carotid artery injury model by single, brief and local delivery of low-dose paclitaxel. This strategy could be applied to clinical settings for the prevention of restenosis after PTCA.
Angioplasty ; Animals ; Carotid Arteries* ; Carotid Artery Injuries ; Cell Death ; Cell Membrane ; Constriction, Pathologic ; Neointima ; Paclitaxel* ; Phenobarbital ; Platelet-Derived Growth Factor ; Rats*

BACKGROUND: The aim of the study was to develop an accurate, convenient, and easy microplate system for the identification of enterococcal species from clinical specimens. METHODS: The microplate identification method was composed of twelve biochemical tests and identification programs. The tests comprised in microplate were initially screened by a two-tube method, NaCl-esculin hydrolysis and pyrrolidonyl-beta-naphthylamide test; arginine dihydrolase, acid production from mannitol, sorbitol, sucrose, arabinose, raffinose, methyl-alpha-D-glucopyranoside, and ribose in the microplate; and pigment production and hemolytic pattern in blood agar plate. The performance of the microplate for identifying enterococci to the species level was evaluated in comparison with conventional reference tests and commercial kits. RESULTS: Among the 111 clinical isolates of Enterococcus species, the microplate system correctly identified 100% to genus level, and 91.0% to species level. All of E. casseliflavus, E. durans, and E. hirae were correctly identified by the microplate. The diagnostic sensitivity and specificity for identification of Enterococcus species were as follows: 100% and 96.7% in E. faecium, 93.5% and 100% in E. faecalis, 100% and 97.2% in E. raffinosus, and 33.3% and 98.1% in both E. avium and E. gallinarum. CONCLUSIONS: It is concluded that the microplate method offers a simple, cost-effective, rapid, and accurate identification system for the identification of most clinical isolates of Enterococcus species.
Agar ; Arabinose ; Arginine ; Enterococcus* ; Hydrolysis ; Mannitol ; Raffinose ; Ribose ; Sensitivity and Specificity ; Sorbitol ; Sucrose

PURPOSE: The purpose of this study was to compare stress levels of elementary students according to three regional levels: a large city, a medium-sized city, and a rural area. METHODS: This was a descriptive comparative survey using a convenience sample of 1,161 5th-and 6th-grade students. The stress level was measured by a stress scale that consisted of 65 items regarding personal characteristics, family, school, and peer factors. The data were analyzed by chi-square-test, t-test, ANOVA and multiple regression using the SPSS 10.0 statistical program. RESULTS: Overall, the mean stress scores reported by the participants were near the middle of a 5-point scale and the level of familyrelated stress was highest, followed by peer, school, and individual-related stress. Sixth-graders and female students showed higher stress levels than 5th-graders and male students, respectively. The participants reporting unsatisfaction with their lives and those living in large cities tended to have significantly higher stress levels. CONCLUSION: Grade, gender, life satisfaction, and regional levels were all significant factors associated with high stress levels among elementary students. Development of stress management programs for this specific population, especially targeting students who are female and living in large cities, is needed.
Analysis of Variance ; Chi-Square Distribution ; Child ; *Child Psychology ; Family Relations ; Female ; Humans ; Male ; Questionnaires ; Rural Population ; Socioeconomic Factors ; Stress, Psychological/*epidemiology ; Students/*psychology ; Suburban Population ; Urban Population

BACKGROUND: Increased resistance rates to macrolide-lincosamide-streptogramin B (MLSB) antibiotics among clinical isolates of staphylococci are considered as a consequence of an expanded use of these antibiotics in the treatment of Gram-positive infections. The proportion of MLSB resistance phenotypes of staphylococci is quite different by geographical variations and study periods. The aim of the present study was to determine the distribution of MLSB resistance phenotypes among clinical isolates of staphylococci in a university hospital. METHODS: The MLSB resistance phenotypes of clinical isolates of staphylococci were investigated by the double-disk diffusion test using erythromycin and clindamycin disks. RESULTS: Of 7,916 isolates, 55.7% exhibited a constitutive resistance phenotype (cMLSB) whereas 8.1% expressed an inducible resistance phenotype (iMLSB). Among 3,419 coagulase-negative staphylococci (CNS), 32.6% and 10.0% exhibited cMLSB and iMLSB resistance phenotypes, respectively. Of 4,497 Staphylococcus aureus isolates, 73.1% and 6.8% were cMLSB and iMLSB resistance phenotypes, respectively. cMLSB was detected among 90.2% of methicillin-resistant S. aureus (MRSA), 46.5% of methicillin-resistant CNS (MRCNS), 3.2% of methicillin-susceptible CNS (MSCNS), and 2.2% of methicillin-susceptible S. aureus (MSSA). iMLSB was detected among 16.5% of MSSA, 11.5% of MRCNS, 6.7% of MSCNS, and 4.4% of MRSA. CONCLUSION: MLSB resistance was more prevalent among S. aureus isolates than CNS strains. Although cMLSB was the most frequently detected resistance phenotype among the total staphylococcal isolates, methicillin-susceptible strains exhibited somewhat higher iMLSB resistance rates compared with methicillin-resistant strains.
Anti-Bacterial Agents ; Clindamycin ; Diffusion ; Erythromycin ; Methicillin Resistance ; Phenotype ; Staphylococcus aureus