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

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

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

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: Bone turnover markers (BTMs) are widely used tool for monitoring the response to osteoporosis therapy, and the normal adult reference range is the baseline value for the treatment of osteoporosis with anti-resorptive agents. This study was aimed to establish age- and sex-specific reference ranges of serum osteocalcin and serum type I collagen C-telopeptide (S-CTX) in adults based on menstrual stage. METHODS: Serum osteocalcin, S-CTX and bone mineral density (BMD) were measured in 291 adults (men: 162, women: 129), and follicle stimulating hormone (FSH) in women. Seven women whose serum FSH levels were >30 IU/mL were categorized as perimenopausal despite their regular menses. RESULTS: Among females with normal BMD, there were no difference in serum osteocalcin and S-CTX levels between premenopausal and postmenopausal women. Females with osteopenia in pre- and postmenopausal stage showed higher serum osteocalcin and S-CTX levels than females with normal BMD. For subjects with normal BMD, reference ranges of serum osteocalcin and S-CTX were 6.4~21.6 ng/mL and 0.08~0.85 ng/mL for 30~59-year-old females. For males with normal BMD, reference ranges of serum osteocalcin were 10.1~24.3 ng/mL for 30~39 years old and 7.7~22.4 ng/mL for 40~59 years old, and reference range of CTX was 0.13~1.27 ng/mL for 30~59 years old. CONCLUSIONS: This study will provide a redefinition of the criteria required in order to establish the normal reference ranges for BTMs. Moreover, we believe that our data will come in handy when used as normal reference ranges of BTMs in premenopausal women.
Adult ; Bone Density ; Bone Diseases, Metabolic ; Collagen Type I ; Female ; Follicle Stimulating Hormone ; Humans ; Male ; Osteocalcin ; Osteoporosis ; Peptides ; Reference Values

Alcohol influences the neuroadaptation of brain cells where receptors and enzymes like protein kinase C (PKC) exist. Naltrexone acts on opioid receptors. However, other mechanisms of action remain unknown. We prepared SH-SY5Y neuroblastoma cells, and fed them with 150 mM ethanol for 72 h followed by treatment with naltrexone for 24 h. We performed microarray analysis and reverse transcriptase-polymerase chain reaction. Our results showed that PKC epsilon increased 1.90 times and showed an overall decreasing pattern as time increased. Phosphorylated ERK also increased 2.0 times according to the change of PKC epsilon. Integrin alpha7 increased 2.32 times and showed an increasing pattern as time increased. In conclusion, naltrexone influences PKC epsilon neuronal signaling system and endothelial adhesion molecule integrin alpha7 in addition to the well-known opioid system.
Antigens, CD/*metabolism ; Cell Line, Tumor ; Comparative Study ; DNA, Complementary/genetics ; Humans ; Integrin alpha Chains/*metabolism ; Naltrexone/*pharmacology ; *Neuroblastoma/enzymology/metabolism/pathology ; Oligonucleotide Array Sequence Analysis ; Protein Kinase C-epsilon/*metabolism ; Research Support, Non-U.S. Gov't ; Reverse Transcriptase Polymerase Chain Reaction ; Time Factors

The ketogenic diet is a nonpharmacologic treatment for refractory childhood epilepsy. This high fat, low protein-carbohydrate content diet produces a ketotic state. During its perioperative period, blood glucose should be monitored frequently and maintained at the lower limit in children on the ketogenic diet undergoing general anesthesia. Also, it is important to monitor serum pH or bicarbonate levels because of the risk of metabolic acidosis. For major surgery, one should consider obtaining perioperative serum chemistry, including electrolytes, calcium and albumin. We report that a pediatric dental caries patient on the ketogenic diet can safely undergo general anesthesia without increased risk of perioperative complications or increased seizure frequency.
Acidosis ; Anesthesia ; Anesthesia, General ; Blood Glucose ; Calcium ; Chemistry ; Child ; Dental Caries ; Diet ; Electrolytes ; Epilepsy ; Humans ; Hydrogen-Ion Concentration ; Ketogenic Diet* ; Perioperative Period ; Seizures

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