PURPOSE: Emergency physicians are usually more experienced in emergency situations; therefore, a cardiopulmonary resuscitation team with an emergency physician as a leader would be operated effectively. The aim of this study is to evaluate the effectiveness of a cardiopulmonary resuscitation that includes an emergency physician. METHODS: A retrospective analysis for in-hospital arrests that occurred in the general ward was conducted based on the in-hospital cardiopulmonary resuscitation registry of a tertiary care university hospital in Korea from January 1, 2005 through December 31, 2010. We compared outcomes of cardiopulmonary resuscitation performed by a team that included an emergency physician with those by a cardiopulmonary resuscitation team that included a non-emergency physician. RESULTS: Survival rates at discharge were 29.6% for the emergency physician team and 17.7% for the non-emergency physician team. The good neurologic outcome rates at discharge were 20.6% and 10.6%, respectively. In multivariate analysis with adjustment for pre-arrest patient condition and arrest variables, survival rate did not differ significantly between the two groups. However, the good neurologic outcomes showed an association with the emergency physician team. CONCLUSION: For in-hospital cardiac arrest, outcomes for patients who were rescued by the emergency physician-directing CPR team might be comparable or better, compared with those by the non-emergency physician team.
Cardiopulmonary Resuscitation ; Emergencies ; Heart Arrest ; Humans ; Korea ; Multivariate Analysis ; Patients' Rooms ; Retrospective Studies ; Survival Rate ; Tertiary Healthcare

Certain beneficial microorganisms isolated from rhizosphere soil promote plant growth and induce resistance to a wide variety of plant pathogens. We obtained 49 fungal isolates from the rhizosphere soil of paprika plants, and selected 18 of these isolates that did not inhibit tomato seed germination for further investigation. Based on a seed germination assay, we selected four isolates for further plant tests. Treatment of seeds with isolate JF27 promoted plant growth in pot tests, and suppressed bacterial speck disease caused by Pseudomonas syringae pathovar (pv.) tomato DC3000. Furthermore, expression of the pathogenesis-related 1 (PR1) gene was higher in the leaves of tomato plants grown from seeds treated with JF27; expression remained at a consistently higher level than in the control plants for 12 h after pathogen infection. The phylogenetic analysis of a partial internal transcribed spacer sequence and the β-tubulin gene identified isolate JF27 as Aspergillus terreus. Taken together, these results suggest that A. terreus JF27 has potential as a growth promoter and could be used to control bacterial speck disease by inducing resistance in tomato plants.
Aspergillus* ; Capsicum ; Germination ; Lycopersicon esculentum* ; Plants ; Pseudomonas syringae* ; Pseudomonas* ; Rhizosphere ; Soil

PURPOSE: Oncogenes, tumor suppressor genes, and growth variables of tumors are important in the assessment of prognosis in lung cancer. The expression of PCNA, c-erbB-2 (HER-2/neu), and c-fos oncoprotein and their prognostic implications in surgically resected patients with non-small cell lung cancer were evaluated. MATERIALS AND METHODS: Seventy patients with non-small cell lung cancer were included and PCNA, c-erbB-2 and c-fos overexpression were evaluated by immunohistochemical stain using paraffin-embedded tissue. RESULTS: The mean proportion of PCNA positive cells was 18.6%, and there was no significant difference according to cell type and stage. The median survival time was significantly shorter in the group with high PCNA expression (>10%) as compared with the group with low PCNA expression (<10%) (37 months vs 16 months). Four (6.3%) of 64 cases demonstrated c-erbB-2 positivity. These were all adenocarcinoma cases. c-fos protein was only rarely overexpressed (1/51). CONCLUSION: PCNA expression was shown to be a useful prognostic parameter in resected non-small cell lung cancer while c-erbB-2 and c-fos oncoprotein were infrequently expressed.
Adenocarcinoma ; Carcinoma, Non-Small-Cell Lung* ; Genes, Tumor Suppressor ; Humans ; Lung Neoplasms ; Oncogenes ; Prognosis ; Proliferating Cell Nuclear Antigen*

Cases of sarcomatoid renal cell carcinoma are very rare. It has been known that sarcomatoid renal cell carcinoma is an epithelial cell variant that has been metaplastically transformed with a very poor prognosis. Diagnosis of sarcomatoid renal cell carcinoma is performed by examining a nephrectomy specimen to see if epithelial and sarcomatoid components are variously mixed together. Therefore, the aim of this paper is to report five cases of sarcomatoid renal cell carcinoma.
Carcinoma, Renal Cell* ; Diagnosis ; Epithelial Cells ; Nephrectomy ; Pathology ; Prognosis

BACKGROUND/AIMS: Because of the similarities in the clinical presentations of Crohn's disease (CD) and intestinal tuberculosis (ITB), differential diagnosis is critical. Mesenteric adipose tissue hypertrophy and creeping fat are characteristic features of CD. The purpose of this study was to assess the usefulness of visceral fat for the differential diagnosis of CD and ITB. METHODS: We conducted a retrospective review of 50 patients with findings of CD or ITB between January 2005 and July 2008. Abdominal computed tomography (CT) was performed on all subjects during their first evaluation. The abdominal fat area was assessed using quantitative abdominal CT. RESULTS: The ratio of visceral fat to total fat (VF/TF) was significantly higher in male CD patients than in male ITB patients. The ratio of visceral fat to subcutaneous fat (VF/SF) was also higher in CD patients than in patients with ITB. For a VF/TF cut-off value of 0.46, the sensitivity and specificity for the diagnosis of CD were 42.1% and 93.3% respectively, with positive and negative predictive values of 88.9% and 56.0%, respectively. CONCLUSION: Measurement of the abdominal fat area using CT can be clinically useful for the differential diagnosis of CD and ITB.
Abdominal Fat ; Adipose Tissue ; Crohn Disease* ; Diagnosis ; Diagnosis, Differential* ; Humans ; Hypertrophy ; Intra-Abdominal Fat* ; Male ; Retrospective Studies ; Sensitivity and Specificity ; Subcutaneous Fat ; Tomography, X-Ray Computed ; Tuberculosis*

OBJECTIVE: To evaluate the efficacy of taxane and platinum-based chemotherapy guided by extreme drug resistance assay (EDRA) in patients with epithelial ovarian cancer. METHODS: Thirty-nine patients were enrolled, who were diagnosed as epithelial ovarian cancer, tubal cancer or primary peritoneal carcinoma and received both debulking surgery and EDRA in Asan Medical Center between August 2004 and August 2006. Another thirty-nine patients were enrolled, who did not receive EDRA as control. Paclitaxel 175 mg/m2 and carboplatin AUC 5 were administered as primary combination chemotherapy to both EDRA group and the control group. In the EDRA group, paclitaxel was replaced by docetaxel 75 mg/m2 if a patient showed extreme drug resistance (EDR) to paclitaxel and not to docetaxel. Carboplatin was replaced by cisplatin 75 mg/m2 if a patient showed EDR to carboplatin and not to cisplatin. If only one drug showed low drug resistance (LDR), it was allowed to add another drug which showed LDR such as gemcitabine 1,000 mg/m2. CT scan was performed every three cycles and CA-125 was checked at each cycle. RESULTS: There was no significant difference in overall response rate between EDRA group and the control group (84.5% vs. 71.8%, p=0.107). However, 93.8% of patients in EDRA group did not show EDR to at least one drug and its response rate was significantly higher than that of the control group (93.3% vs. 71.8%, p=0.023). CONCLUSION: we could choose a combination of taxane and platinum which did not show EDR and could obtain a good response in the patients with ovarian cancer.
Area Under Curve ; Biological Assay ; Bridged Compounds ; Carboplatin ; Cisplatin ; Deoxycytidine ; Drug Resistance ; Drug Therapy, Combination ; Humans ; Neoplasms, Glandular and Epithelial ; Ovarian Neoplasms ; Paclitaxel ; Platinum ; Taxoids

BACKGROUND: A poincare plot of the heart rate variability (HRV) allows for the quantitative display of the vagal tone in conscious humans. However, relatively little is known about standard deviation 1 (SD1) from the poincare plot reflecting the vagal tone and correlating with the high frequency (HF) spectral power of the HRV during general anesthesia. Thus, the association of SD1 from the poincare plot was examined, along with the HF spectral power of the HRV during general anesthesia. METHODS: Beat-to-beat electrocardiograms were recorded for 5 min in 23 patients (isoflurane group, n = 13; sevoflurane group, n = 10) before, during and after general anesthesia. The low frequency (LF) and HF spectral powers, the LF/HF ratio of the HRV and the SD1 and standard deviation 2 (SD2) from the poincare plot were calculated. RESULTS: Both the HF spectral power of the HRV and SD1 from the poincare plot were reduced following general anesthesia, but recovered thereafter. The recovery of both the HF spectral power and SD1 from the poincare plot in the sevoflurane group was faster than those in the isoflurane group. There were strong correlations between the HF spectral power and SD1 before, during and after anesthesia. CONCLUSIONS: These data suggest that the SD1 from the poincare plot is a useful and valid parameter for analysis of the vagal tone during general anesthesia.
Anesthesia ; Anesthesia, General* ; Electrocardiography ; Heart Rate* ; Heart* ; Humans ; Isoflurane