BACKGROUND: We evaluated the effectiveness of isolation measures using cohorting rooms and antimicrobial use in reducing the isolation rate of methicillin-resistant Staphylococcus aureus (MRSA) and multidrug-resistant Acinetobacter baumannii (MDR-AB). METHODS: Four cohorting rooms (16 beds) for patients colonized or infected with multidrug-resistant organisms (MDRO) have been created in the general wards of our 894-bed hospital since October 2003. We prospectively evaluated the isolation rates of MRSA and MDR-AB, and amount of antimicrobial use during the 8-year study period. We also investigated the relationship between antimicrobial use density (AUD) and the isolation rates of MRSA and MDR-AB. RESULTS: After creating cohorting rooms, the isolation rates of MRSA decreased from 1.56 cases per 1,000 patient-days from 2004-2005 to 1.24 from 2006-2007 (P=0.57). The isolation rates of MDR-AB also decreased from 0.72 from 2004-2005 to 0.36 from 2010-2011 (P<0.01). The mean quarterly AUDs of glycopeptides and carbapenems were 30.17+/-6.80 and 19.5+/-7.10, respectively. There were no significant correlations between AUD values and the isolation rate of MRSA or MDR-AB. CONCLUSION: This study suggests that isolation measures using cohorting rooms to help limit the transmission of MDRO infection and colonization, especially MDR-AB, in resource-limited settings is feasible and efficacious.
Acinetobacter ; Acinetobacter baumannii ; Carbapenems ; Cohort Studies ; Colon ; Drug Resistance ; Glycopeptides ; Humans ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Patient Isolation ; Patients' Rooms ; Prospective Studies

Turnip yellow mosaic virus (TYMV) is a spherical plant virus that has a single 6.3 kb positive strand RNA as a genome. Previously, we have made the recombinant TYMV construct containing a 0.7 kb eGFP gene or a 1.8 kb GUS gene. The genomic RNAs from these constructs were efficiently encapsidated. To examine in more detail whether size constraint exists for replication and packaging of TYMV, we have inserted into the TY-GUS an extra sequence derived from either eGFP or GUS. We also made a recombinant containing RNA1 sequence of Flock house virus. These TYMV recombinants were introduced into Nicotiana benthamiana leaves by agroinfiltration. Northern blot analysis of the viral RNAs in the agroinfiltrated leaves showed that the genomic RNA band from the recombinant TYMV became weaker as longer sequence was inserted. The result also showed that the efficiency of genomic RNA encapsidation decreased sharply when an extra sequence of 2.2 kb or more was inserted. In contrast, the recombinant subgenomic RNA containing an extra sequence of up to 3.2 kb was efficiently encapsidated. Overall, these results show that size constraint exists for replication and encapsidation of TYMV RNA.
Blotting, Northern ; Genome ; Genome Size* ; Plant Viruses ; Product Packaging* ; RNA ; RNA, Viral ; Tobacco ; Tymovirus*

The present study was designed to investigate the effects renin-angiotensin-aldosterone system (RAAS), endothelin (ET) and local natriuretic peptide (NP) system for glomerulopathy induced in the experimental bilateral ureteral obstructive rats. Sprague-Dawley male rats (200~220 g body weight) were bilaterally obstructed by ligation of the proximal ureters for 24 hours. Control rats were treated in the same ways, except that no ligature was made. The glomeruli were isolated from cortex by graded sieve methods, and the mRNA expressions of local renin-angiotensin system (RAS), aldosterone synthase (CYP11B2), endothelin-1 (ET-1) and NP system were determined by real-time polymerase chain reaction. Following the bilateral ureteral obstruction, the mRNA expressions of renin, angiotensin converting enzyme 1 as well as ET-1 were increased, while that of angiotensin converting enzyme 2 was not changed. The expressions of CYP11B2 and angiotensin II receptors were not changed. C-type natriuretic peptide (CNP) expression was increased, while its receptors (natriuretic peptide receptor-B) were not changed. We suggest that the upregulation of local RAS and ET play a role in the progressive glomerular injury, and that the enhanced CNP activity also plays a compensatory role in obstructive uropathy in the glomerulus.
Aldosterone Synthase ; Animals ; Endothelin-1 ; Endothelins* ; Humans ; Ligation ; Male ; Natriuretic Peptide, C-Type* ; Peptidyl-Dipeptidase A ; Rats* ; Rats, Sprague-Dawley ; Real-Time Polymerase Chain Reaction ; Receptors, Angiotensin ; Renin ; Renin-Angiotensin System ; RNA, Messenger ; Up-Regulation* ; Ureter* ; Ureteral Obstruction*

The present study was designed to investigate the protein expression of nitric oxide synthase (NOS) and guanylyl cyclase (GC) activity in ischemia/perfusion (I/R) renal injury in rats. Renal I/R injury was experimentally induced by clamping the both renal pedicle for 40 min in Sprague-Dawley male rats. The renal expression of NOS isoforms was determined by Western blot analysis, and the activity of guanylyl cyclase was determined by the amount of guanosine 3', 5'-cyclic monophosphate (cGMP) formed in response to sodium nitroprusside (SNP), NO donor. I/R injury resulted in renal failure associated with decreased urine osmolality. The expression of inducible NOS (iNOS) was increased in I/R injury rats compared with controls, while endothelial NOS (eNOS) and neuronal NOS (nNOS) expression was decreased. The urinary excretion of NO metabolites was decreased in I/R injury rats. The cGMP production provoked by SNP was decreased in the papilla, but not in glomerulus. These results indicate an altered regulation of NOS expression and guanylyl cyclase activity in I/R-induced nephropathy.
Animals ; Blotting, Western ; Constriction ; Guanosine ; Guanylate Cyclase* ; Humans ; Male ; Neurons ; Nitric Oxide Synthase* ; Nitric Oxide* ; Nitroprusside ; Osmolar Concentration ; Protein Isoforms ; Rats* ; Rats, Sprague-Dawley ; Renal Insufficiency ; Tissue Donors

The collecting duct endothelin (ET) system, which involves ET-1 and its two receptors, may play a role in the regulation of renal sodium in association with the nitric oxide synthase (NOS) system. We determined whether sodium retention is associated with changes in the endothelin and NOS systems at different stages (i.e., a sodium retaining stage and a compensatory stage) of nephrotic syndromes. On day 7 after puromycin aminonucleoside (PAN) injection, urinary sodium excretion was decreased, ascites had developed, and there was a positive sodium balance. ET-1 mRNA expression was increased in the inner medulla of the kidney, whereas protein expression of ET receptor type B (ET(B)R) was unchanged. The expression of neuronal NOS (nNOS) was decreased in the inner medulla. On day 14, urinary sodium excretion was unchanged compared with controls. The expression of ET(B)R increased, while nNOS expression in the inner medulla was comparable to controls. These findings suggest that decreased nNOS plays a role in the development of sodium retention in the nephrotic syndrome. Recovery of nNOS and increased renal ET(B)R synthesis may promote sodium excretion in later stages of the nephrotic syndrome (on day 14).
Ascites ; Endothelins ; Kidney ; Nephrotic Syndrome ; Neurons ; Nitric Oxide Synthase ; Nitric Oxide Synthase Type I ; Puromycin ; Puromycin Aminonucleoside ; Receptors, Endothelin ; Retention (Psychology) ; RNA, Messenger ; Sodium

Apoptosis is a physiologic or programmed cell death process which is controlled by genes. It is essential for the function and the appropriate development of multicellular organism. It is also thought to be one of the main mechanisms of cell death in ischemic tissues. The effect of prostaglandin E1(PGE1) is proven to be useful in the recovery of ischemic changes by inducing vasodilation of peripheral vessels and platelet disaggregation. PGE1 is also known to suppress apoptosis in human liver sinusoidal endothelial cell from ischemia-reperfusion injury. The purpose of this study is to evaluate the effects of PGE1 on the apoptosis in the ischemia reperfusion injury of rat intestine. Thirty Sprague-Dawley rats were used. In control group(N=15), superior mesenteric artery was occluded for 60 minutes and after removing the vessel clamp, it was reperfused for 60 minutes and harvested. In experimental group(N=15), a jejunal flap was also made as in the control group except for the intraarterial administration of the PGE1 right after clamping the artery and removing the clamp. H&E, TUNEL and immunohistochemical stains for p53, bax, and bcl-2 were performed. There were ischemic changes in gross and microscopic findings in both groups. The apoptotic index was significantly lower in the experimental group(1.29+/-0.82(p=0.003)) than in the control group (2.33+/-0.95). The rat intestinal ischemia apoptosis by ischemia-reperfusion was partly related to the modulating of bcl-2, bax, and p53 expression. Our results indicate that PGE1 suppresses the apoptosis in the ischemic jejunal flap and this effect is probably the result of a increase in expression of bcl-2.
Alprostadil* ; Animals ; Apoptosis* ; Arteries ; Blood Platelets ; Cell Death ; Coloring Agents ; Constriction ; Endothelial Cells ; Humans ; In Situ Nick-End Labeling ; Intestinal Mucosa* ; Intestines ; Ischemia* ; Liver ; Mesenteric Artery, Superior ; Rats* ; Rats, Sprague-Dawley ; Reperfusion Injury* ; Vasodilation

PURPOSE: Photogrammetry has been introduced as an alternative to direct measurement to obtain facial distances for a variety of anthropometric applications. The aim of this study is to establish morphological and functional value of an eye in Korean youths using specially designed computer software with digital photographic images. METHODS: Authors measured anthropometry of an eye in Korean youths 1,449 individuals(622 males, 827 females) and analyzed stastically them. RESULTS: The mean measurements are as follows. The diameter of cornea was 11.6+/-0.9mm in males and 11.3+/-0.9mm in females. The vertical dimension of palpebral fissure was 7.4+/-1.7mm in males and 8.2+/-1.6mm in females. The intercanthal width was 35.8+/-3.2mm in males and 34.4+/-2.9mm in females. The biocular width was 90.4+/-5.7mm in males and 87.4+/-5.3mm in females. The endocantion-superior margin of palpebral fissure distance was 12.7+/-1.4mm in males and 11.6+/-1.4mm in females. The horizontal dimension of palpebral fissure was 28.5+/-2.2mm in males and 27.4+/-1.9mm in females. The slant of palpebral fissure was 10.7+/-2.6degrees in males and 11.3+/-3.0degrees in females. The height of upper eyelid was 10.6+/-2.3mm in males and 10.7+/-2.3mm in females. The width of double fold was 2.0+/-0.7mm in males and 1.9+/-0.6 mm in females. A double fold was seen in 21.9% of males and 44.9% of females. The most frequent shape of the double fold was type IV. The most common type of epicanthal fold was type III in both males and females. CONCLUSION: Photogrammetic measurement of large population using specially designed software could offer reliable data and these data could be useful reference for preoperative consultation, surgical planning and anthropometic study of eye.
Adolescent* ; Anthropometry ; Cornea ; Eyelids ; Female ; Humans ; Male ; Photogrammetry ; Vertical Dimension

PURPOSE: Photogrammetry has been introduced as an alternative to direct measurement to obtain facial distances for a variety of anthropometric applications. The aim of this study is to establish morphological and functional value of an eye in Korean youths using specially designed computer software with digital photographic images. METHODS: Authors measured anthropometry of an eye in Korean youths 1,449 individuals(622 males, 827 females) and analyzed stastically them. RESULTS: The mean measurements are as follows. The diameter of cornea was 11.6+/-0.9mm in males and 11.3+/-0.9mm in females. The vertical dimension of palpebral fissure was 7.4+/-1.7mm in males and 8.2+/-1.6mm in females. The intercanthal width was 35.8+/-3.2mm in males and 34.4+/-2.9mm in females. The biocular width was 90.4+/-5.7mm in males and 87.4+/-5.3mm in females. The endocantion-superior margin of palpebral fissure distance was 12.7+/-1.4mm in males and 11.6+/-1.4mm in females. The horizontal dimension of palpebral fissure was 28.5+/-2.2mm in males and 27.4+/-1.9mm in females. The slant of palpebral fissure was 10.7+/-2.6degrees in males and 11.3+/-3.0degrees in females. The height of upper eyelid was 10.6+/-2.3mm in males and 10.7+/-2.3mm in females. The width of double fold was 2.0+/-0.7mm in males and 1.9+/-0.6 mm in females. A double fold was seen in 21.9% of males and 44.9% of females. The most frequent shape of the double fold was type IV. The most common type of epicanthal fold was type III in both males and females. CONCLUSION: Photogrammetic measurement of large population using specially designed software could offer reliable data and these data could be useful reference for preoperative consultation, surgical planning and anthropometic study of eye.
Adolescent* ; Anthropometry ; Cornea ; Eyelids ; Female ; Humans ; Male ; Photogrammetry ; Vertical Dimension

Purpose: This study aimed to conduct a systematic literature review and meta-analysis of the exercise intervention effects for the prevention of musculoskeletal injuries in military personnel. Methods: Among studies that included military personnel as participants, we identified randomized controlled trials (RCTs) and cluster-RCT studies that used exercise interventions as a method for injury prevention. Exercise encompassed all types of physical activity, and the effect size was determined by the ratio of injuries between groups.Literature searches were conducted with search terms modified to ensure common inclusion of keywords such as “Soldier,” “Injury prevention,” and “Exercise.” For the analysis of potential factors, variables selected for group differentiation included gender, risk of bias, exercise volume, injury location, exercise type, and study design. Results: Among a total of 8,598 search results, 10 papers were finally confirmed. The meta-analysis of all 10 papers showed that there was no statistically significant injury prevention effect, and significant heterogeneity was observed among the studies (incidence rate ratio, 0.82; 95% confidence interval, 0.62–1.09, I2 =83%). Subgroup analysisrevealed a significant 44% reduction in injuries in studies where exercise volume for injury prevention was relatively high. However, no significant injury prevention effects were observed in other potential factors between groups. Conclusion The results of this study suggest that the effectiveness of injury prevention exercises in military settings was not statistically significant. However, through the analysis of potential factors, it was confirmed that increasing the time spent on injury prevention exercises may have a preventive effect on injuries.

PURPOSE: Excessive scarring in the forms of keloid and hypertrophic scar could be a consequence of the accumulation of granulation tissue cells due to aberrant control of apoptosis. Verapamil retard extracelluar matrix production and inhibits VEGF production in primary cultured keloid fibroblast. The object of this study is to identify the effects of verapamil on VEGF expression and apoptosis in early wound scarring of the rabbit ear. METHODS: Full thickness wounds were created on the ventral side of 6 New Zealand rabbits's ear. 16 days after initial wounding verapamil and saline were injected on each scars, and the scars were harvested for 1 week, 2 weeks, and 4 weeks. The wounds were stained with hematoxylin and eosin, TUNEL stain, immunohistochemical stain for VEGF and calculated scar elevation index. RESULTS: Histologic analysis demonstrated significant reduction in inflammation, vascularity and improvement in dermal collagen organization in experimental group. In TUNEL staining apoptosis positive cells were increased and immunohistochemial staining of VEGF demonstrated significant reduction of VEGF expression in experimental group. No significant difference was noted in scar elevation index between two groups. CONCLUSION: This study suggest that intralesional injection of verapamil on early wound scarring of the rabbit ear decreased VEGF production and increased apoptosis and have a benefit on the pathophysiology of scar formation.
Apoptosis ; Cicatrix ; Cicatrix, Hypertrophic ; Collagen ; Ear ; Eosine Yellowish-(YS) ; Fibroblasts ; Granulation Tissue ; Hematoxylin ; In Situ Nick-End Labeling ; Inflammation ; Injections, Intralesional ; Keloid ; New Zealand ; Vascular Endothelial Growth Factor A ; Verapamil