PURPOSE: This retrospective study was done to evaluate the status of nosocomial urinary tract infections and to determine the risk factors andtransmission route of causal IRPA through molecular epidemiology. METHOD: Two hundred ninety-nine of 423 patients admitted to the internal medicine and surgery ICU at a university hospital incity B had a positiveurine culture. Twelve of the 299 patients who had a urinary tract infection had IRPA strains. The data was collected from November 1, 2004 to January 31, 2005. The following results were obtained after the data was analyzed using percentile and UPGMA. RESULT: The rate of nosocomial urinary tract infections in the ICU was 10.8%. Therewere 16.8 cases of infection based on the period of hospitalization. There were 16.9 cases of infection based on the use of a foley catheter. The rate of nosocomial urinary tract infection in the ICU and urinary tract infections related to IRPA were higher in patients with the following characteristics: men, old age, admission through the emergency room, longer than seven days admission, severity of admitting causes, disturbance of consciousness, hydration less than 300cc in 24hours, a long course of antibiotics, a long period of foley catheterization and perineal care. Most of the microorganisms that caused the urinary tract infection were gram negative bacilli, among which P. aeruginosa was found in 70 patients (18.5%) and IRPA in 12 (4.0%). Among the 12 IRPA strains that were tested with PFGE, eight showed a dice coefficient higher than 80%, suggesting a genetic relationship. They were related with the period of hospitalization in the same ICU. These patients all received direct care for a urinary tract infection. CONCLUSION: Through these results, IRPA can be consideredas a contributing factors to urinary tract infections thus, active preventative measures are needed by the medical staff.
Adult ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents/*pharmacology ; Cross Infection/*epidemiology/etiology/microbiology ; Drug Resistance, Bacterial ; Female ; Humans ; Imipenem/*pharmacology ; Intensive Care Units ; Male ; Middle Aged ; Pseudomonas Infections/drug therapy/*epidemiology ; Pseudomonas aeruginosa/classification/drug effects/*genetics ; Retrospective Studies ; Risk Factors ; Urinary Catheterization ; Urinary Tract Infections/*epidemiology/etiology/microbiology

No abstract available.
Animals ; Horns* ; Nevus, Sebaceous of Jadassohn*

No abstract available.
Diagnosis*

In this study, marginal and internal discrepancies of zirconia crowns fabricated with the CAD/CAM (computer aided design
Crowns ; Methods ; Molar ; Replica Techniques ; Shoulder ; Silicon ; Silicones ; Tomography, X-Ray Computed ; Tooth

PURPOSE: The purpose of the present study was to compare the accuracy of four different metal copings fabricated by CAD/CAM technology and to evaluate clinical effectiveness. MATERIALS AND METHODS: Composite resin tooth of the maxillary central incisor was prepared for a metal ceramic crown and duplicated metal die was fabricated. Then scan the metal die for 12 times to obtain STL files using a confocal microscopy type oral scanner. Metal copings with a thickness of 0.5 mm and a cement space of 50 µm were designed on a CAD program. The Co-Cr metal copings were fabricated by the following four methods: Wax pattern milling & Casting (WM), Resin pattern 3D Printing & casting (RP), Milling & Sintering (MS), Selective laser melting (SLM). Silicone replica technique was used to measure marginal and internal discrepancies. The data was statistically analyzed with One-way analysis of variance and appropriate post hoc test (Scheffe test) (α=.05). RESULTS: Mean marginal discrepancy was significantly smaller in the Group WM (27.66 ± 9.85 µm) and Group MS (28.88 ± 10.13 µm) than in the Group RP (38.09 ± 11.14 µm). Mean cervical discrepancy was significantly smaller in the Group MS than in the Group RP. Mean axial discrepancy was significantly smaller in the Group WM and Group MS then in the Group RP and Group SLM. Mean incisal discrepancies was significantly smaller in the Group RP than in all other groups. CONCLUSION: The marginal and axial discrepancies of the Co-Cr coping fabricated by the Wax pattern milling and Milling/Sintering method were better than those of the other groups. The marginal, cervical and axial fit of Co-Cr copings in all groups are within a clinically acceptable range.
Ceramics ; Crowns ; Dental Marginal Adaptation ; Freezing ; Incisor ; Methods ; Microscopy, Confocal ; Printing, Three-Dimensional ; Replica Techniques ; Silicon ; Silicones ; Tooth ; Treatment Outcome

Candidemia due to uncommon Candida spp. appears to be increasing in incidence. C. dubliniensis has been increasingly recovered from individuals not infected with HIV. Identification of C. dubliniensis can be problematic in routine clinical practice due to its phenotypic resemblance to C. albicans. We report the first case of C. dubliniensis candidemia in Korea, which occurred in a 64-yr-old woman who presented with partial seizure, drowsiness, and recurrent fever. Germ-tube positive yeast that was isolated from blood and central venous catheter tip cultures formed smooth, white colonies on sheep blood agar and Sabouraud agar plates, indicative of Candida spp. C. dubliniensis was identified using the Vitek 2 system (bioMerieux, USA), latex agglutination, chromogenic agar, and multiplex PCR. The blood isolate was susceptible to flucytosine, fluconazole, voriconazole, and amphotericin B. After removal of the central venous catheter and initiation of fluconazole treatment, the patient's condition gradually improved, and she was cleared for discharge from our hospital. Both clinicians and microbiologists should be aware of predisposing factors to C. dubliniensis candidemia in order to promote early diagnosis and appropriate treatment.
Amphotericin B/pharmacology ; Antifungal Agents/pharmacology/therapeutic use ; Candida/drug effects/*isolation & purification ; Candidemia/*diagnosis/drug therapy ; Catheterization, Central Venous ; Female ; Fluconazole/pharmacology/therapeutic use ; Flucytosine/pharmacology ; Humans ; Microbial Sensitivity Tests ; Middle Aged ; Pyrimidines/pharmacology ; Triazoles/pharmacology

Dehumidifying agents are commonly used to remove moisture and odors and are not meant for oral ingestion. The hazards of accidental oral ingestion of dehumidifying agents are not well known. A 31-year-old man with autism drank the liquid desiccant contained in the barrel of a dehumidifier while sleepwalking. The desiccant mainly consisted of calcium chloride. He was taken to the emergency center with persistent vomiting and underwent gastric lavage. The patient was treated for hypercalcemia due to calcium chloride poisoning. He eventually died of multiple organ failure. Autopsy findings were as follows: acute suppurative pneumonia, intra-abdominal inflammation, liver necrosis, acute pancreatitis, and gastrointestinal hemorrhage. Calcium chloride has relatively low toxicity; however, when ingested orally, it can cause severe internal damage, and even death. We suggest active preventive measures to ensure the safe use of dehumidifying agents.
Adult ; Autistic Disorder ; Autopsy ; Calcium Chloride ; Eating ; Emergencies ; Gastric Lavage ; Gastrointestinal Hemorrhage ; Humans ; Hypercalcemia ; Inflammation ; Liver ; Multiple Organ Failure ; Necrosis ; Odors ; Pancreatitis ; Pneumonia ; Poisoning ; Silica Gel ; Somnambulism ; Vomiting

No abstract available.
Animals ; Cell Adhesion* ; Female ; Leiomyoma* ; Mice ; Myometrium* ; Neural Cell Adhesion Molecules*

Conjoined twins are uncommon complications of monoamniotic twinning. Among them, cephalopagus twins are very rare. The accurate prenatal diagnosis of conjoining is essential for the optimal obstetric counseling and management. We describe a case where prenatal sonographic diagnosis of cephalopagus associated with multiple anomalies including meningomyelocele, diaphragmatic hernia, omphalocele, and club feet was made at 18 weeks of gestation.
Counseling ; Diagnosis* ; Foot ; Hernia, Diaphragmatic ; Hernia, Umbilical ; Humans ; Meningomyelocele ; Pregnancy ; Prenatal Diagnosis ; Twins, Conjoined ; Ultrasonography*

BACKGROUND/AIMS: To investigate the diagnostic performance of diffusion-weighted imaging (DWI) for hepatic neuroendocrine tumors (NET) compared with combined DWI and contrast-enhanced magnetic resonance imaging (MRI). METHODS: Fifteen patients with hepatic NET (n=128) underwent enhanced MRI and DWI with multiple-b values. We analyzed three different sets: Precontrast set; DWI set (added DWI); combined set (added enhanced image). Two reviewers rated possibility of NET using a 5-point scale for each image set. Their diagnostic performance was compared using Jackknife alternative free-response ROC (JAFROC). RESULTS: Diagnostic performance was better on the combined set (figure of merit [FOM]=0.852, 0.761) than the precontrast set (FOM=0.427, 0.572, P〈0.05) and the DWI set (FOM=0.682, 0.620, P〈0.05). However, DWI improved performance compared with precontrast set without statistical difference. In small NETs (〈1 cm), all sets showed low sensitivity (10.7-65.9%) with high specificity (95.4-100%). Interobserver agreement was moderate in all image sets (k=0.521 to 0.589). CONCLUSIONS: Combined DWI and enhanced MRI were more useful for detecting NET. Although statistically insignficant, there was a trend in improved diagnostic performance with DWI.
Humans ; Magnetic Resonance Imaging* ; Neuroendocrine Tumors* ; Sensitivity and Specificity