PURPOSE: The purpose of this study was to identify status and characteristics of patients who have been readmitted to ICU, and to analyze risk factors associated with the readmission to ICU within 48hours.METHODS: Data were collected from patient's electronic medical reports from one hospital in B city. Participants were 2,937 patients aged 18 years old or older admitted to the ICU. Data were analyzed using odd ratios (ORs) from multivariate logistic regressions.RESULTS: 2.2% of the 2,937 patients were early readmitted to ICU. Risk factors for early readmission to ICU were existence of respiratory disease, use of mechanical ventilator, and duration of hospitalization (longer).CONCLUSION: The assessment on the respiratory system of the patient who will be discharged from the ICU was identified as an important nursing activity. Therefore, the respiratory system management and education should be actively conducted. In addition, early ICU readmission may be prevented and decreased if a link was built to share the information on patient condition between the ICU and general wards.
Critical Care ; Education ; Hospitalization ; Humans ; Intensive Care Units ; Logistic Models ; Nursing ; Patient Readmission ; Patients' Rooms ; Respiratory System ; Risk Factors ; Ventilators, Mechanical

PURPOSE: The aim of this study is to investigate the changing prevalence rate of Helicobacter pylori infection in children, of different age groups, with recurrent abdominal pain over a 10-year period. METHODS: Children with recurrent abdominal pain who visited the pediatric outpatient clinic at university hospital were screened for H. pylori. Children were divided into 3 age categories of 4-5, 6-11, and 12-16 years. To study the changes in the annual prevalence rates of H. pylori infection, the study period was divided into 3 time periods: 2004-2007, 2008-2010, and 2011-2014. Urea breath test was performed for all children aged 4-16 years, with a cut-off value of 4.0per thousand for children aged > or =6 years and 7per thousand for children aged <6 years. RESULTS: A total of 2,530 children (1,191 boys) with a mean age of 10.0+/-3.0 years (range, 4.0-16.9 years) were included in the study. The total prevalence of H. pylori infection was 7.4% (187/2,530). The prevalence rate of H. pylori infection in children with recurrent abdominal pain was 8.0% (70/873) in 2004-2007, 7.7% (51/666) in 2008-2010, and 6.7% (66/991) in the 2011-2014. Nevertheless, a significant difference was observed in the prevalence rate between children <12 years old and > or =12 years of age (p=0.018). CONCLUSION: The prevalence of H. pylori infection in Korean children with recurrent abdominal pain was 7.4%, showing no significant decrease in the last 11 years; however, the prevalence rate in children <12 years old was significantly lower than that in those > or =12 years old.
Abdominal Pain* ; Ambulatory Care Facilities ; Breath Tests ; Child* ; Endoscopy ; Gastrointestinal Diseases ; Helicobacter ; Helicobacter pylori* ; Humans ; Prevalence* ; Urea

PURPOSE: Interleukin (IL) -13 plays a pivotal role in the induction of immunoglobulin E (IgE) and in the pathogenesis of atopic dermatitis (AD). Recently, an association was reported between the polymorphism of the IL-13 promoter region (-1512A/C) and atopic asthma. We investigated the association between the IL-13 single nucleotide polymorphism (SNP) in the promoter region (-1512A/C) and atopic dermatitis in Korean children with AD. METHODS: We enrolled 204 allergic AD, 92 non-allergic AD, and 116 non-atopic healthy children. Evaluated phenotypes of atopic dermatitis included total IgE, total eosinophil count, and eosinophil fraction. We used a PCR-RFLP method to identify IL-13 genotypes. RESULTS: The allele frequencies of the IL-13 promoter polymorphism (-1512A/C) did not differ statistically among the three groups. Children with one or two copies of risk alleles in the promoter region (-1512C) did not show any significant association with the clinical phenotypes of atopic dermatitis including total IgE, eosinophil phenotypes and SCORAD score in the allergic or non-allergic atopic dermatitis. CONCLUSION: These data suggest that the -1512A/C polymorphism of IL-13 gene may not be associated with neither the development nor the clinical phenotypes of atopic dermatitis in Korean children.
Alleles ; Asthma ; Child* ; Dermatitis, Atopic* ; Eosinophils ; Gene Frequency ; Genotype ; Humans ; Immunoglobulin E ; Immunoglobulins ; Interleukin-13* ; Interleukins ; Phenotype ; Polymorphism, Single Nucleotide ; Promoter Regions, Genetic

Allergic disorders are exaggerated immune responses to foreign antigens, regardless of the mechanism, while atopic disorders are exaggerated IgE-mediated immune responses (type I hypersensitivity). Allergic dermatitis is a common pathological condition of skin in humans and dogs. Canine allergic dermatitis presents with clinical signs similar to those reported in humans, and its causes are complex; therefore, diagnostic tests and treatments may need to be adjusted for each patient. Dogs with allergic dermatitis can suffer from secondary infections, which must be considered and confirmed or excluded for successful treatment. In this report, 35 cases of canine allergic dermatitis diagnosed using variable methods, including histological and cytological examination, are described. Patients were treated with oral or topical medications (antimicrobials, anti-inflammatories, immune modulators, topical ointments, and medicated shampoos), and their diets and environmental surroundings were also modified. This report provides an analysis of the breed, gender, age of onset, clinical signs, diagnostic methods, and treatments for canine allergic dermatitis. The information on canine allergic dermatitis presented here could be helpful in the study of human cases because these two species often share living spaces, environments, and lifestyles more closely than other animals. However, previous reports have suggested that human and canine allergies differ in some features, such as involvement of histamine in induction of pruritus, and in histopathological characteristics such as cutaneous structures.
Age of Onset ; Animals ; Anti-Inflammatory Agents ; Coinfection ; Dermatitis* ; Diagnostic Tests, Routine ; Diet ; Dogs* ; Histamine ; Humans ; Hypersensitivity ; Life Style ; Methods ; Ointments ; Pruritus ; Retrospective Studies* ; Skin

Insulin detemir is a long-acting basal insulin analogue recently introduced in veterinary medicine for treatment of canine diabetes mellitus. As there are only limited studies in dogs, long-term evaluation of insulin detemir in veterinary medicine is required. In this study, we investigated trends in12-hour blood glucose concentration during hospitalization and evaluated initial and following doses of insulin detemir for several months in six diabetic dogs. The mean levels of blood glucose over 12-hour periods were between 113.5 to 327.2 mg/dL, and the average glucose nadir was 103 mg/dL in the six dogs. The dogs were treated with a mean dosage of 0.24 U/kg of insulin detemir, but hypoglycemia was observed in four of the dogs at the first monthly follow-up. Thus, insulin doses were adjusted according to the nadir levels of glucose observed during the follow-up periods (range, 1 to 16 months). The total range of insulin doses throughout the study period was between 0.1 and 0.4 U/kg. Changes in insulin doses in each dog during the follow-up period were not variable. We suggest that insulin detemir might be not only an alternative choice against traditional insulin for patients with insulin resistance or concurrent disease but also an effective home therapy medication in canine patients with DM. This study could help inform veterinary practitioners regarding the use of insulin detemir for canine insulin-dependent DM.
Adrenocortical Hyperfunction ; Animals ; Blood Glucose ; Diabetes Mellitus* ; Diabetic Ketoacidosis ; Dogs* ; Follow-Up Studies ; Glucose ; Hospitalization ; Humans ; Hypoglycemia ; Insulin Resistance ; Insulin* ; Insulin Detemir ; Veterinary Medicine

PURPOSE: To evaluate the effectiveness of a combination of enuresis alarm-desmopressin compared with a desmopressin-based combined pharmacotherapy as the first line in monosymptomatic nocturnal enuresis (MNE). MATERIALS AND METHODS: We evaluated 48 MNE children. Of these, 20 enuretic children were included in the alarm-desmopressin group (AD group) and 28 in the combination pharmacotherapy group (CP group). In the CP group, patients were given desmopressin based combination therapy with imipramine or oxybutynin for 6 months. In the AD group, patients were administered an enuresis alarm associated with an initial 3-month desmopressin combination. The response rates of each therapy were analyzed after 1, 3 and 6 months. After cessation of the 6 month treatment course, the initial and lasting cure rates were analyzed 1 and 6 month later. RESULTS: There was no differentiation in the baseline characteristics and drop-out rates between the two groups during treatment. The mean response rates in the AD and CP groups were 91.8 and 93.7%, respectively. The initial cure rate was higher in the AD (92.3%) than the CP group (52.4%) (p=0.024). The lasting cure rate was also higher in the AD (76.9%) than the CP group (33.3%) (p=0.032). Most of the relapses occurred within 2 month in the CP group and within 4 month in the AD group. CONCLUSIONS: In MNE, a combination of enuresis alarm-desmopressin showed a similar response rate, high initial and lasting cure rates, with a delayed relapse, compared with combination pharmacotherapy. Therefore, a combination of enuresis alarm-desmopressin can be considered a useful tool as the first line in MNE. (Korean J Urol 2005;46:19-24)
Behavior Therapy ; Child ; Deamino Arginine Vasopressin ; Drug Therapy ; Enuresis* ; Humans ; Imipramine ; Nocturnal Enuresis* ; Recurrence

BACKGROUND: Vancomycin-esistant enterococci (VRE) were first recovered from clinical isolates in Korea in 1992, and the incidence has been steadily increasing. The goal of this study was to determine the isolation trend of VRE by year and genotypes of VRE isolated from clinical specimens in Wonju area. METHODS: We investigated the patients' medical records to determine the incidence of VRE among enterococci isolated from 1995 to 1999 in Wonju Christian Hospital, performed antimicrobial susceptibility tests to vancomycin and teicoplanin by agar dilution methods, and genotyped them with multiplex polymerase chain reaction for 117 cryopreserved VRE isolates. RESULTS: VRE were first isolated in December 1995. Overall incidence of VRE during the period of 1996 to 1999 was 6.1% (164/2,682). The annual incidence of VRE was 1.9% in 1996, 5.5% in 1997, 6.7% in 1998, and 9.7% in 1999. The species of VRE included 115 (69.7%) E. faecium, 11 (6.7%) E. faecalis, 17 (10.3%) E. casseliflavus, 10 (6.1%) E. gallinarum, and 12 (7.3%) Enterococcus species. Of 117 VRE, E. faecium and E. faecalis strains were phenotyped as VanA, and genotyped as vanA with the exception of five VRE which the genotypes were not identified. All E. gallinarum and E. casseliflavus strains were genotyped as vanC- and vanC-, respectively. CONCLUSIONS: VRE were first isolated in 1995. And the isolation rate of VRE were increasing trend from 1.9% in 1996 and 9.7% in 1998. Most of VRE were E. faecium with vanA genotype.
Agar ; Enterococcus ; Gangwon-do* ; Genotype* ; Incidence ; Korea ; Medical Records ; Multiplex Polymerase Chain Reaction ; Teicoplanin ; Tertiary Healthcare* ; Vancomycin

BACKGROUND: Vancomycin-esistant enterococci (VRE) were first recovered from clinical isolates in Korea in 1992, and the incidence has been steadily increasing. The goal of this study was to determine the isolation trend of VRE by year and genotypes of VRE isolated from clinical specimens in Wonju area. METHODS: We investigated the patients' medical records to determine the incidence of VRE among enterococci isolated from 1995 to 1999 in Wonju Christian Hospital, performed antimicrobial susceptibility tests to vancomycin and teicoplanin by agar dilution methods, and genotyped them with multiplex polymerase chain reaction for 117 cryopreserved VRE isolates. RESULTS: VRE were first isolated in December 1995. Overall incidence of VRE during the period of 1996 to 1999 was 6.1% (164/2,682). The annual incidence of VRE was 1.9% in 1996, 5.5% in 1997, 6.7% in 1998, and 9.7% in 1999. The species of VRE included 115 (69.7%) E. faecium, 11 (6.7%) E. faecalis, 17 (10.3%) E. casseliflavus, 10 (6.1%) E. gallinarum, and 12 (7.3%) Enterococcus species. Of 117 VRE, E. faecium and E. faecalis strains were phenotyped as VanA, and genotyped as vanA with the exception of five VRE which the genotypes were not identified. All E. gallinarum and E. casseliflavus strains were genotyped as vanC- and vanC-, respectively. CONCLUSIONS: VRE were first isolated in 1995. And the isolation rate of VRE were increasing trend from 1.9% in 1996 and 9.7% in 1998. Most of VRE were E. faecium with vanA genotype.
Agar ; Enterococcus ; Gangwon-do* ; Genotype* ; Incidence ; Korea ; Medical Records ; Multiplex Polymerase Chain Reaction ; Teicoplanin ; Tertiary Healthcare* ; Vancomycin

No abstract available.
Anesthesia ; Dilatation ; Humans

Klinefelter syndrome (KS) is characterized by small testes, gynecomastia, tall stature, and hypergonadotropic hypogonadism. This condition is associated with extra X chromosomes. It is well known that these aneuploidies predispose individuals to the development of several cancers. Moreover, there are many case reports that show KS patients to have a higher relative risk for the development of malignancy. However, incracranial germ cell tumor (ICGCT) associated with KS is very uncommon. Herein, we report delayed diagnosis of KS in a 15-year-old boy with ICGCT, embryonal carcinoma of the pineal gland, after multimodality treatment in Korea.
Adolescent ; Aneuploidy ; Carcinoma, Embryonal ; Delayed Diagnosis ; Gynecomastia ; Humans ; Hypogonadism ; Klinefelter Syndrome ; Korea ; Male ; Neoplasms, Germ Cell and Embryonal ; Pineal Gland ; Testis ; X Chromosome