PURPOSE: The symptoms and signs of urinary tract infection (UTI) in early infancy are non-specific. Prompt diagnosis of UTI is important, as untreated UTI results in renal damage. Especially, febrile UTI in young infants coexist with other serious bacterial infections. The purpose this study was to propose modified Rochester criteria to differentiate viral infection from urinary tract infection. METHODS: We carried out a retrospective investigation of 168 infants less than three months old with a tympanic temperature >38degrees C who were admitted to Chung-Ang University Hospital between 2011 and 2014. We compared the symptoms, physical examination results, and laboratory data between viral infection and UTI groups. A modified Rochester criterion was composed of statistically significant factors. RESULTS: A total of 76 and 92 infants with UTI and a viral infection, respectively, were included. Statistically significant differences in gender, previous admission history, neutrophil ratio, and urine WBC count were found between the two study groups. Using a cut off value of 3 points, the sensitivity and specificity of the modified Rochester criteria were 71.28% and 78.57%, respectively. CONCLUSION: The modified Rochester criteria may give an outline for identifying young infants with UTI.
Bacterial Infections ; Diagnosis ; Humans ; Infant* ; Neutrophils ; Physical Examination ; Retrospective Studies ; Sensitivity and Specificity ; Urinary Tract Infections* ; Urinary Tract*

With the aging society, the prevalence of atrial fibrillation (AF) continues to increase. Nevertheless, there are still limitations in antiarrhythmic drugs (AAD) or catheter interventions for AF. If it is possible to predict the outcome of AF management according to various AADs or ablation lesion sets through computational modeling, it will be of great clinical help. AF computational modeling has been utilized for in-silico arrhythmia research and enabled high-density entire chamber mapping, reproducible condition control, virtual intervention, not possible clinically or experimentally, in-depth mechanistic research. With the recent development of computer science and technology, more sophisti‑ cated and faster computational modeling has become available for clinical application. In particular, it can be applied to determine the extra-PV target of persistent AF catheter ablation or to select the AAD with the best effect. AF com‑ putational modeling combined with artificial intelligence is expected to contribute to precision medicine for more diverse uses in the future. Therefore, in this review, we will deal with the history, development, and various applica‑ tions of computation modeling.

The purpose of this study is to compare the antibacterial effect of Listerine(R) on two microorganisms (P. gingivalis and E. faecalis) with various root canal irrigants (NaOCl, CHX, EDTA) and to identify possibility of using Listerine(R) as a root canal irrigant. Porphyromonas gingivalis ATCC 3327 and Enterococcus faecalis ATCC 29212 were used in this experiment. For the test irrigants, 0.5%, 1%, 2.5%, 5.25% NaOCl, 0.1%, 0.2%, 1%, 2% CHX, 0.5M EDTA (18.6% EDTA) and Listerine(R) were prepared. Distiled water was used as control. Two methods-1) Comparison of turbidity in broth and 2) Agar diffusion test-were used to determine the extent of antibacterial effect of Listerine(R) and to compare it with that of NaOCl, CHX, and EDTA. All solutions tested were effective against two bacterial strains compared with control (p<0.001). Any concentration of NaOCl, CHX, and EDTA showed similarly high effectiveness against all bacterial strains. In all experiment, Listerine(R) showed significantly low antibacterial effect compared with the other root canal irrigants (p<0.05). In conclusion, the results reflect remarkably low antibacterial effect of Listerine(R) as compared with root canal irrigants in general so it is not suitable for the root canal irrigant.
Agar ; Dental Pulp Cavity ; Diffusion ; Edetic Acid ; Enterococcus faecalis ; Porphyromonas gingivalis ; Root Canal Irrigants ; Water

Background and objectives: A prolonged QTc interval is associated with an increased risk of a stroke or atrial fibrillation (AF). However, its direct causal relationship with AF associated a stroke has not been proven yet. To examine whether QTc interval is causally linked with risk of stroke in AF patients, we used the Mendelian randomization analysis. Subjects and methods: Among 2742 patients (73.6% male; 58.2 ± 11.0 years old; 69.5% with paroxysmal AF) who underwent AF catheter ablation, we analyzed 1766 patients who had preablation sinus rhythm electrocardiograms off antiarrhythmic drugs after excluding amiodarone users. Among them, 1213 subjects had genome-wide association study dataset analyzable for the Mendelian randomization. We explored the mechanistic relationships between QTc interval (ms) and the risk of a stroke by analyzing the Mendelian randomization (1213 subjects) after reviewing 35 genetic polymorphisms associated with the QTc in 31 European descent studies. Results: Among the patients in the higher quartile with a higher QTc, CHA2DS2-VASc score (p < 0.001), and age (p  < 0.001), the proportions of a prior stroke (p  < 0.001), females, heart failure, and persistent AF were significantly higher than in those in the lower quartile. The QTc was independently associated with the CHA2DS2-VASc score (β, 4.63E−5; 95% confidence interval, 3.57E−6–8.90E−5; p  = 0.034) and ischemic strokes (odds ratio, 1.01; 95% confidence interval, 1.00–1.01; p  = 0.027). However, there was no direct causal relationship between the QTc and CHA2DS2-VASc score or a prior stroke in either the one-sample or two-sample Mendelian randomizations. Conclusion The QTc was independently associated with the CHA2DS2-VASc score and strokes among the patients with AF who underwent catheter ablation, despite no genetically direct causal relationship.

Background: Although myocardial thickness is an important variable for therapeutic catheter ablation of cardiac arrhythmias, quantification of wall thickness has been overlooked. We developed a software (AMBER) that measures 3D-myocardial thickness using a cardiac computed tomogram (CT) image, verified its accuracy, and tested its clinical feasibility. Methods: We generated 3D-thickness maps by calculating wall thickness (WT) from the CT images of 120 patients’ hearts and a 3D-phantom model (PhM). The initial vector field of the Laplace equation was oriented to calculate WT with the field lines derived from the 3D mesh. We demonstrate the robustness of the Laplace WT algorithm by comparing with the real thickness of 3D-PhM, echocardiographically measured left ventricular (LV) WT, and regional left atrial (LA) WT reported from previous studies. We conducted a pilot case of catheter ablation for atrial fibrillation (AF) utilizing real-time LAWT map-guided radiofrequency (RF) energy titration. Results: AMBER 3D-WT had excellent correlations with the real thickness of the PhM (R = 0.968, p < 0.001) and echocardiographically measured LVWT in 10 patients (R = 0.656, p = 0.007). AMBER 3D-LAWT (n = 120) showed a relatively good match with 12 previously reported regional LAWT. We successfully conducted pilot AF ablation utilizing AMBER 3D-LAWT map-guided real-time RF energy titration. Conclusion We developed and verified an AMBER 3D-cardiac thickness map measured by cardiac CT images for LAWT and LVWT, and tested its feasibility for RF energy titration during clinical catheter ablation.