PURPOSE: We assessed the impact of pelvic lymphadenectomy on the survival of patients who had undergone radical cystectomy. MATERIALS AND METHODS: We retrospectively reviewed 107 patients who underwent radical cystectomy for transitional cell carcinoma of the bladder between January 1991 and December 2000. We preoperatively excluded patients with evidence of pelvic lymphadenopathy and distant metastases from the study. Among 107 patients, 61 patients (Group A) underwent pelvic lymphadenectomy while 46 patients (Group B) did not. The clinicopathological parameters were not significantly different in the two groups. RESULTS: In group A, 12 patients (19.6%) were found to have pelvic node metastases. Five-year overall survival and recurrence-free survival rates were 68% and 75% for Group A, respectively. In group B, 5-year overall survival and recurrence-free survival rates were 36% and 56%, respectively. Multivariate analysis revealed that T stage (p=0.004) and lymphadenectomy (p=0.044) were significant prognostic factors for survival. CONCLUSIONS: The overall survival rates between the two groups were significantly different. Our findings suggested that lymphadenectomy may improve the prognosis of patients who underwent radical cystectomy for transitional cell carcinoma of the bladder.
Carcinoma, Transitional Cell* ; Cystectomy* ; Humans ; Lymph Node Excision* ; Lymphatic Diseases ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Retrospective Studies ; Survival Rate ; Urinary Bladder Neoplasms ; Urinary Bladder*

Pigmented contact dermatitis denotes a kind of secondary hyperpigmentation resulting from recurrent contact dermatitis of low degree. Cinnamic aldehyde is a component of cinnamon,which is widely used in foods and fragrances. A 21 year-old girl presented with a well-defined dark brownish patch on right side of chest for 4 years. Histopathologic examination revealed epidermal spongiosis, hypermelanosis of basal layer, scattered melanophages and mild perivascular inflammatory cell infiltration in the upper dermis Patch test findings were positive to fragrance mix, cinnamic aldehyde and body shampoo which was used by the patient. Peroral challenge with cinnamon tea resulted in flare-up of the positive patch-test sites and the skin lesion.
Aldehydes* ; Cinnamomum zeylanicum ; Dermatitis, Contact* ; Dermis ; Female ; Humans ; Hyperpigmentation ; Patch Tests ; Skin ; Tea ; Thorax ; Young Adult

Lemierre syndrome is characterized by a history of recent oropharyngeal infection, clinical or radiological evidence of internal jugular vein thrombosis, and isolation of pathogens, mainly Fusobacterium necrophorum. Septic emboli resulting from infected thrombophlebitis of the internal jugular vein leads to metastatic infections involving lung, liver, kidney, bone and central nervous system. Before the advent of antibiotics, the disease used to be common, incurring a high mortality rate. The disease is less frequently seen nowadays, but it is still a life-threatening disease, requiring a high index of suspicion and prompt treatment. We report a case of Lemierre syndrome, which showed oropharyngeal infection, and internal jugular vein thrombosis.
Anti-Bacterial Agents ; Central Nervous System ; Fusobacterium necrophorum ; Jugular Veins ; Kidney ; Lemierre Syndrome ; Liver ; Lung ; Thrombophlebitis ; Thrombosis

The molecular phylogeny in nine different commercial cultivated strains of Pleurotus nebrodensis was studied based on their internal transcribed spacer (ITS) region and RAPD. In the sequence of ITS region of selected strains, it was revealed that the total length ranged from 592 to 614 bp. The size of ITS1 and ITS2 regions varied among the strains from 219 to 228 bp and 211 to 229 bp, respectively. The sequence of ITS2 was more variable than ITS1 and the region of 5.8S sequences were identical. Phylogenetic tree of the ITS region sequences indicated that selected strains were classified into five clusters. The reciprocal homologies of the ITS region sequences ranged from 99 to 100%. The strains were also analyzed by RAPD with 20 arbitrary primers. Twelve primers were efficient to applying amplification of the genomic DNA. The sizes of the polymorphic fragments obtained were in the range of 200 to 2000 bp. RAPD and ITS analysis techniques were able to detect genetic variation among the tested strains. Experimental results suggested that IUM-1381, IUM-3914, IUM-1495 and AY-581431 strains were genetically very similar. Therefore, all IUM and NCBI gene bank strains of P. nebrodensis were genetically same with some variations.
DNA ; Genetic Variation ; Phylogeny ; Pleurotus

Pleurotus eryngii, known as king oyster mushroom has been widely used for nutritional and medicinal purposes. This study was initiated to screen the suitable conditions for mycelial growth and to determine the phylogenetic relationship of the selected strains. Optimal mycelial growth was observed at 30degrees C and minimum mycelial growth observed at 10degrees C. This mushroom tolerates a broad pH range for mycelial growth, with most favorable growth observed at pH 6. Results also indicated that glucose peptone, yeast malt extract and mushroom complete media were favorable growth media, while Hennerberg and Hoppkins media were unfavorable. Dextrin was the best and xylose the least effective carbon sources. Results revealed that inorganic nitrogen sources were less effective than organic sources for the mycelial growth of P. eryngii. Investigation of genetic diversity is necessary to identify the strains. The ITS region of rDNA were amplified using PCR. The size of the ITS1 and ITS2 regions of rDNA from the different strains varied from 214 to 222 bp and 145 to 236 bp, respectively. The sequence of ITS2 was more variable than that of ITS1, and the 5.8S sequences were identical. A phylogenetic tree based on the ITS region sequences indicated that selected strains could be classified into six clusters. Fourteen IUM and ATCC-90212 strains were also analyzed by RAPD with 20 arbitrary primers. Fourteen of these primers were efficiently amplified the genomic DNA. The number of amplified bands varied with the primers and strains, with polymorphic fragments in the range from 0.2 to 2.3 kb.
Agaricales ; Carbon ; DNA ; DNA, Ribosomal ; Genetic Variation ; Glucose ; Hydrogen-Ion Concentration ; Nitrogen ; Peptones ; Pleurotus ; Polymerase Chain Reaction ; Xylose ; Yeasts

Objective: The rising number of carbapenemase-resistant Enterobacteriaceae (CRE) cases has become a concern worldwidely. This study investigated patient characteristics with CRE and analyzed the risk factors associated with its acquisition. Methods: A retrospective review of the electronic medical records of the Kangbuk Samsung Medical Center from May 2016 to April 2019 was performed. The inclusion criterion was hospitalized patients aged ≥18 years with confirmed CRE acquisition. Patients were divided by CRE acquired and non-required patients. CRE acquired patients were those with CRE confirmed by their active surveillance cultures, while non-acquired patients were those with carbapenemase-sensitive Enterobacteriaceae (CSE). If CRE was isolated more than once during hospitalization, only the first isolation was used for data analysis. Patient characteristics, antibiotic used, and the duration of use were compared between two groups using univariate analysis, and the risk factors associated with CRE were analyzed using multiple logistic regression analysis. Results: Among the 73 CRE acquired patients, 44 (60.3%) were positive for carbapenemase-producing Enterobacteriaceae (CPE). Infection from Klebsiella pneumonia (42 cases, 57.5%), Escherichia coli (17 cases, 23.3%), and Enterobacter cloacae (5 cases, 6.8%). The risk of CRE acquisition was significantly increased by 4.99 times [confidence interval (CI), 1.40-17.78; p=0.013] with mechanical ventilation, 3.86 times (CI, 1.59-9.36; p=0.003) with penicillin administration, and 21.19 times (CI, 6.53-68.70; p<0.001) with carbapenem administration. Conclusions Proper antibiotic use including the selection, frequency, and duration, and patients on mechanical ventilators need close monitoring.

BACKGROUND: Atrial fibrillation is the commonest arrhythmia seen in clinical practice. However, there have been no epidemiologic data on its prevalence in general population of Korea. We performed this study to investigate the prevalence of atrial fibrillation in Korea. METHODS: From March 1, 1999 to July 31, 2000, Kangwon Branch, Korea Association of Health (KAH) parformed electrocardiograms to investigate the health status in the general public in Kangwon Province. We analyzed these data by of chi square(2) test. RESULTS: A total of 45,133 persons participated in the health screening performed by KAH. The number of persons above 40 years old were 13,768, with men and women 6,367 (46.2%) and 7,401 (53.8%)respectively. Prevalence among those above 40 years old was 0.72% and the prevalence among men, 0.96% (61 persons) was significantly higher than that of women, 0.51% (38 persons)(p<0.01). In the group above 60 years old with the prevalence of 1.24%, a similar phenomenon was observed with 1.57% (40 persons) in men and 0.97% (29 persons) in women (p<0.05). CONCLUSION: Prevalence of atrial fibrillation became higher as age increased, specifically in persons older than 40 years.
Adult ; Arrhythmias, Cardiac ; Atrial Fibrillation* ; Electrocardiography ; Female ; Gangwon-do* ; Humans ; Korea ; Male ; Mass Screening ; Middle Aged ; Prevalence*

OBJECTIVE: Clostridium difficile Infection (CDI) is one of the common nosocomial infections. As elderly population increases, the proper treatment has been emphasized. We investigated the risk factors associated with CDI unimprovement in elderly patients. Furthermore, we performed drug use evaluation of old CDI patients and oldest-old CDI patients. METHODS: It was a retrospective study using electronic medical record at Kangbuk Samsung Medical Center (KBSMC) from January 2016 to December 2017. Seventy three patients aged 65 years or older, diagnosed with CDI by Clostridium difficile Toxin B Gene [Xpert] were screened and they were assessed for risk factors regarding unimprovement status. We also evaluated drug use evaluation in old patients (65≤age<80) and oldest-old patients (80≤age) by assessing the use of initial therapy, severity, dose, route, treatment course, days of use, total days of use and treatment outcome of initial therapy. RESULTS: Out of 73 patients aged over 65 years, four patients were excluded because they did not receive any treatment. There were 31 improved patients and 38 unimproved patients after initial therapy. We were able to find out patients with surgical comorbidity or endocrine comorbidity (especially, diabetes mellitus) had 2.885 more risk of becoming unimproved than those patients without surgical comorbidity or endocrine comorbidity. Drug use evaluation for CDI was generally fair, but vancomycin as initial therapy is more recommended than metronidazole. CONCLUSION: Although age, antibiotics exposure, use of antacids are all important risk factors for CDI, our result did not show statistical significance for these risk factors. However, the study is meaningful because the number of elderly population keeps increasing and recently updated guideline suggests the use of vancomycin as drug of choice for CDI.
Aged* ; Antacids ; Anti-Bacterial Agents ; Clostridium difficile* ; Clostridium* ; Comorbidity ; Cross Infection ; Electronic Health Records ; Humans ; Metronidazole ; Outpatients ; Retrospective Studies ; Risk Factors* ; Treatment Outcome ; Vancomycin

We evaluated the antioxidant activity and tyrosinase inhibitory effects of Pleurotus ostreatus fruiting bodies extracted with acetone, methanol, and hot water. The antioxidant activities were tested against beta-carotene-linoleic acid, reducing power, 1,1-diphenyl-2-picrylhydrazyl free radical scavenging activity, and ferrous chelating ability. Furthermore, phenolic acid and flavonoid contents were also analyzed. The methanol extract showed the strongest beta-carotene-linoleic acid inhibition as compared to the other exracts. The acetone extract (8 mg/mL) showed a significantly high reducing power of 1.54 than the other extracts. The acetone extract was more effective than other extracts for scavenging on 1,1-diphenyl-2-picrylhydrazyl radicals. The strongest chelating effect (85.66%) was obtained from the acetone extract at 1.0 mg/mL. The antioxidant activities of the extracts from the P. ostreatus fruiting bodies increased with increasing concentration. A high performance liquid chromatography analysis detected seven phenolic compounds, including gallic acid, protocatechuic acid, chlorogenic acid, naringenin, hesperetin, formononetin, and biochanin-A in an acetonitrile and 0.1 N hydrochloric acid (5 : 1) solvent extract. The total phenolic compound concentration was 188 microg/g. Tyrosinase inhibition of the acetone, methanol, and hot water P. ostreatus extracts increased with increasing concentration. The results revealed that the methanol extract had good tyrosinase inhibitory ability, whereas the acetone and hot water extracts showed moderate activity at the concentrations tested. The results suggested that P. ostreatus may have potential as a natural antioxidant.
Acetone ; Acetonitriles ; Biphenyl Compounds ; Chlorogenic Acid ; Chromatography, Liquid ; Flavanones ; Fruit ; Gallic Acid ; Hesperidin ; Hydrochloric Acid ; Hydroxybenzoates ; Isoflavones ; Methanol ; Monophenol Monooxygenase ; Phenol ; Picrates ; Pleurotus ; Water

This study was initiated in order to investigate the anticancer and immunomodulating activities of crude polysaccharides extracted in methanol, neutral saline, and hot water (hereinafter referred to as Fr. MeOH, Fr. NaCl, and Fr. HW, respectively) from the fruiting bodies of Panellus serotinus. Content of beta-glucan and protein in Fr. MeOH, Fr. NaCl, and Fr. HW extracts of P. serotinus ranged from 22.92~28.52 g/100 g and 3.24~3.68 g/100 g, respectively. In vitro cytotoxicity tests, none of the various fractions of crude polysaccharides were cytotoxic against sarcoma 180, HT-29, NIH3T3, and RAW 264.7 cell lines at the tested concentration. Intraperitoneal injection with crude polysaccharides resulted in a life prolongation effect of 23.53~44.71% in mice previously inoculated with sarcoma 180. Treatment with Fr. HW resulted in an increase in the numbers of spleen cells by 1.3 fold at the concentration of 50 microg/mL compared with control. Treatment with Fr. NaCl resulted in improvement of the immuno-potentiating activity of B lymphocytes by increasing the alkaline phosphatase activity by 1.4 fold, compared with control, at the concentration of 200 microg/mL. Among the three fractions, maximum nitric oxide (13.48 microM) was recorded at 500 microg/mL in Fr. HW. Production of tumor necrosis factor alpha, interleukin-1beta, and interleukin-6 was significantly higher, compared to the positive control, concanavalin A, at the tested concentration. Therefore, treatment with crude polysaccharides extracted from the fruiting body of P. serotinus could result in improvement of antitumor activity.
Alkaline Phosphatase ; Animals ; B-Lymphocytes ; Cell Line ; Concanavalin A ; Fruit ; Injections, Intraperitoneal ; Interleukin-1beta ; Interleukin-6 ; Life Support Care ; Methanol ; Mice ; Nitric Oxide ; Polysaccharides ; Sarcoma 180 ; Spleen ; Tumor Necrosis Factor-alpha ; Water