Control of tuberculosis is threatened by widespread emergence of drug resistance in Mycobacterium tuberculosis. Understanding the molecular basis of resistance might lead to development of novel rapid methods for diagnosing drug resistance. Rifampin is a key component among therapeutic regimens for the tuberculosis; therefore, patients who have drug resistance do not convalesce satisfactorily. The molecular mechanism of resistance to rifampin in M. tuberulosis has been elucidated. Substitutions of a limited number of highly conserved amino acids encoded by the rpoB gene are responsible for the ""single-step"" high-level resistance of M. tuberculosis to rifampin. Currently, two genotype-based protocols allow drug test from minimally grown cultured materials: (i)mutation identification by direct sequencing of PCR-amplified material. and (ii)mutation screening by PCR-SSCP. The purpose of this study is to evaluate the usefulness of the both methods. A sample of 75 isolates of M. tuberculosis was studied, and it inculded 36 rifampin-resistant strains and 39 rifampin-sensitive strains by conventional methods. Mutaions were identified in 36 rifampin-resistant isolates but in none of 39 sensitive isolates. All mutations were clustered within a region of 23 amino acids. Both methods allow detection of rifampin resistance in 2 to 3 days and will thus help in the early management of infection by M. tuberculosis.
Amino Acids ; Drug Resistance ; Humans ; Mass Screening ; Mycobacterium tuberculosis* ; Mycobacterium* ; Rifampin ; Tuberculosis

Acute generalized exanthematous pustulosis (AGEP) has symptoms of abrupt onset of a widespread pustular eruption on an erythematous. base. Most cases appear to be related to drug reactions, mainly antibiotics, but viral infections and hypersensitivity to mercury may cause AGEP. The essential features of AGEP include. (1) numerous (several dazen) small((5mm), mostly non follicular pustules arising on a widespread erythema:purpura and target-like lesions may be associated; (2) histology showing intraepidermal or subcorneal pustules associated with one or more of the following.clermal edema, vasculitis, perivascular eosinophils, or focal necrosis of keratinocytes; (3) fever (over 38C); (4) neutrophilia, and (5) acute evolution with spontaneous resulotion of pustules within 15 days. We report a case of AGEP which presented with widespread tiny pustules on the whole body except the face, palms and soles. There were petechia, purpura, and vesiculobullous lesions on the axilla, popliteal fossa and upper abdomen. A biopsy specimen from a pustule showed subcorneal pustules with perivascular polymorphous cellular infiltration, marked dermal edema and necrotic keratinocytes. There was complete resolution of the lesions within 10 days.
Abdomen ; Acute Generalized Exanthematous Pustulosis* ; Amoxicillin ; Anti-Bacterial Agents ; Axilla ; Biopsy ; Drug Eruptions ; Edema ; Eosinophils ; Fever ; Hypersensitivity ; Keratinocytes ; Necrosis ; Purpura ; Vasculitis

Control of tuberculosis is threatened by widesread emergence of drug resistant Mycobacterium tuberculosis. Rifampin is a key component among therapeutic regimens for the tuberculosis; therefore patients in whom resistance to this drug develop have a poor outlook, particularly if rifampin resistance is associated with resistance to other tuberculosis drugs. The purpose of this study was to detect the mutation in rpoB gene of rifampin resistant M. tuberculosis in Korea and to evaluate the usefulness of the method in clinical aspects. A sample of 80 M. tuberculosis was studied, and it included 40 rifampin resistance isolates and 40 rifampin sensitive isolates by conventional methods. The detection method involved the amplification by polymerase chain reaction (PCR) of the Rif' region and the identification of mutations by single-strand DNA conformation polymorphism analysis (SSCP) of the amplification products (157 bp). Mutation were identified in 39 of 40 rifampin resistant isolates, and in 1 of 40 rifampin sensitive isolates.
Humans ; Korea ; Mycobacterium tuberculosis* ; Mycobacterium* ; Nucleic Acid Conformation ; Polymerase Chain Reaction* ; Rifampin ; Tuberculosis

BACKGROUND: We evaluated the clinical usefulness of the quick Sepsis-Related Organ Failure Assessment (qSOFA) score (based on the 2016 definition of sepsis) at intensive care unit admission in Korean patients with bacteremia. METHODS: We retrospectively analyzed clinical data from 236 patients between March 2011 and February 2016. In addition to the qSOFA, the Modified Early Warning score (MEWS) and systemic inflammatory response syndrome (SIRS) criteria were calculated. RESULTS: The patients' median age was 69 years, and 61.0% were male. Of the patients, 127 (53.8%) had a qSOFA score ≥2 points. They had significantly higher rates of septic shock, thrombocytopenia, and hyperlactatemia, and increased requirements for ventilator care, neuromuscular blocking agents, vasopressors, and hemodialysis within 72 hours after intensive care unit admission. They also had a significantly higher 28-day mortality rate. When analyzed using common thresholds (MEWS ≥5 and ≥2 SIRS criteria), patients with a MEWS ≥5 had the same results as those with a qSOFA score ≥2 (P < 0.05). However, patients with ≥2 SIRS criteria showed no significant differences. CONCLUSIONS: Our results show that a qSOFA score ≥2 at admission is a useful screening tool for predicting disease severity and medical resource usage within 72 hours after admission, and for predicting 28-day mortality rates in patients with bacteremia. In addition, qSOFA scores may be more useful than SIRS criteria in terms of prognostic utility.
Bacteremia* ; Critical Care* ; Humans ; Hyperlactatemia ; Intensive Care Units* ; Korea* ; Male ; Mass Screening ; Mortality ; Neuromuscular Blocking Agents ; Prognosis ; Renal Dialysis ; Retrospective Studies ; Sepsis ; Shock, Septic ; Systemic Inflammatory Response Syndrome ; Thrombocytopenia ; Ventilators, Mechanical

BACKGROUND: Until the recent development of the Q-switched lasers, it was impossible to remove tattoos without causing scarring and sometimes disfiguring. Variations in wavelengths and pulse widths may result in different clinical effects or risks. OBJECTIVE: The purpose of this study was to investigate the therapeutic effects of the alexandrite laser in removing tattoos clinically, histologically and ultrastructually. METHODS: Fourty-two patients with gray, black, and blue-black colored tattoos were treated with fluences ranging from 6.5 to 8.0 J/cm2 at a minimal interval of 6 weeks. We took pictures of each tattoo prior to treatment and each treatment session in order to evaluate clinical irnprovement. Biopsy specimens were obtained from 8 patients, on prearranged times: before, immediately after, one week after and 6 weeks after irradiation. RESULTS: The results if the treatment of 42 patients with tattoos were analyzed. After two treatment sessions, 89% of patients showed 51% to 95% improvement. Transient hyperpigmentation and hypopigmentation occurred in 7 patients. However, skin atrophy, hypertrophic scar or infection did not occur. Ir a biopsy specimen taken 6 weeks after irradiation on light microscopy, most of tattoo granules disappeared without collagen fiber change. However, macrophage engulfing tattoo granules and a minute amount of tattoo granules still remained in the dermis on electron microscopy. CONCLUSION: The .alexandrite laser is considered to be a safe and effective treatment rnodality for removal of gray, black, and blue-black tattoo pigments.
Atrophy ; Biopsy ; Cicatrix ; Cicatrix, Hypertrophic ; Collagen ; Dermis ; Humans ; Hyperpigmentation ; Hypopigmentation ; Lasers, Solid-State* ; Macrophages ; Microscopy ; Microscopy, Electron ; Skin

Mucocuaneous Lymph Node Syndrome(Kawasaki disease) is a new diseae entity that was first described by Kawasakiin 1967. It occures predominantly in children less than 5yrs old and acute febrile illness, which is mucocutaneousinvolvment associated with swelling of cervical lymph nodes. The coronary artery aneurysms have been revealed 20–30% of patients with Kawsaki disease. The authors report a case of multiple coronary artery aneurysms inKawasaki disease which was diagnosed by a coronary arteriography.
Aneurysm ; Angiography ; Child ; Coronary Vessels ; Humans ; Lymph Nodes ; Mucocutaneous Lymph Node Syndrome

PURPOSE: The purpose of this study was to identify the knowledge, attitude and preventive behaviors of tuberculosis in male high school students and to identify the factors influencing preventive behaviors and to provide basic data for the development of prevention programs for tuberculosis of male high school students. METHODS: This study was conducted from May 1, 2018 to May 30, 2018, and six high school students in S city and Y city of Jeonnam were selected. 465 male high school students in the first grade were selected. Collected data were analyzed using t-test, ANOVA, pearsons's correlation and Multiple regression analysis by SPSS/WIN 21.0 program RESULTS: As a result, the knowledge score was 11.92, the attitude score was 28.32 and the prevention behavior score was 30.07. All of these correlations were statistically correlated. In addition, factors influencing preventive actions against tuberculosis were attitude toward tuberculosis, exercise, health status, and sleep time CONCLUSIONS: Based on the above results, it is thought that to improve the preventive behavior of tuberculosis in male high school students, it is necessary to develop a practice-oriented program for forming healthy lifestyle as well as to change the attitude toward tuberculosis positively.
Humans ; Jeollanam-do ; Life Style ; Male* ; Tuberculosis*

As the breast is a symbol of feminity, so nipple areolar complex is a crucial aesthetic unit of the breast. Symmertrical and appropriate nipple areolar complex completes the breast reconstruction. Throughout the history of breast reconstruction, various methods of nipple areolar reconstruction have been developed. Composite graft and several local flap methods have been used for reconstruction of nipples. Skin grafts from contralateral areolar or inguinal area and tattooing methods have been introduced for areolar reconstruction. Among 85 patients of breast reconstruction during recent three years, we experienced only 14 cases of nipple areolar reconstruction. This fact is partly from conservative attitude of Korean women to breast reconstruction and also from the long time-period needed to accomplish an acceptable breast mound. For nipple reconstrction, we performed eight H-shape local flaps, three fish tail shape local flaps, and three composite grafts. For reconstruction of areola, full thickness skin graft was used in 13 cases(10 from inguinal area, 3 from contralateral areola) and tattooing was used in a case. We experienced necrosis of reconstruction nipple in two cases(one in fish tail shape local flap cases and one in composite graft cases). There was no other remarkable complication. Among the three methods of nipple reconstruction. H-shape local flap method was a reliable one which provides stable nipple projection as well as simplicity. In most cases areola was successefully reconstructed with full thickness skin graft and if the size of contralateral areola is large enough to share, contralateral areolar sharing seems to be the best choice. In conclusion, the combination of a H-shape local flap and a full thickness skin graft from the inguinal area provides a satisfactory projection of the nipple and pigmentation of the nipple and pigmentation of the areola comparable to the other side.
Breast ; Female ; Humans ; Mammaplasty ; Necrosis ; Nipples* ; Pigmentation ; Skin ; Tattooing ; Transplants

Purpose: With Korea’s recent rapid change into a multicultural society, cultural competence is being emphasized as a core nursing competency. This study investigated the effects of a cultural nursing course that aimed to enhance the cultural competence of nursing students in Korea. Methods: This was a single-group pre- and post-comparison study. The subjects were 69 nursing students at Dongyang University who attended a cultural nursing course in 2015, of whom 62 students responded to the survey. The 13-week cultural nursing course was held for 2 hours a week. The methods of the course included small group activities, discussions and presentations, experiential learning, reflective activities, and lectures. Nursing students’ cultural competence was measured pre- and post-course with the Cultural Competence Scale for Korean Nurses, which contains 33 items scored on a 7-point Likert scale. Results: After completing the cultural nursing course, students’ total cultural competence scores increased, as did their scores in each category (cultural awareness, cultural knowledge, cultural sensitivity, and cultural skills) (P<0.001). There was no significant difference in cultural competence by gender (P<0.001). Conclusion This cultural nursing course was found to be effective in enhancing the cultural competence of nursing students. Therefore, the educational program developed in this study can be extended to other university-level nursing programs in Korea.

Purpose: The purpose of this study was to identify the influence of self-esteem and sexual communication on sexual satisfaction among female colorectal cancer patients with ostomy. Methods: A cross-sectional descriptive study was conducted using self-reported online questionnaires. The participants were 85 women with colorectal cancer who had undergone ostomy formation surgery. Data were analyzed using descriptive statistics, the t-test, analysis of variance, the Scheffé test, correlation coefficients, and hierarchical multiple regression with SPSS version 26.0. Results: The mean sexual satisfaction score was 2.79±0.73 (range, 0~5). There was no significant relationship between self-esteem and sexual satisfaction. Sexual communication had a significant correlation with sexual satisfaction (r=.83, p<.001) and was a strong predictor of sexual satisfaction (β=.83, p<.001). Conclusion The findings of this study indicate that colorectal cancer patients with ostomy experience low sexual satisfaction and that sexual communication is a meaningful factor for sexual satisfaction. Accordingly, nurses need to factor in sexual issues when caring for patients, and should encourage both patients and their partners to participate in education related to sexual health. It will also be helpful to inform patients about the importance of sexual communication with their partners as a sustainable intervention.