BACKGROUND: The rising incidence of fungal infections and the increasingly frequent use of antifungal agents have intensified the need for practical and reliable antifungal susceptibility test methods. In the present study, the minimal inhibitory concentration(MIC) distribution of Candida species was investigated and the agar dilution method was compared with the National Committee for Clinical Laboratory Standards(NCCLS) "reference" broth microdilution method for antifungal susceptibility testing. METHODS: A total of 116 clinical isolates of Candida species from patients at Hanyang University Kuri Hospital were studied from October 1997 to July 1999, and the MICs of Candida species were evaluated against amphotericin B and fluconazole by the NCCLS method and the agar dilution method. RESULTS: There were no differences in the MIC50 and MIC90 of Candida albicans and Candida tropicalis against amphotericin B between the two methods, but the MIC50 of C. albicans against fluconazole was higher in the agar dilution method than in the broth microdilution method. The resistant rate of C. albicans against fluconazole was 20.8% in the broth microdilution method and 33.8% in the agar dilution method. For C. tropicalis, 31.3% were resistant to fluconazole in the broth microdilution method and 25.0% in the agar dilution method. The agreement of C. albicans and C. tropicalis between the agar dulution method and the broth microdilution method within one doubling dilution of the microdilution reference were 88.8% for amphotericin B and 34.4% for fluconazole. CONCLUSIONS: The MICs of amphotericin B showed good agreement between the agar dilution and the broth microdilution method. Therefore, resistant strains could easily be detected by screening with agar of 2 g/mL concentrations. However, in the case of fluconazole, the agreement between the two methods was low and the trailing effect could not be ruled out in agar dilution method with some strains, indicating the need for further studies in this area.
Agar* ; Amphotericin B* ; Antifungal Agents ; Candida albicans ; Candida tropicalis ; Candida* ; Fluconazole* ; Humans ; Incidence ; Mass Screening

We examined the effect of leptin on the insulin resistance in skeletal muscles by measuring the glucose transport. Male Wistar rats were fed with chow or high-fat diets for 30 days. Three days before sacrifice, high-fat fed rats were subcutaneously injected with leptin (1 mg/kg body weight) for 3 days. The glucose transports in the epitrochlearis and soleus muscle were not different among the experimental groups under basal state, however these were decreased significantly in the high fat-diet rats under insulin-stimulation (P< 0.01). Leptin treatment recovered the decreased glucose transport in the epitrochlearis (P< 0.05) and soleus (p=0.08). Triglyceride concentration in the soleus muscle was increased significantly in the high fat-fed rats, compared to chow diet rats (P< 0.01), and it was decreased significantly by leptin treatment (P< 0.01). The glucose transport was measured under basal and 60microU/ml of insulin with or without 50 ng/ml of leptin. Leptin had no direct stimulatory effect on glucose transport under both basal and insulin-stimulated conditions in vitro. These results demonstrate that leptin injection to high fat diet fed rats recovered impaired insulin responsiveness of the skeletal muscles and muscle triglyceride concentration. However, there was no direct stimulatory effect of leptin on insulin sensitivity of the skeletal muscle in vitro.
Animals ; Diet ; Diet, High-Fat* ; Glucose ; Humans ; Insulin Resistance* ; Insulin* ; Leptin* ; Male ; Muscle, Skeletal* ; Rats* ; Rats, Wistar ; Triglycerides

Arytenoid cartilage displacement (dislocation and subluxation) following endotracheal intubation is a rare event. Recognition of its occurrence and subsequent treatment are important to prevent longterm consequences. A 44-year-old healthy woman was admitted for total thyroidectomy and isthmusectomy. Anesthesia was induced and a number 7 cuffed endotracheal tube with a stylet was inserted under direct vision after two unsuccessful attempts without a stylet. The trachea was extubated without any difficulty in the recovery room after the surgery. About 8 hours later, the patient complained odynophagea, dysphagea, dysphonia and hoarseness. Indirect laryngoscopy and videolaryngotelescopy at the otolaryngology department revealed anterior subluxation of both cricoarytenoid cartilages with poor mobility and edema on the vocal cords. A follow-up indirect laryngoscopic examination performed after 5 days of conservative trearment showed return of the voice quality with slightly reduced mobility on the left vocal cord.
Adult ; Anesthesia ; Arytenoid Cartilage ; Cartilage ; Dysphonia ; Edema ; Female ; Follow-Up Studies ; Hoarseness ; Humans ; Intubation* ; Intubation, Intratracheal ; Laryngoscopy ; Otolaryngology ; Recovery Room ; Thyroidectomy ; Trachea ; Vocal Cords ; Voice Quality

OBJECTIVES: This study was performed to identify the associations of social capital with suicidal thoughts and attempts in Korean communities with poor health. METHODS: We used the data from community health interviews conducted at 40 administrative sections (dong, eup, or myeon) with high mortality from August to October in 2010, 2011, and 2012 as part of the Health Plus Happiness Plus Projects in Gyeongsangnam-do Province. The 8,800 study subjects composed of 220 adults systematically sampled from each administrative section were asked if they had thought about suicide or had attempted suicide within 1 year. The social participation was measured with 'participation in formal and/or informal group' and trust using responses to three questions about trust of others. RESULTS: The prevalence of suicidal ideation and attempt within 1 year were 10.4% and 0.8%, respectively. The logistic regression analysis revealed that those who participated in only informal groups, or had highest trust level reported less suicidal ideation, or attempt after adjusting for socio-demographic factors (sex, age, marital status, occupation, and food affordability), self-rated health, and health behaviors (smoking, alcohol drinking, and exercise). CONCLUSIONS: This study suggested social capital such as social participation and trust was associated with less suicide ideation and attempt. More studies are warranted for the association of social capital with suicidal behavior.
Adult ; Alcohol Drinking ; Happiness ; Health Behavior ; Humans ; Logistic Models ; Marital Status ; Occupations ; Prevalence ; Social Participation ; Suicidal Ideation ; Suicide ; Suicide, Attempted

Objectives: . The aim of this study was to evaluate vestibular function loss after cochlear implantation (CI) and the relationship between vestibular function and hearing changes. Methods: . Seventy-five patients with CI were enrolled and divided into those with normal preoperative caloric function (group I) and those with a normal preoperative waveform in cervical vestibular evoked myogenic potential (c-VEMP) testing (group II). The relationship between hearing and changes in the vestibular system was analyzed preoperatively and at 3 and 6 months postoperatively. Results: . In group I, unilateral weakness on the implanted side was detected in five (7.7%) and eight (12.3%) patients at 3 and 6 months post-CI, respectively. By 3 months post-CI, the total slow-phase velocity (SPV; warm and cold stimulations) was significantly different between the implanted and non-implanted sides (P=0.011), and the shift in total SPV from pre- to post-CI was significantly correlated with the average hearing threshold at 6 months post-CI. In group II, an abnormal c-VEMP was detected on the implanted side in six patients (16.2%) at 3 months post-CI, and in six patients (16.2%) at 6 months post-CI. Significant changes were noticed in the P1 and N1 amplitude at 3 months postCI (P=0.027 and P=0.019, respectively). Conclusion . Vestibular function and residual hearing function should be afforded equal and simultaneous consideration in terms of preservation.

Type II mucopolysaccharidosis (MPS II) commonly known as Hunter syndrome, is a rare X-linked lysosomal storage disorder caused by iduronate-2-sulfatase deficiency, which in turn causes otorhinolaryngological manifestations, including sensorineural hearing loss (SNHL). Previously, the median survival age of patients with MPS was approximately 13.4 years. However, in the era of enzyme replacement therapy and other multidisciplinary care modalities, the life expectancy has increased. Herein, we report a rare case of an adolescent with MPS II who underwent SNHL treatment with cochlear implantation (CI). Based on unexpected findings of mastoid emissary veins and overgrowth of the vessels around the temporal bone, CI was performed using the transmeatal approach instead of the conventional transmastoid method, to avoid damage to the vessels. The average hearing threshold after CI was 35 dB and no surgical complications were encountered. Adolescent MPS II may present vessel abnormalities, which can reduce the success rate of surgery. In patients with MPS II with SNHL, CI should be performed under careful monitoring of vessel overgrowth. Moreover, with regard to feasibility of CI in adolescent patients with MPS II with SNHL, surgical techniques such as the transmeatal approach should be selected based on adequate assessment of the case.

No abstract available.
Adenocarcinoma* ; Endometrial Hyperplasia* ; Female

Hyperemesis gravidarum is a complication defined as nausea and vomiting during early pregnancy. Wernickes encephalopathy is an illness of acute onset characterized by mental disturbance, paralysis of eye movements, and ataxia of gait cause by thiamine deficiency. We recently experienced a case of Wernickes encephalopalhy due to hyperemesis gravidarum, which is treated by administration of thiamine even though outcome of serious healthy problem to both mother and fetus, and reported it with a brief review of the literature.
Eye Movements ; Female ; Fetus ; Gait Ataxia ; Humans ; Hyperemesis Gravidarum* ; Mothers ; Nausea ; Paralysis ; Pregnancy ; Thiamine ; Thiamine Deficiency ; Vomiting ; Wernicke Encephalopathy*

PURPOSE: For treating advanced non-small cell lung cancer (NSCLC), epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) are known to be very effective in nonsmokers, women, Asian and person with EGFR mutations. The efficacy of EGFR-TKI was analyzed based on the radiologic studies and the serum levels of carcinoembryonic antigen (CEA) to evaluate whether serum CEA can be used as a predicative marker of the response to EGFR-TKI therapy. MATERIALS AND METHODS: Forty-one patients with NSCLC treated with gefitinib at Kosin Medical Center from January 2007 to August 2009 were the subjects of this study. We assayed the serum CEA levels before and after gefitinib therapy with concomitant assessments of the tumor response by serial chest X-ray and chest computer tomograms (CT). RESULTS: The median age of the patients was 62.6 years (range, 32~77 years), 29 patients were women, 36 had adenocarcinoma (87.8%) and the baseline serum CEA was equal or above 5 ng/mL in 31 patients (75.6%). These 31 patients were more responsive to the gefitinib therapy (p=0.021). The overall response rate of the patients was 51.2%, the median survival time was 21.9 months and the time to progression was 8.3 months. Among the 21 responding patients, the serum CEA was decreased after 2 months in 17 (80.9%), and among the 14 progressed patients, the serum CEA was increased in 12 (85.7%) (p=0.000). CONCLUSION: The changes of serum CEA at 2 months after gefitinib therapy were closely related to the radiologic changes. The serum CEA could be used as a complimentary tool for monitoring the tumor response to EGFR-TKI in the advanced NSCLC patients.
Adenocarcinoma ; Asian Continental Ancestry Group ; Carcinoembryonic Antigen ; Carcinoma, Non-Small-Cell Lung ; Female ; Humans ; Protein-Tyrosine Kinases ; Quinazolines ; Receptor, Epidermal Growth Factor ; Thorax ; Biomarkers, Tumor

In contrast to juvenile laryngeal papillomatosis, which occurs most often in children and teenagers and is usually self limited, soliatry papilomas in adults are one of uncommon tumors of airway, and have a higher incidence of cancer. They are caused by the respiratory infection of human papilloma virus(HPV). They culd spread to more distal airways and have a tendency of recurrence after limited surgical excision. Recently endoscopic therapies such as Nd-YAG laser, electrocautery, and cryotherapy provide extremely effective treatment modalities. We report a case of solitary tracheal papillomas in a 48 year-old man who presented with cough, scanty hemoptysis, and functional evidence of central airway obstruction. He was successfully treated by a Nd-TAG laser therapy via fiberoptic bronchoscopy under the local anesthesia.
Adolescent ; Adult ; Airway Obstruction ; Anesthesia, Local ; Bronchoscopy ; Child ; Cough ; Cryotherapy ; Electrocoagulation ; Hemoptysis ; Humans ; Incidence ; Laser Therapy ; Lasers, Solid-State* ; Middle Aged ; Papilloma* ; Recurrence