Carbapenem resistance is a serious clinical and public health threat. Carbapenemase can confer carbapenem resistance, and most carbapenemase genes are plasmid encoded so resistance can easily spread. In this study, we aimed to develop a novel system based on the TaqMan platform for the rapid detection of 6 clinically prevalent carbapenemase genes: Klebsiella pneumoniae carbapenemase, New Delhi metallo-β-lactamase, oxacillinase, imipenem-hydrolyzing, Verona integron-encoded metallo-β-lactamase, and Guiana extended-spectrum β-lactamase.

OBJECTIVE: The aim of this study is to predict spontaneous labor onset delivery within 7 days in low risk pregnant women at 38 weeks' of gestation by ultrasonographic examination of cervical changes. MATERIAL AND METHODS: This prospective study included 110 singleton low risk pregnancies between 37(+0) and 37(+6) weeks of gestation. Fifteen cases were lost during follow-up and finally 95 pregnant women (58 nulliparous, 37 multiparous) were analysed. The study period was from Oct/2005 to May/2007. Four cervical changes (length, gland thickness, funneling and canal formation) were evaluated. Main outcome was remaining day to delivery after the examination. Remaining days to actual delivery with spontaneous labor onset were recorded and the pregnancies were divided into two groups according to remaining days (within 7 days, over 7 days) to compare predicting power of delivery within 7 days. ROC curves were drawn to find out cut-off values of cervical length and gland thickness. Sensitivity, specificity, positive predictive value and negative predictive value were extracted from four cervical changes. RESULTS: Mean cervical length of pregnant women at 38 weeks' of gestation was 25.8 (+/-10.0) mm and mean cervical gland thickness was 4.3 (+/-1.2) mm. Funnelings of uterine cervix were detected in 13 cases (13.7%), canal formations in 6 cases (6.3%). All four cervical changes were statistically valuable to predict delivery within 7 days and the cervical length showed highest sensitivity. When the cervical length was measured under 20 mm, the possibility of delivery within 7 days was 78.6% (p<0.001). The cervical gland thickness less than 4 mm could predict the delivery within 7 days with sensitivity of 57.1% (p<0.01). Sensitivities of funneling and canal formation for delivery within 7 days were 54.5%, 36.4% each. CONCLUSION: Ultrasonographic examination of the cervical changes in low risk singleton pregnancy at 38 weeks' of gestation are valuable for predicting spontaneous labor onset delivery within 7 days. Among four cervical changes, cervical length is most sensitive ultrasonographic marker.
Cervix Uteri ; Female ; Follow-Up Studies ; Humans ; Labor Onset ; Parturition* ; Pregnancy* ; Pregnant Women ; Prospective Studies ; ROC Curve ; Sensitivity and Specificity

No abstract available.
Female ; HELLP Syndrome* ; Pregnancy*

OBJECTIVE: To evaluate the clinical factors that contribute to femoral neuropathy subsequent to abdominal hysterectomy. METHODS: From March 1993 to March 2000, retrospective study on 17 cases of femoral neuropathy subsequent to abdominal hysterectomy was performed. Sixty eight patients who had normal neurologic finding on the lower extremities after the same operation were used as a control group. RESULTS: The incidence of femoral neuropathy subsequent to abdominal hysterectomy was 1.67%. Age, body weight, parity and type of skin incision were significantly different between study and control group. The mean age of the study group was 38.1+6.1 years and that of the control group was 43.2+/-8.9 years(p<0.05). The mean body weight of the study group was 52.9 6.4kg, while that of the control group was 57.8+/-7.4kg(p<0.05). The mean parity of the study group was 1.9+/-0.7 as opposed to 2.6+/-1.3 for the control group(p<0.05). Pfannenstiel`s incision was performed in 13 cases(76.5%) in the study group as opposed to 34 cases(50%) in the control group(p<0.05). There were no correlation between these two groups with respect to patient height, operative time, transfusion and change in hemoglobin level. In the study group, 13 cases(76.5%) with femoral neuropathy on the left side were found, 3 cases(17.6%) on the right side and 1 case(5.9%) on both side. Left side femoral neuropathy was more common than the right(p<0.05). Spontaneous recovery occurred in 16 cases of the study group within 4 months and, although residual symptoms were noted in the remaining 1 case, no serious sequelae have been observed. CONCLUSION: It was suggested that pelvic retractor compresses the femoral nerve during the abdominal hysterectomy. The patients age, body weight, parity and a type of skin incision could be contributing factors to femoral neuropathy.
Body Weight ; Female ; Femoral Nerve ; Femoral Neuropathy* ; Humans ; Hysterectomy* ; Incidence ; Lower Extremity ; Neurologic Manifestations ; Operative Time ; Parity ; Retrospective Studies ; Skin

Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-KP) has been disseminating nationwide due to clonal spread and is taking a serious action at the national level in Korea. The mobilized colistin resistance (MCR1) gene confers plasmid-mediated resistance to colistin and is known to be capable of horizontal transfer between different strains of a bacterial species. We have experienced a fatal case of the patient who developed MCR1-possessing, ST307/Tn4401a[blaKPC2] K. pneumonia bacteremia in the community of non-capital region after being diagnosed as pancreatic cancer with multiple liver metastases and treated in the capital region. The ST307/Tn4401a[blaKPC2] K. pneumonia was the most commonly disseminated clone in Korea. Our strain is the first MCR1 and KPC2 co-producing K. pneumonia in Korea and our case is the critical example that the multi-drug resistant clone can cause inter-regional spread and the community-onset fatal infections. Fortunately, our patient was admitted to the intensive care unit on the day of visit, and the contact precaution was well maintained throughout and KPC-KP was not spread to other patients. The high risk patients for KPC-KP need to be screened actively, detected rapidly and preemptively isolated to prevent outbreak of KPC-KP. Inter-facility communications are essential and the nationwide epidemiologic data of KPC-KP should be analyzed and reported regularly to prevent spread of KPC-KP. The prompt identification of species and antimicrobial susceptibilities for successful treatment against KPC-KP should be emphasized as well.

This article evaluates the overall current disease burden of North Korea through the recent databases of international organizations. It is notable that North Korea as a nation is exhibiting a relatively low burden from deaths and that there is greater burden from deaths caused by non-communicable diseases than from those caused by communicable diseases and malnutrition. However, the absolute magnitude of problems from communicable diseases like TB and from child malnutrition, which will increase the disease burden in the future, remains great. North Korea, which needs to handle both communicable and nutritional conditions, and non-communicable diseases, whose burden is ever more increasing in the nation, can now be understood as a country with the 'double-burden' of disease.
Adolescent ; Adult ; Aged ; Child ; Child Nutrition Disorders/epidemiology ; Child, Preschool ; Communicable Diseases/epidemiology/*mortality ; Databases, Factual ; Democratic People's Republic of Korea ; Humans ; Incidence ; Middle Aged ; Nutritional Status ; Tuberculosis/epidemiology/mortality ; Young Adult

PURPOSE: Advancing genetic knowledge for oncology nurses is especially important in Korea because physicians have launched to incorporate genetic risk assessment and genetic testing into their practice. The purpose of this paper was to identify the effect of the first academic cancer genetic risk assessment and counseling course for Korean nurses. METHODS: Thirty-five nurses were recruited and educated from June 8 to 14, 2006 in Seoul, Korea. Two measurement tools were used: 'knowledge about the hereditary breast and ovarian cancer (HBOC)' and 'knowledge about the cancer genetics'. RESULTS: Students' score of knowledge about HBOC at pre-education was 12.22+/-2.23, and after education, it increased to 13.62+/-1.76. This change was statistically significant (t=-3.253, p=.003). The score of knowledge about cancer genetics at pre-education was 11.31+/-3.44, and after education it has increased to 16.17+/-1.94. It also was statistically significant (t=-6.92, p=.000). CONCLUSION: This program was effective to be a starting point for establishing genetic educational planning for the oncology nurses in Korea. This academically-based course is recognized as valuable by oncology nurses. With this new knowledge, nurses can begin to expand their role in delivering comprehensive cancer care services in Korea.
Breast ; Counseling ; Education, Nursing ; Genetic Counseling ; Genetic Testing ; Korea ; Ovarian Neoplasms ; Risk Assessment

Alloimmune neonatal neutropenia (ANN) is due to maternal IgG neutrophil-specific antibodies that cross the placenta to sensitize fetal neutrophils and cause neutropenia in the neonate. Infection appears within a few days of life. Neutropenia worsens during the very first days of life and persists until 20-50 days in spite of the disappearance of detectable antibody in the infant's serum. We report a case of ANN in female neonate who was admitted on the 5th day of life due to poor oral intake. The diagnosis was made by indirect immunofluorescence with fluorescein-tagged antihuman globulin reagent. The patient was treated successfully with systematic intravenous antibiotics and highdose intravenous immunoglobulin (IVIG).
Anti-Bacterial Agents ; Antibodies ; Diagnosis ; Female ; Fluorescent Antibody Technique, Indirect ; Humans ; Immunoglobulin G ; Immunoglobulins ; Immunoglobulins, Intravenous ; Infant, Newborn ; Neutropenia* ; Neutrophils ; Placenta

PURPOSE: The aim of this study was to investigate the incidence and course of neutropenia following intravenous immunoglobulin (IVIG) therapy in children with idiopathic thrombocytopenic purpura (ITP). METHODS: From January 2001 to June 2006, fifty-four patients with ITP were enrolled in this study. Forty-two of 54 patients were treated with IVIG, while the other 12 were treated with anti-D immunoglobulin (Anti-D Ig). Post-treatment absolute neutrophil counts (ANC) were compared between patients who received IVIG and those who received Anti-D Ig. Comparison of post-treatment ANC between patients who treated with two different IVIG regimens (400 mg/kg/day for 5 days and 1 g/kg/day for 2 days) was also performed. RESULTS: Pretreatment ANC were not significantly different between the two treatment groups. After treatment with IVIG, 32 out of 42 patients (76.2%) showed more than 50% decrease of ANC from the baseline. On the other hand, only 2 out of 12 patients (16.7%) showed more than 50% decrease of ANC from the baseline after treatment Anti-D Ig. No significant difference was observed in the decline of ANC between the first IVIG treatment (42 patients) and repeated IVIG treatment groups (7 patients). There was no statistical difference in post-treatment ANC between patients who treated with two different IVIG regimens. The neutropenia induced by IVIG had resolved spontaneously in 38 out of 39 patients (97%) after several days. CONCLUSION: Neutropenia following IVIG administration may not be an uncommon finding in children with ITP. It seems to be transient and self limited.
Child ; Hand ; Humans ; Immunoglobulins ; Immunoglobulins, Intravenous ; Incidence ; Isoantibodies ; Neutropenia ; Neutrophils ; Purpura, Thrombocytopenic, Idiopathic

Pigmented follicular cyst is a rare disorder which typically presents as a pigmented papule on the head or neck. Histologically, it exhibits terminally differentiated, pigmented hair shafts in an epidermoid cyst. It was described as a variant of epidermal cyst originating from the infundibular epidermis of pilosebaceous unit. We report a case of pigmented follicular cyst on the occipital scalp in a 7-year-old girl with typical histologic features.
Child ; Epidermal Cyst ; Epidermis ; Female ; Follicular Cyst* ; Hair ; Head ; Humans ; Neck ; Scalp