BACKGROUND: Malnutrition is associated with many adverse clinical outcomes. The present study aimed to identify the prevalence of malnutrition in hospitalized patients in Korea, evaluate the association between malnutrition and clinical outcomes, and ascertain the risk factors of malnutrition. METHODS: A multicenter cross-sectional study was performed with 300 patients recruited from among the patients admitted in 25 hospitals on January 6, 2014. Nutritional status was assessed by using the Subjective Global Assessment (SGA). Demographic characteristics and underlying diseases were compared according to nutritional status. Logistic regression analysis was performed to identify the risk factors of malnutrition. Clinical outcomes such as rate of admission in intensive care units, length of hospital stay, and survival rate were evaluated. RESULTS: The prevalence of malnutrition in the hospitalized patients was 22.0%. Old age (≥ 70 years), admission for medical treatment or diagnostic work-up, and underlying pulmonary or oncological disease were associated with malnutrition. Old age and admission for medical treatment or diagnostic work-up were identified to be risk factors of malnutrition in the multivariate analysis. Patients with malnutrition had longer hospital stay (SGA A = 7.63 ± 6.03 days, B = 9.02 ± 9.96 days, and C = 12.18 ± 7.24 days, P = 0.018) and lower 90-day survival rate (SGA A = 97.9%, B = 90.7%, and C = 58.3%, P < 0.001). CONCLUSION: Malnutrition was common in hospitalized patients, and resulted in longer hospitalization and associated lower survival rate. The rate of malnutrition tended to be higher when the patient was older than 70 years old or hospitalized for medical treatment or diagnostic work-up compared to elective surgery.
Cross-Sectional Studies ; Hospitalization ; Humans ; Intensive Care Units ; Korea ; Length of Stay ; Logistic Models ; Malnutrition ; Multivariate Analysis ; Nutrition Assessment ; Nutritional Status ; Prevalence ; Risk Factors ; Survival Rate

No abstract available.
Hair*

Although a decrease in acquired immunodeficiency syndrome (AIDS)-related mortality has been documented in highly active antiretroviral therapy (HAART) era, there are no published data comparing specific causes of death between pre-HAART and HAART era in Korea. Mortality and cause of death were analyzed in three treatment periods; pre-HAART (1990-1997), early-HAART (1998-2001), and late-HAART period (2002-2011). The patients were retrospectively classified according to the treatment period in which they were recruited. Although mortality rate per 100 person-year declined from 8.7 in pre-HAART to 4.9 in late-HAART period, the proportion of deaths within 3 months of initial visit to study hospital significantly increased from 15.9% in pre-HAART to 55.1% in late-HAART period (P < 0.001). Overall, 59% of deaths were attributable to AIDS-related conditions, and Pneumocystis pneumonia (PCP) was the most common cause of death (20.3%). The proportion of PCP as cause of death significantly increased from 8.7% in pre-HAART to 31.8% in late-HAART period (P < 0.001). Despite of significant improvement of survival, there was still a high risk of early death in patients presenting in HAART era, mainly due to late human immunodeficiency virus (HIV) diagnosis and late presentation to care.
Acquired Immunodeficiency Syndrome/mortality ; Adult ; *Antiretroviral Therapy, Highly Active ; Cause of Death/*trends ; Female ; HIV Infections/drug therapy/*mortality ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Pneumonia, Pneumocystis/mortality ; Republic of Korea ; Retrospective Studies

Leukocytosis and neutrophilia is common during the acute phase of Kawasaki disease whereas leukopenia is not common and severe neutropenia is rare. Severe neutropenia is defined as absolute neutrophil count less than 500/mm3. There are only few publicatons reporting of atypical Kawasaki disease with severe neutropenia. We report a case of atypical Kawasaki disease with severe neutropenia.
Leukocytosis ; Leukopenia ; Mucocutaneous Lymph Node Syndrome* ; Neutropenia* ; Neutrophils

Kikuchi-Fujimoto's disease (KFD) is a rare self-limiting necrotizing lymphadenitis found mainly in young women. Patients typically present with lymphadenopathy and often with a high fever. The etiology of the disease remains unknown, but various infection and autoimmune processes have been postulated to be the cause. We report here on a 22-year-old female with 7-year history of systemic lupus erythematosus presented with high fever and many enlarged cervical lymph nodes. Neck computed tomography scan showed multiple lymphadenopathies and KFD was proven by under sonographic guidance percutaneous needle biopsy.
Biopsy, Needle ; Female ; Fever ; Histiocytic Necrotizing Lymphadenitis* ; Humans ; Lupus Erythematosus, Systemic* ; Lymph Nodes ; Lymphadenitis ; Lymphatic Diseases ; Neck ; Ultrasonography ; Young Adult

A dieulafoy lesion, which is an unusual cause of gastrointestinal bleeding that can be fatal in children. Dieulafoy lesions are characterized by an abnormally large eroded submucosal artery that is commonly located in the lesser curvature of the proximal stomach. In most cases, permanent hemostasis is achieved by endoscopic epinephrine injection, however, some patients require other endoscopic treatment modalities, embolization or surgery. We report here a case of a Dieulafoy lesion in an 11-year-old boy who had recurrent bleeding from the lesion in the duodenal bulb after endoscopic epinephrine injection and surgical ligation, that was successfully treated using coil embolization.
Arteries ; Child* ; Cytochrome P-450 CYP1A1 ; Embolization, Therapeutic ; Epinephrine ; Hemorrhage ; Hemostasis ; Humans ; Ligation ; Male ; Stomach

A dieulafoy lesion, which is an unusual cause of gastrointestinal bleeding that can be fatal in children. Dieulafoy lesions are characterized by an abnormally large eroded submucosal artery that is commonly located in the lesser curvature of the proximal stomach. In most cases, permanent hemostasis is achieved by endoscopic epinephrine injection, however, some patients require other endoscopic treatment modalities, embolization or surgery. We report here a case of a Dieulafoy lesion in an 11-year-old boy who had recurrent bleeding from the lesion in the duodenal bulb after endoscopic epinephrine injection and surgical ligation, that was successfully treated using coil embolization.
Arteries ; Child* ; Cytochrome P-450 CYP1A1 ; Embolization, Therapeutic ; Epinephrine ; Hemorrhage ; Hemostasis ; Humans ; Ligation ; Male ; Stomach

OBJECTIVE: In order to elucidate the retrogressive degeneration of orofacial cleft, the fissured tissues of prenatal and postnatal cleft lip and palate were examined by histological and immunohistochemical methods. DESIGN: Totally 42 cases of prenatal (n=17) and postnatal (n=25) cleft lip and/or palate were examined in comparison with 10 cases of normal lip and oral mucosa using immunohistochemical stainings of MMP-3, MMP-9, MMP-10, cathepsin G, PCNA, E-cadherin, TGase 2, HSP-70, vWF, and VEGF. MAIN OUTCOME MEASURES: In the fissured tissue the sebaceous glands were strongly positive for PCNA and grew into the underlying fibromuscular tissue (24/42). Some hyperplastic sebaceous glands of prenatal cleft lip produced infundibular follicular cyst (9/17). The skin and mucosal epithelia from the postnatal cleft lip and palate (10/25) showed severe basal hyperplasia (11/25) and melanocyte infiltration (7/25). RESULTS: The immunostaining of MMP-3 and HSP-70 were strongly positive in the hyperplastic sebaceous glands and nearby atrophying muscle bundles of the fissured tissue, while MMP-9, MMP-10, and cathepsin G were almost negative. The immunoreactions of the other antibodies used in this study were similar between in the fissured tissues and in the normal controls. CONCLUSIONS: These data suggest that the over-expression of MMP-3 is closely related to the sebaceous gland hyperplasia, epithelial dysplasia, and the muscle degeneration, and that the over-expression of MMP-3 in the fissured tissue may continuously aggravate the cleft condition in the later life.
Adult ; Antibodies ; Cadherins ; Cathepsin G ; Cleft Lip* ; Follicular Cyst ; Humans ; Hyperplasia ; Lip ; Melanocytes ; Mouth Mucosa ; Outcome Assessment (Health Care) ; Palate* ; Proliferating Cell Nuclear Antigen ; Sebaceous Glands ; Skin ; Vascular Endothelial Growth Factor A

BACKGROUND: Clinical isolates of Escherichia coli were evaluated to determine the prevalence and genotypes of Ambler class A extended-spectrum beta -lactamases (ESBLs). METHODS: Clinical isolates of E. coli were collected from 12 hospitals from February through July, 2004. Antimicrobial susceptibility was tested by disk diffusion and agar dilution methods, and ESBLproduction was determined by double-disk synergy test. TEM, SHV, CTX-M, PER-1, VEB, IBC, GES, and TLA type ESBL genes were detected by PCR amplifications, and the PCR products were subjected to direct sequencing. RESULTS: The double-disk synergy test was positive in 90.9% (149 in 164) of the ceftazidime- or cefotaxime-resistant E. coli isolates. The most prevalent types of Ambler class A ESBLs in E. coliisolates were CTX-M-15 (n=53). CTX-M-14 (n=24), CTX-M-3 (n=9), CTX-M-9 (n=3), CTX-M-12 (n=3), SHV-2a (n=1), SHV-12 (n=5) and TEM-52 (n=3) were also found. CTX-M-12 ESBL had never been reported before in Korea. CONCLUSIONS: CTX-M type ESBL-producing E. coli isolates are spreading and CTX-M-12 is emerging in Korea.
Agar ; beta-Lactamases* ; Diffusion ; Escherichia coli* ; Genotype ; Korea ; Polymerase Chain Reaction ; Prevalence

Emery-Dreifuss muscular dystrophy is characterized by 1) early contractures of the elbows, Achilles tendons, and postcervical muscles, 2) slowly progressive muscle wasting and weakness with a humeroperoneal distribution in the early stages, and 3) cardiomyopathy with conduction defects and risk of sudden death. The inheritance is usually X-linked recessive but can be autosomal dominant and recessive. We report a case of 28-year old woman who presented with dizziness, palpitation, and progressive muscular weakness. Her ECG revealed high degree AV block and muscle biopsy demonstrated diffuse degenerative change consistent with Emery-Dreifuss muscular dystrophy. She was diagnosed as autosomal dominant Emery-Dreifuss muscular dystrophy by characteristic clinical features, and findings of ECG, nerve conduction test, electromyography and muscle biopsy findings. A VVI-type permanent pacemaker was implanted.
Achilles Tendon ; Adult ; Atrioventricular Block* ; Biopsy ; Cardiomyopathies ; Contracture ; Death, Sudden ; Dizziness ; Elbow ; Electrocardiography ; Electromyography ; Female ; Humans ; Muscle Weakness ; Muscles ; Muscular Dystrophy, Emery-Dreifuss* ; Neural Conduction ; Wills