BACKGROUND: Several antibiotics can be used to treat ventilator-associated pneumonia caused by carbapenem-resistant A. baumannii (CRAB-VAP) including high-dose sulbactam. However, the effectiveness of high-dose sulbactam therapy is not well known. We report our experience with high-dose sulbactam for treatment of CRAB-VAP. METHODS: Medical records of patients with CRAB-VAP who were given high-dose sulbactam between May 2013 and June 2015 were reviewed. RESULTS: Fifty-eight patients with CRAB-VAP were treated with high-dose sulbactam. The mean age was 72.0 ± 15.2 years, and the acute physiology and chronic health evaluation II (APACHE II) score was 15.1 ± 5.10 at the time of CRAB-VAP diagnosis. Early clinical improvement was observed in 65.5% of patients, and 30-day mortality was 29.3%. Early clinical failure (odds ratio [OR]: 8.720, confidence interval [CI]: 1.346-56.484; p = 0.023) and APACHE II score ≥ 14 at CRAB-VAP diagnosis (OR: 10.934, CI: 1.047-114.148; p = 0.046) were associated with 30-day mortality. CONCLUSIONS: High-dose sulbactam therapy may be effective for the treatment of CRAB-VAP. However, early clinical failure was observed in 35% of patients and was associated with poor outcome.
Acinetobacter baumannii* ; Acinetobacter* ; Anti-Bacterial Agents ; APACHE ; Diagnosis ; Humans ; Medical Records ; Mortality ; Pneumonia, Ventilator-Associated* ; Sulbactam*

OBJECTIVE: Many studies have showed that excess or lack of sexual hormones, such as prolactin and testosterone, induced the sexual dysfunction in humans. Little, however, is known about the role of sexual hormones showing normal range in, especially, the basal state unexposed to any sexual stimulation. We hypothesized sexual hormones in the basal state may affect sexual behavior. METHODS: We investigated the association of the sexual hormones level in the basal hormonal state before visual sexual stimulation with the sexual response-related brain activity during the stimulation. Twelve heterosexual men were recorded the functional MRI signals of their brain activation elicited by passive viewing erotic (ERO), happy-faced (HA) couple, food and nature pictures. Both plasma prolacitn and testosterone concentrations were measured before functional MR scanning. A voxel wise regression analyses were performed to investigate the relationship between the concentration of sexual hormones in basal state and brain activity elicited by ERO minus HA, not food minus nature, contrast. RESULTS: The plasma concentration of prolactin in basal state showed positive association with the activity of the brain involving cognitive component of sexual behavior including the left middle frontal gyrus, paracingulate/superior frontal/anterior cingulate gyri, bilateral parietal lobule, right angular, bilateral precuneus and right cerebellum. Testosterone in basal state was positively associated with the brain activity of the bilateral supplementary motor area which related with motivational component of sexual behavior. CONCLUSION: Our results suggested sexual hormones in basal state may have their specific target regions or network associated with sexual response.
Brain ; Cerebellum ; Dopamine ; Heterosexuality ; Humans ; Magnetic Resonance Imaging ; Male ; Plasma ; Prolactin ; Reference Values ; Sexual Behavior ; Testosterone

OBJECTIVES: The aim of this study was to test the reliability and validity of the Korean version of Interpersonal Reactivity Index (K-IRI). METHODS: A total of 484 participants were included in this study. Internal consistency and test/retest reliability (n=35) were examined. Criterion validity of the K-IRI was assessed against Affective Dimension of the 3D-Wisdom Scale. Factor analyses were also performed using principal component analysis with varimax rotation. RESULTS: The internal consistency of the K-IRI was 0.80, and test-retest reliability was 0.76. Criterion validity was evaluated by correlating the K-IRI with the Affective Dimension of 3D-Wisdom Scale (r=0.31). Factor analyses revealed factor structures similar to the original IRI. CONCLUSION: The K-IRI appeared to be a reliable and valid instrument for assessing empathy in the Korean population. This suggests that this scale may be applicable in clinical trials, research, and clinical practice.
Empathy ; Principal Component Analysis ; Reproducibility of Results

OBJECTIVE: The aim of this preliminary collaborative study was to assess the clinical characteristics, management, and outcome of epidural hematoma (EDH) based on the data collected and registered in the Korean Trauma Data Bank System (KTDBS). METHODS: Of 2,698 patients registered in the KTDBS between September 2010 and March 2014, 285 patients with EDH were analyzed. Twenty-three trauma centers participated in the study voluntarily to collect data. We subcategorized the patients into two groups with good and poor outcomes. Various clinical characteristics and the time intervals with regard to treatment course were investigated to determine the relationship between these parameters and the functional outcome. RESULTS: Of multiple parameters for this analysis, older age (p=0.0003), higher degree of brain injury (p<0.0001), cases of surgical EDH (p<0.0001), time interval from trauma to hospital before 6 hours, and the decreasing pattern of Glasgow Coma Scale (GCS) between and initial and final GCS were strongly associated with poor outcome. Use of prophylactic anticonvulsant did not affect the functional outcome. There was an interesting difference in the use of mannitol in treating EDH between the urban and rural regions (p<0.0001). CONCLUSION: This is the first multi-center analysis of etiology of injury, pre-hospital care, treatment, and functional outcome of EDH in Korea. The degree of brain injury and the GCS difference were notable factors that were significant in determining the functional outcome of EDH.
Brain Injuries ; Glasgow Coma Scale ; Hematoma* ; Hematoma, Epidural, Cranial ; Humans ; Korea* ; Mannitol ; Republic of Korea ; Trauma Centers

OBJECTIVE: The results for finding the deficit in the anterior cingulate (ACC) in schizophrenic patients (SZ) have been inconsistent according to the studies that used different Stroop tasks, which is unlike the deficit in the dorsolateral prefrontal cortex (DLPFC). In order to explore for the core region that's responsible for the selective attention deficit in SZ, we examined the results of a functional neuroimaging study, which involved the performance of the Stroop task using high or low prefrontal cortex related loads in SZ. METHODS: Ten schizophrenic patients and healthy controls (HC) received functional magnetic resonance imaging (fMRI) during a Short/Long-term latency Stroop task. The changes in the neural activity were determined in well-known Stroop related regions of interest (ROIs) that consisted of the DLPFC, ACC, the parietal lobule and in the whole brain regions for both the main and interaction effects of latency, and the results of the short-term and long-term latency Stroop conditions were compared. RESULTS: The response times for both the congruency and latency effects were more prolonged in the schizophrenics than in the HC. For the congruency effect, the schizophrenics showed significantly less activation in the same site of the left DLPFC in both the short-term and long-term latency conditions, as compared with the HC. For the latency effect, the regions of the left-side language network were over- or under-activated in the schizophrenics, as compared with the HC. Any interaction effect was not found for both the behavioral and fMRI results. CONCLUSION: Our results indicate that the deficit in the left DLPFC is the core impairment of attentional processing in schizophrenics, regardless of other possible interactions such as the latency effect.
Brain ; Functional Neuroimaging ; Humans ; Magnetic Resonance Imaging ; Prefrontal Cortex* ; Rabeprazole ; Reaction Time ; Schizophrenia*

OBJECTIVE: Emoticon as well as face is a tool for the communication of emotion. However, little is known about behavioral response to emoticon, unlike face. To explore the characteristics of behavioral response of emoticon and face, we measured both response time and accuracy in healthy young subjects. METHODS: The 29 subjects were asked to respond to emoticons or faces which contained one among happy, sad, angry/fearful or neutral emotion. Using univariate analysis of variance, behavioral responses were analyzed for three main effects of stimulation (face, emoticon), emotion (happy, sad, angry/fearful, neutral), gender (male, female) and also their interactions. RESULTS: The response to face was faster and more accurate than that to emoticon. Female's response to face, not to emoticon, was faster than male. A common finding of face and emoticon stimuli was that their responses were slower and less accurate in angry/fearful condition than in the rest emotional ones. There was not any interaction among three factors. The different finding was that neutral condition was less informative in only emoticon, not in face, condition. CONCLUSION: Our results demonstrated emoticon is different from face in terms of the characteristics in the transfer ability of emotion and in gender effect.
Humans ; Male ; Reaction Time ; Transfer (Psychology)

OBJECTIVES : A neural circuit including amygdala, the hippocampal complex and prefrontal cortex was associated with deficits in facial processing in schizophrenia. These deficits have a significant impact on social functioning in schizophrenia. Both neuropsychological deficits and brain structural abnormalities in first-degree relatives of schizophrenia patients suggest that they may also have the deficit in facial information processing as genetic factors. The purpose of this study was to explore the dysfunction of facial information processing in first-degree relatives of schizophrenia patients using functional magnetic neuroimaging (fMRI). METHODS : Ten non-affected siblings of schizophrenic patients and 10 normal comparison subjects having no schizophrenic siblings underwent fMRI during the d ynamic facial change procedure consisting of presentations of facial emotion and gender discrimination stimuli. The emotion discrimination condition consisted of the presentation of 12 happy faces and 12 disgust/fear faces. The gender discrimination condition consisted of the presentation of 12 male faces and 12 female faces. Condition-specific brain activations were compared between non-affected siblings and normal comparison subjects RESULTS : The facial information processing related brain regions including fusiform gyrus, several areas of frontal, temporal, occipital, and cerebellar regions exhibited more activation during gender discrimination than emotion discrimination tasks in each group. During gender discrimination task, siblings of schizophrenic patients showed less activation in right fusiform gyrus, both middle and superior frontal gyrus, left cuneus, and left inferior frontal gyrus, compared with normal comparison subjects. CONCLUSION : Dysfunctional facial information processing, such as a deficit in gender discrimination, might be an endophenotype of schizophrenia.
Amygdala ; Automatic Data Processing ; Brain ; Discrimination (Psychology) ; Endophenotypes ; Female ; Humans ; Magnetic Resonance Imaging ; Magnetics ; Magnets ; Male ; Neuroimaging ; Prefrontal Cortex ; Schizophrenia ; Siblings

Background: Most previous studies have evaluated flexion strength to assess recovery after arthroscopic rotator cuff (RC) repair.However, limited data are available regarding peak torque at the initial angle (iPT) because most studies have measured flexion strength for peak torque (PT), particularly in small- and medium-sized supraspinatus tears. The purpose of this study was to compare conventional PT and iPT to evaluate supraspinatus muscle strength after arthroscopic RC repair in patients with small- and medium-sized supraspinatus tears. Methods: Isokinetic muscle performance testing was performed in 42 patients with small tears and in 47 patients with medium-sized tears. PT and iPT were evaluated before and 1 year after surgery and were recorded at an angular velocity of 60°/sec and 180°/sec with an isokinetic test. Results: PT and iPT were significantly lower in the involved-side shoulders than in the uninvolved-side shoulders (PT: small tear, p < 0.001; medium tear, p < 0.001; iPT: small tear, p < 0.001; medium tear, p < 0.001) in both groups, preoperatively. However, postoperatively, in the involved-side shoulders, PTs were not different in both small- and medium-sized tears (all p > 0.05), but iPTs were significantly lower in the involved-side shoulders (small tear, p < 0.001; medium tear, p < 0.001). iPT was significantly lower in the involved side shoulders in the medium-sized tear group than in the small-sized tear group before and after surgery (p < 0.05). In the smalland medium-sized tear groups, tear size was significantly correlated with preoperative iPT in the involved-side shoulders (small tear: r = –0.304, p = 0.046; medium tear: r = –0.323, p= 0.027). However, pain visual analog scale was significantly correlated with preoperative (small tear: r = –0.455,p = 0.002; medium tear: r = –0.286, p = 0.044) and postoperative (small tear: r = –0.430, p = 0.005; medium tear: r = –0.354, p = 0.021) iPT in the involved-side shoulders. Furthermore, fatty infiltration grade of the supraspinatus muscle and global fatty degeneration index were not associated with preoperative and postoperative PT and iPT in each group (all p > 0.05). Conclusions iPT is as important as conventional PT in isokinetic testing to assess supraspinatus muscle strength before and after RC repair.

This paper aims to demonstrate current health expenditure (CHE) and National Health Accounts of the years 2018 constructed according to the SHA2011, which is a manual for System of Health Accounts (SHA) that was published jointly by the Organization for Economic Cooperation and Development (OECD), Eurostat, and World Health Organization in 2011. Comparison is made with international trends by collecting and analyzing health accounts of OECD member countries. Particularly, scale and trends of the total CHE financing as well as public-private mix are parsed in depth. In the case of private financing, estimation of total expenditures for (revenues by) provider groups (HP) is made from both survey on the benefit coverage rate of National Health Insurance (by National Health Insurance Service) and Economic Census and Service Industry Census (by National Statistical Office); and other pieces of information from Korean Health Panel Study, etc. are supplementarily used to allocate those totals into functional classifications. CHE was 144.4 trillion won in 2018, which accounts for 8.1% of Korea's gross domestic product (GDP). It was a big increase of 12.8 trillion won, or 9.7%, from the previous year. GDP share of Korean CHE has already been close to the average of OECD member countries. Government and compulsory schemes' share (or public share), 59.8% of the CHE in 2018, is much lower than the OECD average of 73.6%. ‘Transfers from government domestic revenue’ share of total revenue of health financing was 16.9% in Korea, lower than the other social insurance countries. When it comes to ‘compulsory contributory health financing schemes,’ ‘transfers from government domestic revenue’ share of 13.5% was again much lower compared to Japan (43.0%) and Belgium (30.1%) with social insurance scheme.
Belgium ; Censuses ; Classification ; Gross Domestic Product ; Guanosine Diphosphate ; Health Expenditures ; Healthcare Financing ; Japan ; Korea ; National Health Programs ; Organisation for Economic Co-Operation and Development ; Social Security ; World Health Organization

PURPOSE: The purpose of this study was to compare the cutting method and the lamination method to investigate whether the CAD data of the proposed inlay shape are machined correctly. MATERIALS AND METHODS: The Mesial-Occlusal shape of the inlay was modeled by changing the stereolithography (STL). Each group used SLS (metal powder) or SLA (photocurable resin) in the additive method, and wax or zirconia in the subtractive method (n=10 per group, total n=40). Three-dimensional (3D) analysis program (Geomagic Control X inspection software; 3D systems) was used for the alignment and analysis. The root mean square (RMS) in the 2D plane state was measured within 50 µm radius of eight comparison measuring points (CMP). Differences were analyzed using one-way analysis of variance and post-hoc Tukey's test were used (α=.05). RESULTS: There was a significant difference in RMS only in SLA and SLS of 2D section (P < .05). In CMP mean, CMP 4 (−5.3±46.7 µm) had a value closest to 0, while CMP 6 (20.1±42.4 µm) and CMP 1 (−89.2±61.4 µm) had the greatest positive value and the greatest negative value, respectively. CONCLUSION: Since the errors obtained from the study do not exceed the clinically acceptable values, the lamination method and the cutting method can be used clinically.
Inlays ; Methods ; Radius