No abstract available.
Deoxycholic Acid* ; Phosphatidylcholines* ; Prurigo*

No abstract available.

Flap survival is critical to the success in reconstructive surgery, there have been many investigations to increase the blood supply to the flaps such as surgical delay and pharmacologic delay. Prostaglandin(PG) is released from various tissues including blood vessel in response to physical stimulus. Among the Prostaglandins, PGE1 has been proven to be a vasodilatation property and many authors have demonstrated its effect to increase blood supply after random cutaneous flap surgery. Clinically, however, muscle flap or musculocutaneous flap is more significantly used in reconstructive surgery and hemodynamic effects of PGE1 of this type of flap are still not documented. The authors designed the random muscle flap to study the hemodynamic effects of PGE1 of the muscle flap. Superior based rectus muscle flap was elevated from rats and the superior epigastric artery, its major vascular pedicle, was ligated to create the random-type muscle flap. Twenty two rats were divided into two experimental groups and each group had 11 rats; Group I: No drugs Group II: PGE1 injection group for 7 postoperative days intraperitoneally The average muscle flap survival rate of group I was 46+/-3.0 precent and it had a higher survival rate than the control group(23+/-4.3%). The muscle flap survival rates showed significant differences between the two groups (p< 0.005) This study shows that the administration of the PGE1, in clinical usage of the rare random muscle flap with a pedicle injury or musculocutaneous flap with the risk of distal cutaneous flap necrosis, such as TRAM flap, which might be much safer and popular.
Alprostadil ; Animals ; Blood Vessels ; Epigastric Arteries ; Hemodynamics ; Myocutaneous Flap ; Necrosis ; Prostaglandins ; Rats* ; Rectus Abdominis* ; Survival Rate ; Vasodilation

OBJECTIVE: The aims of this study were to analyze the natural history of patients with pseudomyxoma peritonei originated from mucinous ovarian tumor, evaluate clinical and pathologic variables, and review our experience with available therapeutic modalities. METHODS: Six patients were treated for pseudomyxoma peritonei originating from mucinous ovarian tumor at Severance Hospital between 1990 and 1998. The data were collected retrospectively and all charts were reviewed RESULTS: The mean age at diagnosis was 51 years, and most common symptoms were abdominal distension. Pseudomyxoma peritonei was found in association with five mucinous ovarian tumors of borderline malignancy, and one ovarian mucinous adenoma. All patients underwent surgical staging and cytoreduction, three patients received postoperative adjuvant chemotherapy and, of these, two developed recurrence. With respect to survival, all patients were alive, four were alive and free of disease, two were alive with disease at the end point of study. CONCLUSION: Pseudomyxoma peritonei is commonly associated with borderline mucinous ovarian tumors, and is a frequently relapsing and protracted disease. But aggressive and repeated debulking surgery is recommended for long survival.
Adenoma ; Chemotherapy, Adjuvant ; Diagnosis ; Humans ; Mucins* ; Natural History ; Pseudomyxoma Peritonei* ; Recurrence ; Retrospective Studies

Autism Spectrum Disorder (ASD) is characterized by persistent deficits in social communication and restricted, repetitive patterns of behavior and interest. Sleep problems are not uncommon in children with autism spectrum disorders. Symptoms of insomnia are the most frequent sleep problems in individuals with ASD. Sleep problems can cause significant difficulties in the daily life of children with ASD and their families. Genetic factor, deregulations of melatonin synthesis, extraneous environmental stimuli and psychiatric and medical conditions may cause sleep problems. The first line treatment of sleep problems in ASD includes managements for potential contributing factors and parent education about sleep hygiene care for child and behavioral therapy. Supplementation with melatonin may be effective before considering other medications, such as risperidone, clonidine, and mirtazapine.
Autistic Disorder* ; Child ; Autism Spectrum Disorder* ; Clonidine ; Education ; Genetics ; Humans ; Hygiene ; Melatonin ; Parents ; Risperidone ; Sleep Initiation and Maintenance Disorders

PURPOSE: This study aimed to examine the impact of alcohol use on the antiretroviral therapy (ART) adherence of Koreans living with human immunodeficiency virus (HIV). METHODS: A total of 144 HIV-infected Koreans older than the age of 19 years who had been receiving antiretroviral drugs for at least 3 months were surveyed. Alcohol use was identified as nonhazardous, binge, hazardous, and alcohol dependent as determined by the Alchol Use Disorder Identification Test-Korea (AUDIT-K). ART adherence was defined according to the components of adherence motivation, adherence knowledge, and 95% medication adherence using the modified Morisky scale. Collected data were analyzed using logistic regression analysis for each component of therapy adherence. RESULTS: Of all participants, 13.9% were binge drinkers, 17.4% were hazardous drinkers, and 4.2% were alcohol dependent. For low adherence motivation, the odds ratio for the hazardous drinkers was 7.47 [95% confidence interval (CI): 1.72–32.41; p = .007] and for the alcohol dependent, it was 12.61 (95% CI: 1.38–115.38; p = .025) when compared with the nonhazardous drinkers. For medication adherence under 95%, the odds ratio for binge drinkers was 4.65 (95% CI: 1.15–18.92; p = .032), for hazardous drinkers was 8.05 (95% CI: 2.08–31.20; p = .003), and for the alcohol dependent was 27.67 (95% CI: 2.12–360.51; p = .011). CONCLUSION: It is recommended that Korean institutions and governments develop specific mediation and counseling programs that include alcohol useerelated monitoring for the improvement of the ART adherence of people living with HIV.
Acquired Immunodeficiency Syndrome ; Alcoholism ; Counseling ; HIV* ; Korea ; Logistic Models ; Medication Adherence ; Motivation ; Negotiating ; Odds Ratio

BACKGROUND: Carbapenem-resistant Enterobacteriaceae (CRE) with acquired metallo β-lactamase (MBL) resistance have been increasingly reported worldwide and associated with significant mortality and morbidity. Here, an outbreak of genetically related strains of Klebsiella pneumoniae producing the imipenemase (IMP)-1 MBL in a medical intensive care unit (MICU) in Korea is reported. METHODS: Since isolating carbapenem-resistant K. pneumoniae (CRKP) at the MICU of the hospital on August 10, 2011, surveillance cultures for CRE in 31 hospitalized patients were performed from August to September 2011. Carbapenem resistance was determined based on the disk diffusion method outlined in the Clinical and Laboratory Standards Institute guidelines. Polymerase chain reaction (PCR) was performed for genes coding for β-lactamase. Associations among isolates were assessed via pulsed-field gel electrophoresis (PFGE). In addition, a surveillance study of environmental cultures and health-care workers (HCWs) was conducted in the MICU during the same time frame. RESULTS: During the study period, non-duplicated CRKP specimens were discovered in four patients in the MICU, suggestive of an outbreak. On August 10, 2011, CRKP was isolated from the sputum of a 79-year-old male patient who was admitted to the MICU. A surveillance study to detect additional CRE carriers by rectal swab revealed an additional three CRKP isolates. PCR and sequencing of the four isolates identified the presence of the IMP-1 gene. In addition, PFGE showed that the four isolated strains were genetically related. CRE was not identified in specimens taken from the hands of HCWs or other environmental sources during surveillance following the outbreak. Transmission of the carbapenemase-producing Enterobacteriaceae strain was controlled by isolation of the patients and strict contact precautions. CONCLUSIONS: This study shows that rapid and systemic detection of CRE and strict infection controls are important steps in preventing nosocomial transmission.
Aged ; Clinical Coding ; Critical Care* ; Diffusion ; Disease Outbreaks ; Drug Resistance, Bacterial ; Electrophoresis, Gel, Pulsed-Field ; Enterobacteriaceae ; Hand ; Humans ; Infection Control ; Intensive Care Units* ; Klebsiella pneumoniae* ; Klebsiella* ; Korea ; Male ; Methods ; Mortality ; Pneumonia ; Polymerase Chain Reaction ; Sputum

PURPOSE: This study was performed to evaluate the dietary nutrient intake status and hair mineral content of Korean young children. METHODS: Fifty-five children who visited Seoul National University Bundang Hospital were divided into three groups by age: infants, toddlers, and preschoolers. The 24-hour recall method was used to collect the food intake data of the subjects. Hair mineral analysis was conducted using a Mass Spectrometer. Serum iron, ferritin, and calcium were also measured. RESULTS: The mean energy intakes of the subjects were 730.3 kcal, 994.3 kcal, and 1,482.9 kcal for each age group. The mean percentage of energy intake compared to recommendation was 101.4% and was not different by age group. Toddlers of 37.8% and preschoolers of 54.5% consumed less than the Estimated Average Requirement (EAR) of calcium. Infants of 28.6%, toddlers of 10.8% and preschoolers of 9.1% consumed less than the EAR of iron. In the case of zinc, copper, and selenium, only 0% to 5% of toddlers and none of the preschoolers consumed less than the EAR of those minerals. The hair calcium, iron and copper concentrations were lower in toddlers and preschoolers than those in infants. Serum calcium levels of preschoolers were significantly lower than those of infants, whereas serum iron and ferritin levels were not. CONCLUSION: Hair calcium, iron, and copper concentrations were significantly lower in toddlers and preschoolers than in infants. Insufficient dietary intake of calcium and iron seems to be related with decreased hair mineral contents in young children.
Calcium ; Child* ; Copper ; Ear ; Eating ; Energy Intake ; Ferritins ; Hair* ; Humans ; Infant ; Iron ; Methods ; Minerals ; Miners* ; Selenium ; Seoul ; Zinc

A 29 kDa cysteine protease of Taenia solium metacestodes was purified by Mono Q anion-exchanger and Superose 6 HR gel filtration chromatography. The enzyme was effectively inhibited by cysteine protease inhibitors, such as iodoacetic acid (IAA) and trans-epoxy-succinyl-L-leucyl-amido (4-guanidino) butane (E-64) while inhibitors acting on serine- or metallo-proteases did not affect the enzyme activity. The purified enzyme degraded human immunoglobulin G (IgG), collagen and bovine serum albumin (BSA), but human IgG was more susceptible for proteolysis by the enzyme. To define the precise biological roles of the enzyme, more detailed biochemical and functional studies would be required.
Taenia solium/*enzymology ; Serum Albumin, Bovine/metabolism ; Leucine/analogs & derivatives/pharmacology ; Iodoacetic Acid/pharmacology ; Immunoglobulin G/metabolism ; Humans ; Cysteine Proteinase Inhibitors/pharmacology ; Cysteine Endopeptidases/chemistry/*isolation & purification/metabolism ; Collagen/metabolism ; Chromatography, Ion Exchange ; Chromatography, Gel ; Animals

A 74-year-old man presented with recurrent vomiting and aspiration pneumonia in the left lower lobe. He entered the intensive care unit to manage the pneumonia and septic shock. Although a percutaneous endoscopic gastrostomy tube was implanted for recurrent vomiting, vomiting and aspiration recurred frequently during admission. Subsequently, he complained of neck pain when in an upright position. A videofluoroscopic swallowing study showed compression of the esophagus by cervical osteophytes and tracheal aspiration caused by an abnormality at the laryngeal inlet. Cervical spine X-rays and computed tomography showed anterior cervical osteophytes at the C3-6 levels. Surgical decompression was scheduled, but was cancelled due to his frailty. Unfortunately, further recurrent vomiting and aspiration resulted in respiratory arrest leading to hypoxic brain damage and death. Physicians should consider cervical spine disease, such as diffuse skeletal hyperostosis as an uncommon cause of recurrent aspiration pneumonia.
Aged ; Bays ; Decompression, Surgical ; Deglutition ; Esophagus ; Gastrostomy ; Humans ; Hyperostosis ; Hypoxia, Brain ; Intensive Care Units ; Neck Pain ; Osteophyte* ; Pneumonia ; Pneumonia, Aspiration* ; Shock, Septic ; Spine ; Vomiting