PURPOSE: Recently, vancomycin-resistant enterococci (VRE) have become one of the major nosocomial pathogens in Korea. However, there have been few studies on the epidemiology of VRE colonization among neonates. In this study, we investigated the prevalence of VRE colonization, risk factors for VRE, and how to control the spread of VRE infection in the Neonatal Intensive Care Unit (NICU) of Pusan National University Hospital (PNUH). METHODS: We retrospectively reviewed medical records of 192 neonates who were admitted to the NICU of PNUH from March 2006 to March 2007. Surveillance cultures from rectal swabs for detecting VRE were obtained weekly during the study period. We analyzed the prevalence of VRE and various risk factors. RESULTS: The rate of VRE colonization among NICU patients was 25% (48/192). Thirty five of these VRE colonized patients were transferred to the NICU from other local hospitals. Compared with the non-VRE group, the risk factors associated with VRE colonization were lower birth weight, congenital heart disease, applied mechanical ventilation, use of a central venous catheter, chest tubing, a history of surgery, and use of antibiotics. CONCLUSION: VRE colonization among patients admitted to the NICU is rapidly increasing. Monitoring and managing premature neonates from the beginning of the birth process, avoiding many invasive procedures, avoiding antibiotics such as vancomycin and third generation cephalosporin are important for preventing the emergence and spread of VRE colonization in the NICU.
Anti-Bacterial Agents ; Birth Weight ; Central Venous Catheters ; Colon ; Heart Diseases ; Humans ; Infant ; Infant, Newborn ; Intensive Care, Neonatal ; Korea ; Medical Records ; Parturition ; Prevalence ; Respiration, Artificial ; Retrospective Studies ; Risk Factors ; Thorax ; Vancomycin ; Vancomycin Resistance

In Asia, mammography following the injection of foreign materials into the breasts for cosmetic augmentation is frequently seen and diagnosis based on the typical radiologic findings is straightforward. We report the unusual radiologic findings in two patients with foreign body granulomas caused by injected foreign materials and discovered incidentally during screening work up. The mammographic findings were bilateral, hyperdense, spiculated masses, with occasional microcalcification, and at sonography, markedly hypoechoic, spiculated solid masses, located near the pectoralis muscle and partly extending into it, were observed. These radiologic findings mimicked malignancy.
Breast Neoplasms/radiography ; Case Report ; Cholesterol ; Diagnosis, Differential ; Esthetics ; Female ; Granuloma, Foreign-Body/etiology/*radiography/*ultrasonography ; Human ; Injections/adverse effects ; Mammography ; Middle Age ; Paraffin

A clinico-pathologic study with an immunohistochemical examination for c-erbB-2 expression in 54 cases of ductal carcinoma in situ and 16 cases of Paget's disease of the breast was performed. c-erbB-2 oncoprotein overexpression was observed in 45% (24/54) and 88% (14/16) of ductal carcinoma in situ and Paget's disease, respectively. The overexpression of c-erbB-2 oncoprotein was significantly correlated with the nuclear grade of tumors and inversely with the status of the estrogen receptor. c-erbB-2 was positive in 4 out of 5 patients with metastasis to axillary lymph nodes and 3 out of 4 patients who died of the disease. Prognostic significance of c-erbB-2 oncoprotein in ductal carcinoma in situ was highly suggested. The expression of c-erbB-2 oncoprotein in Paget's disease was well correlated with coexisting infiltrating or in situ ductal carcinoma. The high positive rate of c-erbB-2 oncoprotein in ductal carcinoma with Paget's disease could be understood with a recent hypothesis that c-erbB-2 oncoprotein is involved in promotion of cell motility and the spread of carcinoma cells.
Neoplasm Metastasis

A case of clear cell adenocarcinoma arising in the female urinary bladder, which is accompanied by endometriosis of the urinary bladder and the uterus, is reported. The carcinoma protruded into the vesical lumen as a fungating mass, and had a tubulocyotic pattern. The tumor cell had intracytoplasmic glycogen and electron microscopically short microvilli on their surface, resembling clear cell acenocarcinoma of the female genital tract including ovary. This is the fourth case report of clear cell adenocarcinoma complicating vesical endometriosis, and may support the view that clear cell carcinome arises from endometriosis which, in turn, from the Mullerian remnant.
Female ; Humans ; Adenocarcinoma

A case of clear cell adenocarcinoma arising in the female urinary bladder, which is accompanied by endometriosis of the urinary bladder and the uterus, is reported. The carcinoma protruded into the vesical lumen as a fungating mass, and had a tubulocyotic pattern. The tumor cell had intracytoplasmic glycogen and electron microscopically short microvilli on their surface, resembling clear cell acenocarcinoma of the female genital tract including ovary. This is the fourth case report of clear cell adenocarcinoma complicating vesical endometriosis, and may support the view that clear cell carcinome arises from endometriosis which, in turn, from the Mullerian remnant.
Female ; Humans ; Adenocarcinoma

The purpose of this study was to evaluate the status of sanitary management based on HACCP. The surveys which were on various aspects of general characteristics, food handling practice, personal sanitation, equipment sanitation, and equipment possession were carried out using questionnaires for 146 business and industry foodservice operations in Taegu and Kyungpook areas. The results of this study were summarized as follows. Forty-nine percent of surveyed foodservice operations was in Taegu, 51% in Kyungpook and 69.2% in direct foodservice operations and 28.1% in contracted foodservice operations. Seventy-eight percent of foodservice operations replied that they have done only basic sanitary management, while 13% surveyed stated that they were implementing HACCP. Food handling practice and personal sanitation were significantly better in Kyungpook area than in Taegu. Significantly high levels in food handling practice, personal sanitation, equipment sanitation, and equipment possession were seen in foodservice operations which had more than 1,000 meal served than those which had less than 1,000 meals served. According to the results of food handling practice, in items of food-temperature measurement during receiving, cooking, holding after cooking, and reheating, foodservice operations showed very low scores below the average. All foodservice operations presented good scores in the parts of personal and equipment sanitation. In equipment possession, sterilizing systems were generally not enough, dishwasher and sterilizing facilities of contracted foodservice operation showed significantly high scores. Therefore, the business and industry foodservice operations will have to pay special attention to temperature management in the foodservice production process as the first step to implement of HACCP.
Commerce* ; Cooking ; Daegu* ; Food Handling ; Gyeongsangbuk-do* ; Hazard Analysis and Critical Control Points* ; Humans ; Meals ; Surveys and Questionnaires ; Sanitation

We report herein the case of a 38-year-old woman with Cushings syndrome caused by bilateral adrenocortical adenomas. The adrenal tumor on the left side hypersecreted cortisol and no findings of cortisol hypersecretion from the adrenal tumor on the right side were observed on bilateral adrenal vein samplings. Both adrenal tumors were resected and histologically without any findings of nodular hyperplasia. The left adrenal tumor was histologically diagnosed as a so-called black adenoma. These data imply that the adrenal adenomas developed primarily from the adrenal gland itself, and that one of the tumors was well differentiated and secreted excess hormones, while the other remained in cell proliferation without hypersecretion.
Adenoma* ; Adrenal Glands ; Adrenocortical Adenoma* ; Adult ; Cell Proliferation ; Cushing Syndrome* ; Female ; Humans ; Hydrocortisone ; Hyperplasia ; Veins

Adenosquamous carcinoma of the liver is a rare variant of cholangiocarcinoma. It is known to be a highly aggressive tumor with a poor prognosis, but its pathogenesis remains unclear owing to limited data in the literature. We report a case of 56-year-old woman who presented with a 1-week history of epigastric pain. Magnetic resonance imaging revealed a 6.5-cm ill-defined mass with low signal intensity in the left lobe of the liver, which was suspicious of cholangiocarcinoma. The patient underwent left hemihepatectomy. Microscopically, the tumor consisted of malignant glandular and squamous components and staged as pT2aN1. Despite postoperative chemoradiation, the patient had recurrence 8 months after surgery.
Abdomen/diagnostic imaging ; Carcinoma, Adenosquamous/diagnostic imaging/*pathology ; Cholangiopancreatography, Endoscopic Retrograde ; Female ; Gallstones/surgery ; Humans ; Liver Neoplasms/diagnostic imaging/*pathology ; Middle Aged ; Sphincterotomy, Endoscopic ; Tomography, X-Ray Computed

PURPOSE: Whereas allergic disease has the high morbidity during preschool age, there have not been sufficient surveys among the children in that age group. Thus we evaluated the prevalence of allergic disease among pre-school age children and risk factors which could cause or aggravate the disease. METHODS: A questionnaire survey was conducted among 593 kindergarten children, from 5 different kindergartens in Seoul between May and June, 2004. The standard for prevalence was whether one had been treated for allergic disease in past 12 months. Parents or guardians were surveyed to answer for each risk factor. RESULTS: For a question, "Have you been treated for allergic disease during past 12 months?", asthma showed 3.9% prevalence. For allergic rhinitis and atopic dermatitis were 11.1% and 20.1% respectively. Children with at least one of three diseases were 29.7%. Among children with asthma, risk factors were past history of bronchiolitis and paternal history of allergic disease. For allergic rhinitis, they were past history of bronchiolitis, mother's high education, and maternal history of allergic disease. For atopic dermatitis, risk factors were history of allergic disease of mother and father only. Other possible risk factors were statistically insignificant. CONCLUSION: Compared to the prevalence of primary school children (1995, 2000), asthma showed no difference but allergic rhinitis was lower and atopic dermatitis was higher. Among pre-school children, risk for allergic disease was higher with parental history of allergic disease. Especially the risk for respiratory allergy was even higher for those children with history of bronchiolitis.
Asthma ; Bronchiolitis ; Child* ; Dermatitis, Atopic ; Education ; Fathers ; Humans ; Hypersensitivity ; Korea* ; Mothers ; Parents ; Prevalence* ; Surveys and Questionnaires ; Rhinitis ; Risk Factors ; Seoul

No abstract available.
Chickens* ; Yolk Sac*