Torsades de pointes, a polymorphic ventricular tachycardia associated with prolonged QT interval, is a well-known life-threatening arrhythmia, which has been found to be induced by various causes such as drugs, electrolyte imbalances, and severe bradycardia. Cisapride is a gastrointestinal prokinetic drug, which is widely used to treat gastroesophageal reflux disease or other functional gastrointestinal disorders. Cisapride can cause torsades de pointes and cases of torsedes de pointes induced by cisapride have been reported in other countries. Cases of torsades de pointes associated with antihistamine drugs have been reported in Korea, however, cisapride-induced torsades de pointes case has not been reported. We report a case of 31 year-old female patient who experienced repeated loss of consciousness due to cisapride-induced torsades de pointes.
Adult ; Arrhythmias, Cardiac ; Bradycardia ; Cisapride* ; Female ; Gastroesophageal Reflux ; Gastrointestinal Diseases ; Humans ; Korea ; Tachycardia, Ventricular ; Torsades de Pointes* ; Unconsciousness

BACKGROUND: Fungal-bacterial interactions are ubiquitous. Implanted medical devices, including urinary bladder catheters, are particularly susceptible to colonization by Candida spp. and opportunistic bacterial pathogens. Less is known about the fungal side of fungal-bacterial interactions. OBJECTIVE: The aim of the present study was to evaluate the effect of mixed culture on C. albicans and bacteria. METHODS: After C. albicans was incubated either alone or in mixed culture with bacteria (Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii, Staphylococcus aureus, S. epidermidis, Enterococcus faecalis, and E. faecium) in blood agar plate, colony count and diameter were read. Minimum inhibitory concentration (MIC) of C. albicans to fluconazole, itraconazole, and voriconazole were tested by broth microdilution method of the Clinical and Laboratory Standards Institute (CLSI) M27-A3. The expression of target gene (ERG11) was analyzed by RT-PCR using real-time PCR system. RESULTS: When C. albicans and P. aeruginosa were mixed cultured, the colony count of C. albicans significantly decreased (p=0.021). The colony size, MIC, and ERG11 mRNA expression were no significant differences between single and mixed culture. CONCLUSIONS: Further investigations are warranted to understand the fungal-bacterial interaction in order to aid in the design of new strategies for the treatment and prevention of infections.
Acinetobacter baumannii ; Agar ; Bacteria ; Candida albicans* ; Candida* ; Catheters ; Colon ; Enterococcus faecalis ; Fluconazole ; Itraconazole ; Klebsiella pneumoniae ; Methods ; Microbial Sensitivity Tests ; Pseudomonas aeruginosa ; Real-Time Polymerase Chain Reaction ; RNA, Messenger ; Staphylococcus aureus ; Urinary Bladder

BACKGROUND: Candida dubliniensis is phenotypically similar to Candida albicans that may be underdiagnosed in clinical laboratory. In 2010, C. dubliniensis was first recovered from blood of a candidemia patient in Seoul, Korea. Also, a simple commercial latex agglutination (LA) test is available. OBJECTIVE: The aim of the present study was to investigate the prevalence of C. dubliniensis among isolates in our stocks during 2-years period (2010-2011) and to evaluate the ability of LA test (Bichro-Dubli Fumouze®) for the differentiation of C. albicans and C. dubliniensis. METHODS: A total 509 isolates including 504 C. albicans and 5 C. dubliniensis were examined for LA test, the presence of “spiking” on blood agar plate, and the germ tube test. Also all isolates were tested using the VITEK 2 ID-YST system. RESULTS: No C. dubliniensis was found in 504 isolates of initially identified as C. albicans. The LA test was positive only in 5 clinical isolates and 2 type strains of C. dubliniensis. CONCLUSIONS: The data show that the prevalence of C. dubliniensis in Korea is still expected to be extremely low and LA test is very rapid, simple, and reliable tool for the differentiation of C. albicans and C. dubliniensis.
Agar ; Agglutination ; Candida albicans* ; Candida* ; Candidemia ; Humans ; Korea ; Latex Fixation Tests* ; Latex* ; Prevalence ; Seoul

PURPOSE: The purpose of this study was to analyze and clarify the ambiguous concept of DNR, and to distinguish between DNR and euthanasia. METHOD: This study used the process of Walker & Avant's concept analysis. RESULT: The definable attributes of DNR were care for comfort, no further treatment and no CPR. The antecedents of DNR were the autonomy of patients and families feelings about death, the uselessness of treatment and the right to die with dignity. The process of the DNR decision should be documented and the antecedents of DNR also can be a basis for objective standards of DNR decision-making. The result of DNR was the acceptance of death by patients and families. CONCLUSION: DNR is decided and documented by the antecedents of DNR, and the result is a natural acceptance of death, the last process of human life. Hospice care should be activated and nurses must be patient's advocates and families' supporters in the process.
*Attitude to Death ; Decision Making ; Family ; Hospice Care ; Humans ; *Resuscitation Orders

The proliferating trichilemmal cyst is a rare, usually benign tumor of external root sheath origin. About 90% of the cases gccur on the scalp, with the residual 10% occurring mainly on the back. More than 80% of the patients are women, most of whom are elderly. The cysts are commonly large, measuring up to 6 cm or more in diameter. A 33-year-old woman visited our department with a history of a matchhead- sized erythematous tender papule on her left knee that had been present for two years. A histopathological examination revealed a well-circumscribed, multilobulated cystic tumor with trichilemmal keratinization in the dermis. There were individual cell keratinization and focal calcification in some areas. This case was diagnosed as a proliferating trichilemmal cyst. This case was very unusual not only because the tumor occurred on the knee as a matchhead-sized papule but also because of her young age at presentation.
Adult ; Aged ; Dermis ; Female ; Humans ; Knee ; Scalp

PURPOSE: The purpose of this study was to identify the relationship between the degree of support from the spouse and the degree of health promoting behavior among the patients with a mastectomy or both mastectomies. METHODS: This study used a descriptive research design. The Participants with a mastectomy or both mastectomies were 224 patients. Data were collected though a structured questionnaire from June to October, 2013. The utilized measurements were Support of Spouse and The Health Promoting Life Profile II. The data were analyzed using descriptive statistics, t-test, ANOVA, and Pearson's correlation coefficients. RESULTS: The mean scores in support of spouse (3.69+/-0.91) and health promoting behavior (2.89+/-0.48) by perception of patients with mastectomy were moderate. The degree of support from the spouse was positively related to five health promoting behaviors; spiritual growth (r=.54, p<.001), stress management (r=.47, p<.001), health responsibility (r=.31, p<.001), interpersonal relations (r=.32, p<.001), nutrition (r=.16, p=.017), except physical activity (r=.09 p=.184). CONCLUSION: It is necessary to educate patients and their spouses about health management after mastectomy to overcome long-term treatment and to improve the quality of life for the patient and spouse.
Breast Neoplasms* ; Health Promotion ; Humans ; Interpersonal Relations ; Mastectomy* ; Motor Activity ; Quality of Life ; Research Design ; Spouses*

No abstract available.
Adolescent* ; Female* ; Humans

PURPOSE: The purpose of this study was to explore the resilience of adult children of alcoholics (ACOA) who are college students, and examine factors contributing to their resilience. METHODS: A total of 459 college students from a university in Incheon, participated in this study. Data were collected between April 6 to 30, 2010 using the Korean version of the Children of Alcoholics Screening Test (CAST-K), CAGE, Social Support, Self-Esteem, Family Adaptability and Cohesion, and Resilience measurements. Data were analyzed using the SPSS/WIN 18.0 program. RESULTS: Overall, ACOA group showed lower scores of resilience, social support, self-esteem and family adaptability and cohesion compared to non-ACOA group. Resilience among the ACOA group showed significant relationships with self-esteem (r=.53, p<.001), social support (r=.43, p<.001), and family adaptability and cohesion (r=.25, p<.013). Multiple regression analysis showed that 45% of the variance for resilience in the ACOA group was accounted for by age, gender, social support, self-esteem, and religion. CONCLUSION: The results of the study show that self-esteem and social support are important determinants of resilience in ACOA, thus it is recommend that further resilience training programs for ACOA be developed to enhance their social support and self-esteem, and ultimately to increase their resilience.
Adaptation, Psychological ; Age Factors ; *Alcoholics ; Female ; Humans ; Male ; Questionnaires ; *Resilience, Psychological ; Self Concept ; Sex Factors ; Social Support ; Students/*psychology ; Young Adult

BACKGROUND: Antifungal susceptibility testing methods are relatively expensive and laborious and are not easily applicable for screening purposes in routine laboratories. OBJECTIVE: We have developed a susceptibility screening method by adding fluconazole to Sabouraud dextrose agar (SDA) plate. In this study, SDA plates screening was compared with the Clinical and Laboratory Standards Institutes (CLSI) broth microdilution method for determining fluconazole susceptibility of Candida spp. METHODS: A total 186 isolates of Candida spp. (134 C. albicans, 24 C. tropicalis, 15 C. glabrata, 13 C. parapsilosis) were tested with the CLSI document M27-A2 method and fluconazole-containing SDA plate (0, 8, 16 microgram/mL of fluconazole). By this method, colony count and diameter were read after 24 hr of incubation. RESULTS: Fluconazole-susceptible Candida spp. are significantly smaller (> or =50%) on SDA with fluconazole than on fluconazole-free SDA. On SDA with 8 and 16 microgram of fluconazole per mL, 80.7% (150/186) and 87.1% (162/186) of isolates were correctly predicted, respectively. CONCLUSIONS: These data suggest that the fluconazole-containing SDA plates can be used as a routine screening procedure for susceptibility of Candida spp. in clinical laboratories.
Academies and Institutes ; Agar ; Candida ; Fluconazole ; Glucose ; Mass Screening

OBJECTIVES: This study was designed to assess the epidemiology of DSM-IV posttraumatic stress disorder(PTSD), including information on lifetime and current prevalence, the kinds of traumas most often associated with PTSD, and sociodemographic correlates. METHOD: For this survey, an urban area with total population of 611,921 persons was chosen. Modified version of traumatic event checklist and Clinician Administered PTSD Scale were administrated to a representative sample of 850 persons aged 15 to 65 years above through home visiting. RESULTS: The lifetime and current prevalence of PTSD in survey area was 4.71% and 2.12%. the lifetime and current prevalence in male and female were of no significant statistical differences(p>.05). And the lifetime prevalence by age, and education were of no significant statistical differences. Only the lifetime prevalence by marital status was of significant statistical differences(p<0.001). The lifetime prevalence to any traumatic exposure was 78.79%. Sudden unexpected death of a close person was the most prevalent traumatic event(51.06%). Among the traumas, natural disaster, fire and explosion, motor vehicle accident, serious accident at work or home, physical assault, assault with a weapon, combat, life-threatening illness, and serious injury to death you caused to someone else were more commonly associated with male sex, and sexual assault was more commonly associated with female sex. The traumas commonly associated with PTSD were natural disaster, fire and explosion, motor vehicle accident, serious accident at work or home, physical assault, sexual assault, combat, and life-threatening illness. CONCLUSION: The lifetime and current prevalence in survey area were lower than those of previous studies. This study found differences between men and women on the type of trauma experienced, and the type of trauma associated with PTSD. Future epidemiological studies to assess PTSD from all lifetime traumas rather than from only a small number of retrospectively reported ones will be required, and larger sample size covering the country will be required for better estimation.
Checklist ; Diagnostic and Statistical Manual of Mental Disorders ; Disasters ; Education ; Epidemiologic Studies* ; Epidemiology ; Explosions ; Female ; Fires ; House Calls ; Humans ; Male ; Marital Status ; Motor Vehicles ; Prevalence ; Retrospective Studies ; Sample Size ; Stress Disorders, Post-Traumatic* ; Weapons