No abstract available.
Apoptosis ; Cell Aging ; Humans ; Keratinocytes ; Tretinoin

No abstract available.
Korea* ; Lung*

OBJECTIVES: The aim of this study was to evaluate the caries preventive effects of oral health programs composed of pit and fissure sealant and community water fluoridation in Hapcheon-Up, Hapcheon-Gun, the Republic of Korea. METHODS: Dental surveys were conducted on 6 to 14 year old children at Hapcheon-Up, Hapcheon-Gun in 2000 and 2009, respectively. The number of the subjects was 1,957 and 1,535 children in 2000 and 2009, respectively. The percentage of samples among total population aged 6 to 14 years in 2000 and 2009 was 90.6% and 92.3%, respectively. The obtained data from these surveys were analyzed with the PASW statistical package version 18.0 (SPSS Inc., Chicago, IL, USA). The 2009 dental health data including the prevalence of dental caries and fissure sealants on children's permanent teeth was compared to the 2000 dental health data, and assessed using chi-square test and independent-sample t-test. RESULTS: DMF rate of 12-year olds was 76.9% in 2000, and it significantly decreased to 42.5% in 2009. DMFT index of 12-year olds was 3.03 in 2000, and it significantly decreased to 1.07 in 2009. The prevalence rate of sealed permanent teeth among the 12-year olds was 15.4% in 2000, and it significantly increased to 97.2% in 2009. The caries reduction rate from pit and fissure sealant added by community water fluoridation program was calculated as 44.7% in 12-year olds by the difference of DMFT index between 2000 and 2009 year. Logistic regression analysis revealed that both programs were associated with an increasing likelihood of experiencing no dental caries (OR=4.00, 95% CI; 3.23-4.95). CONCLUSIONS: These results suggest that the oral health program composed of pit and fissure sealant and community water fluoridation in Hapcheon was very effective in caries prevention. The program should be expanded to other area to prevent dental caries among children.
Aged ; Chicago ; Child ; Dental Caries ; DMF Index ; Fluoridation ; Humans ; Logistic Models ; Oral Health ; Pit and Fissure Sealants ; Prevalence ; Tooth

Nosocomial Legionnaires' disease has often been documented to occur in immunocompromised patients and to be severe, potentially fatal, pneumonia. We report a case of fatal nosocomial Legionnaires' disease developed shortly after steroid pulse therapy. A 39-year old woman with systemic lupus erythematosus was admitted via emergency room due to generalized edema and gross hematuria. Under the diagnosis of lupus nephritis, she was given intravenous steroid pulse therapy for 3 days and then maintained with oral prednisolone. On the 7th day of admission the patient's conditions got worse with progression to acute renal failure and respiratory difficulty. On the 10th day of admission when she was started on hemodialysis, chestradiograph showed newly developed multifocal mass-like consolidations on both lung fields. In spite of empirical therapy with roxithromycin and rifampin, the consolidations were aggravated and rapidly extended to both whole lung fields. On the 15th day of admission she was mechanically ventilated due to respiratory failure, but died of hypoxia and shock on the 19th day. Later, a legionella species was isolated from the tracheal aspirates and identified as L. pneumophila serogroup 1. We also detected L. pneumophila from the tracheal aspirates by duplex PCR which amplified both 5S rRNA and mip genes of L. pneumophila.
Acute Kidney Injury ; Adult ; Anoxia ; Diagnosis ; Edema ; Emergency Service, Hospital ; Female ; Hematuria ; Humans ; Immunocompromised Host ; Legionella pneumophila* ; Legionella* ; Legionnaires' Disease* ; Lung ; Lupus Erythematosus, Systemic ; Lupus Nephritis ; Pneumonia ; Polymerase Chain Reaction ; Prednisolone ; Renal Dialysis ; Respiratory Insufficiency ; Rifampin ; Roxithromycin ; Shock

BACKGROUND: Because of the ubiquity of Legionella species in aquatic environments, molecular epidemiological analysis of Legionella isolates is important in investigation for source of infection and subsequent control of nosocomial legionellosis. In association with an unusual cluster of nosocomial pneumonia with Legionella in a tertiary-care hospital, we performed an environmental surveillance with molecular epidemiological study of Legionella isolates. METHODS: We randomly collected 20 samples of environmental and portable water from the hospital where three cases of Legionella pneumonia occurred consecutively during the period of 5 months. We detected Legionella from the samples by using both culture and polymerase chain reaction(PCR), and analyzed Legionella isolates from patients and environmental samples together with 12 reference strains by ribotyping using HpaI and EcoRI. RESULTS: Legionella was isolated from 3 out of 20(15%) samples by culture, and detected in 9 of 20(45%) by PCR. Ribotyping analysis showed that 2 patients' and 2 environmental isolates from a faucet of the patient's room and an air handling unit shared the same pattern which was also identical to that of Legionella pneumophila serogroup 6, a reference strain. CONCLUSION: The study showed that the hospital environments were contaminated with at least 2 Legionella species including L. pneumophila serogroup 6, and indicated that an unusual cluster of Legionella pneumonia occurred in the hospital was possibly linked to the contamination of a faucet with L. pneumophila serogroup 6.
Environmental Monitoring ; Epidemiologic Studies* ; Humans ; Legionella pneumophila ; Legionella* ; Legionellosis ; Pneumonia* ; Polymerase Chain Reaction ; Ribotyping ; Water

BACKGROUND: To prevent and control legionellosis outbreaks, it is important to monitor cooling towers for Legionella and establish epidemiological markers. We determined level of contamination with Legionella of cooling tower in Seoul city, analyzed the distribution of Legionella subtypes, and evaluated molecular typing methods for discrimination power and feasibility. METHODS: Water samples from 120 cooling towers in 25 areas(Gu) of Seoul city were collected during June, 1997. Culture and duplex-PCR(polymerase chain reaction) with Southern hybridization probed with Legionella-specific genes were performed with filtered samples. Twenty-two Legionella isolates were analyzed comparatively by pulsed-field gel electrophoresis(PFGE) and arbitrarily primed(AP)-PCR using a M13 reverse primer. RESULTS: Culture and duplex-PCR with Southern hybridization were positive for Legionella in 22(18.3%) and 106(88.3%) of 120 samples, respectively, resulting in 90.8%(109/120) of contamination level. Out of 22 Legionella isolates, 17 were identified as Legionella pneumophila serogroup 1, 4 as L. pneumophila serogroup 6 and 1 as an unknown. Molecular analysis of 17 isolates of L. pneumophila serogroup 1 showed 7 subtypes by PFGE(A0 in 9 isolates; A1, 2; A2, 1; A3, 2; B, 1; C, 1; D, 1) and 5 subtypes by AP-PCR(Ia in 11 isolates; Ib, 2; Ic, 2; II, 1; III, 1). The agreement of results of both methods was 76.5%(13/17) of L. pneumophila serogroup 1 and 81.8%(18/22) of all isolates, respectively. CONCLUSION: Most of cooling towers in Seoul city were already contaminated with Legionella just before summer, requiring decontamination measures and continuous surveillance. L. pneumophila serogroup 1 was the predominant isolate with variable subtypes. The AP-PCR can be used as a rapid and reproducible screening tool in tracking legionellosis outbreak.
Decontamination ; Discrimination (Psychology) ; Disease Outbreaks ; Legionella pneumophila ; Legionella* ; Legionellosis ; Mass Screening ; Molecular Typing ; Seoul* ; Water*

PURPOSE: To present the survival of consecutive patients with a minimum of three years follow-up after undergoing a metal-on-metal hip resurfacing arthroplasty. MATERIALS AND METHODS: Twenty hips from twenty patients (male: 16, female: 4) who underwent metal-on-metal resurfacing arthroplasty between October 2001 and April 2004 were followed up for at least 3 years. The mean patient age was 49 years (range 23~70), and the mean follow-up period was 56 months (range 36~84 months). A clinical evaluation was performed using the Harris hip score, and radiologic evaluation was performed regularly after surgery with plain radiographs. RESULTS: The mean Harris hip score improved from 46 points (range 73~32) preoperatively to 94 points at final follow-up. There were no cases of radiolucency or osteolysis around the stem or acetabular cup, and there was no migration of the acetabular or femoral component. The average femoral stem-shaft angle was 135degrees(range 121degrees- 139degrees), and at the final follow-up study, there was no change of the femoral stem. CONCLUSION: In the short-term, metal-on-metal resurfacing arthroplasty performed on the basis of bone quality and patient selection, showed excellent clinical and radiological results. Hip resurfacing is an attractive option for young patients fearing a potentially difficult future revision or for more active patients with hip disease.
Arthroplasty ; Follow-Up Studies ; Hip ; Humans ; Osteolysis ; Patient Selection

Objective: Early identification of patients at risk for deterioration is crucial to reduce in-hospital mortality. Various early warning scores have been widely applied in the emergency department (ED) of hospitals. This study evaluates and compares the effectiveness of three early warning scores_Modified Early Warning Score, Rapid Acute Physiology Score (RAPS), Worthing Physiological Scoring System (WPS), and Rapid Emergency Medicine Score. These scores help predict the need for critical care and 24- and 72-hour mortalities among alert patients presenting to the ED with dyspnea. Methods: This retrospective cohort study used data from electronic medical records of patients admitted between 2018 and 2020 and included all consecutive alert patients who presented with dyspnea in the ED. The primary outcome was to evaluate the performance of early warning scores regarding the need for critical care. The secondary outcomes were the prediction of 24- and 72-hour in-hospital mortalities. Results: Among 4,322 patients evaluated, 255 received critical care, and 17 and 84 died within 24 and 72 hours, respectively. The WPS had the overall highest performance for predicting the need for critical care (area under the curve [AUC], 0.781; 95% confidence interval [CI], 0.751-0.810) and 24-hour (AUC, 0.816; 95% CI, 0.738-0.894) and 72-hour mortalities (AUC, 0.794; 95% CI, 0.750-0.838), but differed significantly only from the RAPS. Conclusion The WPS might better predict the need for critical care and short-term mortality in alert patients with dyspnea in the ED. However, owing to a lack of its superiority in statistics, further studies are warranted to conclude the optimal tools applicable for these patients.

Boerhaave's syndrome is a rare spontaneous rupture of the esophagus that requires an immediate diagnosis and surgical repair. It might result from a severe and uncoordinated contraction of the esophagus and stomach. The rate of mortality and morbidity can increase with increasing time between the onset and treatment. In recent years, there have been some reports of non-surgical treatment in cases with perforation but with minimal symptoms and clinical evidence of the systemic effects such as sepsis. We experienced a case of Boerhaave's syndrome occurring during an endoscopic examination that was treated successfully using non-surgical measures.
Diagnosis ; Endoscopy* ; Esophagus ; Mortality ; Rupture, Spontaneous ; Sepsis ; Stomach

BACKGROUND/AIMS: Hypothyroidism is a common side effect induced by sunitinib. Studies have suggested that sunitinib induces destructive thyroiditis or inhibits iodine uptake by the thyroid or anti-thyroid peroxidase activity. Therefore, the amount of iodine intake will also influence the incidence and clinical characteristics of hypothyroidism after sunitinib treatment. We evaluated the incidence and clinical characteristics of hypothyroidism after sunitinib treatment in Korea, an area where iodine is abundant. METHODS: Between November 2005 and July 2007, 25 patients who had thyroid hormone levels measured during or after sunitinib treatment were included. Of the 25 patients, 13 had thyroid function tests (TFT) because they had symptoms suggesting hypothyroidism and 12 underwent TFT independent of symptoms for screening. RESULTS: All 13 patients who had symptoms suggesting hypothyroidism were hypothyroid (9 overt, 4 subclinical), 6 of 12 patients who had TFT independent of symptoms were hypothyroid (2 overt, 4 subclinical), and two had thyrotoxicosis. Of the 19 hypothyroid patients, the 11 overt hypothyroid patients took longer for a diagnosis of TSH elevation (44.5 vs. 14.8 weeks, p<0.05) and had a greater cumulative sunitinib dose (8050+/-3211 vs. 3718+/-1961 mg, p<0.05) compared with the subclinically hypothyroid patients. At the point of detecting TSH elevation, the TSH level correlated with the period and cumulative dose of sunitinib. CONCLUSIONS: The anticipated incidence of sunitinib-induced hypothyroidism is more than 50%. Compared with previous studies performed in other areas, the iodine intake did not affect the incidence of sunitinib-induced hypothyroidism.
Humans ; Hypothyroidism ; Incidence ; Indoles ; Iodine ; Korea ; Peroxidase ; Pyrroles ; Thyroid Function Tests ; Thyroid Gland ; Thyroiditis ; Thyrotoxicosis