No abstract available.
Child* ; Humans ; Tuberculosis, Renal*

The extended medical insurance system has resulted in increasing numbers of patients who go directly to specialists in the general hospitals via consultation of general practice physicians in local clinics as well as on the patient's own decision. In order to classify and evaluate the patients, who come to the emergency room of the general hospital, whether the patient's disease status truely needed emergency treatment or whether the patients were treated adequately or not at the emergency room, we reviewed retroscpectively 3,775 patients who came to the emergency room of Kang Nam St. Mary's hosptial Between January and July 1984. We classified them according to their age, sex, department, the status of disease(emergency or not) and evaluated the adequacy of emergency treatment and the prognosis. We concluded as follows: 1) Every emergency room shoul be prepared with adequate equipment and operated by sufficient numbers of well trained medical personnel. 2) It is necessary that the medical personnel who work at the emergency room should be continuously educated and trained for adequate care of the patients with central nervous system, respiratory system, gastrointestinal system and cardiovascular system problems. 3) Our review revealed that it seems necessary that the specialists in emergency care, including cardiopulmonary resuscitation, should be stationed at emergency room. 4) For the more efficient operation of the emergency room, the establishment of a medical delivery system is necessary.
Cardiopulmonary Resuscitation ; Cardiovascular System ; Central Nervous System ; Emergencies* ; Emergency Medical Services ; Emergency Service, Hospital* ; Emergency Treatment ; General Practitioners ; Hospitals, General ; Humans ; Insurance ; Prognosis ; Respiratory System ; Specialization

No abstract available.
Kyphosis* ; Spine* ; Tuberculosis*

PURPOSE: Long-term exposure to extremely low-frequency (60 Hz) electromagnetic fields (ELF-EMF) raises the questions of the induction of biological effects including tumorigenesis. One mechanism through which ELF-MFS could influence neoplastic development is the imbalance of cellular proliferation and cell apoptosis. The present study investigated the effect of ELF-EMF on chemically-induced thyroid carcinogenesis in a rat. METHODS: We examined cellular proliferation index measured by anti-Ki-67 antigen, apoptosis, apoptosis related proteins such as caspase 3 and p53, and cell cycle-related proteins (cyclin D1 and p21(WAF1/Cip1)). Forty Male F344 rats received a subcutaneous N-bis(2-hydroxypropyl)nitrosamine (DHPN, 2,800 mg/kg) injection, and 1 week later were allowed free access to drinking water containing sulfadimethoxine (0.1%) for 12 weeks. Twenty rats were exposed by ELF-EMF. During the carcinogenesis, sequential histological changes from hyperplasia, adenoma, and ultimately to overt carcinomas were noted. RESULTS: The exposure group of ELF-EMF, significantly increases the number size of carcinomas. Also, the proliferative and apoptotic indices were significantly increased in the ELF-EMF exposure group than in the control group. The caspase 3 protein expression did not show any significant changes between ELF-EMF group and control group. The p53 protein was not detected in both ELF-EMF exposure and control group. Among the cell cycle related proteins, cyclin D1, not p21(WAF1/Cip1), was significantly increased in adenomas and carcinomas in ELF-EMF exposure group compared with the control group. CONCLUSION: Exposure of ELF-EMF effects on chemically-induced rat thyroid carcinogenesis as results of altered increase of cellular proliferation, apoptosis, and cyclin D1 expression.
Adenoma ; Animals ; Apoptosis ; Caspase 3 ; Cell Cycle ; Cell Proliferation ; Cell Transformation, Neoplastic ; Cyclin D1 ; Drinking Water ; Electromagnetic Fields ; Humans ; Hyperplasia ; Male ; Nitrosamines ; Proteins ; Rats ; Rats, Inbred F344 ; Sulfadimethoxine ; Thyroid Gland

OBJECTIVE: This study was performed to evaluate the status of p16 tumor suppressor gene in 25 endometrial carcinomas (ECs) and to correlate the loss of heterozygosity (LOH) at p16 locus, the presence of inactivating mutations, the methylation status of the promotor, and the expression of p16 protein with clinicopathological parameters. METHODS: Methylation-specific PCR (MSP) distinguishes unmethylated from methylated alleles in a given gene on sequence changes produced after bisulfite treatment of DNA. Allelic losses were determined at two polymorphic dinucleotide repeat microsatellite markers of the p16 gene on chromosome 9p21 that included D9S974 and D9S1748 at CDKN2A. Mutations were analyzed by exons 1 and 2 of p16 PCR-SSCP. Immunohistochemical staining for p16 protein was performed. The associations between genetic alterations of the p16 and the clinicopathological parameters of ECs were evaluated by chi-squared or Fisher's extraction tests. RESULTS: The median age of the 25 cases was 52 years, ranging from 32 to 72. The median tumor size was 3.6 cm, ranging from 0.8 to 9.5 cm. Histologically, the ECs were 21 endometrioid, 2 adenosquamous, 1 secretory and 1 papillary serous types. Nine cases of p16 protein staining were negative or minimal positive in 25 ECs (36%). Allelic losses were found in 6 loci (66.7%) of 5 ECs without p16 protein expression (Fisher's extraction test, p=0.0029), In this study, only 2 of 25 ECs (8%) disclosed mutations. Non-endometrioid (secretory and adenosquamous) carcinomas showed more frequent mutation and methylation than endometrioid carcinomas (p=0.043) and high grades (G3, p=0.018) showed more frequent mutation and methylation than low grade ECs. CONCLUSION: This study suggests that methylation of p16 promoter region seems not to be common (only 9.5% in our present series) and not to be associated with loss of nuclear p16 protein expression. Loss of p16 protein indicates a higher frequency of LOH, which contributes to the development of high grade or aggressive ECs. The mechanism of p16 inactivation is not clear, so other genetic or nongenetic mechanisms for inactivation should be further studied.
Alleles ; Carcinoma, Endometrioid ; Dinucleotide Repeats ; DNA ; Endometrial Neoplasms* ; Exons ; Female ; Genes, p16 ; Genes, Tumor Suppressor ; Loss of Heterozygosity ; Methylation ; Microsatellite Repeats ; Polymerase Chain Reaction ; Promoter Regions, Genetic*

BACKGROUND: The isolation rate of nontuberculous mycobacteria (NTM) in clinical laboratories and the incidence of NTM infections are on the increase recently in Korea, but there have been only a few studies that reveal the general aspect of NTM isolation or species distribution. Therefore, this study was performed to examine the isolation rate of NTM, species identification, and the clinical significance of mycobacterial cultures. METHODS: From August 2004 to May 2005, we examined mycobacterial isolates by AccuProbe test to differentiate NTM from Mycobacterium tuberculosis complex. NTM was then identified by polymerase chain reaction-restriction fragment length analysis (PCR-RFLP). RESULTS: A total of 6,742 specimens from 2,784 patients were requested for mycobacterial culture. Mycobacteria were isolated from 776 specimens (11.5%). The isolation rates of NTMs among the total culture positive specimens and culture positive sputum specimens were 24.4% (189/776) and 25.3% (169/667), respectively. Fourteen species of NTM identified in 172 of the 175 specimens tested included M. avium (39.0%), M. intracellulare (22.7%), and M. abscessus (19.8%). CONCLUSIONS: Using AccuProbe tests and PCR-RFLP method for mycobacterial cultures processed in a clinical laboratory, we were able to identify NTMs to the species level. The isolation rate of NTM in this study was similar to that reported in past studies in Korea. In addition, we found that some of the NTMs isolated in this study could cause pulmonary diseases.
Humans ; Incidence ; Korea ; Lung Diseases ; Mycobacterium tuberculosis ; Nontuberculous Mycobacteria* ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Sputum

Three trials of external quality assessment for clinical microbiology laboratory were performed in 2002. A total of 19 specimens were distributed. Five specimens were distributed to 241 laboratories with 222 returns in Trial I, seven specimens to 241 laboratories with 232 returns in Trial II, and seven specimens to 245 laboratories with 220 returns in Trial III. The percentages of fully correct results of Plasmodium falciparum, P. malariae, P. vivax, gram-positive rods, group 5, S. aureus, E. faecium, Leuconostoc spp. Aeromonas hydrophila, Alternaria spp. S. aureus, E. coli, K. pneumoniae, E. faecalis, P. aeruginosa, E. coli, and K. pneumoniae were 38%, 66%, 68%, 85%, 68%, 94%, 76%, 51%, 86%, 76%, 100%, 99%, 93%, 79%, 86%, 95% and 96%, respectively. The acceptable percentages on disk-diffusion antibacterial susceptibility tests against oxacillin and vancomycin of S. aureus (M0206) were 99% and 94%, respectively. Those against vancomycin and teicoplanin of E. faecium (M0208) were 99% and 94%, respectively. Those against vancomycin, oxacillin, penicillin G, clindamycin, erythromycin, ciprofloxacin, gentamicin and teicoplanin of S. aureus (M0213) were 87%, 95%, 93%, 93%, 93%, 82%, 92%, 99%, and 95%, respectively. The acceptable percentages on disk diffusion test against ciprofloxacin, imipenem, ampicillin, cefotaxime, and cephalothin of E. coli (M0214) were 98%, 100%, 98%, 96%, and 87%, respectively. Those against ciprofloxacin, imipenem, ampicillin, cefotaxime, and cephalothin of K. pneumoniae (M0215) were 96%, 100%, 98%, 93% and 99%, respectively. Those against vancomycin, ciprofloxacin, ampicillin, penicillin G, erythromycin, and teicoplanin of E. faecalis (M0216) were 91%, 85%, 94%, 87%, 97%, and 100%, respectively. Those against ciprofloxacin, gentamicin, imipenem, ceftazidime, and piperacillin of P. aeruginosa (M0217) were 89%, 99%, 100%, 100%, and 100%, respectively. Those against amikacin, ciprofloxacin, gentamicin, imipenem, ampicillin, cefotaxime, and cephalothin of E. coli (M0218) were 98%, 98%, 98%, 100%, 98%, 100% and 90%, respectively. Those against amikacin, ciprofloxacin, gentamicin, imipenem, ampicillin, cefotaxime, and cephalothin of K. pneumoniae (M0219) were 97%, 97%, 98%, 100%, 99%, 99% and 99%, respectively. Twenty laboratories on Trial III had reported the both results of disk diffusion and MIC methods. The performance on the automated or E-test susceptibility tests was generally good, except in case of teicoplanin, showing the lower MIC in 63% of 51 participants. The susceptibility against teicoplanin should be confirmed by disk diffusion method in case of vancomycin-resistant Enterococcus in the laboratories using automated MIC methods. In conclusion, it is necessary that the quality assurance of the individual laboratories should be improved in the identification of malaria and Enterococcus spp., and in susceptibility tests against vancomycin, erythromycin and ciprofloxacin of S. aureus, and cephalothin of E. coli in case of disk diffusion method, and teicoplanin of Enterococcus in the laboratories using automated MIC methods.
Aeromonas hydrophila ; Alternaria ; Amikacin ; Ampicillin ; Cefotaxime ; Ceftazidime ; Cephalothin ; Ciprofloxacin ; Clindamycin ; Diffusion ; Enterococcus ; Erythromycin ; Gentamicins ; Gram-Positive Rods ; Imipenem ; Korea* ; Leuconostoc ; Malaria ; Oxacillin ; Penicillin G ; Piperacillin ; Plasmodium falciparum ; Pneumonia ; Teicoplanin ; Vancomycin

OBJECTIVE: To evaluate the efficacy of radiofrequency ablation (RFA) in the treatment of loco-regional, recurrent, and well-differentiated thyroid carcinoma. MATERIALS AND METHODS: Thirty-five recurrent well-differentiated thyroid carcinomas (RTC) in 32 patients were treated with RFA, between March 2008 and October 2011. RTCs were detected by regular follow-up ultrasound and confirmed by biopsy. All patients had fewer than 3 RTCs in the neck and were at high surgical risk or refused to undergo repeated surgery. Average number of RFA sessions were 1.3 (range 1-3). Post-RFA biopsy and ultrasound were performed. The mean follow-up period was 30 months. Pre- and post-RFA serum thyroglobulin values were evaluated. RESULTS: Thirty-one patients with 33 RTCs were treated with RFA only, whereas 1 patient with 2 RTCs was treated with RFA followed by surgery. At the last follow-up ultrasound, 31 (94%) of the 33 RTCs treated with RFA alone completely disappeared and the remaining 2 (6%) RTCs showed decreased volume. The largest diameter and volume of the 33 RTCs were markedly decreased by 93.2% (from 8.1 +/- 3.4 mm to 0.6 +/- 1.8 mm, p < 0.001) and 96.4% (from 173.9 +/- 198.7 mm3 to 6.2 +/- 27.9 mm3, p < 0.001), respectively. Twenty of the 21 RTCs evaluated with post-RFA biopsies (95%) were negative for malignancy. One (5%) showed remaining tumor that was removed surgically. The serum thyroglobulin was decreased in 19 of 26 patients (73%). Voice change developed immediately after RFA in 6 patients (19%) and was spontaneously recovered in 5 patients (83%). CONCLUSION: Radiofrequency ablation can be effective in treating loco-regional, recurrent, and well-differentiated thyroid carcinoma in patients at high surgical risk.
Adult ; Aged ; Aged, 80 and over ; Carcinoma/*pathology/surgery/ultrasonography ; Catheter Ablation ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Thyroglobulin/blood ; Thyroid Neoplasms/*pathology/surgery/ultrasonography ; Tomography, X-Ray Computed

Two trials of external quality assessment for clinical microbiology laboratory were performed in 2004. A total of 12 specimens were distributed. Six specimens were distributed to 293 laboratories with 277 returns in Trial I and six specimens to 293 laboratories with 274 returns in Trial II. The acceptable percentages of Gram-stain on Streptococcus pneumoniae, Escherichia coli, Pseudomonas aeruginosa, and Enterococcus faecalis were 96.0%, 98.5%, 97.4% and 98.2%, respectively. The acceptable percentages of bacterial identification on Streptococcus pneumoniae, Escherichia coli, Enterococcus faecalis, Staphylococcus saprophyticus, Shigella flexneri, Gemella spp., Pseudomonas aeruginosa, Enterococcus faecalis (Trial II), Streptococcus agalactiae, Listeria monocytogenes, Erysipelothrix rhusiopathiae, and Eikenella corrodens were 97.5% (including 33.7% of no growth), 99.6%, 93.2%, 82.3%, 95.4%, 50.7%, 98.4%, 92.3%, 87.0%, 78.9%, 92.5% (including 53.4% of no growth), respectively. The acceptable percentages for antimicrobial susceptibility tests on Escherichia coli and Pseudomonas aeruginosa were relatively high, but those on Streptococcus pneumoniae and Enterococcus faecalis were not high. In conclusion, the acceptable percentages of bacterial stain and identification were relatively good. However, it is necessary that the quality assurance of the individual laboratories should be improved for antimicrobial susceptibility tests on Streptococcus pneumoniae and Enterococcus faecalis, and the selection of the most appropriate antimicrobial agents to test should be also considered.
Anti-Infective Agents ; Eikenella corrodens ; Enterococcus faecalis ; Erysipelothrix ; Escherichia coli ; Gemella ; Korea* ; Listeria monocytogenes ; Pseudomonas aeruginosa ; Shigella flexneri ; Staphylococcus saprophyticus ; Streptococcus agalactiae ; Streptococcus pneumoniae

In off-pump coronary artery bypass grafting (CABG), multiple proximal anastomosis may increase the risk of cerebral embolism (air, debris) and aortic injury (dissection, pseudoaneurysm). Radial artery (RA) has no intraluminal valve such as saphenous vein. We applied Cabrol technique using aortic root replacement for proximal anastomosis in off-pump CABG. Cabrol technique using RA graft can reduce numbers of proximal anastomosis and reduce number of aortic manipulation in off-pump CABG. We report a Cabrol technique for proximal anastomosis in off-pump CABG with RA graft.
Coronary Artery Bypass ; Coronary Artery Bypass, Off-Pump* ; Intracranial Embolism ; Radial Artery* ; Saphenous Vein ; Surgical Procedures, Minimally Invasive ; Transplants*