BACKGROUND: Serratia marcescens proliferates well in a humid environment or soil and is recently considered as an important pathogen for the severe nosocomial infections. this organism is spreads easily by hand-to-hand transmission, and contaminates medical equipment used for invasive procedures, working environment, medications, and soap. METHODS: We investigated the source of an outbreak of bloodstream infections by S. marcescens isolated that occurred during the period from July to December, 2004, at a university hospital in Gyeonggi Province and attempted to intervene in the outbreak and control it. RESULTS: From July to December, 2004, S. marcescens grew from 296 blood culture from 283 patients. The medical charts of the patients were reviewed, and surveillance cultures were taken to identify the outbreak of nosocomial infections and risk factors. Only four cases of infection were identified and all remaining positive blood cultures were due to contamination. Nine isolates randomly selected from the 296 S. marcescens showed an identical pulsed-field gel electrophoresis pattern. To identify the source of infection, environmental culture and hand cultures of the related medical workers were carried out, but S. marcescens was not isolated. CONCLUSION: As the result of aggressive infection control activities, such as re-education on environmental management methods, hand washing techniques, and blood culture sampling techniques, no more S. marcescens had been grown in blood culture since January, 2005.
Cross Infection ; Electrophoresis, Gel, Pulsed-Field ; Gyeonggi-do ; Hand ; Hand Disinfection ; Humans ; Infection Control ; Risk Factors ; Serratia marcescens ; Serratia* ; Soaps ; Soil

No abstract available.
Gastric Outlet Obstruction*

Acute calcific retropharyngeal tendinitis, also known as calcific tendinitis of the longus colli, is an underrecognized inflammatory condition by deposition of calcium hydroxyapatite in the tendon fibers of the longus colli muscles. This disease entity may occur in any part of the body, however, rarely occur in the prevertebral musculature. Symptoms and signs of this disease are neck pain and stiffness associated with odynophagia and retropharyngeal soft tissue swelling. Because of self-limiting disease, the symptoms resolve usually with or without anti-inflammatory medication and analgesics within days or weeks. We report a case of acute calcific retropharyngeal tendinitis with a reviews of the related literatures.
Analgesics ; Durapatite ; Muscles ; Neck Pain ; Tendinopathy* ; Tendons

There is growing evidence that crosstalk between mantle cell lymphoma (MCL) cells and stromal microenvironments, such as bone marrow and secondary lymphoid tissues, promotes tumor progression by enhancing survival and growth as well as drug resistance of MCL cells. Recent advances in the understanding of lymphoma microenvironment have led to the identification of crucial factors involved in the crosstalk and subsequent generation of their targeted agents. In the present study, we evaluated the combinatory effect of blocking antibodies (Ab) targeting CXCR4 and VLA-4, both of which were known to play significant roles in the induction of environment-mediated drug resistance (EMDR) in MCL cell line, Jeko-1. Simultaneous treatment with anti-CXCR4 and anti-VLA-4 Ab not only reduced the migration of Jeko-1 cells into the protective stromal cells, but also enhanced sensitivity of Jeko-1 to a chemotherapeutic agent to a greater degree than with either Ab alone. These combinatorial effects were associated with decreased phosphorylation of ERK1/2, AKT and NF-kappaB. Importantly, drug resistance could not be overcome once the adhesion of Jeko-1 to the stromal occurred despite the combined use of Abs, suggesting that the efforts to mitigate migration of MCLs should be attempted as much as possible. Our results provide a basis for a future development of therapeutic strategies targeting both CXCR4 and VLA-4, such as Ab combinations or bispecific antibodies, to improve treatment outcomes of MCL with grave prognosis.
Antibodies, Bispecific ; Antibodies, Blocking ; Bone Marrow ; Cell Line ; Drug Resistance ; Drug Therapy* ; Integrin alpha4beta1* ; Lymphoid Tissue ; Lymphoma ; Lymphoma, Mantle-Cell* ; NF-kappa B ; Phosphorylation ; Prognosis ; Stromal Cells

PURPOSE: To evaluate the results of simple keratectomy for limbal dermoids. METHODS: We reviewed the ocular records of 29 consecutive patients with limbal dermoids who had undergone simple keratectomy in Seoul National University Children's hospital from 1989 to 2006. The preoperative and postoperative visual acuity and astigmatism levels as well as the cosmetic outcomes were measured. RESULTS: The mean age at surgery was 28 months (range, 6~70 months), and the mean follow-up period was 56 months (range, 18~168 months). The mean visual acuity at the last follow-up was 20/30. The mean preoperative and postoperative cylinder was -2.64D and -2.12D, respectively, in the affected eye (p=0.064); and -0.79D and -0.43D, respectively, in the fellow eye (p=0.149). There was a significant correlation between preoperative astigmatism and the final visual acuity in the involved eye. No opaque lesions were visible at a distance of 1 meter in 16 of the 29 eyes (55.2%), and there were no significant complications related to the surgery. CONCLUSIONS: Simple keratectomy of limbal dermoids can be a good surgical technique to get a cosmetically acceptable corneal clarity without complication.
Astigmatism ; Cosmetics ; Dermoid Cyst ; Eye ; Follow-Up Studies ; Humans ; Visual Acuity

PURPOSE: Carcinoembryonic antigen (CEA) is known to be elevated in nearly all solid malignancies. The prognostic role of CEA in gastric cancers however, is still controversial. We evaluated preoperative serum CEA levels and CEA expression from the resected tumor tissues to determine whether they have prognostic significance in gastric cancer patients. MATERIALS AND METHODS: Medical records of 810 patients who underwent surgery for gastric adenocarcinoma from June, 1998 to February, 2002 in Kyungpook National University Hospital were reviewed. Serum CEA level was evaluated by radioimmunoassay preoperatively, and the cut-off level for positivity was 7.0 ng/ml. Labeled streptavidin-biotin peroxidase method was used to determine CEA expression from the gastric cancer tissues. RESULTS: Serum and tissue CEA were positive in 9.3% and 91.1% of the patients, respectively. They had no correlation with each other. The positivity rate of serum CEA had positive correlation with invasion depth (p<0.001), lymph node metastasis (p<0.001), distant metastasis (p=0.006), and final stage (p<0.001). Well differentiated tumors showed higher serum CEA positivity (p=0.002). Patients with positive serum CEA had higher recurrence rate (p<0.001). Multivariate analysis showed significantly lower survival rate in patients with preoperative CEA levels over 7 ng/ml than those with lower levels (48.0% vs. 80.7%; p<0.001). The positivity rates of tissue CEA were higher in advanced cancers (p=0.033) and in more advanced stages (p=0.029). Tissue CEA positivity showed no correlation with recurrence or survival. CONCLUSIONS: Preoperative serum CEA level had correlation with disease progression and survival in gastric cancer patients, and proved to be an independent prognostic factor. Tissue CEA expression in gastric cancers had no prognostic information.
Adenocarcinoma ; Carcinoembryonic Antigen ; Disease Progression ; Humans ; Lymph Nodes ; Medical Records ; Multivariate Analysis ; Neoplasm Metastasis ; Peroxidase ; Radioimmunoassay ; Recurrence ; Stomach Neoplasms ; Survival Rate

BACKGROUND: There is an increasing interest in physical activity as a preventive and/or therapeutic option of non alcoholic fatty liver disease (NAFLD). The aim of this study was to examine the association between physical activity and ultrasound-diagnosed NAFLD. METHODS: From April to June 2007, 198 clients who had consumed alcohol less than 140 gram per week among 598 clients who visited a general hospital for medical check-up were enrolled in this study. Clinical, biochemical variables and physical activity were compared. Physical activity was measured by self-reported questionnaire using IPAQ-short form in Korean version. Multiple logistic regression analysis was used to identify independent association. RESULTS: The prevalence of NAFLD was significantly lower in the physical active group (more than 1500 MET- minutes per week) compared to the inactive group (9.6% vs 19.2%, P<0.05). This association was not attenuated when adjusted for age, BMI, HDL cholesterol, triglycerides, fasting glucose, and HOMA2-IR (Odds Ratio 0.23 [95% CI 0.07~0.77, P<0.05]). CONCLUSION: Compared to the physically inactive group, the risk of NAFLD was lower in the physically active group. Our data suggests that regular and moderate physical exercise can prevent the development of fatty liver disease.
Cholesterol, HDL ; Exercise ; Fasting ; Fatty Liver ; Fatty Liver, Alcoholic ; Glucose ; Hospitals, General ; Logistic Models ; Motor Activity ; Obesity ; Prevalence ; Triglycerides ; Surveys and Questionnaires

Hem-o-Lok clips (Weck Surgical Instruments, Teleflex Medical, Durham, NC, USA) are widely used in robot-assisted laparoscopic radical prostatectomy because of their easy application and secure clamping. To date, there have been some reports of intravesical migration of these clips causing urethral erosion, bladder neck contractures, and subsequent calculus formation. We report the first case of bladder migration of Hem-o-Lok clips without stone formation after robot-assisted laparoscopic radical prostatectomy. The Hem-o-Lok clips were found during urethral dilation with a guide wire for bladder neck contracture under cystourethroscopy. The Hem-o-Lok clips were floating in the bladder without stone formation and were removed by a cystoscopic procedure.
Calculi ; Constriction ; Contracture ; Neck ; Prostatectomy ; Robotics ; Surgical Instruments ; Urinary Bladder

PURPOSE: Controversy still exists over in the prognostic significance of microscopic tumor cell dissemination in patients with cancer. This study evaluated the prognostic implication of isolated tumor cells in the bone marrow of patients with gastric cancer. MATERIALS AND METHODS: Four hundred nineteen (419) patients who underwent surgery for gastric cancer between June 1998 and July 2000 were enrolled in the study. Bone marrow aspirate was obtained from the iliac crest before removal of the primary tumor. Mononuclear cells were isolated and stained with AE-1/AE-3 PAN-CYTOKERATIN. RESULTS: Cytokeratin-positive cells were found in the bone marrow of 219 patients (52.3%). The incidence varied significantly with the depth of invasion (P=0.021) and the stage (P=0.026). The five-year survival rate of patients with cytokeratin-positive cells was 74.1% and that of patients without cytokeratin-positive cells was 81.1% (P=0.2481). There were no significant differences in the recurrence rate and the site of recurrence according to whether or not cytokeratin-positive cells were present in the bone marrow. CONCLUSION: The presence of cytokeratin-positive cells in the bone marrow of patients with gastric cancer did not predict outcome and recurrence. Therefore, it cannot be used as a prognostic factor.
Bone Marrow* ; Humans ; Incidence ; Prognosis ; Recurrence ; Stomach Neoplasms* ; Survival Rate

PURPOSE: p53 is one of the most commonly mutated genes in human tumors. The aim of this study was to analyze p53 mutation in gastric cancer and its correlations with the clinicopathologic variables to clarify the usefulness of p53 mutation as a prognostic factor. MATERIALS AND METHODS: Specimens from 331 patients with gastric cancer who underwent a gastrectomy between March 1999 and April 2001 at the Kyungpook National University Hospital were used. p53 gene mutations were assessed by using a polymerase chain-reaction single-strand conformation polymorphism (PCR-SSCP) analysis. The correlations between p53 gene mutation and clinocopathologic parameters were analyzed. RESULTS: p53 mutations were found in 66 (19.9%) tumors. Among those 66 cases, mutations were seen in 23 tumors at exon 5, in 8 at exon 6, in 21 at exon 7, and in 17 at exon 8. Two mutations were shown in 3 tumors. Thirty-six (23.1%) of 156 intestinal-type tumors and 19 (13.1%) of 145 diffuse-type tumors showed p53 gene mutation (P=0.007). The frequency of p53 gene mutation didn't show any significant differences according to age, sex, stage, location, or gross type. Exon 5 mutations showed more frequently in intestinal-type tumors than in diffuse-type tumors (9.7% vs. 2.8%, P=0.024), and p53 mutation were more frequent in lymph nodes metastasis group than lymph nodes non-metastasis group with statistical significance (25.0% vs 15.6%, P=0.034). The five-year survival rate showed no statistically significant difference with p53 mutation (P=0.704). CONCLUSION: p53 mutations assessed by PCR-SSCP had little value as a prognostic factor after gastrectomy in patients with gastric cancer.
Exons ; Gastrectomy ; Genes, p53* ; Gyeongsangbuk-do ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Stomach Neoplasms* ; Survival Rate