BACKGROUND: This study tested the efficacy of 0.12% chlorhexidine gluconate for improving oral hygiene in intubated intensive care patients. METHODS: In a group of 57 ventilated patients, 29 received normal saline (NS) for oral hygiene, and 28 were treated with chlorhexidine gluconate (CHG). Data on oral bacterial colonization was collected for 11 months from October 2005 to August 2006. Tests of oral hygiene and oral microorganism culture were performed on the day of the ventilation, and repeated on days 4, 8, and 12. RESULTS: Oral hygiene was significantly improved in the CHG group compared to that in the NS group (P<.001). Further, all patients (100%) in the NS group tested positive for Staphylococcus aureus on the 12th day after the endotracheal intubation, whereas only 42.9% (P=0.026) of the CHG group were positive. The NS group also had higher isolation rates of Pseudomonas aeruginosa at 66.7% on the 8th day after intubation and 87.5% on the 12th day. At these same intervals, the CHG group had isolation rates of 29.4% (P=.028) and 14.3% (P=.010) respectively. CONCLUSION: The longer the period of endotracheal intubation, the more effective the 0.12% CHG treatment was for improved oral hygiene and reduction of S. aureus and P. aeruginosa colonization when compared to treatment with NS.
Chlorhexidine ; Colon ; Humans ; Critical Care ; Intensive Care Units ; Intubation ; Intubation, Intratracheal ; Oral Hygiene ; Pseudomonas aeruginosa ; Sodium Chloride ; Staphylococcus aureus ; Ventilation

OBJECTIVES: Outbreaks of pneumonia caused by Mycoplasma pneumoniae (MP) occur every 3-4 years in Korea, most recently in 2011. The aim of our study was to determine the optimal time to perform indirect particle agglutination antibody assays to improve early diagnosis of MP pneumonia in children. METHODS: A database of 206 pediatric patients treated for pneumonia at the Hanyang University Hospital from June to October 2011 was analyzed retrospectively for demographic characteristics and laboratory test results. RESULTS: Among the 206 patients treated for pneumonia during the study period, there were 160 children (mean age, 5.44 years) diagnosed with MP pneumonia, who were studied further. The mean age of these MP pneumonia patients was 5.44 years. Antibody titers increased with increasing time between symptom onset and the collection of serum collection: MP titers were <1:640 for sera collected after 5.44 days and titers > or =1:640 for those collected after 8.58 days; P<0.001). Antibody titers were considered positive when they reached > or =1:640. In 42 MP pneumonia patients in whom there was a four-fold or greater increase in titer between successive serum samples, the optimal cut-off time-point for distinguishing between the initial and second titer groups was 7.5 days after the onset of symptoms (sensitivity, 90.5%; specificity, 92.9%). CONCLUSIONS: Negative MP antibody titers earlier than 8 days after the onset of symptoms in children with pneumonia may require repeating to confirm the diagnosis. This finding could optimize diagnosis and result in better therapeutic outcomes of MP pneumonia in children.
Agglutination ; Child ; Disease Outbreaks ; Early Diagnosis ; Humans ; Korea ; Mycoplasma ; Mycoplasma pneumoniae ; Pneumonia ; Pneumonia, Mycoplasma ; Retrospective Studies ; Sensitivity and Specificity

PURPOSE: The loss of estrogen and progesterone receptors appeats to be associated with a progression to less differentiated and hormone-independent tumors. The gain of hormone independency over time even in estrogen receptor-positive tumors has become another obstacle to endocrine therapy for breast cancer. We tried to regain the hormone dependency in estrogen receptor-negative breast cancer cells by lipofecting estmgen receptor cDNA. MATERIALS AND METHODS: The mutant human estrogen receptor cDNA (pSGS-HEO) was lipofected into estrogen receptor-negative human breast cancer cell line MDA-MB-231, in an attempt to restore their sensitivity to antiestrogen. Then the effects of 17p-estradiol and tamoxifen were studied by counting viable cell numbers after treating the lipofected cell line with either one or together. RESULTS: Culture medium cantaining phenol red, a weak estrogen, has growth advantages compared with culture medium without it. In both culture conditions, cell growth was most profoundly inhibited in 4 days after lipofection with mutant human estrogen receptor cDNA, which was overcome after that day. Tamoxifen, as an antiestrogen, showed a growth inhibitory effect slightly stronger tban combined conditions of tamoxifen and 17- estradiol compared to estrogen-treated group and to control, and the inhibitory effect was lasted 4 days. CONCLUSION: The temporary induction of estrogen receptor by lipofection with pSGS-HEO on estrogen receptor-negative human breast cancer cell line MDA-MB-231 showed negative growth control on these cells by tamoxifen, indicating that liposome-mediated estrogen receptor transfection may be used as a novel therapeutic strategy for hormane independent human breast cancers in the near future.
Breast Neoplasms* ; Breast* ; Cell Count ; Cell Line ; DNA, Complementary ; Estradiol ; Estrogen Receptor Modulators ; Estrogens* ; Genetic Therapy ; Humans* ; Phenolsulfonphthalein ; Receptors, Progesterone ; Tamoxifen ; Transfection

A muscular calf is esthetically unappealing in Asian women. Treatment by liposuction alone has poroven to be difficult due to a small amount of fat. We established a new method of transecting half of the gastrocnemius tendon in order to improve the contour of the calf. Thirty-five patients were operated on during the past 3 years. The medial or lateral half of the gastrocnemius tendon was cut using an endoscopic-guided 3M AGEE blade through a 1cm-sized incision. The portion of the muscle above the site of the transection was elevated from the underlying soleus muscles. We checked the calf circumference and evaluated the clinical results at 6 months postoperatively. An average 10% reduction in calf circumfernce was measured, showing a significant esthetic improvement. There were no significant changes in gait analysis or in the Cybex test. There were no specific complications related to the procedure. Through our clinical experience in 35 cases, we were able to prove that tenotomy is a effective, simple and easy method without severe morbidity.
Asian Continental Ancestry Group ; Female ; Gait ; Humans ; Lipectomy ; Muscles ; Tendons ; Tenotomy*

No abstract available.

The treatment of acutely torn anterior cruciate ligament(A.C.L) remains a controversial subject. The purpose of this paper is to show the arthroscopic technique of A.C.L. primary repair with or without augmentation with semitendinosus tendon. Twenty-one patients with acute A.C.L. tear were treated with repair or augmented repair under arthroscopic control from April 1989 to August 1993. Five A.C.L. torn at femoral attachment with intact distal stump were treated with arthoscopic repair alone & 16 A.C.L. torn at substance near the femoral attachment with arthroscopic repair & augmentation with semitendinosus tendon. The patient population included of 16 males and 5 females with an average age 28.3 years. Fifteen patients injuried during sports activity. Postoperative results were evaluated by Lysholm knee score & Hospital for Special Surgery knee scale in average 26 months (range from 12 months to 64 months). All patients were rated as good or excellent result except one patient who had fair result. At follow-up study, testing with KT1000 arthrometer revealed 17 patients had less than 3mm of side to side difference. Second look arthroscopy was performed in 15 patients from 4 to 29 months after repair or augmented repair. Eleven out of these 15 A.C.L. were well healed with good tension 8r. revascularization of graft. Remaining 4 A.C.L. were healed with scar tissue. On the based of this study, arthroscopic repair or augmented repair is very effective treatment for acutely torn A.C.L. near the femoral attachment.
Anterior Cruciate Ligament ; Arthroscopy ; Cicatrix ; Female ; Follow-Up Studies ; Humans ; Knee ; Lysholm Knee Score ; Male ; Sports ; Tears ; Tendons ; Transplants

We reviewed 24 patients who had performed arthroscopic meniscal repair for the treatment off discoid lateral meniscal tear between january 1989 and December 1992. The follow up ranged from 1 year 6 month to 4 year 6 month(average 32month). The mean age was 17.9(range,8-50)years, the patients under 20 years old were 17(cases,71%).Common preoperative clinical symptom was pain on the knee joint(21 cases,87.5%) and click(19 cases,79%).Positive McMurry test was the most common physical examination finding(19 cases, 79%). All the lateral discoid meniscal tears were confirmed by arthroscopy. The mean interval between symptom onset and operation was 18.7 months(range 1 month to 10 year). The types of tear were peripheral (14cases, 58%), complex tear(4cases), longitudinal tear(2cases), transverse tear(2cases), horizontal tear(2cases)and the most common location of tear was posterior horn(1 1cases, 45%). The mean number of suture was four. In operative method, Scases(33%) were performed only meniscorrhaphy and meniscorrhaphy combined with partial meniscectomy was done in 16 cases(67%). According to Ikeuchi's grading system, the result was satisfactory in 21cases, fair in three cases. Second look arthroscopy was done in eleven cases(46%) between post operative 4 months to 2 years(mean, 8.3 months). The arthroscopic examination revealed complete healing of repaired meniscus in eight cases(73%). The remained three cases which were not completely healed was fair result.
Arthroscopy ; Follow-Up Studies ; Humans ; Knee ; Methods ; Physical Examination ; Sutures ; Tears

No abstract available.
Paragonimiasis*

We present a case with congenital absence of the infrarenal portion of inferior vena cava and lilac venous system, showing unusual venous collaterals including the left ovarian venous collateral via parametrial venous complex, and a mesenteric-periureteric venous connection. The venous collateral pathways were demonstrated by computed tomography and venography.
Phlebography ; Vena Cava, Inferior

PURPOSE: We evaluated the diagnostic accuracy and clinical usefulness of fluoroscopy-guided bone biopsy. MATERIALS AND METHODS: A total of 31 patients with various skeletal lesions underwent fluoroscopy-guided bone biopsies. The targets were long bones in 16 cases, pelvic bones in 7 cases, spines in 6 cases, and ribs in the rest 2 cases. RESULTS: The overall accuracy was 71%(22/31). The accuracy was 100% in case of primary sarcoma and multiple myeloma. But it was low in malignant lymphoma(1/4), malignant fibrous histiocytoma(0/1), and nonossifying fibroma(0/1). CONCLUSION: Percutaneous fluoroscopy-guided bone biopsy is a simple, safe, not-expensive, and rather accurate diagnostic procedure in evaluation of bone tumors. In addition to that, it is useful in the managment planning and fllow-up of the patients.
Biopsy* ; Humans ; Multiple Myeloma ; Pelvic Bones ; Ribs ; Sarcoma ; Spine