There are limited data on the impact of diabetes control on the risk of subclinical coronary atherosclerosis.

The poisoning information database (PIDB) provides clinical toxicological information on commonly encountered toxic substances in Korea. The aim of this study was to estimate the coverage rate of the PIDB by comparing the database with the distribution of toxic substances that real poisoning patients presented to 20 emergency departments. Development of the PIDB started in 2007, and the number of toxic substances increased annually from 50 to 470 substances in 2014. We retrospectively reviewed the medical records of patients with toxic exposure who visited 20 emergency departments in Korea from January to December 2013. Identified toxic substances were classified as prescription drug, agricultural chemical, household product, animal or plant, herbal drug, or other. We calculated the coverage rate of the PIDB for both the number of poisoning cases and the kinds of toxic substances. A total of 10,887 cases of intoxication among 8,145 patients was collected. The 470 substances registered in the PIDB covered 89.3% of 8,891 identified cases related to poisoning, while the same substances only covered 45.3% of the 671 kinds of identified toxic substances. According to category, 211 prescription drugs, 58 agricultural chemicals, 28 household products, and 32 animals or plants were not covered by the PIDB. This study suggested that the PIDB covered a large proportion of real poisoning cases in Korea. However, the database should be continuously extended to provide information for even rare toxic substances.
Adolescent ; Adult ; Aged ; Animals ; Animals, Poisonous ; Child ; Child, Preschool ; Databases, Factual ; Drugs, Chinese Herbal/poisoning ; Emergency Service, Hospital ; Female ; Humans ; Infant ; Male ; Middle Aged ; Pesticides/poisoning ; Plants, Medicinal/poisoning ; Poisoning/*epidemiology ; Prescription Drugs/poisoning ; Republic of Korea ; Retrospective Studies ; Young Adult

OBJECTIVE: There has been a limited investigation looking into the correlation between pericardial fat and abdominal fat with coronary artery disease (CAD) as measured by coronary computed tomographic angiography (CCTA). We proposed that the volume of pericardial fat is larger in patients with CAD than in patients without CAD, and sought to determine which abdominal adiposity index best correlated with pericardial fat volume. METHODS: Participants were examined using CCTA between October 2007 and January 2008. All participants had no previous history of CAD. Pericardial adipose tissue (PAT) volume, abdominal total adipose tissue volume, abdominal subcutaneous adipose tissue volume, and abdominal visceral adipose tissue (AVAT) volume were measured using CCTA. RESULTS: Fifty patients (26.5%) demonstrated CAD, and 139 patients did not demonstrate CAD by CCTA. PAT volume in patients with CAD was larger than that of patients without CAD (173.2+/-64.2 cm3 vs. 147.6+/-50.4 cm3, p<0.01). However, indices of abdominal adiposity were not significantly different between the two groups. Using multivariable analysis, independent predictors of CAD were PAT volume (odds ratio [OR] 1.01, 95% confidence interval [CI] 1.00-1.02, p=0.04), coronary artery calcium score (OR 1.01, 95% CI 1.00-1.01, p<0.01), and typical chest pain (OR 4.88, 95% CI 1.47-16.21, p=0.01). AVAT volume showed a linear correlation with PAT volume. CONCLUSION: PAT volume was an independent predictor of CAD as measured by CCTA. PAT volume was also well correlated with the AVAT volume among the indices of abdominal adiposity.
Abdominal Fat ; Adipose Tissue ; Adiposity ; Angiography ; Calcium ; Chest Pain ; Coronary Artery Disease* ; Coronary Vessels ; Humans ; Intra-Abdominal Fat ; Subcutaneous Fat, Abdominal

BACKGROUND: We compared vaccinia virus shedding from the vaccine inoculation site (vaccination lesion) and two sites of a dressing covering the vaccination site; the outer surface of the semipermeable dressing (outer surface) and the inner surface of the semipermeable dressing, that is, the surface of a folded gauze under the semipermeable membrane (gauze surface) MATERIAL AND METHODS: Subjects were recruited from the volunteers who participated in a clinical trial of the efficacy of a 1:10 dilution of Lancy-Vaxina? (Berna Biotech, Switzerland), and were seen every 2-3 days (days 6, 8, 10, 13, and 15 after smallpox vaccination) for scheduled dressing changes. Swab specimens were obtained from the vaccination lesion, the outer surface, and the gauze surface. Quantitative viral culture assays for these specimens were done. RESULTS: Vaccinia virus was recovered from 126 (81%) of the 156 vaccination lesion samples collected from the 40 participants. A high virus titer was recovered from the vaccination lesion (geometric mean titer (log10)=3.91 on day 8). Of the 39 swab samples obtained from the gauze surface of the gauze, 16 (41%) were positive for virus. An intermediate titer was recovered from the gauze surface (geometric mean titer (log10)=0.91 on day 8). Of the 133 swab samples obtained from the outer surface, only one (0.8%) was positive for vaccinia. No virus was recovered from the outer surface on day 8. CONCLUSION: Our findings suggest that the addition of a semipermeable dressing to the folded gauze further reduces viral shedding and therefore increases protection.
Bandages* ; Membranes ; Smallpox* ; Vaccination* ; Vaccinia virus* ; Vaccinia* ; Viral Load ; Virus Shedding ; Volunteers

BACKGROUND: We compared vaccinia virus shedding from the vaccine inoculation site (vaccination lesion) and two sites of a dressing covering the vaccination site; the outer surface of the semipermeable dressing (outer surface) and the inner surface of the semipermeable dressing, that is, the surface of a folded gauze under the semipermeable membrane (gauze surface) MATERIAL AND METHODS: Subjects were recruited from the volunteers who participated in a clinical trial of the efficacy of a 1:10 dilution of Lancy-Vaxina? (Berna Biotech, Switzerland), and were seen every 2-3 days (days 6, 8, 10, 13, and 15 after smallpox vaccination) for scheduled dressing changes. Swab specimens were obtained from the vaccination lesion, the outer surface, and the gauze surface. Quantitative viral culture assays for these specimens were done. RESULTS: Vaccinia virus was recovered from 126 (81%) of the 156 vaccination lesion samples collected from the 40 participants. A high virus titer was recovered from the vaccination lesion (geometric mean titer (log10)=3.91 on day 8). Of the 39 swab samples obtained from the gauze surface of the gauze, 16 (41%) were positive for virus. An intermediate titer was recovered from the gauze surface (geometric mean titer (log10)=0.91 on day 8). Of the 133 swab samples obtained from the outer surface, only one (0.8%) was positive for vaccinia. No virus was recovered from the outer surface on day 8. CONCLUSION: Our findings suggest that the addition of a semipermeable dressing to the folded gauze further reduces viral shedding and therefore increases protection.
Bandages* ; Membranes ; Smallpox* ; Vaccination* ; Vaccinia virus* ; Vaccinia* ; Viral Load ; Virus Shedding ; Volunteers

We conducted this study to compare clinical features, outcomes, and clinical implication of antimicrobial resistance in Klebsiella pneumoniae bacteremia acquired as community vs. nosocomial infection. A total of 377 patients with K. pneumoniae bacteremia (191 community-acquired and 186 nosocomial) were retrospectively analyzed. Neoplastic diseases (hematologic malignancy and solid tumor, 56%) were the most commonly associated conditions in patients with nosocomial bacteremia, whereas chronic liver disease (35%) and diabetes mellitus (20%) were the most commonly associated conditions in patients with community-acquired bacteremia. Bacteremic liver abscess occurred almost exclusively in patients with community-acquired infection. The overall 30-day mortality was 24% (91/377), and the mortality of nosocomial bacteremia was significantly higher than that of community-acquired bacteremia (32% vs. 16%, p<0.001). Of all community-acquired and nosocomial isolates, 4% and 33%, respectively, were extended-spectrum cephalosporin (ESC)-resistant, and 4% and 21%, respectively, were ciprofloxacin (CIP)-resistant. In nosocomial infections, prior uses of ESC and CIP were found to be independent risk factors for ESC and CIP resistance, respectively. Significant differences were identified between community-acquired and nosocomial K. pneumoniae bacteremia, and the mortality of nosocomial infections was more than twice than that of community-acquired infections. Antimicrobial resistance was a widespread nosocomial problem and also identified in community-acquired infections.
Treatment Outcome ; Risk Factors ; Retrospective Studies ; Middle Aged ; Male ; *Klebsiella pneumoniae ; Klebsiella Infections/*drug therapy ; Humans ; Female ; Drug Resistance, Bacterial ; Cross Infection/*drug therapy/mortality ; Community-Acquired Infections/*drug therapy/mortality ; Ciprofloxacin/therapeutic use ; Cephalosporins/therapeutic use ; Bacteremia/*drug therapy/mortality ; Aged, 80 and over ; Aged ; Adult ; Adolescent ; APACHE

BACKGROUND AND OBJECTIVES: The BNP concentration varies considerably after the onset of AMI, and this makes it difficult to determine the right time to measure the BNP as a valid prognostic marker. The aim of this study was to examine the early changing patterns of BNP and to decide on the suitable time for measuring the BNP as a prognostic marker after the onset of AMI. SUBJECTS AND METHODS: From Feb 2002 to May 2005, we analyzed the changing patterns of BNP in 321 AMI patients. BNP (Triage(R)) was measured at the acute phase (< or = 24 hr), the early phase (2 to 6 day), the late phase (1 to 4 week) & the long-term phase (>4 week) after the onset of AMI. The end points were major adverse cardiac events (MACE) and cardiovascular death (CVD). RESULTS: The mean BNP was 306.2+/-802.8 at the acute phase (mean: 9.5 hours), 251.9+/-592.8 at the early phase (mean: 5.1 days), 103.1+/-172.9 at the late phase (mean: 26.8 days) and 179.7+/-353.3 pg/mL at the long-term phase (mean: 45.9 days). There were no significant differences of the demographic factors between the MACE and Non-MACE group. Multivariative analysis showed that early phase BNP (p=0.007) and male gender (p=0.009) were significant risk factors for MACE. The early phase BNP (p=0.037) and age (p=0.022) were the significant risk factors of CVD. On the ROC curve, the early phase BNP for predicting the CVD risk was 186 pg/mL (AUC=0.87, p<0.001). The Kaplan-Meier survival curve showed that the survival rate was higher for the patients with an early phase BNP<186 pg/mL than it was for those patients with a BNP> or = 186 pg/mL (p=0.000). CONCLUSION: The early levels or changing patterns of the BNP concentrations following AMI showed different patterns of change depending on several prognostic factors. The early phase (2 to 6 day) BNP concentration after the onset of AMI could be used as a significant prognostic marker.
Demography ; Humans ; Male ; Myocardial Infarction* ; Natriuretic Peptide, Brain* ; Prognosis ; Risk Factors ; ROC Curve ; Survival Rate

BACKGROUND: To identify specific risk factors for Pseudomonas aeruginosa and evaluate the relationship between the mortality rate and P. aeruginosa bacteraemia in bloodstream infections, we compared the clinical features and outcomes of patients with P. aeruginosa bacteremia with the patients with Klebsiella pneumoniae or Enterobacter bacteremia. MATERIALS AND METHODS: A total of 190 patients with P. aeruginosa bacteremia were identified from January 1998 to December 2002 and included in this retrospective analysis. During the same period, 377 patients with K. pneumoniae bacteremia and 183 patients with Enterobacter bacteremia were identified and compared with those with P. aeruginosa bacteremia. RESULTS: Factors associated with P. aeruginosa bacteremia in the multivariate analysis included pneumonia, soft tissue infection, nosocomial acquisition, neutropenia, and prior invasive procedure (All P<0.05). The 30-day mortality rate was 37.9% (72/190) in patients with P. aeruginosa bacteremia, 24.1% (91/377) in those with K. pneumoniae, and 25.7% (47/183) in those with Enterobacter bacteremia (P<0.001). However, in the analysis including patients who had received appropriate initial antimicrobial therapy (n=552), the mortality rate of P. aeruginosa bacteremia was not significantly higher than that of non-pseudomonas bacteremia (28.6% [18/63] vs. 22.5% [110/489]; P=0.282). Inappropriate initial antimicrobial therapy was found to be one of the significant independent predictors of mortality. P. aeruginosa bacteremia as a risk factor for mortality did not reach statistical significance (OR, 1.30; 95% CI, 0.73-2.32; P=0.371), after adjusting for underlying illness and adequacy of antimicrobial therapy. CONCLUSION: An initial empirical antimicrobial coverage of P. aeruginosa should be seriously considered in patients with pneumonia, soft tissue infection, neutropenia, and prior invasive procedure, when gram-negative sepsis was suspected in nosocomial infection.
Bacteremia* ; Cross Infection ; Enterobacter* ; Gram-Negative Bacterial Infections ; Humans ; Klebsiella pneumoniae* ; Klebsiella* ; Mortality ; Multivariate Analysis ; Neutropenia ; Pneumonia ; Pseudomonas aeruginosa* ; Pseudomonas* ; Retrospective Studies ; Risk Factors ; Sepsis ; Soft Tissue Infections ; Treatment Outcome

During the neutropenic phase, leukemia patients receiving chemotherapy are prone to bacterial and, fungal infections; occasionally mycobacterial, viral and protozoal organisms may also cause infections. Mycobacterium tuberculosis infection was reported very rarely in these patients. This report describes four patients with M. tuberculosis infection identified from 185 adult patients who were diagnosed myelogenous leukemia between January 2003, and December 2004. There was no patient with M. tuberculosis infection from 44 lymphoid leukemia and 11 acute biphenotypic leukemia patients. Sites of infection were all lymph nodes. Three among four patients were presented with lymphadenopathy at initial diagnosis of leukemia, and the other one presented with lymphadenopathy after induction chemotherapy. There was no patient presented with lymphadenopathy during the neutropenic phase. Tuberculous lymphadenitis was presented in a patient with three acute myelogenous leukemia (FAB class 2 M4, 1 M2) and a chronic myelogenous leukemia, accelerated phase. An acute myelogenous leukemia patient had a leukemic cell and tubercle bacilli in the same lymph node. Tuberculosis should also be included as a differential diagnosis in myelogenous leukemia patient with lymphadenopathy, especially in the countries in which the disease is endemic.
Adult ; Diagnosis ; Diagnosis, Differential ; Drug Therapy ; Humans ; Induction Chemotherapy ; Leukemia ; Leukemia, Biphenotypic, Acute ; Leukemia, Lymphoid ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Leukemia, Myeloid* ; Leukemia, Myeloid, Acute ; Lymph Nodes ; Lymphatic Diseases ; Mycobacterium tuberculosis ; Tuberculosis ; Tuberculosis, Lymph Node*

BACKGROUND: To identify specific risk factors for Pseudomonas aeruginosa and evaluate the relationship between the mortality rate and P. aeruginosa bacteraemia in bloodstream infections, we compared the clinical features and outcomes of patients with P. aeruginosa bacteremia with the patients with Klebsiella pneumoniae or Enterobacter bacteremia. MATERIALS AND METHODS: A total of 190 patients with P. aeruginosa bacteremia were identified from January 1998 to December 2002 and included in this retrospective analysis. During the same period, 377 patients with K. pneumoniae bacteremia and 183 patients with Enterobacter bacteremia were identified and compared with those with P. aeruginosa bacteremia. RESULTS: Factors associated with P. aeruginosa bacteremia in the multivariate analysis included pneumonia, soft tissue infection, nosocomial acquisition, neutropenia, and prior invasive procedure (All P<0.05). The 30-day mortality rate was 37.9% (72/190) in patients with P. aeruginosa bacteremia, 24.1% (91/377) in those with K. pneumoniae, and 25.7% (47/183) in those with Enterobacter bacteremia (P<0.001). However, in the analysis including patients who had received appropriate initial antimicrobial therapy (n=552), the mortality rate of P. aeruginosa bacteremia was not significantly higher than that of non-pseudomonas bacteremia (28.6% [18/63] vs. 22.5% [110/489]; P=0.282). Inappropriate initial antimicrobial therapy was found to be one of the significant independent predictors of mortality. P. aeruginosa bacteremia as a risk factor for mortality did not reach statistical significance (OR, 1.30; 95% CI, 0.73-2.32; P=0.371), after adjusting for underlying illness and adequacy of antimicrobial therapy. CONCLUSION: An initial empirical antimicrobial coverage of P. aeruginosa should be seriously considered in patients with pneumonia, soft tissue infection, neutropenia, and prior invasive procedure, when gram-negative sepsis was suspected in nosocomial infection.
Bacteremia* ; Cross Infection ; Enterobacter* ; Gram-Negative Bacterial Infections ; Humans ; Klebsiella pneumoniae* ; Klebsiella* ; Mortality ; Multivariate Analysis ; Neutropenia ; Pneumonia ; Pseudomonas aeruginosa* ; Pseudomonas* ; Retrospective Studies ; Risk Factors ; Sepsis ; Soft Tissue Infections ; Treatment Outcome