BACKGROUND: Candida dubliniensis is newly described yeast that is a close phylogenetic relative of C. albicans and isolates mainly from the oral cavity. OBJECTIVE: The aim of the present study was to screen for C. dubliniensis using the 'spiking' appearance on a blood agar plate (BAP), germ tube test with human pooled serum (HPS) and fetal bovine serum (FBS) and to investigate the prevalence of C. dubliniensis from respiratory samples in Korea. METHODS: A total 434 isolates of Candida spp. were examined for the presence of 'spiking' on BAP and the germ tube test with HPS and FBS. Also all isolates were tested using the VITEK 2 ID-YST system. RESULTS: No C. dubliniensis was found in the study population. C. albicans was the most frequently isolated species (74.9%). CONCLUSIONS: No C. dubliniensis was identified in our study. Further large-scale studies are needed to isolate and to confirm the prevalence of C. dubliniensis.
Agar ; Candida ; Humans ; Korea ; Mass Screening ; Mouth ; Prevalence ; Yeasts

Idiopathic thrombocytopenic purpura (ITP) mostly presents with bleeding tendencies, and thrombotic events are very uncommon. Our case report presents a male patient with ITP refractory to standardized therapies who continuously showed thrombocytopenia and hematuria. With no evidence of autoimmune diseases or other secondary causes of ITP, he developed recurrent cerebral infarctions and deep venous thrombosis. Our report calls for attention to possible thrombotic events, as well as more common bleeding tendencies in patients with ITP and outlines rehabilitation treatment specially designed for ITP patients with rare thrombotic complications.

BACKGROUND AND OBJECTIVES: The Osborn wave is the name designated to the wave formation produced when there is a large, prominent deviation of the J point from the baseline. The wave has been reported in many countries, but only 2 cases have been reported in Korea. Thus, the purpose of our study was to evaluate the clinical characteristics and therapy of hypothermia employing the Osborn wave with Koreans. SUBJECTS AND METHODS: Between February 2001 and April 2001, five patients visiting our department with hypothermia were enrolled in this study. We analyzed these patients for their distribution, symptoms and signs, associated disorders, risk factors, electrocardiogram and laboratory findings. RESULTS: All 5 patients were male with an average age was 44.8+/-12.7 years. Three patients had a semi-comatose mentality and 2 cases had a comatose mentality. Their associated disorders were diabetes (2 cases), psychotic problems (1 case) and nutritional deficiency (1 case). Risk factors were alcohol abuse (3 cases) and drug in toxication (1 case). Laboratory abnormalities were acidosis (4 cases), increased serum glucose levels (all 5 cases) and increased serum potassium levels (3 cases). After active core rewarming by a line heat exchanger, 3 of the 5 patients completely recovered from hypothermia, 1 case immediately expired following admission and 1 case survived for 10 days, but later expired due to acute respiratory distress syndrome. The Osborn wave was persistent in 1 case and disappeared in 3 cases. CONCLUSION: We experienced 5 cases of hypothermia with an Osborn wave. The mortality of patients displaying an Osborn wave is expected to decrease if this anomaly is immediately found and treated by an appropriate method.
Acidosis ; Alcoholism ; Blood Glucose ; Coma ; Electrocardiography* ; Hot Temperature ; Humans ; Hypothermia* ; Korea ; Male ; Malnutrition ; Mortality ; Potassium ; Respiratory Distress Syndrome, Adult ; Rewarming ; Risk Factors

Ischemic colitis is a medical condition in which inflammation and injury of the large intestine result from inadequate blood supply. Although uncommon in the general population, ischemic colitis occurs with greater frequency in the elderly, and is the most common form of bowel ischemia. Other possible causes include medications such as NSAIDs(non-steroidal antiinflammatory drugs), oral contraceptives, diuretics and others. In recent years, many of NSAID use in young age can cause ischemic lesions, but it is not common. Here we report a case of ischemic colitis in a 31-year-old man who had no specific medical history except taking 200mg of ibuprofen three times a day for seven days. It suggests the importance of precise history taking, including medications usage such as NSAIDs and other risk factors.
Adult ; Aged ; Anti-Inflammatory Agents, Non-Steroidal ; Colitis, Ischemic* ; Contraceptives, Oral ; Diuretics ; Humans ; Ibuprofen* ; Inflammation ; Intestine, Large ; Ischemia ; Risk Factors

No abstract available.
Humans ; Nephritis, Interstitial* ; Nephrotic Syndrome*

BACKGROUND: Although complications from transfusion are known to happen, transfusion is performed during most open heart surgeries. The aim of this study was to investigate the possibility of performing cardiac surgery without allogenic blood transfusion. MATERIAL AND METHOD: Between January to August 2007, 44 consecutive patients who underwent open heart surgery with using various blood conservation methods were retrospectively enrolled. They were divided into group I (the onpump group, n=17) and group II (the offpump group, n=27). The blood conservation methods were intraoperative autologous donation, cell saver, retrograde autologous priming, conventional ultrafiltration and modified ultrafiltration. Antianemic agents were administered to all the patients postoperatively. We analyzed the possibility of bloodless operations, the causes of homologous transfusion, the serial change of the hematocrit and the postoperative chest tube drainage, and we compared the results between the two groups. If comparison between the two groups was not reasonable, then we compared two groups with the individual control groups I and II (49 patients) in 2006. RESULT: 40 (90.9%) of 44 patients were successfully operated on without transfusion and the success rate was 88.2% (15/17) for group I and 92.6% (25/27) for group II. There was no statistical difference between the two groups (p=NS). The causes of transfusion were 2 cases of postoperative bleedings, 1 case of intraoperative bleeding and 1 mistake of the indication for transfusion. There was no statistical difference of the total chest tube drainage (Group I: 417+/-359 mL, Group II: 451+/-237 mL) (p=NS), but the total chest tube drainages of the two groups were less than each of the control groups 1 and II (p<0.05). The lowest hematocrit level of Group I was 16.4+/-2%, and this occurred just after infusion of cardioplegics and the hematocrits of both groups were recovered to the preoperative level at 2 months postoperatively. CONCLUSION: In this study, bloodless open heart surgery could be performed in 90.9% of the patients with intraoperative autologous donation, cell saver, retrograde autologous priming, conventional ultrafiltration and modified ultrafiltration. A combination of various blood conservation methods is the most important and bloodless cardiac surgery could be performed with meticulous bleeding control and strictly following the transfusion indications.
Blood Transfusion ; Cardiopulmonary Bypass ; Chest Tubes ; Drainage ; Heart ; Hematocrit ; Hemorrhage ; Humans ; Retrospective Studies ; Thoracic Surgery ; Ultrafiltration

OBJECTIVE: TNF-alpha related apoptosis inducing ligand (TRAIL) is a member of TNF superfamily that promotes apoptosis by binding to the transmembrane receptors. The effects of TRAIL in patients with rhematoid arthritis (RA) are still debatable. This study was performed to evaluate the effects of TRAIL on RA by measuring serum concentration of TRAIL in patients with RA and assessing relationships between the TRAIL concentration and various clinical parameters of RA. METHODS: A total of 105 patients with RA, 34 patients with osteoarthritis (OA), and 35 age- and gender-matched healthy controls were enrolled in this study. Data from the RA patients included subject's age, duration of disease, daily steroid doses, ESR, CRP, rheumatoid factor, leukocyte count, lymphocyte count, tender joint count, swollen joint count, and serum TRAIL concentration. Serum TRAIL concentration was measured by enzyme immunoassay (EIA) method. The serum concentration of TRAIL in RA patients was compared to those of OA patients and healthy controls. Relationships of TRAIL concentration with various clinical parameters were evaluated. RESULTS: Serum concentration of TRAIL in patients with RA was significantly decreased compared to that in healthy controls (RA: 42.60+/-26.39 pg/mL, control: 57.21+/-19.49 pg/mL, p=0.029). Serum concentration of TRAIL in patients with OA (50.79+/-15.92 pg/mL) was not different from that in normal controls (p=0.115). There were no significant differences in serum TRAIL concentration between patients with RA and those with OA (p=0.360). In patients with RA, serum TRAIL concentration showed no difference between high- and normal ESR subgroups, as well as high- and normal CRP subgroups. Serum TRAIL concentration correlated significantly with ESR (r=0.406, p<0.001). However, other clinical parameters, such as subject's age, duration of disease, daily steroid doses, CRP, leukocyte count, lymphocyte count, tender joint count, swollen joint count revealed no significant correlation with serum TRAIL concentration. CONCLUSION: Serum concentrations of TRAIL in RA patients were significantly lower than those in healthy controls, suggesting that apoptotic ability is decreased in the patients with RA. Serum TRAIL concentration does not seem to reflect disease activity of RA.
Apoptosis ; Arthritis ; Arthritis, Rheumatoid ; Humans ; Immunoenzyme Techniques ; Joints ; Leukocyte Count ; Lymphocyte Count ; Osteoarthritis ; Rheumatoid Factor ; Tumor Necrosis Factor-alpha

Recently, increased emphasis has been placed on the need for rehabilitation professionals to objectively evaluate a patient's potential for and progress toward a return to normal function. But as medical recovery nears completion, additional questions are commonly asked by physicians regarding work function and ability to return to full active employment. In the past, therapists have attempted to reestablish the work situation using real tools, but these machines were expensive, have space limitations and in some cases, potentially dangerous as well. A Baltimore Therapeutic Equipment(BTE) Work Simulator overcomes these shortcomings. It can be used for isometric and isotonic evaluation and treatment and assisted in providing the information needed to make determinations regarding progress in therapy, return-to-work status and job modifications. We are going to obtain normative isometric, dynamic and endurance of grip strength, key pinch strength and three point pinch strength data using BTE Work Simulator model WS20. We also compare these data between ages and sexs. This study will be helpful in clinical applications of the BTE Work Simulator and providing the more specific job related occupational therapy and developing special vocational rehabilitation program.
Employment ; Hand Strength* ; Occupational Therapy ; Pinch Strength* ; Rehabilitation ; Rehabilitation, Vocational ; Return to Work

Background: and Purpose The American College of Cardiology and the American Heart Association (ACC-AHA) have released new guidelines and expanded indications for statin treatment. We aimed to reveal the clinical efficacy of each indication in the guidelines using a large-scale national cohort. Methods: We used National Health Screening Cohort data to determine the proportions of participants for whom statin therapy would be recommended using the different guidelines.We assessed the cumulative incidence rates of major adverse cardiovascular events (MACE) using the Cox proportional-hazards model. Results: Under the 2013 ACC-AHA guidelines, 111,600 participants were additionally eligible to receive statins, compared with 50,023 participants according to the Third Adult Treatment Panel (ATP-III). Most of the additional statin-eligible participants in the ACC-AHA guidelines were indicated by their 10-year cardiovascular disease risk. The increase in statineligible participants in the ACC-AHA guidelines mainly involved elderly patients aged 60–75 years. Among participants not requiring statin, participants who were eligible for a statin under the ACC-AHA guidelines had a significantly higher hazard ratio of MACE when compared with those eligible under the ATP-III guidelines. Among the not-recommended groups, patients with diabetes and low-density lipoprotein <70 mg/dL constituted the group with the highest risk of MACE. Conclusions The 2013 ACC-AHA guidelines increase the number of statin-eligible participants, especially among the elderly. These guidelines provide a stronger recommendation for statins to high-risk groups, but it remains necessary to consider the characteristics of the population in the risk equation. In addition, the aggressive use of statin in diabetes patients and further studies of older subjects are needed.

Between June 1994 to August 1996, 13 patients underwent emergency coronary artery bypass operations. There were 3 males and 10 females and ages ranged from 56 to 80 years with the mean of 65.5 years. The indications for emergency operations were cardiogenic shock in 12 cases and intractable polymorphic VT(ventricular tachycardia) in 1 case. The causes of cardiogenic shock were acute evolving infarction in 6 cases, PTCA failure in 4 cases, acute myocardial infarction in 1 case, and post-AMI VSR(ventricular septal rupture) in 1 case. Five out of 13 patients could go to operating room within 2 hours. However, the operations were delayed from 3 to 10 hours in 8 patients due to non-medical causes. In 12 patients, 37 distal anastomoses were constructed with only 3 LITA's(left internal thoracic arteries) and 34 saphenous veins. In a patient with post-AMI VSR, VSR repair was added. In a patient with intractable VT and critical stenosis limited to left main coronary artery, left main coronary angioplasty was performed. Five patients died after operation with the operative mortality of 38.5%. Three patients died in the operating room due to LV pump failure, one patient died due to intractable ventricular tachycardia on postoperative second day, and one patient died on postoperative 7th day due to multi-organ failure with complications of mediastinal bleeding, low cardiac output syndrome, ARF, and lower extremity ischemia due to IABP. In 8 survived patients, 3 major complications (mediastinitis, PMI, UGI bleeding) developed but eventually recovered. We think that the aggressive approach to critically ill patients will salvage some of such patients and the most important factor for patient salvage is early surgical intervention before irreversible damage occurs.
Angioplasty ; Cardiac Output, Low ; Constriction, Pathologic ; Coronary Artery Bypass* ; Coronary Vessels* ; Critical Illness ; Emergencies* ; Female ; Hemorrhage ; Humans ; Infarction ; Ischemia ; Lower Extremity ; Male ; Mortality ; Myocardial Infarction ; Operating Rooms ; Saphenous Vein ; Shock ; Shock, Cardiogenic* ; Tachycardia, Ventricular