BACKGROUND: As the population of immunocompromised patients continues to grow, the incidence of infections caused by opportunistic filamentous fungi will continue to increase. Inhalation of fungal spores which are found in the environmental air precedes infection with molds. We investigated the relative frequency of various molds recovered from hospital air as compared to isolates from clinical specimens. METHODS: Air samples were taken from 83 sites in Chonnam University Hospital during December 1997. Air sampler (Biotest, Germany) with Rose Bengal agar strip (Biotest, Germany) was calibrated to take 40 liters of air. The strips were incubated at 37degrees C for 2-14 days. The results of air cultures were compared with those from the clinical specimens during a year (1997). RESULTS: Of 83 air samples cultured, 61 (73.5%) were positive for molds: 43 (51.8%) samples with 1-2 CFU, 15 (18.1 %) samples with 3-5 CFU, and 3 (3.6%) samples with > 5 CFU. A total of 184 molds were isolated and the most frequently recovered molds were Cladosporium (26.0%), followed by Penicillium (25.5%), Aspergillus (18.5%) and Alternaria (9.8%). The most frequently isolated molds from clinical specimens were Aspergillus (62.8%) and Fusarium (20.2%). For Aspergillus species, A. flavus (28,8%) and A. fumigates (25.4%) were predominant among the clinical isolates, whereas A sydowii (44.1%) and A. niger (38.2%) were common in the hospital air. CONCLUSION: This result shows that Cladosporium and Penicillium are the predominant molds in the hospital air and the relative frequency of molds recovered from hospital air is quite different from those of clinical isolates.
Agar ; Alternaria ; Aspergillus ; Cladosporium ; Fungi* ; Fusarium ; Immunocompromised Host ; Incidence ; Inhalation ; Jeollanam-do ; Niger ; Penicillium ; Rose Bengal ; Spores, Fungal

PURPOSE: Purposes of this study were to understand the current trends on complementary therapy in relieving chemotherapy-induced nausea and vomiting and to suggest the future research direction. METHOD: Subjects were selected on CINAHL, MEDLINE, Korean Academy Data Base from 1980 to 2001 which used nausea, vomiting, chemotherapy and complementary therapy as key words in experimental studies. Eight korean articles and twenty-one international articles were analyzed in terms of general characteristics, research methods, and types of complementary therapy. Data were analyzed by using descriptive statistical methods. RESULT: Since 2000, researchers have more actively used complementary therapy. In subject characteristics, mean age was 35.5 years old, 45% of the researchers were performed with high level of incidence of chemotherapy induced vomiting, 14% of them set limit of consecutive cycle during research, and 65% of them did not comment the selecting criteria of sample. About 60% of them were designed post-test only control group; 35% used INV by Rhodes, 31% used Likert scale, and 24% used VAS for dependent variable. Muscle relaxation therapy was mostly applied for relief of nausea and vomiting. CONCLUSION: Further studies will be needed to control extrinsic variables affecting nausea and vomiting in research design and to accumulate evidence with studies applying various complementary therapies.
Complementary Therapies ; Drug Therapy ; Incidence ; Muscle Relaxation ; Nausea* ; Research Design ; Vomiting*

OBJECTIVE: To investigate the expression of cytokines and growth factors in disc specimens obtained from small numbers of patients with herniated nucleus pulposus (HNP) and degenerated disc disease (DDD). METHOD: A total of ten human intervertebral disc samples consisted of five painful degenerative discs and five herniated intervertebal discs were obtained from surgery. MRI and Western blot analyses on these disc samples were performed to determine the levels of disc degeneration and the expression levels of cytokines and growth factors. RESULTS: The levels of IL-6 were significantly greater in the DDD patients than in the HNP patients, but no statistical differences were observed in the expression of IL-1beta, IL-8 and TNF-alpha between the HNP and DDD patients. In addition, the expression of TGF beta was significantly higher in the DDD patients than in the HNP patients. CONCLUSION: The higher levels of cytokine and growth factor expression in the DDD than in the HNP show why discogenic patients usually have more severe back pain than patients with herniated discs.
Back Pain ; Blotting, Western ; Cytokines ; Dichlorodiphenyldichloroethane ; Humans ; Intercellular Signaling Peptides and Proteins ; Interleukin-6 ; Interleukin-8 ; Intervertebral Disc ; Intervertebral Disc Degeneration ; Intervertebral Disc Displacement ; Tumor Necrosis Factor-alpha

BACKGROUND: BRCA1 (breast-cancer gene 1) is a tumor suppressor gene that accounts for nearly all families of both early onset breast and ovarian cancer and about 45% of families with breast cancer only. Sporadic nonhereditary breast cancer is recognized as the most common form of this malignancy. However, presence of germ-line mutations in the BRCA1 gene of these tumors is an infrequent event. The BRCA1 protein includes a ring domain and an acidic domain, both of which are characteristics of certain transcription factors, as well as two putative nuclear localization signals (NLS) that interact with importin-alpha. The normal BRCA1 protein is located in the nucleus of most breast-cell types whereas the BRCA1 protein of breast cancer cells is aberrantly localized in the cytoplasm. This mislocation of the BRCA1 protein in breast cancer cells may be due to defects in the NLS receptor-mediated pathway for the nuclear import of the BRCA1 gene product. Identification of importin-alpha mutations as a cellular protein responsible for the nuclear import of BRCA1 in breast-cancer cell lines and primary breast cancers is the focus of this investigation. METHODS: A series of 15 surgical samples of breast cancer and 3 samples of breast-cancer cell lines (Hs578T, ZR75-1, MCF-7) was assayed for the presence of the deletion mutant in importin-alpha by using both RT-PCR amplification of importin-alpha transcripts and sequencing analysis. RESULTS: Three of the 15 primary breast cancers and 1 of the 3 breast-cancer cell lines showing deletions in importin-alpha transcripts produced two different truncated transcripts. 1208 bp deletions were observed in transcripts from breast cancer (T-1, T-3) and ZR75-1, which is specified by the nucleotide 251-1458 of the transcript. Another transcript encoded by primary breast cancer (T-2) included a 1312 bp deletion in the nucleotide 61-1372 of the transcript. CONCLUSIONS: The deletions eliminated part of the importin-alpha transcript segment encoding the putative NLS-binding domain but not the importin-beta binding domain, suggesting that these deletion mutants could not bind to NLS of the BRCA1 protein. These results suggest that the composite effects of mislocationof the BRCA1 protein by deletion of the NLS-binding domain in importin-alpha may contribute to tumorigenesis in sporadic breast cancer.
Active Transport, Cell Nucleus ; alpha Karyopherins* ; Alternative Splicing ; beta Karyopherins ; BRCA1 Protein ; Breast Neoplasms* ; Breast* ; Carcinogenesis ; Cell Line ; Cytoplasm ; Genes, BRCA1 ; Genes, Tumor Suppressor ; Germ-Line Mutation ; Humans ; Nuclear Localization Signals ; Ovarian Neoplasms ; Transcription Factors

Sarcoidosis is a multi-system granulomatous disorder of an unknown etiology and affects individuals worldwide. It is characterized pathologically by the presence of non-caseating granulomas in more than one involved organ. However, pleural involvement of sarcoidosis is rare and there are no reported cases in Korea. Traditionally, sarcoidosis has often been treated with systemic corticosteroids or cytotoxic agents. In particular, chylothorax with sarcoidosis is usually treated with corticosteroid for approximately 3~6 months, followed by repeated therapeutic thoracentesis, talc pleurodesis, dietary treatment, or thoracic duct ligation where needed. We encountered a 46 years old female patient presenting with cough, dyspnea and both hilar lymphadenopathy (stage I) on chest radiograph. The patient was diagnosed with a non-caseating granuloma, sarcoidosis by a mediastinoscopic biopsy. For one month, she had suffered from dyspnea due to right side pleural effusion, which was clearly identified as a chylothorax on thoracentesis. Corticosteroid therapy with dietary adjustment was ineffective. She was treated successfully with a subcutaneous injection of octreotide for 3 weeks and oral corticosteroid. We report a case of successful and rapid treatment of chylothorax associated with sarcoidosis using octreotide and oral corticosteroid.
Adrenal Cortex Hormones ; Biopsy ; Chylothorax* ; Cough ; Cytotoxins ; Dyspnea ; Female ; Granuloma ; Humans ; Injections, Subcutaneous ; Korea ; Ligation ; Lymphatic Diseases ; Mediastinoscopy ; Middle Aged ; Octreotide* ; Pleural Effusion ; Pleurodesis ; Radiography, Thoracic ; Sarcoidosis* ; Talc ; Thoracic Duct

PURPOSE: A task force appointed by the Korean Society of Acute Care Surgery reviewed previously published guidelines on antibiotic use in patients with abdominal injuries and adapted guidelines for Korea. METHODS: Four guidelines were assessed using the Appraisal of Guidelines for Research and Evaluation II instrument. Five topics were considered: indication for antibiotics, time until first antibiotic use, antibiotic therapy duration, appropriate antibiotics, and antibiotic use in abdominal trauma patients with hemorrhagic shock. RESULTS: Patients requiring surgery need preoperative prophylactic antibiotics. Patients who do not require surgery do not need antibiotics. Antibiotics should be administered as soon as possible after injury. In the absence of hollow viscus injury, no additional antibiotic doses are needed. If hollow viscus injury is repaired within 12 hours, antibiotics should be continued for ≤ 24 hours. If hollow viscus injury is repaired after 12 hours, antibiotics should be limited to 7 days. Antibiotics can be administered for ≥7 days if hollow viscus injury is incompletely repaired or clinical signs persist. Broad-spectrum aerobic and anaerobic coverage antibiotics are preferred as the initial antibiotics. Second-generation cephalosporins are the recommended initial antibiotics. Third-generation cephalosporins are alternative choices. For hemorrhagic shock, the antibiotic dose may be increased twofold or threefold and repeated after transfusion of every 10 units of blood until there is no further blood loss. CONCLUSION: Although this guideline was drafted through adaptation of other guidelines, it may be meaningful in that it provides a consensus on the use of antibiotics in abdominal trauma patients in Korea.
Abdominal Injuries* ; Advisory Committees ; Anti-Bacterial Agents ; Antibiotic Prophylaxis ; Cephalosporins ; Consensus ; Humans ; Korea ; Shock, Hemorrhagic