PURPOSE: This retrospective study was done to evaluate the status of nosocomial urinary tract infections and to determine the risk factors andtransmission route of causal IRPA through molecular epidemiology. METHOD: Two hundred ninety-nine of 423 patients admitted to the internal medicine and surgery ICU at a university hospital incity B had a positiveurine culture. Twelve of the 299 patients who had a urinary tract infection had IRPA strains. The data was collected from November 1, 2004 to January 31, 2005. The following results were obtained after the data was analyzed using percentile and UPGMA. RESULT: The rate of nosocomial urinary tract infections in the ICU was 10.8%. Therewere 16.8 cases of infection based on the period of hospitalization. There were 16.9 cases of infection based on the use of a foley catheter. The rate of nosocomial urinary tract infection in the ICU and urinary tract infections related to IRPA were higher in patients with the following characteristics: men, old age, admission through the emergency room, longer than seven days admission, severity of admitting causes, disturbance of consciousness, hydration less than 300cc in 24hours, a long course of antibiotics, a long period of foley catheterization and perineal care. Most of the microorganisms that caused the urinary tract infection were gram negative bacilli, among which P. aeruginosa was found in 70 patients (18.5%) and IRPA in 12 (4.0%). Among the 12 IRPA strains that were tested with PFGE, eight showed a dice coefficient higher than 80%, suggesting a genetic relationship. They were related with the period of hospitalization in the same ICU. These patients all received direct care for a urinary tract infection. CONCLUSION: Through these results, IRPA can be consideredas a contributing factors to urinary tract infections thus, active preventative measures are needed by the medical staff.
Adult ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents/*pharmacology ; Cross Infection/*epidemiology/etiology/microbiology ; Drug Resistance, Bacterial ; Female ; Humans ; Imipenem/*pharmacology ; Intensive Care Units ; Male ; Middle Aged ; Pseudomonas Infections/drug therapy/*epidemiology ; Pseudomonas aeruginosa/classification/drug effects/*genetics ; Retrospective Studies ; Risk Factors ; Urinary Catheterization ; Urinary Tract Infections/*epidemiology/etiology/microbiology

Reactive human mesothelial cells were examined by immunocytochemical stain with intermediate filaments(cytokeratin [CK1, CK7, CK8, CK18, CD19/, vimentin, desmin, actin), epithelial membrane antigen, carcinoembryonic antigen(CEA), MHC class II antigen(HLA-DR), LeuM-1(CD15), alpha1-antitrypsin(ACT), alpha1-antichymotrypsin (ACHT), CD68(KP-1) and FcgammaRIII(CD16). The mesothelial cells were isolated from patients with liver cirrhosis and pleural effusion, and short-term cultured in RPMI 1640 media containing 10% heat inactivated fetal calf serum and 1% identical supernatant fluid of the patients' transudates. The results obtained are as follows. 1. The cultured-reactive mesothelial cells were positive for the protein of cytoskeleton such as cytokeratin and vimentin, but negative for desmin and actin. The resting mesothelial cells showed positive reactions for cytokeratin, but negative for vimentin, desmin and actin. 2. The primary antibodies to the cytokeratin were strongly reactive for CK1, CK8 and CK18 but negative for CK7 and CK19 in both reactive and resting mesothelial cells. 3. Resting mesothelial cells showed negative reactions for CEA, but strong positive reactions in cultured-reactive mesothelial cells. 4. The markers for the monocytes\histiocytes (CD11b, CD14, CD16, CD68, lysozyme and alpha1-antitrypsin and alpha1-antichymotrypsin) were nonreactive in resting mesothelial cells, but lysozyme and alpha1-antitrypsin were weakly reactive in reactive and proliferative mesothelial cells. 5. MHC Class II molecule(HLA-DR antigen) was negative in both resting and reactive mesothelial cells. These results suggest that the short-term cultured, reactive mesothelial cells show a newly aberrant expression of the vimentin and carcino-embryonic antigen. The reason of the aberrant expression of the intermediate filament and oncofetal antigen in reactive and proliferative mesothelial cells should be further evaluated.
Actins ; Antibodies ; Cytoskeleton ; Desmin ; Exudates and Transudates ; Hot Temperature ; Humans ; Intermediate Filaments ; Keratins ; Liver Cirrhosis ; Mucin-1 ; Muramidase ; Pleural Effusion ; Vimentin

No abstract available.
Breast* ; Lymphoma*

The purpose of this study was to evaluate the influence of sodium ascorbate on microtensile bond strengths of total-etching adhesive system to pulp chamber dentin treated with NaOCl. Pulp chambers of extracted human non-caries permanent molars were treated as follows: group 1, with 0.9% NaCl; group 2, with 5.25% NaOCl; group 3, with 5.25% NaOCl and 10% sodium ascorbate for 1min; group 4, with 5.25% NaOCl and 10% sodium ascorbate for 1 min and 10ml of water; group 5, with 5.25% NaOCl and 10% sodium ascorbate for 5 min; group 6, with 5.25% NaOCl and 10% sodium ascorbate for 5 min and 10ml of water; group 7, with 5.25% NaOCl and 10% sodium ascorbate for 10 min; group 8, with 5.25% NaOCl and 10% sodium ascorbate for 10 min and 10ml of water. Treated specimens were dried, bonded with a total-etching adhesive system (Single bond), restored with a composite resin(Z250) and kept for 24h at 100% humidity to measure the microtensile bond strength. NaOCl-treated group (group 2) demonstrated significantly lower strength than the other groups. No significant difference in microtensile bond strengths was found between NaCl-treated group (group 1) and sodium ascorbate-treated groups (group 3-8). The results of this study indicated that dentin treated with NaOCl reduced the microtensile bond strength of Single bond. Application of 10% sodium ascorbate restored the bond strength of Single bond on NaOCl-treated dentin. Application time of sodium ascorbate did not have a significant effect.
Adhesives ; Ascorbic Acid ; Bisphenol A-Glycidyl Methacrylate ; Dental Pulp Cavity ; Dentin ; Humans ; Humidity ; Molar ; Sodium ; Water

Ki-1 positive anaplastic large cell lymphoma is a newly described high-grade lymphoma and is defined by histopathological and immunologic criteria. We experienced a case of systemically involving Ki-1 positive anaplastic large cell lymphoma in a 44 year-old female which initially manifested as pleural effusion. Abdominopelvic CT scan showed the evidence of marked lymphadenopathy in retroperitoneal and both external and inguinal lymph nodes. On cytologic examination of pleural fluid tumor cells revealed pleomorphic large isolated cells with prominent nucleoli and abundant cytoplasms. The nuclei were large with irregular profiles including some deep invaginations. Also. occasional multilobed/multinucleated and binucleated nuclei were seen. Immunohistochemical examination was performed to differentiate from the undifferentiated adenocarcinoma. Hodgkin's disease, non-Hodgkin's lymphoma and malignant histiocytosis. The neoplastic cells were positive for leukocyte common antigen. CD3 CD30(ki-1) but negative for cytokeratin. epithelial membrane antigen. and CD15. A histologic diagnosis of Ki-1 positive anaplastic lymphoma was made by biopsies of the inguinal lymph node, polypoid lesion of the stomach and cecum.
Adenocarcinoma ; Adult ; Antigens, CD45 ; Biopsy ; Cecum ; Cytoplasm ; Diagnosis ; Female ; Histiocytic Sarcoma ; Hodgkin Disease ; Humans ; Keratins ; Lymph Nodes ; Lymphatic Diseases ; Lymphoma ; Lymphoma, Large-Cell, Anaplastic* ; Lymphoma, Non-Hodgkin ; Mucin-1 ; Pleural Effusion ; Stomach ; Tomography, X-Ray Computed

BACKGROUND: Carbapenem-resistant Acinetobacter baumannii (CRAB) infection is associated with high mortality. One of the strategies to reduce the mortality in patients with CRAB infections is to use intravenous colistin early but the effect of this strategy has not been proven. Therefore, we investigated the association of early colistin therapy with 28-day mortality in patients with CRAB bacteremia. METHODS: This retrospective multicenter propensity score-matching analysis was conducted in the Korea by reviewing the medical records of adult patients with CRAB bacteremia between January 2012 and March 2015. Early colistin therapy was defined as intravenous colistin administration for > 48 hours within five days after the blood culture collection. To identify the risk factors associated with the 28-day mortality in CRAB bacteremia, the clinical variables of the surviving patients were compared to those of the deceased patients. RESULTS: Of 303 enrolled patients, seventy-six (25.1%) patients received early colistin therapy. The 28-day mortality was 61.4% (186/303). Fatal or rapidly-fatal McCabe classifications, intensive care unit admission, Sequential Organ Failure Assessment scores ≥ 8, vasopressor use, and acute kidney injury were statistically independent poor prognostic factors. Catheter-related infection and early colistin therapy (adjusted odds ratio [aOR], 0.45; 95% confidence interval [CI], 0.21–0.94) were independent favorable prognostic factors associated with 28-day mortality in patients with CRAB bacteremia. Early colistin therapy was still significantly associated with lower 28-day mortality in the propensity score-matching analysis (aOR, 0.31; 95% CI, 0.11–0.88). CONCLUSION: This study suggests that early colistin therapy might help reduce the mortality of patients with CRAB bacteremia.
Acinetobacter ; Acinetobacter baumannii ; Acute Kidney Injury ; Adult ; Bacteremia ; Catheter-Related Infections ; Classification ; Colistin ; Humans ; Intensive Care Units ; Korea ; Medical Records ; Mortality ; Odds Ratio ; Organ Dysfunction Scores ; Retrospective Studies ; Risk Factors

The Mental foramen is the exit of the mandibular canal through which the mental nerve pass. The location of the mental foramen, an anthropologically valuable structure, is not only influenced by factors such as tooth attrition, age, loss of teeth, and alveolar bone resorption but also race, diet and geographical position. This study was undertaken to clarify the anthropological characteristics of the location of the mental foramina in the mandibles of the selected Korean population. Forty four mandibles (23 males and 21 females with average age of 66.5 years obtained from the collection of the department of anatomy and cell biology of Hanyang medical college were studied. The apparent position of mental foramen in relation to the mandibular teeth and the true position of mental foramen in relation to the body of the mandible were measured. The obtained results were as follows: In 89% of 35 mandibular sides the mental foramen was located around the second premolar, the most commonly between the second premolar and the first molar, which belongs to type V according to Wang et al. (1986). The distances from the alveolar bone crest across the mental foramen to the lower border of the mandible was 27.4+/-2.4 mm. The mean distances from mental foramen to the alveolar crest and lower border were 12.1+/-2.3 and 13.1+/-2.0 mm, respectively. The mean position of mental foramen was 4.08 on the line between the second premolar and the first molar. The mental foramen of selected Korean population was located more posterioly when compared with many previous reports from various races. The results of this study would be useful to clarify the anthropological position of the mental foramen in Korean.
Anthropology ; Bicuspid ; Bone Resorption ; Continental Population Groups ; Diet ; Female ; Humans ; Male ; Mandible ; Molar ; Tooth ; Tooth Attrition

This study aims to investigate the anatomical information of the sphenopalatine foramen with special reference to the bleeding control of the sphenopalatine artery and to the blockage of the pterygopalatine ganglion during functional endoscopic sinus surgery. Forty-three midsagittal sectioned Korean heads were used in the study. The mucosa on the lateral nasal wall was removed for showing the sphenopalatine foramen. The shapes of the sphenopalatine foramen were classified by 4 types. Angle from the akanthion and distances from akanthion, conchae, sphenoidal sinus and greater palatine foramen were measured. The sphenopalatine foramen was frequently found as oval shape and bilateral symmetry of 28.6%. The vertical length was 5.5 mm, the horizontal length was 5.3 mm. The most anterior point of the sphenopalatine foramen was located on 54.4 mm few and angles were between 15.9degrees and 22.1degrees from akanthion. The distances were 36.2 mm from anterior end of middle nasal concha, 6.2 mm from posterior end of middle nasal concha, 27.2 mm from greater palatine foramen. The uppermost point of the sphenopalatine foramen was located on 22.3 mm from the most superoanterior end of the sphenoidal sinus, 18.6 mm from the lowermost end of the sphenoidal sinus. This study could be useful to provide the confidence about the location of the sphenopalatine foramen during functional endoscopic sinus surgery.
Arteries ; Ganglion Cysts ; Head ; Hemorrhage ; Mucous Membrane ; Turbinates

A variety of clinical conditions are known to result in a giant T wave and a marked QT prolongation. We report a case of a giant T wave and a QT prolongation after the resolution of an acute cardiogenic but nonischemic pulmonary edema.
Heart Failure ; Pulmonary Edema*

We experienced a case of adult T cell leukemia/lymphoma (ATLL) in a 48-year-old Korean female, who has never been abroad since birth and no history of blood transfusion. The patient had hypercalcemia and multiple lymphadenopathy. Histopathologic study of left cervical lymph node (LN) and bone marrow (BM) revealed that infiltrates of malignant lymphoid cells were composed of small, medium and large cells with pleomorphic nuclei. Smears of peripheral blood (PB) showed lymphopenia (16%) with the appearance of a few atypical lymphoid cells (less than 2%), but not the typical clover leaf cells seen in ATLL. Immunophenotypic study of LN and BM revealed T cell phenotype. PB showed increased CD4+ T cell (T(H), CD3/CD4+, 57%) and decreased CD8+ T cell counts (T(S), CD3/CD8+, 6.7%). The sera of the patient and her family were reactive for HTLV-I antibody. The specific sequences of pol, env, and tax of HTLV-I DNA were detected in the lymphoma cells and peripheral blood mononuclear cells (PBMC) using polymerase chain reaction. Ultrastructural examination of PBMC confirmed numerous type c virus particles in extracellular space. This case was an acute type of ATLL without overt leukemic features in PB. Despite chemotherapy and intensive conservative treatment, she died 3 months after admission.
Biopsy ; Bone Marrow/pathology ; Case Report ; DNA, Viral/analysis ; Fatal Outcome ; Female ; Flow Cytometry ; Gene Products, env/genetics ; Gene Products, pol/genetics ; Gene Products, tax/genetics ; HTLV-BLV Infections/pathology ; HTLV-I ; Human ; Hypercalcemia/virology ; Hypercalcemia/pathology ; Immunophenotyping ; Korea ; Leukemia, T-Cell/virology ; Leukemia, T-Cell/pathology* ; Leukemia, T-Cell/immunology ; Lymph Nodes/pathology ; Lymphopenia/virology ; Lymphopenia/pathology* ; Lymphopenia/immunology ; Microscopy, Electron ; Middle Age ; Support, Non-U.S. Gov't ; T-Lymphocytes/virology ; T-Lymphocytes/ultrastructure ; T-Lymphocytes/pathology