PURPOSE: To evaluate correlation between the clinical results and causative bacteria in diabetic foot patients with lower extremity amputation. MATERIALS AND METHODS: One hundred twenty nine patients(131 feet) of diabetic foot amputations were followed for more than one year. Wound cultures were done by deep tissue or bone debris at first visit to our clinics. Retrospective analysis was performed using chart review and interview with the patients. Depending on the culture result, level of amputation, reinfection, duration of treatment, death rate, patient satisfaction and admission dates were evaluated. RESULTS: Microorganisms were confirmed in 114 cases. In the other 17 cases, there were no cultured microorganisms. In bacterial growth group, Methicillin-sensitive Staphylococcus aureus was the most common pathogen and accounted for 34 cases. As other common pathogens, there were Methicillin-resistant Staphylococcus aureus(24 cases) and mixed infection(14 cases). Mortality is no difference in each infected group. Mixed bacterial infected patients have higher reinfection, longer hospital day and duration of treatment, but there is no difference in patients satisfaction and pain at last follow up. CONCLUSION: The most common pathogen in diabetic foot patients with lower extremity amputation was Methicillin-sensitive Staphylococcus aureus, and mixed bacterial infected patients have higher reinfection rate, longer admission date and duration of treatment than other bacterial infected patients.
Amputation ; Bacteria ; Chronology as Topic ; Diabetic Foot ; Humans ; Lower Extremity ; Methicillin Resistance ; Patient Satisfaction ; Retrospective Studies ; Staphylococcus ; Staphylococcus aureus

PURPOSE: We aimed to ascertain the degree of association between bladder cancer and human papillomavirus (HPV) infection. MATERIALS AND METHODS: We performed a meta-analysis of observational studies with cases and controls with publication dates up to January 2011. The PubMed electronic database was searched by using the key words "bladder cancer and virus." Twenty-one articles were selected that met the required methodological criteria. We implemented an internal quality control system to verify the selected search method. We analyzed the pooled effect of all the studies and also analyzed the techniques used as follows: 1) studies with DNA-based techniques, among which we found studies with polymerase chain reaction (PCR)-based techniques and 2) studies with non-PCR-based techniques, and studies with non-DNA-based techniques. RESULTS: Taking into account the 21 studies that were included in the meta-analysis, we obtained a heterogeneity chi-squared value of Qexp=26.45 (p=0.383). The pooled odds ratio (OR) was 2.13 (95% confidence interval [CI], 1.54 to 2.95), which points to a significant effect between HPV and bladder cancer. Twenty studies assessed the presence of DNA. The overall effect showed a significant relationship between virus presence and bladder cancer, with a pooled OR of 2.19 (95% CI, 1.40 to 3.43). Of the other six studies, four examined the virus's capsid antigen and two detected antibodies in serum by Western blot. The estimated pooled OR in this group was 2.11 (95% CI, 1.27 to 3.51), which confirmed the relationship between the presence of virus and cancer. CONCLUSIONS: The pooled OR value showed a moderate relationship between viral infection and bladder tumors.
Antibodies ; Blotting, Western ; Capsid ; Chronology as Topic ; DNA ; Electronics ; Electrons ; Humans ; Odds Ratio ; Polymerase Chain Reaction ; Population Characteristics ; Publications ; Quality Control ; Urinary Bladder ; Urinary Bladder Neoplasms ; Viruses

PURPOSE: This study was conducted to examine the effect of baby massage on attachment between mothers and their newborns. METHODS: This study was carried out from June 2008 to February 2010 in a quasi-experimental design (57 in the experimental group, 60 in the control group). Between the dates of the study, all healthy primipara mothers and their healthy babies were included. Data were collected regarding their demographic characteristics and by using the Maternal Attachment Inventory (MAI). All mothers were assessed on the first and the last days of the 38-day study period. In the experimental group, the babies received a 15-minute massage therapy session everyday during the 38 days. RESULTS: There was no significant difference found in the pretest mean value baseline of the MAI score in both groups. The posttest mean values of the MAI of the experimental group mothers (90.87 +/- 10.76) were significantly higher than those of control group (85.10 +/- 15.50). There was a significant difference between groups (p < .05). CONCLUSION: The results of the study have shown that baby massage is effective in increasing the mothere infant attachment.
Chronology as Topic ; Complementary Therapies ; House Calls ; Humans ; Infant ; Massage ; Mothers

BACKGROUND AND OBJECTIVES: Ultrasonography (USG)-guided sclerotherapy using a sclerotherapic agent such as ethanol, OK-432, recently has gained popularity as a treatment for nonfunctioning benign thyroid nodules. The study evaluates the efficacy and safety of the USG-guided sclerotherapy for that purpose. SUBJECTS AND METHOD: Included in the study were 23 patients who had complaints of applied pressure or cosmetic problems due to cystic thyroid nodules, which had been diagnosed as benign and nonfunctioning by fine-needle aspiration biopsy and thyroid function test. Sclerotherapy was performed with OK-432 or 99.9% ethanol following nearly complete evacuation of the fluid from the cystic portion of thyroid nodule. At each USG follow-up, we measured the volume of cysts, symptom scores, cosmetic scores using a visual analog scale, and related complications were examined at postoperative dates of one and six months. RESULTS: The volume of thyroid cysts were significantly reduced (p<0.01) with mean volume reduction rates of 77.3+/-21.2% at postoperative 6 months. The cosmetic score and symptom score were significantly improved following sclerotherapy (p<0.01). Major complications related to sclerotherapy, such as vocal cord paralysis, thyrotoxicosis and tissue necrosis, did not happen during the follow-up observation. CONCLUSION: USG-guided sclerotherapy could be a simple and effective treatment modality for benign cystic thyroid nodules.
Biopsy, Fine-Needle ; Chronology as Topic ; Cosmetics ; Ethanol ; Follow-Up Studies ; Humans ; Necrosis ; Picibanil ; Prospective Studies ; Sclerotherapy ; Thyroid Function Tests ; Thyroid Gland ; Thyroid Nodule ; Thyrotoxicosis ; Vocal Cord Paralysis

Spinal deformity is one of the oldest known diseases that date back thousands of years in human history. It appears in fairy tales and mythologies in association with evil as its dramatic appearance in patients suffering from the disease easily lent itself to be thought of as a form of divine retribution. The history of spinal deformity dates back to prehistoric times. The early attempts to treat patients suffering from this disease started from Hippocrates age. Side traction or axial traction and cast immobilization were the only possible option prior to the discovery of anesthesia. The first surgical attempts to correct scoliosis occurred in the mid 19th century with percutaneous myotomies of the vertebral musculature followed by postoperative bracing, which outcomes were very quite horrifying. Hibbs' fusion operation had become a realistic treatment option to halt the progression of deformity in the early 20th century. Harrington's introduction of the internal fixation device to treat paralytic scoliosis in 1960's started revolution on deformity correction surgery. Luque developed a segmental spinal using sublaminar wiring technique in 1976 and Cotrel developed Cotrel-Dubousset (CD) instrumentation, which was a posterior segmental instrumentation system that used pedicle and laminar hooks on either thoracic or lumbar spine and pedicle screws on the lumbar spine.
Anesthesia ; Braces ; Chronology as Topic ; Congenital Abnormalities ; Humans ; Immobilization ; Internal Fixators ; Scoliosis ; Spine ; Stress, Psychological ; Traction

PURPOSE: No clinically useful target molecule has been identified for triple-negative (TN) breast cancer, i.e., estrogen receptor-negative, progesterone receptor-negative, human epidermal growth factor receptor-2-negative phenotype, and its prognosis is poor. The aim of this study is to clarify the clinical and pathologic characteristics of triple negative breast cancer (TNBC). METHODS: The study subjects, 87 women with TNBC, were a subset of patients operated at Kosin University Gospel Hospital from January 2000 to December 2005. We examined pathologic characteristics such as tumor necrosis, infiltrating border, lymphocytic infiltration, prominent nucleoli in TNBC. And we studied the correlation between TNBC and several factors related to pathologic morphology. Chi-squared tests were used for statistical analysis. Kaplan-Meier estimates are presented for the survival function, and differences in survival were analyzed using the log rank test. RESULTS: Tumor necrosis was found in 51 patients (58.3%) in TNBC. And infiltrating border was found in 71 patients (81.0%). Also continuous lymphocytic distribution and prominent nucleoli was found in 31 patients (35.7%), 52 patients (59.7%), respectively. No association was detected between pathologic characteristics and other biological markers. Patients with tumor necrosis positive for TNBC didn't show shorter disease-free survival (P = 0.4490) or overall survival (P = 0.979) than patients without tumor necrosis. CONCLUSION: These findings suggest that pathologic characteristics cannot be used to classify triple-negative breast cancer into only two subtypes with differing prognoses. But because our study is small size study, more abundant patients' dates will be needed to evaluate the morphologic characteristics' predictive role.
Biomarkers ; Breast ; Breast Neoplasms ; Chronology as Topic ; Disease-Free Survival ; Epidermal Growth Factor ; Estrogens ; Female ; Humans ; Necrosis ; Phenotype ; Progesterone ; Prognosis

PURPOSE: We aimed to develop and validate a prediction model for the number of patients visiting emergency departments. METHODS: Enrolled patients were from eleven regional emergency departments (EDs) (level-1) that inputted information on emergency patients into the National Emergency Department Information System since 2004. We developed the automated regressive integrated moving average (ARIMA)-based prediction model using a dataset covering 2005 to 2007. To validate the prediction model, we performed Bland-Altman plot analysis for a new dataset, that of 2008, calculating the agreement rate. RESULTS: The total number of enrolled patients was 1,532,294. Of these, 844,802 (55.1%) were male and mean age was 36.5. The ARIMA (1, 1, 1) (1, 1, 1) 7 was selected as the best-fit prediction model. When we tested the validity using Bland-Altman plots, the agreement rate was 96.4% (95% CI, 94.0%~98.1%). Non-agreement dates were national holidays (n=9), and the other weekdays (n=4), respectively. CONCLUSION: We developed the ARIMA-based prediction model for emergency patients at regional EDs. The model showed a very high validity.
Chronology as Topic ; Emergencies ; Emergency Medical Services ; Holidays ; Humans ; Information Systems ; Male ; Moclobemide ; Models, Statistical ; Reproducibility of Results

The history of treatment for cryptorchidism dates back more than 200 years. This review is intended to highlight some historical aspect that led us to our current surgical treatment of this condition. The medical and historical surgical literatures pertaining to cryptorchidism were reviewed. Data sources were PubMed, Embase, conference proceedings, and bibliographies. No language, date, or publication status restrictions were imposed. The study of cryptorchidism began with the anatomical descriptions of Baron Albrecht von Haller and John Hunter. Attempts at surgical correction of the undescended testis began in the early 1800s, culminating in the first successful orchiopexy by Thomas Annandale in 1877. Max Schuller, Arthur Dean Bevan and Lattimer contributed to the establishment of current techniques for standard orchiopexy. Later, laparoscopy, high inguinal incision (Jones' approach) and scrotal approach were added to the list of current orchiopexy.
Chronology as Topic ; Cryptorchidism ; Information Storage and Retrieval ; Laparoscopy ; Male ; Orchiopexy ; Publications

OBJECTIVE: To investigate the recurrent preterm birth (PTB) risk in women with a history of previous PTB, and whether the interpregnancy interval or the indication for previous PTB is associated with the recurrent PTB risk. METHODS: A retrospective analysis was conducted on a group of 325 women whose first delivery ended at preterm and subsequently delivered their second birth. Data regarding delivery dates, gestational age at delivery and indication for PTB in the first and second pregnancies, respectively, were collected from medical records. Interpregnancy interval was defined as the period of time between the first PTB and subsequent conception. The patients were divided into six groups based on the interpregnancy intervals (<6, 6-12, 12-24, 24-36, 36-48, >48 months). RESULTS: The recurrent PTB rate in the study population was 24.3%, which was significantly higher than PTB rate in the control groups (primipara, 15.5%, P<0.001; multipara who delivered at term in their first pregnancy, 11.8%, P<0.001). The recurrent PTB rate was lowest in the 6-12 months interpregnancy interval group, and highest in the 36-48 months group. However, the rate of recurrent PTB was not significantly different among the six different interpregnancy interval groups (chi square test, P=0.394, linear-by-linear association test, P=0.343). In addition, there was no association between the indication for previous PTB and the recurrent PTB rate. CONCLUSION: Although the risk of PTB was increased in women with a history of PTB, the risk was not influenced by the interpregnancy interval or the indication for previous PTB.
Chronology as Topic ; Female ; Fertilization ; Gestational Age ; Humans ; Medical Records ; Parturition ; Pregnancy ; Premature Birth ; Retrospective Studies

PURPOSE: Antivenin is a standard therapy in snakebite victims. While the required antivenin dose can be easily estimated, based on the initial symptoms, this strategy may be unsuccessful if the initial symptoms progressively worsen. The purpose of this study was to identify the progression rate of the initial symptoms following snakebite and its associated factors. METHODS: The medical records of 44 patients treated for snakebite from give the actual dates of the study period were retrospectively examined. Thirty-two of these patients were enrolled. Demographic data, local wound grade and local effect score at initial presentation (G-0 and LES-0, respectively) and 12 hours after admission (G-12 and LES-12, respectively) were reviewed, along with laboratory data. RESULTS: The 32 patients had an average age of 54.0+/-14.5 years and were predominantly male (n=26) and presented mainly during summer. Compared to G-0 and LES-0, re-evaluated G-12 and LES-12 were significantly increased despite initial administration of proper antivenin dosage (p=0.001 and p=0.000, respectively). Total amounts of antivenin correlated with LES-12 (correlation co-efficiency 0.558, p<0.05). However, factors associated with symptom progression were not revealed. CONCLUSION: Initial snakebite symptoms might progressively worsen within hours despite acceptable initial antivenin therapy. Therefore, re-evaluation within several hours must be considered if when the initial snakebite symptoms are minimal or mild.
Antivenins ; Chronology as Topic ; Disease Progression ; Humans ; Male ; Medical Records ; Retrospective Studies ; Snake Bites