PURPOSE: The quality of bowel preparation is a major determinant of the quality of colonoscopy. This study evaluated lifestyle factors, including usual dietary style, associated with bowel preparation. METHODS: This retrospective study evaluated 1,079 consecutive subjects who underwent complete colonoscopy from December 2012 to April 2014 at National Cancer Center of Korea. Questionnaires on bowel preparation were completed by the subjects, with the quality of bowel preparation categorized as optimal (excellent or good) or suboptimal (fair, poor or inadequate). Lifestyle factors associated with bowel preparation were analyzed. RESULTS: The 1,079 subjects included 680 male (63.0%) and 399 female patietns (37.0%), with a mean age of 49.6 ± 8.32 years. Bowel preparation was categorized as optimal in 657 subjects (60.9%) and as suboptimal in 422 (39.1%). Univariate analyses showed no differences between groups in lifestyle factors, such as regular exercise, alcohol intake, smoking, and dietary factor. Body mass index (BMI) > 25 kg/m2 was the only factor associated with suboptimal bowel preparation on both the univariate (P = 0.007) and the multivariate (odds ratio, 1.437; 95% confidence interval, 1.104–1.871; P = 0.007) analyses. CONCLUSION: Most lifestyle factors, including dietary patterns, exercise, alcohol intake and smoking, were not associated with suboptimal bowel preparation in Koreans. However, BMI > 25 kg/m2 was independently associated with suboptimal bowel preparation. More intense preparation regimens before colonoscopy can be helpful in subjects with BMI > 25 kg/m2.
Body Mass Index ; Colonoscopy* ; Dietary Supplements ; Female ; Humans ; Korea ; Life Style* ; Male ; Mass Screening* ; Retrospective Studies ; Smoke ; Smoking

Pancreatic cancer patients often have a poor prognosis and suffer from nutritional problems. Malnutrition is characterized by weight loss and decreased dietary intake, and is common among pancreatic cancer patients. The objective of this report was to describe the changes in dietary intake, body weight, nutritional status, and metabolic rate on a continuum from the time of diagnosis until the end of life in a patient with pancreatic cancer. In summary, the patient's nutritional status gradually declined, accompanied by extreme weight loss and decreased dietary intake. Conversely, resting energy expenditure, measured by indirect calorimetry, increased from 24 kcal/kg/day to 35 kcal/kg/day. Nutritional management during cancer treatment is important but may be challenging in pancreatic cancer patients.
Basal Metabolism ; Body Weight* ; Calorimetry, Indirect ; Diagnosis ; Diet Records ; Energy Metabolism ; Humans ; Malnutrition ; Nutritional Status* ; Pancreatic Neoplasms* ; Prognosis ; Weight Loss

BACKGROUND AND OBJECTIVES: To identify the relation between the preservation status of the parathyroid glands and the risk of hypoparathyroidism after total thyroidectomy and central lymph node dissection in papillary thyroid carcinoma. SUBJECTS AND METHOD: A retrospective review was carried out for the medical records of 63 patients with papillary thyroid carcinoma (PTC), who satisfied our inclusion criteria and received treatment at the Department of Otolaryngology-Head and Neck Surgery, Hospital from May 2010 to December 2011. Patients with PTC who underwent total thyroidectomy with central lymph node dissection (CLND) were included and grouped according to the number of preserved parathyroid glands as follows: Group 1 (with four intact glands), Group 2 (three intact glands), Group 3 (less than two intact glands). The total and ionized serum calcium and intact parathyroid hormone levels of each group were monitored after the surgery. Patients with postoperative symptomatic hypocalcemia were considered to have postoperative hypoparathyroidism and received calcium/vitamin D therapy. The hypoparathyroidism was considered to be permanent when calcium/vitamin D therapy was still required six months after surgery. RESULTS: Out of 63 cases of total thyroidectomy with CLND, 31 (49.2%) showed postoperative hypoparathyroidism as demonstrated by laboratory findings. Permanent hypoparathyroidism, however, was not observed in these cases. The development of hypoparathyroidism was not significantly related with the number of preserved parathyroid glands. CONCLUSION: To prevent postoperative hypoparathyroidism following total thyroidectomy and CLND, at least two parathyroid glands should be preserved in situ with an intact blood supply in order to prevent permanent hypoparathyroidism after the surgery.
Calcium ; Carcinoma ; Factor IX ; Humans ; Hypocalcemia ; Hypoparathyroidism ; Lymph Node Excision ; Lymph Nodes ; Medical Records ; Neck ; Parathyroid Glands ; Parathyroid Hormone ; Retrospective Studies ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy

BACKGROUND: Uncomplicated acute cystitis (CA-UAC) is one of the most common infections treated with antibiotics in the community. However, few data on etiology of CA-UAC and its susceptibility to antibiotics are available, primarily because, in Korea, insurance does not allow reimbursement for microbiological evaluation of CA-UAC. However, microbiologic data on community-acquired uncomplicated acute pyelonephritis (CA-UAPN) are available. The objective of the study was to evaluate the question of whether microbiologic data on CA-UAPN can be used for treatment of CA-UAC; therefore, etiology and antimicrobial susceptibility were compared between pathogens of CA-UAC and those of CA-UAPN. MATERIALS AND METHODS: During 2008, 538 CA-UACs and 1,265 CA-UAPNs were recruited retrospectively from 14 hospitals (UTI research group). Microbiologic data on etiology and susceptibility to antibiotics were collected retrospectively. RESULTS: Urine culture was positive in 131 CA-UACs (131/469, 27.9%) and 719 CA-UAPNs (719/1249, 57.6%). Escherichia coli was the most common pathogen in both groups [83.2% (109/131) in CA-UAC vs. 91.9% (661/719) in CA-UAPN]. Susceptibility to common UTI regimens, such as ciprofloxacin, extended-spectrum cephalosporins, and trimethoprim/sulfamethoxazole did not differ between urinary pathogens of CA-UACs and CA-UAPNs, however, a significant difference was observed in rates of resistance to ampicillin/sulbactam (16.5% vs. 42.9%, P<0.001, respectively). CONCLUSIONS: Rates of resistance of E. coli from CA-UAC and CA-UAPN to most antibiotics did not differ. For proper treatment, further microbiological evaluation for CA-UAC is mandatory.
Anti-Bacterial Agents ; Cephalosporins ; Ciprofloxacin ; Cystitis ; Escherichia coli ; Insurance ; Korea ; Pyelonephritis ; Retrospective Studies

PURPOSE: The purpose of this study was to evaluate the long term results of performing femoral varus osteotomy (FVO) for the treatment of Legg-Calve-Perthes disease (LCPD). MATERIALS AND METHODS: We selected 35 LCPD patients who received FVO and they were followed up to the time their skeletons' matured. The inclusion criteria were patients in a fragmentation stage, the patients were in Catterall group III or IV, and the patients underwent a teleoroentgenographic examination at the time of full skeletal maturity. RESULTS: The radiological outcome at the time of skeletal maturity was assessed using Stulberg's classification. The final results were 4 hips in class I, 17 hips in class II, 13 hips in class III, one hip in class IV and none in class V. The satisfactory results (good+fair hips) were 34 hips (97%). Significant shortening (>10 mm) was observed in 12 hips (34%). In 35 patients, 5 (14%) had same leg length (less than 2 mm difference), 27 (77%) had shortening of 2 mm or more, and 3 had lengthening of 2 mm or more in the operated limb. Of these 12 patients with significant shortening, only 3 patients (9%) showed shortening of 21 mm or more. CONCLUSION: FVO is a reliable method for managing LCPD in patients who are in Catterall group III or IV and who are in the fragmentation stage of disease.
Extremities ; Hip ; Humans ; Leg ; Legg-Calve-Perthes Disease ; Osteotomy

Disseminated cryptococcosis is a systemic infection that occurs most commonly in immunocompromised patients, especially those with human immunodeficiency virus (HIV) infection. Although the attack rate is much higher among immunocompromised patients, cryptococcal disease does occur in persons without any apparent predisposing conditions. A previously healthy 26-year- old man was admitted to the hospital because of persistent fever and cervical lymphadenopathy. Despite empirical antibiotic therapy, he developed cutaneous erythematous papules, generalized lymphadenopathy, miliary pulmonary infiltration, and meningitis successively soon after admission. Biopsy of the skin and the cervical lymph node revealed chronic granuloma with cryptococcal organisms and tissue culture of lymph node confirmed cryptococcal infection. He was treated with intravenous amphotericin B plus flucytosine for 2 weeks, and then with fluconazole for 2 months. After the therapy, there was no evidence of recurrence for 2 years.
Adult* ; Amphotericin B ; Biopsy ; Cryptococcosis* ; Fever ; Fluconazole ; Flucytosine ; Granuloma ; HIV ; Humans ; Immunocompromised Host ; Lymph Nodes ; Lymphatic Diseases ; Meningitis ; Recurrence ; Skin

Disseminated cryptococcosis is a systemic infection that occurs most commonly in immunocompromised patients, especially those with human immunodeficiency virus (HIV) infection. Although the attack rate is much higher among immunocompromised patients, cryptococcal disease does occur in persons without any apparent predisposing conditions. A previously healthy 26-year- old man was admitted to the hospital because of persistent fever and cervical lymphadenopathy. Despite empirical antibiotic therapy, he developed cutaneous erythematous papules, generalized lymphadenopathy, miliary pulmonary infiltration, and meningitis successively soon after admission. Biopsy of the skin and the cervical lymph node revealed chronic granuloma with cryptococcal organisms and tissue culture of lymph node confirmed cryptococcal infection. He was treated with intravenous amphotericin B plus flucytosine for 2 weeks, and then with fluconazole for 2 months. After the therapy, there was no evidence of recurrence for 2 years.
Adult* ; Amphotericin B ; Biopsy ; Cryptococcosis* ; Fever ; Fluconazole ; Flucytosine ; Granuloma ; HIV ; Humans ; Immunocompromised Host ; Lymph Nodes ; Lymphatic Diseases ; Meningitis ; Recurrence ; Skin

BACKGROUND: ESBL-producing Klebsiella spp. are increasing worldwide, and infections with ESBL-producing organisms are usually hospital-acquired and common infections with ESBL-producing organisms include urinary tract infections, peritonitis, cholangitis, intraabdominal abscesses and nosocomial pneumonia. We studied the phenotypic and genotypic characteristics of ESBL-producing K. pneumoniae, which were isolated from the patients in St. Vincent Hospital. METHODS: Susceptibility to antibiotic was determined by standard disk diffusion and agar dilution methods for all 22 strains of K. pneumoniae. PCR amplifications were performed with primers specific for TEM. SHY, and CMY-1 genes, and the DNA of the amplified products were sequenced. Total DNA was extracted from the isolates restricted with XbaI, and fingerprinted using pulsed-field gel electrophoresis. Crude preparations of beta-lactamase were obtained by sonications and used for characterization of beta-lactamase by isoelectric focusing. RESULTS: The MIC90 values for ceftazidime and aztreonam were 128 microgram/mL and 64 microgram/mL, respectively. The MIC90 values for cefotaxime and sulperazon were 8 microgram/mL and 4microgram/mL, respectively, and that for cefoxitin was 1.0 microgram/mL, which is much lower than the value for third-generation cephalosporins. The MICs for ciprofloxacin. cefepime, and imipenem were less than 1 microgram/mL for all organisms, which is within the susceptible range. Isoelectric focusing studies demonstrated three beta-lactamases with pls of 5.. (TEM-1), 7.6 (SHV-2a), and 8.2 (SHV-12). The presence of blaSHV and blaTEM genes was confirmed by specific PCRs and DNA sequencing analysis. but blaCMY-1 genes were not found. According to DNA sequencing analysis, 21 K. pneumoniae strains produced SHV-12 ESBL and one strain produced SHV-2a ESBL. CONCLUSIONS: Our results suggest that the resistance of K. pneumoniae from clinical isolates to extended spectrum beta-lactam antibiotics may be due to the production of SHY-type ESBL. This approach in detecting and characterizing ESBL will be valuable for the control of infection and antibiotics use in medical institution.
Abscess ; Agar ; Anti-Bacterial Agents ; Aztreonam ; beta-Lactamases ; Cefotaxime ; Cefoxitin ; Ceftazidime ; Cephalosporins ; Cholangitis ; Ciprofloxacin ; Dermatoglyphics ; Diffusion ; DNA ; Electrophoresis, Gel, Pulsed-Field ; Humans ; Imipenem ; Isoelectric Focusing ; Klebsiella pneumoniae* ; Klebsiella* ; Peritonitis ; Pneumonia ; Polymerase Chain Reaction ; Sequence Analysis, DNA ; Sonication ; Urinary Tract Infections

No abstract available.
Carbapenems* ; Korea*

BACKGROUND: Recent hospital environments have changed, and the most common and important causative agents of nosocomial infections are Gram positive organisms, such as staphylococci, streptococci and enterococci. And increasing resistance of such Gram-positive organisms to antimicrobials, including glycopeptides, is causing big problems in hospital infections. Therefore, we confirmed and compared the antimicrobial activities of glycopeptides [Tapocin(r) (CJ Pharmaceutics. Korea), vancomycin, teicoplanin] against clinical isolates of streptococci(PSSP, PNSSP), staphylococci (MSSA, MRSA, MRCNS) and enterococci. METHODS: Total 666 strains of Gram-positive cocci, collected in five Catholic University affiliated Hospitals were tested by broth microdilution method using Muller-Hinton broth according to the recommendation of NCCLS (National Committee for Clinical Laboratory Standard, USA). RESULTS: In PSSP (n=46), MIC range of vancomycin was 0.25-0.5 microgram/mL, and that of Tapocin(r) and teicoplanin was equally 0.015-0.06 microgram/mL. MIC90 of vancomycin was 0.5 microgram/mL, and that of Tapocin(r) and teicoplanin was equally 0.06 microgram/mL. In PNSSP (n=123), MIC range of vancomycin was 0.25-0.5 microgram/mL, and MIC range of Tapocin(r) and teicoplanin was equally 0.03-0.06 microgram/mL. The MIC range of vancomycin against MSSA (n=116) was 2-4 microgram/mL, and that of Tapocin(r) and teicoplanin was equally 0.5-8 microgram/mL. MIC90 of vancomycin was 4 microgram/mL, and that of Tapocin(r) and teicoplanin was equally 2 microgram/mL. In MRSA (n=116), MIC range of Tapocin(r) and teicoplanin was equally 0.25-8 microgram /mL, showing broader range distribution than that of vancomycin (2-4 microgram/mL). MIC90 of vancomycin was 4 microgram/mL, and that of Tapocin(r) and teicoplanin was equally 8 microgram/mL. MIC range against MRCNS (n=14) of vancomycin was 0.25-8 microgram/mL, and that of Tapocin(r) and teicoplanin was equally 0.06- 16 microgram/mL. In enterococci (n=123), the MIC range of vancomycin was 0.5-64 microgram/mL, and that of Tapocin(r) and teicoplanin was equally 0.25-64 microgram/mL. MIC90 of all antibiotics was 8 microgram/mL, but 6 E. faecium resistant to all antibiotics were detected. CONCLUSION: The results of susceptibility tests showed that the against glycopeptides against Gram- positive cocci, which were isolated in our study university hospitals, seem to be largely unaffected. We also confirmed that the antimicrobial activity of Tapocin(r) was equal to that of teicoplanin.
Anti-Bacterial Agents ; Cross Infection ; Glycopeptides ; Gram-Positive Cocci* ; Hospitals, University ; Methicillin-Resistant Staphylococcus aureus ; Microbial Sensitivity Tests ; Teicoplanin ; Vancomycin