BACKGROUND/AIMS: The incidence and severity of Clostridium difficile infection (CDI) have increased worldwide, resulting in a need for rapid and accurate diagnostic methods. METHODS: A retrospective study was conducted to compare CDI diagnosis methods between January 2014 and December 2014. The stool samples, which were obtained in presumptive CDI patients, were compared for their diagnostic accuracy and rapidity, including real-time polymerase chain reaction (PCR) of toxin genes, C. difficile toxin assay, and culture for C. difficile. RESULTS: A total of 207 cases from 116 patients were enrolled in this study and 117 cases (56.5%) were diagnosed as having CDI. Among the 117 cases, the sensitivities of real-time PCR, C. difficile toxin assay, and culture for C. difficile were 87.2% (102 cases; 95% CI, 80.7%–92.8%), 48.7% (57 cases; 95% CI, 41.0%–59.8%), and 65.0% (76 cases; 95% CI, 60.2%–78.5%), respectively (P < 0.005). Notably, 34 cases (29.0%) were diagnosed with CDI by real-time PCR only. The time required to obtain results was 2.27 hours (136.62±82.51 minutes) for real-time PCR, 83.67 hours (5,020.66±3,816.38 minutes) for toxin assay, and 105.79 hours (6,347.68±3,331.46 minutes) for culture (P < 0.005), respectively. CONCLUSIONS: We confirmed that real-time PCR of toxin genes is the most effective diagnostic method for accurate and early diagnosis of CDI. It also helps to diagnose hypervirulent CDI, such as ribotype 027 infection.
Clostridium difficile ; Clostridium ; Diagnosis ; Early Diagnosis ; Humans ; Incidence ; Methods ; Polymerase Chain Reaction ; Real-Time Polymerase Chain Reaction ; Retrospective Studies ; Ribotyping

Cephalopods have the most advanced nervous systems and intelligent behavior among all invertebrates. Their brains provide comparative insights for understanding the molecular and functional origins of the human brain. Although brain maps that contain information on the organization of each subregion are necessary for a study on the brain, no whole brain atlas for adult cephalopods has been constructed to date. Here, we obtained sagittal and coronal sections covering the entire brain of adult Octopus minor (Sasaki), which belongs to the genus with the most species in the class Cephalopoda and is commercially available in East Asia throughout the year. Sections were stained using Hematoxylin and Eosin (H&E) to visualize the cellular nuclei and subregions. H&E images of the serial sections were obtained at 30~70-µm intervals for the sagittal plain and at 40~80-µm intervals for the coronal plain. Setting the midline point of the posterior end as the fiducial point, we also established the distance coordinates of each image. We found that the brain had the typical brain structure of the Octopodiformes. A number of subregions were discriminated by a Hematoxylin-positive layer, the thickness and neuronal distribution pattern of which varied markedly depending upon the region. We identified more than 70 sub-regions based on delineations of representative H&E images. This is the first brain atlas, not only for an Octopodiformes species but also among adult cephalopods, and we anticipate that this atlas will provide a valuable resource for comparative neuroscience research.
Adult ; Arm* ; Brain* ; Cephalopoda ; Eosine Yellowish-(YS) ; Far East ; Hematoxylin ; Histology, Comparative ; Humans ; Invertebrates ; Nervous System ; Neurons ; Neurosciences ; Octopodiformes*

BACKGROUND: Q-switched lasers have made it possible to remove tattoos without leaving unsightly scars. OBJECTIVE: Tobdetermine the optimal time for permanent makeup removal using Q-switched Nd:YAG and ruby lasers, we compared the degree of removal and associated histological changes following irradiation at different time points. METHODS: Using black ink and a permanent makeup machine, we performed 108 separate permanent makeup applications on rat skin. The 1,064-nm Q-switched Nd:YAG laser (QSNDL) and 694-nm Q-switched ruby laser (QSRL) were used to irradiate the permanent makeup on the day of its application and also 3, 5, 7, 14, and 21 days later. We assessed changes in pigmentation over time at each irradiated site using Mexameter® measurements and skin biopsies. RESULTS: The Mexameter® analysis demonstrated no significant differences in pigment removal among irradiations with QSNDL or QSRL on the day of permanent makeup application or at 3, 5, 7, 14, and 21 days later. Histological analysis demonstrated that permanent makeup pigment migrated from the epidermis to the superficial and mid dermis over time. QSNDL more effectively removed pigment throughout the epidermis and dermis compared to QSRL. CONCLUSION: For maximum pigment removal efficacy, the melanin index results suggest that laser treatment should be performed on the day permanent makeup is applied. However, from the histological perspective, permanent makeup should be removed approximately 1 week later, at which point the crusts have peeled off and the wound repair process is almost complete. In this study, histological analysis suggested the superiority of treatment with QSNDL to that with QSRL.
Animals ; Biopsy ; Cicatrix ; Dermis ; Epidermis ; Ink ; Lasers, Solid-State* ; Melanins ; Pigmentation ; Rats ; Skin* ; Wounds and Injuries

BACKGROUND: Until recently, the removal of melanocytic nevi has been performed with a CO2 laser or Er:YAG laser. These lasers have been useful for removing affected spots. However, enlargement of spots or some sequelae, including depressed or hypertrophic scars, could develop as unwanted results. The Q-switched Nd:YAG laser has been used to remove deep-seated melanocytes, such as Ota nevus or tattoos. However, there have been no previous experiments performed to test the efficacy and safety of this laser treatment for melanocytic nevi. OBJECTIVE: The objective of this study was to investigate the efficacy and safety of the 1,064 nm Q-switched Nd:YAG laser for removing melanocytic nevi, including congenital nevomelanocytic and acquired nevomelanocytic nevi. METHODS: Two thousand and sixty four Korean patients with small melanocytic nevi were treated with a Q-switched Nd:YAG laser from 2005 to 2009. High-resolution photographs were taken in identical lighting and positions before and after the six weeks of treatment to observe the procedural efficacy. RESULTS: About 70% of the nevi treated using a 1,064 nm Q-switched Nd:YAG laser were completely removed after one session. The other 30% were completely treated within three sessions. The appearance of sequelae such as hollow scars noticeably decreased compared to the results seen in CO2 or Er:YAG laser treatments. CONCLUSION: Use of the 1,064 nm Q-switched Nd:YAG laser is a safe and effective treatment modality for melanocytic nevi.
Cicatrix ; Cicatrix, Hypertrophic ; Humans ; Lasers, Gas ; Light ; Lighting ; Melanocytes ; Nevus ; Nevus of Ota ; Nevus, Pigmented

BACKGROUND/AIMS: Clostridium difficile is the predominant cause of nosocomial diarrhea. Recently, the incidence of Clostridium difficile infection (CDI) increases in Europe and North America. A retrospective study was performed to evaluate the change of incidence and clinical features of CDI in Korea. METHODS: From January 2003 to December 2008, inpatients diagnosed with CDI in Seoul Paik hospital were enrolled. The diagnosis of CDI was made when patients complained diarrhea with any positive results in C. difficile toxin assay, stool culture, or endoscopy. The incidence, recurrence rate, and clinical features were compared between early period (2003-2005) and late period (2006-2008). RESULTS: The incidence of CDI was 21.73 cases per 10,000 admitted patients in early period group, and significantly increased to 71.71 cases per 10,000 admitted patients in late period group (p<0.01). The hospital stay duration at the time of CDI diagnosis was shorter in late period group. Cephalosporin had the highest ratio as the causative antibiotics of CDI. However, there was no difference in recurrence rate between early and late period groups. Recurrence associated clinical factor was serum albumin level. CONCLUSIONS: The incidence of CDI showed increasing tendency during recent 6 years. The awareness of increasing disease burden is the first step in control of CDI.
Aged ; Anti-Bacterial Agents/therapeutic use ; Cephalosporins/therapeutic use ; *Clostridium difficile ; Enterocolitis, Pseudomembranous/diagnosis/drug therapy/*epidemiology ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Recurrence ; Retrospective Studies ; Risk Factors ; Serum Albumin/analysis

PURPOSE: This study was conducted to evaluate clinical validity of a zirconia full-coverage crown by comparing zirconia's wear capacity over antagonistic teeth with that of feldspathic dental porcelain. MATERIALS AND METHODS: The subject groups were divided into three groups: the polished feldspathic dental porcelain group (Group 1), the polished zirconia group (Group 2), and the polished zirconia with glazing group (Group 3). Twenty specimens were prepared from each group. Each procedure such as plasticity, condensation, and glazing was conducted according to the manufacturer's manual. A wear test was conducted with 240,000 chewing cycles using a dual-axis chewing simulator. The degree of wear of the antagonistic teeth was calculated by measuring the volume loss using a three-dimensional profiling system and ANSUR 3D software. The statistical significance of the measured degree of wear was tested with a significant level of 5% using one-way ANOVA and the Tukey test. RESULTS: The degrees of wear of the antagonistic teeth were 0.119 +/- 0.059 mm3 in Group 1, 0.078 +/- 0.063 mm3 in Group 3, and 0.031 +/- 0.033 mm3 in Group 2. Statistical significance was found between Group 1 and Groups 2 and between Group 2 and 3, whereas no statistical significance was found between Group 1 and Group 3. CONCLUSION: Despite the limitations of this study on the evaluation of antagonistic teeth wear, the degree of antagonistic tooth wear was less in zirconia than feldspathic dental porcelain, representing that the zirconia may be more beneficial in terms of antagonistic tooth wear.
Analysis of Variance ; Ceramics ; Crowns ; Dental Porcelain ; Mastication ; Plastics ; Tooth ; Tooth Wear ; Zirconium

Henoch-Scholein Purpura(HSP) is a syndrome characterized by nonthrombocytopenic purpura accompanied by a arthralgia, gastrointestinal symptom, or renal involvement. This report describes a 13-year-old boy with hemorrhaic bullous HSP followed by cellulitis as a complication. This unusual cutaneous manifestation of HSP may be a source of diagnostic confusion, but it does not appear to have prognostic implication.
Adolescent ; Arthralgia ; Cellulitis* ; Humans ; Male ; Purpura* ; Purpura, Schoenlein-Henoch

Lymphoepithelioma-like carcinonma of the skin(LELCS) is a rare tumor with a microscopic resemblance to lymphoepitheliomatous tumors of the nasopharynx. Less than 100 examples of LELCS are having been reported since its initial description in 1988. Elderly patient are preferentially affected, and the skin of the head and neck is the principal location for this neoplasm. We report a 70 year-old male patient who had brownish colored, moderately firm nodule on the left malar area of the face. Histopathologically, the nodule showed features of LELCS and he was treated with excision and local flap coverage.
Aged ; Head ; Humans ; Male ; Nasopharynx ; Neck ; Skin*

Angiolymphoid hyperplasia with eosinophilia(ALHE) is a benign, uncommon disorder of unknown etiology, that usually appears as intradermal, subcutaneous or both, red to brown, papules and/or nodules, usually located on the head and neck of young adults and is often associated with peripheral blood eosinophilia. Extracutaneous lesions are rare. We report a 25 year-old male patient who had pruritic dark brown colored, moderately firm nodules and plaques on the left postauricular area, that histopathologically showed features of ALHE. He was treated with triamcinolone acetonide intralesional injection successfully.
Adult ; Angiolymphoid Hyperplasia with Eosinophilia* ; Eosinophilia ; Head ; Humans ; Hyperplasia ; Injections, Intralesional* ; Male ; Neck ; Triamcinolone Acetonide ; Young Adult

PURPOSE: To evaluate the usefulness of four-phase dynamic MR imaging technique by analyzing the imagingfeatures of hepatocellular carcinoma(HCC). MATERIALS AND METHODS: We reviewed four-phase dynamic MR images of 63lesions in 38 patients. MR imaging of the whole liver on gradient T1-weighted sequence was obtained at 10seconds(phase I), 35 seconds(phase II), 60 seconds(phase III), and 5 minutes(phase IV) after the start ofGd-DTPA(0.1mmol/kg) hand injection(3-4cc/sec) through the vein. We evaluated the degree of lesional contrastenhancement during each phase by comparing surrounding liver parenchyma, and analyzed signal intensity in lesionsover and less 2cm, respectively. RESULTS: The number of lesions showing high signal intensity compared withsurrounding liver parenchyma was 52(83%)during phase I, 30(48%) during phase II, 12(19%) during phase III, and 4(6%) during phase IV. During each phase, the number of lesions with signal intensity lower than that ofsurrounding liver parenchyma was 7(11%), 2(3%), 7(11%) and 21(33%), respectively. Thirty-four lesions wereenhanced only during phase I and eleven during only phase II. In tumors less than 2cm(n=40), more enhanced lesionswere during phase I(n=33) than more during phase II(n=16)(p=.0020). CONCLUSION: During each phase, four-phasedynamic MR imaging is useful for the effective detection of HCC showing varying degrees of contrast enhancement.
Carcinoma, Hepatocellular* ; Hand ; Humans ; Liver ; Magnetic Resonance Imaging* ; Veins