BACKGROUND: Several factors contribute to differences in Streptococcus pneumoniae serotype distribution. We investigated the serotype distribution and antimicrobial resistance of S. pneumoniae isolated between 2014 and 2016 in Korea. METHODS: We collected a total of 1,855 S. pneumoniae isolates from 44 hospitals between May 2014 and May 2016, and analyzed the serotypes by sequential multiplex PCR. We investigated the distribution of each serotype by patient age, source of the clinical specimen, and antimicrobial resistance pattern. RESULTS: The most common serotypes were 11A (10.1%), followed by 19A (8.8%), 3 (8.5%), 34 (8.1%), 23A (7.3%), and 35B (6.2%). The major invasive serotypes were 3 (12.6%), 19A (7.8%), 34 (7.8%), 10A (6.8%), and 11A (6.8%). Serotypes 10A, 15B, 19A, and 12F were more common in patients ≤5 years old, while serotype 3 was more common in patients ≥65 years old compared with the other age groups. The coverage rates of pneumococcal conjugate vaccine (PCV)7, PCV10, PCV13, and pneumococcal polysaccharide vaccine 23 were 11.8%, 12.12%, 33.3%, and 53.6%, respectively. Of the 1,855 isolates, 857 (46.2%) were multi-drug resistant (MDR), with serotypes 11A and 19A predominant among the MDR strains. The resistance rates against penicillin, cefotaxime, and levofloxacin were 22.8%, 12.5%, and 9.4%, respectively. CONCLUSIONS: There were significant changes in the major S. pneumoniae serotypes in the community. Non-PCV13 serotypes increased in patients ≤5 years old following the introduction of national immunization programs with the 10- and 13-polyvalent vaccines.
Cefotaxime ; Humans ; Immunization Programs ; Korea ; Levofloxacin ; Multiplex Polymerase Chain Reaction ; Penicillins ; Pneumococcal Vaccines ; Pneumonia ; Serogroup ; Streptococcus pneumoniae ; Streptococcus ; Vaccines

This study was conducted to evaluate three different mixed formulations of sodium hyaluronate (SH) and carboxymethyl cellulose (CMC) using a low-humidity air flow-induced rat dry eye model and determine the most suitable mixture. The total thickness of the cornea, corneal epithelial thickness, corneal stroma thickness, damaged corneal epithelium percentage region, thickness of the bulbar conjunctiva epithelium, number of goblet cells, goblet cell occupation percentage region, and damaged bulbar conjunctiva epithelium percentage region were measured by histomorphological evaluation. After 5 h exposure to drying airflow, the thickness of the cornea and conjunctiva was decreased with desquamation of the corneal and conjunctiva epithelium. However, these dry eye symptoms were markedly inhibited by treatment with the reference and test formulations. More favorable effects on decreased thickness were detected in response to the CMC than the SH. However, SH had a greater protective effect against corneal and conjunctiva epithelial damage. The application of a mixture of 0.1% SH and 0.2% CMC showed more favorable effects on the corneal and conjunctival damage and the stabilization of the ocular surface than SH or CMC alone.
Animals ; Carboxymethylcellulose Sodium* ; Conjunctiva ; Cornea ; Corneal Stroma ; Epithelium ; Epithelium, Corneal ; Goblet Cells ; Hyaluronic Acid* ; Occupations ; Rats* ; Sodium*

PURPOSE: To determine what proportion of patients visiting a tertiary knee clinic had pre-obtained knee magnetic resonance imaging (MRI) and to assess the impact of pre-obtained knee MRI on the selection of treatment plans. MATERIALS AND METHODS: Six hundred and eighty patients were enrolled from patients who visited our knee clinic during a 6-month period. The proportion of patients with pre-obtained knee MRI was calculated, and associations of sociodemographic factors, disease category, and finally selected treatment options with knee MRI pre-obtainment were investigated. A utility assessment panel of five orthopaedic surgeons was formed and established utility assessment criteria. Two rounds of utility assessment (before and after MRI review) were performed. RESULTS: Of the 680 patients, 185 (27%) had pre-obtained knee MRI. In the first round of utility assessment, 39%, 18%, and 43% of the 185 knee MRIs were evaluated as useful, equivocal, and arguably useless, respectively, and almost identical results were obtained in the second round. The proportion of assessed 'useful MRI' was higher in sports related injury (84%) and other conditions (91%) than in degenerative joint disease (18%) and nonspecific knee pain (31%). Utility assessment results among panels varied little for practice patterns and education duration. CONCLUSIONS: This study suggests clinicians should reconsider and counsel patients the expected utility of knee MRI acquisition.
Education ; Humans ; Joint Diseases ; Knee ; Magnetic Resonance Imaging ; Sports

PURPOSE: To evaluate the efficacy and safety of an intracavernous injection of lyophilized papaverine/phentolamine/alprostadil (Standro(R)) for the treatment of erectile dysfunction (ED) in Koreans. MATERIALS AND METHODS: 249 men (>20 years old), with ED (>6 month duration), were enrolled from 14 clinical centers. The intracavernous 'TMs' were titrated in a stepwise fashion at the clinic, from 0.05-0.25ml (17.64mg papaverine, 0.6mg phentolamine, and 6mug alprostadil per ml), with increment of 0.02-0.05ml, according to the etiology and severity of the ED and the patients' ages. RESULTS: Of the 249 men, 238 completed the dose titration, and progressed to home treatment of 3 months duration. Of these 238, 193 (psychogenic 13.0%, organic 75.5%, mixed 11.5%) completed the home treatment (4 or more self-injections), with the other 45 dropping out (lost to follow-up in 24, patient refusal in 9, no chance to have intercourse in 7 and omitted recording of patient diary in 2). The success rate per trial (a total number of sufficient erection for vaginal intromission/a total number of injections) and per patient (number of patients who had one or more sufficient erections for vaginal intromission/the enrolled patients at beginning or 193 patients), and the satisfaction rate per patient (number of patients who had both patient and partner satisfaction with erection/193 patients) were 74.1, or 91.2 and 75.1%, respectively. The adverse reactions were prolonged erections in 3, urethral pain in 1 and penile skin edema in 2. Three patients complained of penile pain during an erection, but there was no dropout due to the pain. No significant changes in laboratory tests were found after the home treatment. CONCLUSIONS: A 'TM' seems to be effective and safe for an intracavernous injection for the treatment of men with erectile dysfunction.
Alprostadil ; Disulfiram ; Edema ; Erectile Dysfunction* ; Follow-Up Studies ; Humans ; Male ; Papaverine ; Patient Dropouts ; Phentolamine ; Skin

PURPOSE: Acute lymphoblastic leukemia (ALL) accounts for approximately 75% of all cases of childhood leukemia. We investigated epidemiology, clinical and laboratory features and treatment outcome of the children with ALL in Korea during recent 5 years. METHODS: One thousand forty nine patients were enrolled between January 1994 and December 1998 from 37 major hospitals in Korea. The data regarding the clinical and laboratory features including age, WBC counts at diagnosis, immunophenotype, morphology, cytogenetics and treatment outcome of patients were analyzed retrospectively by review of patient's medical records. Kaplan-Meier survival curves were constructed. The differences between groups analyzed by log-rank test. RESULTS: There were 597 males and 452 females. The distribution between the age 2 and 5 years is most common in 46.1%. The annual incidence rate per 100,000 population varied from 1.6 to 2.2. The 5 year event free survival (EFS) rates according to good prognostic factors were as follows: 67% bet ween 1-9 year of age at diagnosis, 69% in under 10,000/mm3of initial WBC count, 74% in early pre-B cell CALLA ( ) immunophenotype, 65% in L3 morphology, 68% in no CNS invasion. Most of patients were treated by CCG treatment protocol. The 5 year EFS was 63%. Main complications were sepsis (21.8%) and hemorrhage (12.5%). The relapse rate was 15.6%. The common causes of death were sepsis, DIC, pneumonia, relapse. CONCLUSION: Our results could provide the most recent and important information about acute lymphoblastic leukemia of children in Korea.
Cause of Death ; Child ; Clinical Protocols ; Cytogenetics ; Dacarbazine ; Diagnosis ; Disease-Free Survival ; Epidemiology* ; Female ; Hemorrhage ; Humans ; Incidence ; Kaplan-Meier Estimate ; Korea* ; Leukemia ; Male ; Medical Records ; Pneumonia ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Precursor Cells, B-Lymphoid ; Recurrence ; Retrospective Studies ; Sepsis ; Treatment Outcome

Type I thyroplasty, we know, could not overcome the large posterior glottal chink and arytenoid adduction have been proved to be uneffective in the cases of unilateral vocal cord paralysis with vocal cord atrophy or bowing deformity. So we performed type I thyroplasty in conjunction with arytenoid adduction and tried to compare the postoperative results with that of arytenoid adduction. We experienced 8 cases of arytenoid adductions and 6 cases of combined operations in the cases of unilateral vocal cord paralysis. All 14 patients had large posterior glottal chink. In order to compare the postoperative voice results of two groups as objective as possible, we performed preoperative and postoperative videoimage analysis(chink size, interarytenoid distance) and computer-assisted voice analysis(MPT, Jitter, Shimmer, S/N ratio). As a results, the postoperative voice outcome is superior with the combined operation than with the arytenoid adduction only in the cases of unilateral vocal cord paralysis with large glottal chink.
Atrophy ; Congenital Abnormalities ; Humans ; Laryngoplasty* ; Vocal Cord Paralysis* ; Vocal Cords ; Voice

No abstract available.
Colon* ; Dilatation* ; Humans ; Infant, Newborn*

The authors report a case of 21-year-old, neurologically normal female who presented with a teratoma contained in a cervical meningocele. The concurrence of a congenital neoplasm within the spine associated with spina bifida cystica seems to be a very rare event. The radiographic studies, histological examinations, treatment and follow up findings in this case are presented with a review of the literature.
Female ; Follow-Up Studies ; Humans ; Meningocele* ; Spina Bifida Cystica ; Spine ; Teratoma* ; Young Adult

Although fibromas are the most common renal medullary tumor identified at autopsy. their small sized and benign course make clinical detection extremely difficult. Only 9 clinical cases of renal medullary fibromas have been reported. Many fibromas of the renal medulla, previously considered as bamahomas. seemed to be composed of tumerous transformation of renomedullary interstitial calls Herein we report on a patient with huge renal medullary fibroma treated by right radical nephrectomy.
Autopsy ; Brain Stem Neoplasms ; Fibroma ; Humans ; Nephrectomy

No abstract available.
Diabetic Ketoacidosis* ; Lung Abscess* ; Lung* ; Mucormycosis*