With increase of multi-drug resistant Escherichia coli in community-acquired urinary tract infections (CA-UTI), other treatment option with a therapeutic efficacy and a low antibiotic selective pressure is necessary. In this study, we evaluated in vitro susceptibility of E. coli isolates from CA-UTI to fosfomycin (FM), nitrofurantoin (NI), temocillin (TMO) as well as trimethoprim-sulfamethoxazole (SMX), ciprofloxacin (CIP) and cefepime (FEP). The minimal inhibitory concentrations were determined by E-test or agar dilution method according to the Clinical and Laboratory Standards Institute guidelines, using 346 E. coli collected in 12 Korean hospitals from March 2010 to February 2011. FM, NI and TMO showed an excellent susceptibility profile; FM 100% (346/346), TMO 96.8% (335/346), and NI 99.4% (344/346). Conversely, resistance rates of CIP and SMX were 22% (76/346) and 29.2% (101/349), respectively. FEP still retained an activity of 98.5%. In Korea, NI and TMO in addition to FM are a good therapeutic option for uncomplicated CA-UTI, especially for lower UTI.
Anti-Bacterial Agents/*administration & dosage ; Cell Survival/*drug effects ; Cephalosporins/administration & dosage ; Ciprofloxacin/administration & dosage ; Community-Acquired Infections/drug therapy/*microbiology ; Dose-Response Relationship, Drug ; Drug Combinations ; Drug Resistance, Bacterial/drug effects ; Escherichia coli/*drug effects ; Escherichia coli Infections/drug therapy/*microbiology ; Fosfomycin/administration & dosage ; Humans ; Nitrofurantoin/administration & dosage ; Penicillins/administration & dosage ; Republic of Korea ; Sulfadoxine/administration & dosage ; Treatment Outcome ; Trimethoprim/administration & dosage ; Urinary Tract Infections/diagnosis/*microbiology

With increase of multi-drug resistant Escherichia coli in community-acquired urinary tract infections (CA-UTI), other treatment option with a therapeutic efficacy and a low antibiotic selective pressure is necessary. In this study, we evaluated in vitro susceptibility of E. coli isolates from CA-UTI to fosfomycin (FM), nitrofurantoin (NI), temocillin (TMO) as well as trimethoprim-sulfamethoxazole (SMX), ciprofloxacin (CIP) and cefepime (FEP). The minimal inhibitory concentrations were determined by E-test or agar dilution method according to the Clinical and Laboratory Standards Institute guidelines, using 346 E. coli collected in 12 Korean hospitals from March 2010 to February 2011. FM, NI and TMO showed an excellent susceptibility profile; FM 100% (346/346), TMO 96.8% (335/346), and NI 99.4% (344/346). Conversely, resistance rates of CIP and SMX were 22% (76/346) and 29.2% (101/349), respectively. FEP still retained an activity of 98.5%. In Korea, NI and TMO in addition to FM are a good therapeutic option for uncomplicated CA-UTI, especially for lower UTI.
Anti-Bacterial Agents/*administration & dosage ; Cell Survival/*drug effects ; Cephalosporins/administration & dosage ; Ciprofloxacin/administration & dosage ; Community-Acquired Infections/drug therapy/*microbiology ; Dose-Response Relationship, Drug ; Drug Combinations ; Drug Resistance, Bacterial/drug effects ; Escherichia coli/*drug effects ; Escherichia coli Infections/drug therapy/*microbiology ; Fosfomycin/administration & dosage ; Humans ; Nitrofurantoin/administration & dosage ; Penicillins/administration & dosage ; Republic of Korea ; Sulfadoxine/administration & dosage ; Treatment Outcome ; Trimethoprim/administration & dosage ; Urinary Tract Infections/diagnosis/*microbiology

We described here a patient who presented with symptoms of heart failure who was found to have severe bilateral impairment of atrioventricular inflow. Primary cardiac lymphoma (PCL) with extensive involvement of the two atria, pericardium and myocardium is an extremely rare tumor in immunocompetent patients. We report here a case of PCL in an immunocompetent patient with involvement of both atria and the atrial septum. The tumor had a butterfly shape. We could not do surgical excision because of the massive pericardiac invasion. The diagnosis was B-cell lymphoma and this was confirmed by the pericardiac biopsy.
Atrial Septum ; Biopsy ; Butterflies ; Heart Atria ; Heart Failure ; Heart Neoplasms ; Humans ; Lymphoma ; Lymphoma, B-Cell ; Myocardium ; Pericardium

The efficacy of low molecular weight heparin (LMWH) with low dose unfractionated heparin (UFH) during percutaneous coronary intervention (PCI) with or without glycoprotein (Gp) IIb/IIIa inhibitor compared to UFH with or without Gp IIb/IIIa inhibitor has not been elucidated. Between October 2005 and July 2007, 2,535 patients with ST elevation acute myocardial infarction (STEMI) undergoing PCI in the Korean Acute Myocardial Infarction Registry (KAMIR) were assigned to either of two groups: a group with Gp IIb/IIIa inhibitor (n=476) or a group without Gp IIb/IIIa inhibitor (n=2,059). These groups were further subdivided according to the use of LMWH with low dose UFH (n=219) or UFH alone (n=257). The primary end points were cardiac death or myocardial infarction during the 30 days after the registration. The primary end point occurred in 4.1% (9/219) of patients managed with LMWH during PCI and Gp IIb/IIIa inhibitor and 10.8% (28/257) of patients managed with UFH and Gp IIb/IIIa inhibitor (odds ratio [OR], 0.290; 95% confidence interval [CI], 0.132-0.634; P=0.006). Thrombolysis In Myocardial Infarction (TIMI) with major bleeding was observed in LMHW and UFH with Gp IIb/IIIa inhibitor (1/219 [0.5%] vs 1/257 [0.4%], P=1.00). For patients with STEMI managed with a primary PCI and Gp IIb/IIIa inhibitor, LMWH is more beneficial than UFH.
Acute Disease ; Aged ; Drug Therapy, Combination ; Female ; Hemorrhage ; Heparin/*therapeutic use ; Heparin, Low-Molecular-Weight/*therapeutic use ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Myocardial Infarction/epidemiology/mortality/*therapy ; Myocardial Revascularization ; Odds Ratio ; Platelet Glycoprotein GPIIb-IIIa Complex/*antagonists & inhibitors/metabolism ; Prognosis ; Registries

The aim of this study was to examine the anti-proliferative and anti-inflammatory effects of ezetimibe/simvastatin (E/S) after drug-eluting stent (DES) implantation in a porcine coronary restenosis model. Pigs were randomized into two groups in which the coronary arteries (23 pigs) had DES. Stents were deployed with oversizing (stent/artery ratio 1.3:1) in porcine coronary arteries. Fifteen pigs were taken 10/20 mg of E/S and eight pigs were not taken E/S. Histopathologic analysis was assessed at 28 days after stenting. In neointima, most inflammatory cells were lymphohistiocytes. Lymphohistiocyte count was not different between two groups (337+/-227 vs. 443+/-366 cells, P=0.292), but neointima area was significantly smaller (1.00+/-0.49 mm2 vs. 1.69+/-0.98 mm2, P=0.021) and percent area stenosis was significantly lower (23.3+/-10% vs. 39+/-19%, P=0.007) in E/S group compared with control group. There were no significant differences in fibrin score (1.99+/-0.79 vs. 1.81+/-0.88, P=0.49), endothelial score (1.75+/-0.66 vs. 1.80+/-0.59, P=0.79), and the percent of endothelium covered lumen (43+/-21% vs. 45+/-21%, P=0.84) between E/S group and control group. Combined therapy with ezetimibe and simvastatin inhibits neointimal hyperplasia, but does not inhibit inflammatory infiltration and arterial healing after DES implantation in a porcine coronary restenosis model.
Animals ; Anticholesteremic Agents/administration & dosage ; Azetidines/*administration & dosage ; Coronary Restenosis/diagnosis/drug therapy/*etiology ; *Disease Models, Animal ; Drug Combinations ; Drug Implants/administration & dosage ; Drug-Eluting Stents/*adverse effects ; Female ; Graft Occlusion, Vascular/diagnosis/*drug therapy/*etiology ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/administration & dosage ; Simvastatin/*administration & dosage ; Swine ; Treatment Outcome

Cavernous hemangiomas are rarely found in the adrenal gland. Most of the tumors are nonfunctioning, and the patients present with no clinical symptoms. Although rare, the presence of adrenal hemangiomas should be kept in mind in the differential diagnoses of adrenal tumors. We report a case of an adrenal cavernous hemangioma that was removed by laparoscopic adrenalectomy in a 71-year-old female patient. The chief complaint was right flank pain. The patient was pathologically diagnosed as a having a cavernous hemangioma of the adrenal glands.
Female ; Humans ; Diagnosis, Differential ; Hemangioma

PURPOSE: This study aims to compare the efficacy and safety of propiverine hydrochloride (propiverine) 40mg for the treatment of overactive bladder (OAB). MATERIAL AND METHODS: Total of 284 patients (male:86, female:198) with OAB were included in this study. The patients were treated with propiverine 20mg twice daily or 40mg once daily for 8 weeks. The initial evaluation included with history taking, physical examination, International Prostatic Symptom Score (IPSS), IPSS QoL and consecutive voiding diaries for 3 days. After a 8-week treatment, IPSS, IPSS QoL, patients perception of treatment benefit, global assessment of efficacy by physicain and safety were evaluated. RESULTS: Two hundred eighteen patients were treated with propiverine 20mg twice daily and 66 patients treated with 40mg once daily. The 59 patients had been treated previously with anticholinergics. After a 8-week treatment, IPSS score (total, voiding and storage subscore) and IPSS QoL were improved in all patients (p<0.05). After a 8-week with propiverine 40mg once daily, improvement of IPSS score was noted in the patients non-responsive to anticholinergics previously (p<0.05). The patients treated with propiverine 40mg once daily showed much more symptomatic improvements assessed by physicians than 20mg twice daily (p<0.05). The overall side effect was noted in the 13.4% patients and the most common side effect was dry mouth. CONCLUSION: Propiverine 40mg once daily is considered to reduce the symptom of OAB effectively and can be used safely in the patients with OAB. Treatment with propiverine 40mg is seemed to show more improvement in the unsatisfactory patients with previous anticholinergics.
Cholinergic Antagonists ; Humans ; Mouth ; Observational Study* ; Physical Examination ; Prospective Studies* ; Treatment Outcome ; Urinary Bladder, Overactive*

This is a statistical analysis based on the data of legal autopsies performed at the Headquarters of the National Institute Scientific Investigation(NISI), requested by every kind of law enforcement agencies during the year of 2006. NISI is located in Seoul, Korea and has three branches throughout the country. The Seoul NISI covers all legal autopsies in Seoul City, Incheon City and Kyunggi Province and some cases referred from other regions. This report aims to analyse various aspects of 2,515 unusual deaths in Korea, chiefly Seoul and its surrounding area. Followings are the summary of the results. 1. The number of male was 1,788 cases(71.1%) and that of female 727(28.9%). Male was over twice more than female. The forties were 709 cases(28.2%), the fifties 496(19.7%), and these two decades occupied 47.9%. 2. Unnatural deaths were 1,437 cases(57.1%), natural 955(38.0%), and the unknown 123(4.9%). Among 1,437 unnatural deaths, suicide was 366(25.5%), homicide 387(26.9%), accident 392(27.3%), and the unclear 292(20.3%). Homicide occupied 40.4% of trauma, 51.9% of blunt force injury excluding traffic and fall-down injury, and 91.2% of sharp force injury. The homicide rate in asphyxia was 33.2%, but it went up to 71.4% excluding hanging. It showed only 1.3% percent of homicide in poisoning. 3. Traumatic deaths were 681 cases, occupying 47.4% of 1,437 unnatural deaths, followed by drowning deaths(199 cases). Blunt trauma was 206 cases(30.2%) and the leading cause of death in traumatic death. Poisoning was 158 cases, among which the cyanides were dominant(37cases). Thermal injuries were 144 cases, electrocution 14 cases, and starvation/neglect 21 cases. and 17 cases were directly due to medical procedures. 4. Among 955 natural deaths, heart diseases were 495 cases(51.8%), and vascular diseases 165(17.3%), and these two categories were added up to 660(69.1%). 5. Child deaths under the age of 10 were 118 cases. Homicide was 35 cases(57.4%) out of 61 unnatural deaths. Neonates including still births were the leading period of age in unnatural death, counting 45 cases(38.1%)
Asphyxia ; Autopsy* ; Cause of Death ; Child ; Cyanides ; Drowning ; Female ; Gyeonggi-do ; Heart Diseases ; Homicide ; Humans ; Incheon ; Infant, Newborn ; Korea ; Law Enforcement ; Male ; Parturition ; Poisoning ; Seoul ; Suicide ; Vascular Diseases

This is a statistical analysis based on the data of legal autopsies performed at the Headquarters of the National Institute Scientific Investigation (NISI), requested by every kind of law enforcement agencies during the year of 2005. NISI is located in Seoul, Korea and has three branches throughout the country. The Seoul NISI covers all legal autopsies in Seoul City, Incheon City and Kyunggi Province and some cases referred from other regions. This report aims to analyse various aspects of 2,851 unusual deaths in Korea, chiefly Seoul and its surrounding area. Followings are the summary of the results. 1. The number of male was 2,007 cases (70.4%) and that of female 844 (29.6%). Male was over twice more than female. The forties were 807 cases (28.3%), the thirties 573 (20.1%), and these two decades occupied 48.4%. 2. Unnatural deaths were 1,716 cases (60.2%), natural 1011 (35.5%), and the unknown 124 (4.3%). Among 1,716 unnatural deaths, suicide was 497 (29.0%), homicide 426 (24.9%), accident 510 (29.6%), and the unclear 283 (16.5%). Homicide occupied 42.0% of trauma, 75.6% of blunt force injury excluding traffic and fall-down injury, and 85.5% of sharp force injury. The homicide rate in asphyxia was 31.1%, but it went up to 60.1% excluding hanging. It showed only 0.4% percent of homicide in poisoning. 3. Traumatic deaths were 716 cases, occupying 41.7% of 1,716 unnatural deaths, followed by asphyxial deaths(296 cases). Blunt trauma was 205 cases (28.6%) and the leading cause of death in traumatic death. Poisoning was 229 cases, among which the ethanols were dominant (58cases). Thermal injuries were 198 cases, electrocution 20 cases, and starvation/neglect 14 cases. and 18 cases were directly due to medical procedures. 4. Among 1,011 natural deaths, heart diseases were 481 cases (47.6%), and vascular diseases 193 (19.1%), and these two categories were added up to 674 (66.7%). 5. Child deaths under the age of 10 were 129 cases. Homicide was 40 cases (62.5%) out of 64 unnatural deaths. Neonates including still births were the leading period of age in unnatural death, counting 41 cases(31.8%)
Asphyxia ; Autopsy* ; Cause of Death ; Child ; Ethanol ; Female ; Gyeonggi-do ; Heart Diseases ; Homicide ; Humans ; Incheon ; Infant, Newborn ; Korea ; Law Enforcement ; Male ; Parturition ; Poisoning ; Seoul ; Suicide ; Vascular Diseases

This is a statistical analysis based on the data of legal autopsies performed at the Headquarters of the National Institute Scientific Investigation(NISI), requested by every kind of law enforcement agencies during the year of 2004. NISI is located in Seoul, Korea and has three branches throughout the country. The Seoul NISI covers all legal autopsies in Seoul City, Incheon City and Kyunggi Province and some cases referred from other regions. This report aims to analyse various aspects of 3,051 unusual deaths in Korea, chiefly Seoul and its surrounding area. Followings are the summary of the results. 1. The number of male was 2,214 cases(73%) and that of female 837(27%). Male was over twice more than female. The forties were 899 cases(29.5%), the thirties 561(18.4%), and these two decades occupied 47.9%. 2. Unnatural deaths were 1,816 cases(59.5%), natural 1,104(36.2%), and the unknown 131(4.3%). Among 1,816 unnatural deaths, suicide was 513(28.2%), homicide 414(22.8%), accident 505(27.8%), and the unclear 384(21.2%). Homicide occupied 38.4% of trauma, 62.9% of blunt force injury excluding traffic and fall-down injury, and 82.7% of sharp force injury. The homicide rate in asphyxia was 31.1%, but it went up to 67.7% excluding hanging. It showed only 0.4% percent of homicide in poisoning. 3. Traumatic deaths were 779 cases, occupying 42.9% of 1,816 unnatural deaths, followed by poisoning deaths(286 cases) and asphyxial deaths(283 cases). Blunt trauma was 240 cases(30.8%) and the leading cause of death in traumatic death. Poisoning was 286 cases, among which the ethanols were dominant( 76cases). Thermal injuries were 162 cases, electrocution 27 cases, and starvation/neglect 7 cases and 17 cases were directly due to medical procedures. 4. Among 1,104 natural deaths, heart diseases were 522 cases(47.3%), and vascular diseases 182(16.5%), and these two categories were added up to 704(63.8%). 5. Child deaths under the age of 10 were 147 cases. Homicide was 31 cases(51.7%) out of 60 unnatural deaths. Neonates including still births were the leading period of age in unnatural death, counting 48 cases(32.7%).
Asphyxia ; Autopsy* ; Cause of Death ; Child ; Ethanol ; Female ; Gyeonggi-do ; Heart Diseases ; Homicide ; Humans ; Incheon ; Infant, Newborn ; Korea ; Law Enforcement ; Male ; Parturition ; Poisoning ; Seoul ; Suicide ; Vascular Diseases