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Minoxidil was originally introduced as a potent vasodilator, but is now widely used as a topical treatment for human alopecia. A 4-year-old neutered male Norwegian Forest cat presented with a 2-day history of anorexia, lethargy, and dyspnoea. A physical examination revealed hypothermia, tachypnoea, hypotension, and bilateral pulmonary crackles. The radiographs revealed pulmonary oedema and pleural effusions. The hypotension and pleural effusions exacerbated despite the supportive therapy, and the underlying cause remained undetermined. A further medical inquiry revealed the cat had been exposed to a topical minoxidil solution 3 days before admission. Accordingly, minoxidil toxicosis was managed using both i.v. fluids and vasopressors. Dopamine and norepinephrine were infused for 3 days to normalise the patient's blood pressure and related clinical signs. The cat recovered fully and was discharged 6 days after the minoxidil exposure. This is the first report on the successful management of minoxidil toxicosis in a cat. To broaden our knowledge of minoxidil toxicosis in cats, we have also described the serial changes in the clinical findings of this cat over the treatment period. Furthermore, on the basis of the experience gained from this case, we suggest an optimised management plan for future cases of feline minoxidil toxicosis.

Jun Hyeong Song,1 Woo Yong Lee,2 Kyoung Rai Cho,3 Sang Hyun Nam,4 Ki Deok Park,5,&ast; Yongbum Park1,&ast; 1Department of Physical Medicine & Rehabilitation, Sanggye Paik Hospital, Inje UniversityCollege of Medicine, Seoul, Republic of Korea; 2Department of Anesthesiology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, South Korea; 3Department of Otorhinolaryngology Head and Neck Surgery, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea; 4Department of Plastic and Reconstructive Surgery, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea; 5Department of Rehabilitation Medicine, Gachon University, Gil Medical Center, Incheon, South Korea&ast;These authors contributed equally to this workCorrespondence: Yongbum ParkDepartment of Physical Medicine & Rehabilitation, Sanggye Paik Hospital, Inje University College of Medicine, Sanggye 7 Dong 761-7, Nowon-gu, Seoul, 139-707, KoreaEmail swc328@naver.comKi Deok ParkDepartment of Rehabilitation Medicine, Gachon University, Gil Medical Center, Namdong-Daero 774 Beon-gil, Namdong-gu, Incheon, Korea, 33 Tel +82-2-950-1145Fax +82-2-935-3076Email bduck@gilhospital.comIntroduction: This study is to compare advantages, safety and mid-term effects of fluoroscopy (FL)-guided transforaminal (TF) to caudal (CA) epidural steroid injection (ESI) for chronic pain after spinal surgery (CPSS) by assessing pain relief and improvement of functionality.Methods: Patients with radicular pain in CPSS who received FL-guided CA (n = 21) or TF (n = 28) ESI were included in this retrospective study. Complication frequencies, adverse events, treatment effects, and functional improvements for each procedure were compared at 1, 3, and 6 months following the last injection.Results: Both the Oswestry Disability Index (ODI) and verbal numeric pain scale scores (VNS) demonstrated improvement in both groups at all 1, 3, and 6 months following the last injection, without meaningful difference between groups (p < 0.05). Moreover, no meaningful difference was present between groups in terms of treatment success rate at every time point. The amount of time used for the injection procedure was shorter in CA group than in TF group (410.32 ± 25.73 seconds vs 640.65 ± 18.03 seconds, p < 0.05). Within 2 weeks of the injection treatment, the patient satisfactory scores were evaluated, with excellent being rated 85.7% (n = 18) among CA-ESI patients and 55.7% (n = 16) among TF-ESI patients (p < 0.05). Logistic regression analysis revealed that variables such as method of injection (CA or TF approach), sex, use of analgesics, pain duration, number of injections, and age were not significant variables for successful treatment results. There were no adverse complications after the procedure in both groups.Conclusion: The outcomes of FL-guided CA-ESI and TF-ESI for CPSS are similar in terms of pain reduction and functional improvements. CA-ESI is associated with lesser procedure time. In addition, compared with the TF-ESI, the patient experiences less discomfort during the injection, and the satisfaction with the injection treatment is confirmed to be better. Accordingly, both methods are effective; however, in the CA approach, patient satisfaction is higher and the procedure time is shorter.Keywords: epidural block, fluoroscopy, transforaminal, caudal, FL, CA, TF

Jung Youb Kang,1,* Ju Hwan Song,2,* Sang Joon Lee1 1Department of Ophthalmology, Kosin University College of Medicine, Busan, South Korea; 2The Bom Eye Clinic, Busan, South Korea*These authors contributed equally to this workCorrespondence: Sang Joon LeeDepartment of Ophthalmology, Gospel Hospital, Kosin University College of Medicine, 262, Gam Cheon-ro, Seo-gu, Busan 49267, South KoreaTel +82-51-990-6140Fax +82-51-990-3026Email hhiatus@gmail.comPurpose: To investigate optic opacification of hydrophobic acrylic intraocular lens (IOL) depending on hydration and temperature conditions.Methods: IOL (Acrysof® MA60BM Alcon, Fort Worth, Texas, USA) extracted from a 55-year-old male who underwent binocular cataract 11 years ago were used for the analysis. On slit lamp examination, the binocular IOL optics showed homogenous opacification. After extraction of the IOLs, the IOL opacification disappeared during dry storage at 4°C. To investigate the changes in IOL opacification according to temperature and hydration, an extracted IOL was stored in either dry conditions or normal saline at 4°C, room temperature, or 37°C for 24 hours, and then the degree of haziness was examined. To investigate the impact of an opaque optic on visual function, light transmission was performed using an ultraviolet-visible spectrophotometer (U-3000, Hitachi High-Technologies Corp., Tokyo, Japan).Results: The extracted IOL optics at 4°C, room temperature, and 37°C were transparent at dry conditions. When the dried IOL was immersed in normal saline at room temperature and 37°C, opacification appeared. However, when the dried IOL was immersed in normal saline at 4°C, opacification of the IOL did not appear. When compared with the control, light transmission of the extracted IOLs from the right and left eyes stored in 37°C normal saline decreased by 4.7% at 453 nm and by 5.1% at 482 nm, respectively.Conclusion: In acrylic hydrophobic IOLs, optic opacification can occur depending on temperature and hydration conditions.Keywords: intraocular lens, whitening, scattering, opacification, hydrophobic lens, acrylic lens

Jin Hwa Song,1 Chang-Hoon Lee,1 Soo-Jung Um,2 Yong Bum Park,3 Kwang Ha Yoo,4 Ki Suck Jung,5 Sang-Do Lee,6 Yon-Mok Oh,6 Ji Hyun Lee,7 Eun Kyung Kim,7 Deog Kyeom Kim8,9 On behalf of KOLD, KOCOSS, and SNU airway registry investigators 1Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea; 2Division of Respiratory Medicine, Department of Internal Medicine, Dong-A University College of Medicine, Dong-A University Medical Center, Busan, Republic of Korea; 3Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Kangdong Sacred Heart Hospital, Seoul, Republic of Korea; 4Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea; 5Division of Pulmonary Medicine, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University Medical School, Anyang Gyeonggi-do, Republic of Korea; 6Department of Pulmonary and Critical Care Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul, Republic of Korea; 7Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam Gyeonggi-do, Republic of Korea; 8Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea; 9Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea Purpose: While GOLD classification has been revised, its clinical impacts on outcomes of COPD patients have not been widely evaluated in real-world cohorts.Materials and methods: According to 2007, 2013, and 2017 GOLD classifications, distribution and clinical characteristics of group-shifted patients and the risk of acute exacerbation were analyzed in combined Korean COPD cohorts. Future risk for annual moderate-to-severe exacerbation was estimated as incidence rate ratio (IRR) and compared by groups.Results: Among 1,880 COPD patients, in GOLD 2017 classification, groups B and A were increased to 61.2% and 22.2% of total population, while group C was shrunken to 2.2% and patients with higher risk were decreased (16.6% in GOLD 2017 vs 44.7% in GOLD 2013). The kappa coefficient of agreement of both systems was 0.581 (agreement 71.7%). Groups B and D showed higher IRR of moderate-to-severe exacerbation than group A (IRR 2.4 and 5.3 respectively, P

Youngmok Park, Ji Ye Jung, Young Sam Kim, Kyung Soo Chung, Joo Han Song, Song Yee Kim, Eun Young Kim, Young Ae Kang, Moo Suk Park, Joon Chang, Ah Young Leem Division of Pulmonology, Department of Internal Medicine, Institute of Chest Disease, Severance Hospital, Yonsei University College of Medicine, Seodaemun-gu, Seoul, South Korea Background: Lung function and depression are closely related to many chronic lung diseases. However, few studies have evaluated this association in the general population. In this study, we evaluated the relationship between lung function and depression in the general population in Korea. Participants and methods: Data from the Ansung–Ansan cohort, a community-based cohort in Korea, were used to analyze the relationships between depression and lung function parameters. A total of 3,321 men and women aged 40–69 years were enrolled. Spirometry data included the forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and the FEV1/FVC ratio. Depression was defined as a score of ≥16 by the Beck Depression Inventory (BDI). A propensity score analysis was conducted with the aim of reducing the bias of the retrospective study. Results: The overall prevalence of depression in the study population was 13.1% (434/3,321 participants). Depression was significantly more prevalent in women than in men (P

Jin Hwa Song,1 Chang-Hoon Lee,1 Jin Woo Kim,2 Won-Yeon Lee,3 Ji Ye Jung,4 Joo Hun Park,5 Ki Suck Jung,6 Kwang Ha Yoo,7 Yong Bum Park,8 Deog Keom Kim9 1Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, 2Division of Pulmonology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, 3Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Gangwon-do, 4Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, 5Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Suwon, 6Division of Pulmonary Medicine, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University Medical School, Anyang, Gyeonggi-do, 7Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, 8Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Kangdong Sacred Heart Hospital, 9Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea Background: Recent studies that assessed the relevance of the blood eosinophil count as a biomarker in patients with COPD may have overestimated it because they included patients with asthma–COPD overlap syndrome (ACOS). We investigated the clinical implications of the blood eosinophil count in patients with non-ACOS COPD.Patients and methods: From a Korean COPD Subtype Study (KOCOSS) cohort, we selected patients with non-ACOS COPD after excluding ACOS patients according to Spanish criteria. Clinical characteristics and the incidence of moderate-to-severe exacerbation were compared among the four groups stratified according to the quartiles of blood eosinophil percent and count.Results: Of the KOCOSS cohort of 1,132 patients with COPD, 467 non-ACOS COPD patients (41.2%) with data of blood eosinophil count remained after excluding those with ACOS based on the Spanish definition. There was no difference in clinical characteristics among groups classified according to the quartiles of eosinophil percent and count. On multivariate logistic regression, eosinophil quartiles in percent and absolute count were not associated with the incidence of moderate-to-severe acute exacerbations of COPD (AECOPD). The eosinophil count did not affect the risk of AECOPD or forced expiratory volume in 1 second (FEV1) changes according to exposure to inhaled corticosteroid (ICS). However, by increasing the cutoff value for the eosinophil count from 200/µL to 600/µL, the odds ratio for risk of exacerbation increased serially from 0.82 to 2.96 on trend analysis.Conclusion: In patients with non-ACOS COPD, the blood eosinophil count and percent were not associated with FEV1 changes, quality of life (QoL), AECOPD frequency, or response to ICS. The clinical implication of the blood eosinophil count should not be overestimated in patients with non-ACOS COPD. Keywords: eosinophil, chronic obstructive lung disease, asthma, acute exacerbation, inhaled corticosteroid

Chan Ho Lee, Eun Kyung Goag, Su Hwan Lee, Kyung Soo Chung, Ji Ye Jung, Moo Suk Park, Young Sam Kim, Se Kyu Kim, Joon Chang, Joo Han Song Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Institute of Chest Disease, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea Background: Iron-catalyzed oxidative stress contributes to lung injury after exposure to various toxins, including cigarette smoke. An oxidant/antioxidant imbalance is considered to play a critical role in the pathogenesis of COPD. Ferritin is a key protein in iron homeostasis, and its capacity to oxidize and sequester the metal preventing iron prooxidant activity implicates its possible role in the alteration of antioxidant imbalance. We investigated the relationship among cigarette smoking, lung function, and serum ferritin concentration in a large cohort representative of the Korean adult population. Materials and methods: Among 50,405 participants of the Korean National Health and Nutrition Examination Survey from 2010 to 2014, 15,239 adult subjects older than 40 years with serum ferritin levels and spirometric data were selected for this study. Results: The mean age was 56.5 years for men (43%) and 56.9 years for women (57%). The prevalence of airway obstruction was 13.4%, which was significantly higher in men than in women, and increased in former or current smokers. The median levels of serum ferritin were highest in the airway obstruction group, followed by the restrictive pattern group, and lowest in the normal lung function group. The median ferritin levels were increased by smoking status and amounts in each spirometric subgroup. In multivariable regression analysis, serum ferritin was positively associated with forced expiratory volume in 1 second and forced expiratory volume in 1 second/forced vital capacity, whereas the smoking amount was negatively associated with the adjustment with age, sex, height, and weight. Conclusion: Serum ferritin levels were increased in former or current smokers and were increased with smoking amount in all subgroups of participants categorized according to spirometric results. The result was also evident in the subgroups divided by obstructive severity. While smoking amount was inversely related to lung function, higher levels of serum ferritin were associated with enhanced spirometric results in a representative sample of the general Korean adult population. Future prospective studies will be needed to clarify the causality between serum ferritin and lung functions and their role in COPD morbidity. Keywords: airway obstruction, ferritin, smoking

Kyung Soo Chung,1,2 Ji Ye Jung,1,2 Moo Suk Park,1,2 Young Sam Kim,1,2 Se Kyu Kim,1,2 Joon Chang,1,2 Joo Han Song1,2 1Division of Pulmonology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; 2Institute of Chest Disease, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea Background: Forced expiratory volume in 1 second (FEV1)/forced expiratory volume in 6 seconds (FEV6) has been proposed as an alternative to FEV1/forced vital capacity (FVC) for detecting airway obstruction. A fixed cut-off value for FEV1/FEV6 in a Korean population is lacking. We investigated a fixed cut-off for FEV1/FEV6 as a surrogate for FEV1/FVC for detecting airway obstruction.Materials and methods: We used data obtained in the 5 years of the Fifth and Sixth Korean National Health and Nutrition Examination Survey. A total of 14,978 participants aged ≥40 years who underwent spirometry adequately were the study cohort. “Airway obstruction” was a fixed cut-off FEV1/FVC

Hee Jin Park, Ah Young Leem, Sang Hoon Lee, Ju Han Song, Moo Suk Park, Young Sam Kim, Se Kyu Kim, Joon Chang, Kyung Soo Chung Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Severance Hospital, Institute of Chest Disease, Yonsei University College of Medicine, Seoul, South Korea Background: Comorbidities can occur frequently in patients with chronic obstructive pulmonary disease (COPD) and can influence mortality and morbidity independently. It is increasingly recognized that many patients with COPD have comorbidities that have a major impact on their quality of life and survival. Therefore, we investigated the prevalence of comorbidities in Korean COPD populations. Methods: We used data obtained in the 6 years of the fourth and fifth Korean National Health and Nutrition Examination Survey (KNHANES) IV and V. Among 50,405 subjects, 16,151 subjects aged ≥40 years who performed spirometry adequately were included in this study. Airway obstruction was defined as forced expiratory volume in 1 second/forced vital capacity

Creating oxide interfaces with precise chemical specificity at the atomic layer level is desired for the engineering of quantum phases and electronic applications, but highly challenging, owing partially to the lack of in situ tools to monitor the chemical composition and completeness of the surface layer during growth. Here we report the in situ observation of atomic layer-by-layer inner potential variations by analysing the Kikuchi lines during epitaxial growth of strontium titanate, providing a powerful real-time technique to monitor and control the chemical composition during growth. A model combining the effects of mean inner potential and step edge density (roughness) reveals the underlying mechanism of the complex and previously not well-understood reflection high-energy electron diffraction oscillations observed in the shuttered growth of oxide films. General rules are proposed to guide the synthesis of atomically and chemically sharp oxide interfaces, opening up vast opportunities for the exploration of intriguing quantum phenomena at oxide interfaces.

Purpose: The purpose of this study was to assess the clinical and radiographic results of a total hip arthroplasty with the double tapered Mallory-Head system.Methods: The clinical and radiographic results of a consecutive series of 81 total hip replacements in 75 patients were reviewed 10-15 years (average 11.4 years) postoperatively. The patients' underlying conditions were avascular necrosis in 46 hips (57 %), osteoarthritis in 12 hips (15 %), RA in nine hips (11 %), and others. Clinical results were evaluated based on the modified Harris hip score and modified Merle d'Aubigné-Postel score. A radiographic analysis was performed.Results: The average modified Harris hip score improved from a preoperative score of 56 points to a postoperative 92 points. The average modified Merle d'Aubigné-Postel score was 15 points at the latest follow up, and 55 hips (68 %) were classified as the clinical grades of excellent or good results. One acetabular component was revised because of loosening, and one was revised for recurrent dislocation.Conclusion: The clinical and radiological evaluations of the total hip replacements using the Mallory-Head system showed good results. [ABSTRACT FROM AUTHOR]

BACKGROUND: Community-associated meticillin-resistant Staphylococcus aureus (CA-MRSA) has emerged as an important pathogen worldwide in a continent-specific manner. Clinical characteristics of infections caused by CA-MRSA other than USA300, especially in healthcare settings, have not been well established. AIM: To conduct a retrospective cohort study to determine the clinical characteristics of infections caused by Panton-Valentine leukocidin (PVL)-negative, multilocus sequence type (ST) 72 staphylococcal cassette chromosome mec (SCCmec) type IV, a major CA-MRSA clone in Korea. METHODS: ST72-IV isolates, which were susceptible to fluoroquinolones, gentamicin, rifampicin, and cotrimoxazole, were presumptively identified among 4667 MRSA isolates and then confirmed by SCCmec typing and multilocus sequence typing. A total of 124 cases of ST72-IV infections were analysed. FINDINGS: The annual incidence of infections by ST72-IV per 100,000 admissions increased from 45.5 to 66.3 cases during 2007-2009. The most frequently occurring type of infection was skin and soft tissue infection (SSTI) (46.0%), followed by pneumonia (27.4%) and bone and joint infection (9.7%). Surgical site infection accounted for 22.6% and 32.5% of community-onset (CO) healthcare-associated infection and hospital-onset (HO) infection, respectively. Pneumonia was most frequent (45.0%) among HO infection. Multivariate analysis showed that pneumonia increased the odds of all-cause mortality (odds ratio: 18.8; 95% confidence interval: 2.6-133.9) compared with other types of infection. CONCLUSIONS: Increasing trends were observed in annual incidence of CO and HO infections by ST72-IV in Korea. Pneumonia was the most frequent among HO infection and was associated with higher mortality. These findings pose important implications for successful antibiotic therapy and infection control in the era of CA-MRSA.Copyright © 2012 by Elsevier Inc. [ABSTRACT FROM AUTHOR]

Background: Cytosine arabinoside-based chemotherapy coupled with anthracycline is currently the first-line treatment for acute myeloid leukaemia (AML), but diverse responses to the regimen constitute obstacles to successful treatment. Therefore, outcome prediction to chemotherapy at diagnosis is believed to be a critical consideration.Methods: The mRNA expression of 12 genes closely involved in the actions of cytosine arabinoside and anthracycline was evaluated by real-time reverse transcriptase PCR (RT-PCR), in 54 diagnostic bone marrow specimens of M2-subtype AML.Results: Low expression levels of ribonucleotide reductase M2 (RRM2) and high expression levels of topoisomerase 2 beta (TOP2B) were correlated with longer survival in a univariate analysis. Another interesting finding is that high ratios of TOP2B/RRM2 and TOP2B/TOP2 alpha (TOP2A) in a combined analysis were also shown to have a prognostic impact for longer survival with improved accuracy. Among the four markers, when adjusted for the influence of other clinical factors in multivariate analysis, the TOP2B/TOP2A ratio was significantly correlated with treatment outcomes; patients with high ratios trended toward longer disease-free survival (HR, 0.24; P=0.002) and overall survival (HR, 0.29; P=0.005).Conclusion: Genes with distinct expression profiles such as TOP2B/TOP2A expression ratio at diagnosis can be employed for outcome prediction after the treatment with standard regimens in AML patients with M2 subtype. [ABSTRACT FROM AUTHOR]

This study was performed to evaluate the impact of extended-spectrum β-lactamase (ESBL)-producing bacteremia on outcome in patients with hematologic malignancy. We collected and analyzed data on 156 hematologic malignancy patients with Escherichia coli or Klebsiella pneumoniae bacteremia from the database of nationwide surveillance studies for bacteremia. Thirty-seven of the 156 patients (23.7%) harbored ESBL-producing bacteremia. No significant differences in underlying diseases were found in either group. The multivariate analysis showed that significant factors associated with ESBL-producing bacteremia were ICU care (OR = 7.03, 95% CI = 1.79-27.6) and nosocomial acquisition (OR = 5.66, 95% CI = 1.60-20.23). There was an association between prior receipt of cephalosporins and ESBL-producing bacteremia, although this association was not statistically significant (OR = 2.27, 95% CI = 0.99-5.23). The overall 30-day mortality rate of the study population was 20.4% (29/142), and the 30-day mortality rate for the ESBL group was significantly higher than that for the non-ESBL group (44.8% vs. 14.2%, P < 0.001). Multivariate analysis showed that ESBL-producing bacteremia was the most important risk factor associated with 30-day mortality (OR, 5.64; 95% CI, 1.91-16.67), along with ICU care (OR = 4.35, 95% CI = 1.16-16.26) and higher Pitt bacteremia score (per 1-point increment) (OR = 1.50, 95% CI = 1.18-1.92). In conclusion, ESBL-producing bacteremia was the most important risk factor associated with 30-day mortality in patients with hematologic malignancy, along with ICU care and higher Pitt bacteremia score. Our data suggest that determining the optimal empiric antimicrobial therapy in patients with hematologic malignancy is now becoming a challenge for clinicians in the era of multidrug-resistant Gram-negative bacilli. [ABSTRACT FROM AUTHOR]

Purpose: Bacteremia is an important clinical condition in febrile neutropenia that can cause clinical failure of antimicrobial therapy. The purpose of this study was to investigate the clinical factors predictive of bacteremia in low-risk febrile neutropenia at initial patient evaluation.Methods: We performed a retrospective cohort study in a university hospital in Seoul, Korea, between May 1995 and May 2007. Patients who met the criteria of low-risk febrile neutropenia at the time of visit to emergency department after anti-cancer chemotherapy were included in the analysis.Results: During the study period, 102 episodes of bacteremia were documented among the 993 episodes of low-risk febrile neutropenia. Single gram-negative bacteremia was most frequent. In multivariate regression analysis, initial body temperature ≥39°C, initial hypotension, presence of clinical sites of infection, presence of central venous catheter, initial absolute neutrophil count <50/mm(3), and the CRP ≥10 mg/dL were statistically significant predictors for bacteremia. A scoring system using these variables was derived and the likelihood of bacteremia was well correlated with the score points with AUC under ROC curve of 0.785. Patients with low score points had low rate of bacteremia, thus, would be candidates for outpatient-based or oral antibiotic therapy.Conclusions: We identified major clinical factors that can predict bacteremia in low-risk febrile neutropenia. [ABSTRACT FROM AUTHOR]

Objective: The number of people with metabolic syndrome is increasing worldwide, and changes in socioenvironmental factors contribute to this increase. Therefore, investigation of changes in metabolic syndrome and its components in South Korea, where rapid socioenvironmental changes have occurred in recent years, would be foundational in setting up an effective strategy for reducing this increasing trend.Research Design and Methods: We compared the prevalence and pattern of metabolic syndrome among participants in the Korean National Health and Nutrition Examination Surveys for 1998, 2001, 2005, and 2007. In each survey, stratified, multistage, probability-sampling designs and weighting adjustments were conducted to represent the entire Korean population. The revised National Cholesterol Education Program criteria were used as the definition of metabolic syndrome. All biochemical parameters were measured in a central laboratory.Results: A total of 6,907 (mean ± SE age 45.0 ± 0.2 years), 4,536 (45.5 ± 0.2), 5,373 (47.1 ± 0.2), and 2,890 (49.9 ± 0.3) Koreans over 20 years of age have participated in the studies in 1998, 2001, 2005, and 2007, respectively. The age-adjusted prevalence of metabolic syndrome increased significantly from 24.9% in 1998, 29.2% in 2001, and 30.4% in 2005 to 31.3% in 2007. Among the five components, the level of low HDL cholesterol increased the most, by 13.8% over the 10 years. Abdominal obesity and hypertriglyceridemia followed, with 8.7 and 4.9% increases, respectively.Conclusions: Because dyslipidemia and abdominal obesity were major factors in increasing the prevalence of metabolic syndrome in Koreans for the past 10 years, lifestyle interventions should be conducted at the national level to reduce the burden and consequences of metabolic syndrome. [ABSTRACT FROM AUTHOR]