Efficacy of infection control strategies to reduce transmission of vancomycin-resistant enterococci in a tertiary care hospital in Korea: a 4-year follow-up study.

To determine the effectiveness of infection control strategies to reduce transmission of vancomycin-resistant enterococci (VRE), a cohort study was performed in a university hospital. Contact precautions alone were not effective in reducing transmission of VRE. Strict isolation of affected patients in private rooms, in addition to use of contact precautions, showed a significantly improved reduction in the transmission of VRE.     

A new case of a branchial cyst of the parapharyngeal space.

Branchial cysts in the parapharyngeal space are rare. Until now, only 23 such cases have been reported in the literature. In this article, we report a new case in a 65-year-old man. Information gained from the clinical examination, fiberoscopy, and computed tomography revealed that the cyst was obstructing the oropharynx and filling the parapharyngeal and retropharyngeal spaces on the right. The mass was excised via a transcervical approach without any complications. We also review the literature on this condition.     

The location of photodegradable nitric oxide store in the mouse stomach fundus

The aim of this study was to investigate the location of photodegradable nitric oxide (NO) store using a pharmacological approach in mouse gastric fundus. The ultraviolet light irradiation (UV; 360 nm, 60 s), electrical field stimulation (EFS; 4 Hz, 25 V, 1 ms, 15s-train), exogenous nitric oxide (NO; 10 microM), nitroglycerin (100 microM) and isoproterenol (5 nM) induced relaxation in mouse gastric fundus preparations in the absence or presence of an intact mucosa. The NO scavenger, haemoglobin (20 microM), significantly inhibited the relaxation of intact and denuded mucosa stomach fundus to UV light irradiation, EFS and NO, but not to nitroglycerin and isoproterenol. The superoxide anion generator, pyrogallol (50 microM), inhibited relaxation of intact and denuded mucosa stomach fundus induced by UV light irradiation, EFS, NO, but not to nitroglycerin and isoproterenol. The inhibition observed with pyrogallol was prevented by exogenous Cu/Zn superoxide dismutase (SOD; 100 U/ml), a membrane impermeable antioxidant. The Cu/Zn SOD inhibitor, diethyldithiocarbamic acid (DETCA; 8 mM), inhibited the relaxation of intact and denuded mucosa stomach fundus to UV light irradiation, EFS, NO and nitroglycerin but not those to isoproterenol. Exogenous SOD (100 U/ml) partially prevented the inhibitory effect of DETCA on relaxation to UV light irradiation, EFS, NO but not to nitroglycerin. DETCA-induced inhibition of the nitroglycerin-induced relaxation was partially prevented by the cell-permeable polyethylene-glycol-superoxide dismutase (100 U/ml). These results indicate that photodegradable NO store is, at least in part, unlikely to be within smooth muscle cells, and furthermore, that UV light-induced relaxation is not dependent on gastric mucosal layer.     

Study of mandibular alveolar distraction osteogenesis using a three-dimensional computed tomography measurement method: report of four patients, a preliminary study

OBJECTIVE: This study was conducted to show dimensional and volumetric changes after vertical alveolar distraction osteogenesis using a three-dimensional computed tomography measurement method. MATERIALS: Four patients with mandibular alveolar ridge atrophy were evaluated. Three-dimensional computed tomography reconstructions were obtained 2 weeks before and 3 months after the operation. The results of the three-dimensional computed tomography measurements were used for preoperative planning and for quantitative assessment of the mandibular alveolar distraction. The results of the preoperative and postoperative three-dimensional computed tomography measurements were compared statistically using paired t-test. RESULTS: The increase in distracted mandibular segment volume and surface area, height, and width of each slice after distraction were statistically significant (P < 0.001). CONCLUSION: In atrophic jaw cases, the dimensions of the present alveolar bone were clearly measured so that the amount of augmentation needed could be estimated. Three-dimensional computed tomography provided better understanding of the effects of distraction osteogenesis on the anterior mandible. Newly formed bone can be viewed as close to its real dimensions after distraction osteogenesis.     

Subtype Is a Predictive Factor of Nonsentinel Lymph Node Involvement in Sentinel Node-Positive Breast Cancer Patients

Purpose

This study aimed to identify the effect of breast cancer subtype on nonsentinel lymph node (NSLN) metastasis in patients with a positive sentinel lymph node (SLN).

Methods

The records of 104 early breast cancer patients with a positive SLN between April 2009 and September 2013 were retrospectively evaluated. All patients underwent axillary lymph node dissection. The effects of the tumor subtype (luminal A, luminal/HER2+, human epidermal growth factor receptor 2 [HER2] overexpression, and triple-negative) and other clinicopathological factors on NSLN metastasis were examined by univariate and multivariate statistical analyses.

Results

Fifty of 104 patients (48%) exhibited NSLN metastasis. Univariate and multivariate analyses revealed that tumor size and the ratio of positive SLNs were significant risk factors of NSLN metastasis in patients with a positive SLN. The rate of NSLN metastasis was higher in patients with luminal/HER2+ and HER2 overexpression subtypes than that in patients with other subtypes in the univariate analysis (p<0.001). In the multivariate analysis, both patients with luminal/HER2+ (p<0.006) and patients with HER2 overexpression (p<0.031) subtypes had a higher risk of NSLN metastasis than patients with the luminal A subtype.

Conclusion

Subtype classification should be considered as an independent factor when evaluating the risk of NSLN metastasis in patients with a positive SLN. This result supports the development of new nomograms including breast cancer subtype to increase predictive accuracy.     

Dietary whey supplementation in experimental models of wound healing

Whey is a dairy product containing milk serum proteins with diverse biological effects. In this study, the effect of dietary whey supplementation on wound healing was investigated. Rats were fed a standard or whey-supplemented diet for three weeks. Wound healing parameters, glutathione, and lipid peroxide levels were determined three days after the application of two different models of wound healing, i.e. laparotomy and colonic anastomosis. Dietary whey supplementation significantly increased glutathione levels and suppressed lipid peroxidation after experimental laparotomy and colonic anastomosis. Bursting pressures, hydroxyproline, and cytokine levels were not changed. Our results show that dietary whey supplementation increases glutathione synthesis and cellular antioxidant defense. Long-term effects of whey feeding on wound healing remains to be investigated.     

The role of free oxygen radicals in the aetiopathogenesis of rosacea

A possible link between superoxide dismutase activity and malondialdehyde level with the clinical manifestations of rosacea was investigated. We found differences in superoxide dismutase activities between mild rosacea (stages I and II) and severe involvement (stage III) groups, as well as between disease and control groups that were statistically significant (P < 0.05). In the mild involvement group (stages I and II), the superoxide dismutase activity was higher than in the control group (P < 0.05), while the malondialdehyde levels did not differ from the control. In the severe involvement group (stage III), the superoxide dismutase activity was lower than in the control group (P < 0.05), and this was coupled to a raised level of malondialdehyde (P < 0.05). These findings clearly show that in the mild involvement phase of rosacea patients, superoxide dismutase activity was stimulated to protect the skin against reactive oxygen species so that the malondialdehyde levels were maintained. In contrast, in more severe disease, due to a decrease in the capacity of the antioxidant defence system, the malondialdehyde levels were increased. These findings support the 'antioxidant system defect hypothesis' in rosacea patients.