Central Venous Catheter-Related Infection in Severe Trauma Patients.

AIM: To evaluate the CVC-related infection rate according to catheter insertion site and to analyze the risk factors for catheter-related local infections (CRLI) and bloodstream infections (CRBSI) among severe trauma patients. METHODS: We reviewed the medical records of 736 severe trauma patients with an Injury Severity Score of >15. Poisson regression was used to compare the infection rates according to the catheter insertion sites. Univariate analysis of the groups with and without CVC-related infection was used to identify confounding variables for inclusion in multivariate models that were used to identify the risk factors for CRLI and CRBSI. RESULTS: We evaluated 1646 catheter insertions and their duration of insertion and found 1241 subclavian (18,461 days), 251 internal jugular (3454 days), and 154 femoral catheters (1526 days). The CRLI infection rate per 1000 catheter days was significantly lower for subclavian, compared to that for internal jugular (4.83 vs. 9.55, respectively; P < 0.001) and femoral catheters (4.83 vs. 7.93, respectively; P = 0.013). Multivariate logistic regression analysis revealed that catheter insertion duration [odds ratio (95 % confidence interval): 1.035 (1.021-1.050), P < 0.001] and subclavian access [0.532 (0.366-0.775), P < 0.001] were significantly associated with CRLI, while catheter insertion duration [1.024 (1.002-1.046), P = 0.032] was significantly associated with CRBSI. CONCLUSIONS: To reduce the rate of CVC-related infections in severe trauma patients, we suggest that catheters be shifted from the internal jugular or femoral veins to the subclavian vein as soon as possible and that the duration of catheter insertion should be minimized.

Influence of bridge structure manipulation on the electrochemical performance of π-conjugated molecule-bridged silicon quantum dot nanocomposite anode materials for lithium-ion batteries.

To assess the influence of bridge structure manipulation on the electrochemical performance of π-conjugated molecule-bridged silicon quantum dot (Si QD) nanocomposite (SQNC) anode materials, we prepared two types of SQNCs by Sonogashira cross-coupling and hydrosilylation reactions; one is SQNC-VPEPV, wherein the Si QDs are covalently bonded by vinylene (V)-phenylene (P)-ethynylene (E)-phenylene-vinylene, and the other is SQNC-VPV. By comparing the electrochemical performances of the SQNCs, including that of the previously reported SQNC-VPEPEPV, we found that the SQNC with the highest specific capacity varied depending on the applied current density; SQNC-VPEPV (1420 mA h g-1) > SQNC-VPV (779 mA h g-1) > SQNC-VPEPEPV(465 mA h g-1) at 800 mA g-1, and SQNC-VPV (529 mA h g-1) > SQNC-VPEPEPV (53 mA h g-1) > SQNC-VPEPV (7 mA h g-1) at 2000 mA g-1. To understand this result, we performed EIS and GITT measurements of the SQNCs. In the course of investigating the lithium-ion diffusion coefficient, charge/discharge kinetics, and electrochemical performance of the SQNC anode materials, we found that electronic conductivity is a key parameter for determining the electrochemical performance of the SQNC. Two probable causes for the unique behavior of the electrochemical performances of the SQNCs are anticipated: (i) the SQNC with predominant electronic conductivity is varied depending on the current density applied during the cell operation, and (ii) the degree of surface oxidation of the Si QDs in the SQNCs varies depending on the structures of the surface organic molecules of the Si QDs and the bridging molecules of the SQNCs. Therefore, differences in the amount of oxides (SiO2)/suboxides (SiOx) on the surface of Si QDs lead to significant differences in conductivity and electrochemical performance between the SQNCs.

The Shorr Versus Modified Ultrafast Papanicolaou Method for Intraoperative Diagnosis of Peritoneal Washing Cytology in Advanced Gastric Cancer: A Phase II Study.

PURPOSE: According to the American Joint Committee on Cancer cancer staging system, positive peritoneal washing cytology (PWC) indicates stage IV gastric cancer. However, rapid intraoperative diagnosis of PWC has no established reliable method. This study evaluated and compared the diagnostic accuracy of the Shorr and the modified ultrafast Papanicolaou (MUFP) methods for intraoperative PWC. MATERIALS AND METHODS: This study included patients with gastric cancer who were clinically diagnosed with stage cT3 or higher. The Shorr and MUFP methods were performed on all PWC specimens, and the results were compared with those of conventional Papanicolaou (PAP) staining with carcinoembryonic antigen immunohistochemistry. Sensitivity, specificity, and partial likelihood tests were used to compare the 2 methods. RESULTS: Forty patients underwent intraoperative PWC between November 2019 and August 2021. The average time between specimen reception and slide preparation using Shorr and MUFP methods was 44.4±4.5 minutes, and the average time between specimen reception and pathologic diagnosis was 53.9±8.9 minutes. Eight patients (20.0%) had positive cytology in PAP staining. The Shorr method had a sensitivity of 75.0% and specificity of 93.8%; the MUFP method had 62.5% sensitivity and 100.0% specificity. The area under the curve was 0.844 for Shorr and 0.813 for MUFP. In comparing the C-indices of each method with overall survival, no difference was found among the Shorr, MUFP, and conventional PAP methods. CONCLUSIONS: The Shorr and MUFP methods are acceptable for the intraoperative diagnosis of PWC in advanced gastric cancer.

Clinical characteristics of nontuberculous mycobacterial disease in people living with HIV/AIDS in South Korea: A multi-center, retrospective study.

With the introduction of combination antiretroviral therapy (cART), the prevalence of human immunodeficiency virus (HIV)-associated nontuberculous mycobacteria (NTM) disease has declined. However, NTM diseases still occur in people living with HIV/acquired immunodeficiency syndrome (AIDS) (PLWHA). We analysed the clinical and microbiological features of NTM diseases in PLWHA in South Korea. PLWHA who were diagnosed with NTM diseases between January 2000 and March 2021 were retrospectively enrolled from five different hospitals in South Korea. Data on baseline demographics, HIV status, CD4+ T cell counts, viral load, past and current cART regimens, isolated NTM species, results of antimicrobial susceptibility tests, treatment regimens, and outcomes were collected by reviewing medical records. A total of 34 cases of NTM in PLWHA were included. Pulmonary and extrapulmonary NTM diseases accounted for 58.8% (n = 20) and 41.2% (n = 14), respectively. The lymph node was the most common site of extrapulmonary NTM disease (64.3%). The age at the time of NTM disease diagnosis was younger in the extrapulmonary NTM group than in the pulmonary NTM group (37.0 vs. 49.0 years). Mean CD4+ T cell counts at the time of NTM disease diagnosis was 186.6 cells/µL (range: 1-1394). Nine patients (26.5%) had fully suppressed viral loads at the time of NTM disease diagnosis. Mycobacterium avium complex (MAC) was the most common species found, followed by M. intracellulare and M. kansasii. MAC isolates were all susceptible to clarithromycin, but the rates of non-susceptibility to moxifloxacin, linezolid, ethambutol, and rifampin were 75%, 37.5%, 12.5%, and 12.5%, respectively. The average duration of treatment was 17 months and the mortality rate was 8.8%. NTM diseases may occur in PLWHA, even with completely suppressed viral loads. The identified clinical features of NTM diseases are essential for its clinical management in South Korea.

Synthesis and Electrochemical Performance of π-Conjugated Molecule Bridged Silicon Quantum Dot Cluster as Anode Material for Lithium-Ion Batteries.

π-Conjugated molecule bridged silicon quantum dots (Si QDs) cluster was prepared by Sonogashira C-C cross-coupling reaction between 4-bromostyryl and octyl co-capped Si QDs (4-Bs/Oct Si QDs) and 1,4-diethynylbenzene. The surface chemical structure, morphology, and chemical composition of the Si QD cluster were confirmed by Fourier transform infrared spectroscopy, field emission transmission electron microscopy, and energy-dispersive X-ray spectroscopy. Lithium-ion batteries were fabricated using 4-Bs/Oct Si QD and Si QD clusters as anode materials to investigate the effect of QD clustering on the electrochemical performance. Compared with the 4-Bs/Oct Si QD electrode, the Si QD cluster exhibits improved electrochemical performance, such as a high initial discharge capacity of ∼1957 mAh/g and good cycling stability with ∼63% capacity retention following 100 cycles at a current rate of 200 mA/g when tested at the voltage window of 0.01-2.5 V. The improved electrochemical performance of the Si QD cluster is attributed to the π-conjugated molecules between the Si QDs and on the surface of Si QD cluster, which serve as a buffer layer to alleviate the mechanical stresses arising from the alloying reaction of Si with lithium and maintain the electrical conduits in the anode system.

Electronic Coupling in π-Conjugated Molecule-Bridged Silicon Quantum Dot Clusters Synthesized by Sonogashira Cross-Coupling Reaction.

π-Conjugated molecule-bridged silicon quantum dot (Si QD) clusters were first synthesized by Sonogashira cross-coupling reaction between 4-ethynylstyryl and octyl co-capped Si QDs (4-Es/Oct Si QDs) and 2,5-dibromo-3-hexylthiophene. The formation of Si QD clusters was confirmed by field emission transmission electron microscopy. The electronic coupling between the QDs in the Si QD cluster is significantly enhanced as compared with that for 4-Es/Oct Si QDs, which is verified from the red shift in ultraviolet-visible absorption and photoluminescence spectra of the Si QD cluster with the possibility of exciton transport, the increased charging effect found in the core-level photoemission spectra, the shift to lower binding energy of the valence band photoemission spectrum, and more decisively, the increase in electrical conductance of the Si QD cluster thin film. To investigate the physical origin of the temperature dependence of the electrical conductance, we have merged the microscopic viewpoint, Marcus theory, on the electron transfer (W) between the adjacent QDs, with macroscopic concepts, such as the conductance (G), mobility (µ), and diffusion coefficient (D). The effective reorganizational energies of charge transfer between the neighboring Si QDs in 4-Es/Oct Si QD and Si QD cluster thin films are estimated to be 170 and 140 meV, respectively, while the ratio of the effective electronic coupling of the latter to that of the former is determined to be 7.3:1.

Blood mercury can be a factor of elevated serum ferritin: analysis of Korea National Health and Nutrition Examination Survey (KNHANES 2008-2012).

Serum ferritin as well as blood mercury are reported to be associated with chronic inflammation. However, the relation between serum ferritin and blood mercury has not yet been established. We utilized the Korea National Health and Nutrition Examination Survey (KNHANES, 2008-2012) 10,977 subjects (5433 males and 5544 females). To evaluate the association of serum ferritin and blood mercury cross-sectionally, complex sample analysis was conducted after adjustment for the relevant variables. Serum concentrations of ferritin and blood mercury were higher in males than in females (115.7 ± 1.7 vs. 40.9 ± 0.7 ng/mL and 5.0 ± 0.1 vs. 3.6 ± 0.1 µg/L, respectively). Serum ferritin and blood mercury concentrations had significant correlations in both genders after adjustment (r = 0.062, P < 0.001 in males; r = 0.055, P < 0.001 in females). The analysis of covariance (ANCOVA) test showed significantly higher serum ferritin according to the tertile of blood mercury (P = 0.007) in males. The adjusted odds ratio of having the highest tertile of serum ferritin in the top tertile of blood mercury in males was 1.52 (95 % confidence interval (CI), 1.05-2.21). Thus, the current study indicates that blood mercury concentration can be a factor for the elevated serum ferritin concentration.

Erratum: Revised Adult Immunization Guideline Recommended by the Korean Society of Infectious Diseases, 2014.

[This corrects the article on p. 68 in vol. 47, PMID: 25844267.].

Liquid-based cytology of villoglandular adenocarcinoma of the cervix: a report of 3 cases.

Villoglandular adenocarcinoma (VGA) is a rare subtype of cervical adenocarcinoma with a more favorable prognosis compared to conventional adenocarcinomas. Although the tumors are usually recognized on colposcopic examination due to the mainly exophytic growth pattern, they may be underdiagnosed as benign lesions by cytology because of their minimal cytologic atypia. We report the liquid-based cytology (LBC) findings of three histologically confirmed VGAs which we have recently identified. They were characterized by hypercellular smears on low-power examination with smooth-bordered three-dimensional papillary fragments. The nuclei were relatively uniform with irregular nuclear membranes. Nucleoli were small but distinct and macronucleoli were also seen. The abnormal architectural patterns such as papillary structures and nuclear overlapping and nuclear hyperchromasia are important clues to the diagnosis of VGA. In addition, nuclear membrane irregularity and prominent nucleoli can be recognized on LBC specimens, further facilitating its diagnosis.

Atypical pathogens as etiologic agents in hospitalized patients with community-acquired pneumonia in Korea: a prospective multi-center study.

Local epidemiologic data on the etiologies of patients hospitalized with community-acquired pneumonia (CAP) is needed to develop guidelines for clinical practice. This study was conducted prospectively to determine the proportion of atypical bacterial pathogens in adults patients hospitalized with CAP in Korea between October 2001 and December 2002. Microbiological diagnosis was determined by serology for antibodies to Mycoplasma pneumoniae, Chlamydia pneumoniae, and Legionella pneumophila. Nucleic acid of M. pneumoniae and C. pneumoniae in respiratory samples and Legionella antigen in urine samples were detected. The study population consisted of 126 patients (71 males, 55 females), averaging 54.6 yr (SD+/-17.8), whose paired sera were available. An etiologic diagnosis for atypical pathogens was made in 18 patients (14.3%): C. pneumoniae 9 (7.1%), M. pneumoniae 8 (6.3%), and L. pneumophila 3 patients (2.4%). Streptococcus preumoniae and other typical pathogens were isolated from 36 patients (28.6%). Of 126 patients, 16 (12.7%) were admitted to intensive care unit and atypical pathogens were identified in 5 patients (31.3%). Initial clinical features of patients with pneumonia due to atypical, typical or undetermined pathogens were indistinguishable. We conclude that atypical pathogens should be seriously considered in hospitalized patients with CAP, when initiating empiric treatment in Korea.