BACKGROUND: The purpose of this clinical study was to evaluate the Incentive Spirometry (IS) and Deep Breathing Exercises (DBE) to prevent postoperative pulmonary complications after abdominal surgery in patients over 60 years of age. METHODS: We prospectively randomized 90 patients into 1 of 3 groups: the control group (30 patients) received no respiratory treatment, the IS group (30 patients) was treated with incentive spirometry 4 times daily and DBE group (30 patients) carried out deep breathing exercises under supervision for 15 min 4 times daily. ABGA was taken at ward, PR (preop.room), RR (recovery room), POD1 day and POD2 day. Roentgenographic changes observed at 24 h. and 48 h. after surgery. Pulmonary complications were defined as the development of 3 or more of 6 new findings: cough, sputum, dyspnea, chest discomfort, temperature greater than 38oC, pulse rate more than 100 beats/min. RESULTS: PaO2 in the DBE group and IS group at PR were significantly increased than the values at ward, and the values of the PaO2 in the DBE group at RR and POD1 day, and those of IS group at PR and POD2 day were significant higher than those of the control group (p<0.05). The frequency of development of pulmonary complications (43.3% in the control group, 20% in the DBE group, 20% in the IS group) and roentgenographic changes were comparable in the 3 groups (26.7%, 16.7%, 20% respectively). The DBE group showed the different incidence of postoperative pulmonary complications between upper and lower abdominal surgery (upper: lower= 35.7: 6.3%). CONCLUSIONS: We concluded that DBE and IS were effective in preventing postoperative pulmonary complications after abdominal surgery and lower abdominal surgery causes lesser postoperative pulmonary complications than upper abdominal surgery.
Breathing Exercises ; Cough ; Dyspnea ; Heart Rate ; Humans ; Incidence ; Motivation* ; Organization and Administration ; Prospective Studies ; Respiration* ; Spirometry* ; Sputum ; Thorax

BACKGROUND: An intensive and ongoing surveillance program is effective for preventing the hospital infections. but it is time-consuming to detect all cases of hospital infections. So, labratory-based surveillance was performed with the aid of personal computer. The software 'MICRO' that coded and used privately was written in FoxPro 2.0 code. METHODS: All results of the microbiologic culture were stocked in the software and hospital infections were detected by review d an positive microbiology reports and daily ward rounds with examination of patient progress notes. If there was any suggestion or evidence of outbreak of hospital infections the data were analyzed by the 'MICRO' and reported to hospital infections control committee. RESULTS: We detected the outbreak of nosoccmial pneumonia due to a putative single species of methicillin-resistant Staphylococcus aureus in the neurosurgical ward at May, 1996. The suggestive outbreak of wound infections in the 7th ward at April, 1966 was denied by the 'MICRO'. The possible outbreak of 10th ward at May, 1996 was detected. CONCLUSIONS: We describe a surveillance method that identifies excessive rates of positive culture on patient location culture site, and organism indentification using the 'MICRO'. We were able to monitor patient-to-patient cross-infections and possible breakdowns in proper technique, and expect suggestive outbreak of infections early. These results demonstrate that computer analysis of positive culture rates by 'MICRO' is a sensitive and time-efficient method for detecting potentially preventable hospital infections.
Cross Infection* ; Humans ; Methicillin-Resistant Staphylococcus aureus ; Microcomputers* ; Pneumonia ; Wound Infection

No abstract available.
Dysentery, Bacillary*

No abstract available.
Occupational Diseases*

Five cases of cerebral arteriovenous malformation(AVM) are presented, which underwent total extirpation using the operating microscope. The following are considerations which favor the total extirpation of AVM and the advantages of using the operating microscope, including the rationale for non-use of hypotensive anesthesia or mannitolization which is commonly used in intracranial aneurysm surgery: 1) Relatively small sized AVMs are found to show a high rate of large intracerebral hematoma, including that the degree of bleeding from the malformed vessels is not related to the size of the AVM. 2) The operating microscope facilitates the following procedures: a) determination of the extent of the malformed vessels. b) clipping feeders. c) identification of red vein and laminar flow. d) preservation of normal brain tissue.
Anesthesia ; Brain ; Hematoma ; Hemorrhage ; Intracranial Aneurysm ; Intracranial Arteriovenous Malformations* ; Mannitol ; Veins

BACKGROUND: The purpose of this study was to discover ways to screen urine culture specimens through Gram stains, urine stick analyses and microscopic examinations for the laboratory cost saving. METHODS: One hundred and fifty-eight urine specimens for culture were included. Fifty uL of urine were inoculated onto one well each of 10-well slide, dried on the hot plate, and Gram-stained. The results combined with routine urinalyses including urine nitrite and leukocyte esterase, and pyuria, were compared with the routine culture results. RESULTS: The screening of bacteriuria by Gram stains, urinalyses and microscopic examinations revealed the high sensitivity (91.9%) and negative predictive value(95.5%) with cost saving of 41.8% of inoculating media. Not considering the Gram stains, the screening revealed 83.8% sensitivity and 92.5% negative predictive value, even if the cost saving of inoculating media were as high as 50.1%. CONCLUSION: It was demonstrated that it was sensitive and economic and produced rapid preliminary results to screen bacteriuria by the Gram stains combined with urinalyses and microscopic examinations.
Bacteriuria ; Coloring Agents ; Cost Savings ; Leukocytes ; Mass Screening* ; Pyuria ; Urinalysis*

BACKGROUND: It is difficult to control an outbreak of Shigella infection, because of the ease of transmission and the resistance to multiple antibiotics. Recently, there were outbreaks of Shigella infection in Chinju area. The objective of this study was to investigate the molecular epidemiology of the outbreaks using pulsed-field gel electrophoresis(PFGE). METHOD: Thirteen S. flexneri strains, 25 S. sonnei strains from Chinju and 15 S. sonnei strains from Pusan were studied. All strains were isolated from stool cultures of diarrheal patients. Identification and antimicrobial susceptibility test those were tested by Vitek GNI and GNS-LH. Chromosomal DNA restricted with Xbal was resolved by PFGE. RESULT: All the S. flexneri strains and 23(92%)S. sonnei strains from Chinju were resistant to one or more antimicrobial agents. All the clinical isolates of S. flexneri showed the same PFGE pattern which was different from type strains(KTCC 2517). PFGE patterns of 25 (100%) S. sonnei strains from Chinju and 12 (80%) S. sonnei strains from Pusan were identical to those of type strain (KTCC 2009). Three S. sonnei strains from Pusan showed distinct PFGE patterns, respectively. CONCLUSION: PFGF demonstrated identical restriction pattern among most of Shigella isolates from Chinju and Pusan, indicating that an outbreak with genetically related strains had occurred. PFGE was useful in molecular epidemiology of Shigella outbreaks
Anti-Bacterial Agents ; Anti-Infective Agents ; Busan ; Disease Outbreaks ; DNA* ; Gyeongsangnam-do ; Humans ; Molecular Epidemiology ; Shigella

Nickel is widely known throughout the world as a common source of contact dermatitis. Korea is one of the rapidly developing countries where the use of nickel and nickel by-products is on the rise. Lacking in ore, Korea imports most of its nickel. In the last ten years, in relation to rapid industrial development, the amount of nickel imported has increased over 1, 000 times. Nickel dermatitis is becoming an increasing problem in the patch test clinic. With regards to this, we have tried the dimethylglyoxime spot test to all materials mentioned in the textbooks which are regarded as nickel sources in other industrialized societies, so as to make an up-to-date list of nickel sources applicable to Korea. In addition, we have also included traditional nickel sources such as acupuncture needles, fire pot, old and new coins and chest of drawers etc. We also have analyzed data concerning nickel imports to Korea during the past 10 years.
Acupuncture ; Dermatitis ; Dermatitis, Contact ; Developing Countries ; Fires ; Korea* ; Needles ; Nickel* ; Numismatics ; Patch Tests ; Thorax

We present a patient who developed a pseudolymphoma after ear piercing. A patch test showed gold sensitivity. Therefore, long standing dermal exposure to gold from a pierced-type earring might have produced the patient's disease. This patient did not respond to an intralesional steroid injection and was finally treated with a complete resection of the lesion. It is proposed that every patient with a hyperplastic lesion in the ear lobe should be taken a biopsy in order to rule out the possibility of a pseudolymphoma. When a pseudolymphoma develops in the ear lobe, a complete surgical excision could be the treatment of choice, especially for the prevention of recurrence.
Biopsy ; Body Piercing* ; Ear* ; Humans ; Patch Tests ; Pseudolymphoma* ; Recurrence

No abstract available.
Humans