METHODS: We investigated and compared the epidemiologic characteristics of the E. cloacae isolation in the period of outbreak (April-June, 1998) with those in the control period (January-March, 1998). To identify the risk factors for E. cloacae sepsis, we retrospectively conducted a chart review for the patients who had E. cloacae sepsis during the period of outbreak. On the basis of these results, environmental culture was performed hospital wide. RESULTS: Ten clinical isolates E. cloacae were recovered from the blood of ten patients from April to June. 1998. Seven out of 10 patients recieved ERCP procedure just before E. cloacae sepsis. Hence, we performed surveillance study in the endoscopy room before and after the procedure. The survey showed that distilled water which was used for washing the endoscopy was contaminated with E. cloacae, which was suspected to be the common source of this outbreak. Therefore, we changed distilled water into sterilized distilled water on washing the endoscopy. After this correction was performed, the incidence of ERCP-associated E. cloacae sepsis declined markedly (P<0.011). CONCLUSION: We investigated an outbreak of ERCP-related E. cloacae sepsis and the outbreak was successfully controlled by removing the source of infection.
Cholangiopancreatography, Endoscopic Retrograde* ; Cloaca ; Endoscopy ; Enterobacter cloacae* ; Enterobacter* ; Humans ; Incidence ; Methods ; Retrospective Studies ; Risk Factors ; Sepsis* ; Water

OBJECTIVE: The aim of this study was to assess the relationship between disease progression and expression of c-erbB-2 and S-100 protein positive dendritic cells in Cervical cancer. STUDY DESIGN: Tissues were analyzed from 100 patients. Each of them had invasive carcinoma(44), microinvasive(12), CIS(33), CIN(II) before treatment, c-erbB-2 oncoprotein expression and S-100 protein positive dendritic cell were confirmed by immunohistochemical staining. (Avidin-biotin complex method) RESULTS: C-erbB-2 immunostaining was significantly associated with disease progression (p<0.05). In case of CIN I, there was not noted stained specimen but in case of invasive carcinoma, 24 cases of stained specimen were noted. S-100 protein positive dendritic cell was not associated with disease progression of cervical carcinoma.(p>0.05) CONCLUSIONS: According to our results, c-erbB-2 is possible factor in Carcinogenesis of cervical carcinoma with progression of it. and S-100 protein positive dendritic cell was not associated with disease progression of cervical carcinoma.
Carcinogenesis ; Carcinoma, Squamous Cell* ; Cervix Uteri* ; Dendritic Cells* ; Disease Progression ; Female ; Humans ; S100 Proteins* ; Uterine Cervical Neoplasms

No abstract available.
Rectum*

A case of chronic granulomatous infection of Fsarium solani had decreased response to recalled antigens and lacked of dinitrochlorobenzene(DNCB) sensitization in vivo. He has had frequent attacks of common cold-like symptoms and same attacks were very suggestive of pneumonia but he relatively healthy until he developed cutaneous Fusarium infection. Recently he also developed herpes zoster.
Fusariosis ; Fusarium* ; Herpes Zoster ; Pneumonia

An 84-year-old woman had an ovoid shallow ulcer with an elevated, indurated, pigmented border on the left cheek. Histological examination revealed a moderately differentiated squamous cell carcinoma and a solar keratosis with abundant melanocytes and melanin pigment. Ultrastructurally, the keratinocytes contained numerous melanosomes in their cytoplasms and the melanocytes in the squamous cell carcinoma and the solar keratosis had mature melanosomes.
Aged, 80 and over ; Carcinoma, Squamous Cell* ; Cheek ; Cytoplasm ; Epithelial Cells* ; Female ; Humans ; Keratinocytes ; Keratosis ; Melanins ; Melanocytes ; Melanosomes ; Ulcer

Serial neurosonographic examinations are routinely performed at frequent intervals during nursery course of all preterm infants of very low-birth-weight who are admitted to the intensive care nursery of Presbyterian Medical Center from November 1, 1990 to July 30, 1992. After discharge, the following survivors who had received periodic, serial scanning by meas of cranial ultrasonography were longitudinally observed in an interdisciplinary neurodevelopmental follow-up program to a mean corrected age of 13 months. Neurodevelopmental outcome was assessed by means of Vojta's postural reaction and other neurological examinations. The results are as follows: 1) The incidence of PV-IVH in the study was 79%. 2) According to Papile's grading system of PV-IVH, gradel was 20%, gradell was 46%, gradelll was 19%, and grade IV was 13%. 3) The risk factors associated with PV-IVH were birth weight, gestational age, apgar score, ventilator care, RDS, and sepsis. 4) The mortality of PV-IVH was 20% for gradel, 19% for gradell, 44% for gradelll, and 67% for grade lV. 5) According to relationship between PV-IVH and neurodevelopmental outcome, in two of the four subjects with grade lll PV-IVH, moderate/severe CCD was developed. 6) According to relationship between PVE with cysts and nuerodevelopmental outcome, moderate/severe PVE with periventricular cysts larger than 3mm in diameter was associated with development of severe CCD.
Apgar Score ; Birth Weight ; Follow-Up Studies ; Gestational Age ; Hemorrhage* ; Humans ; Incidence ; Infant, Newborn ; Infant, Premature* ; Critical Care ; Mortality ; Neurologic Examination ; Nurseries ; Protestantism ; Risk Factors ; Sepsis ; Survivors ; Ultrasonography ; Ventilators, Mechanical

BACKGROUND: According to previous investigation on antibiotic use at Dankook University Hospital, cephalosporin and aminoglycoside were the most commonly used antibiotics accounting for 52.8% and 30.4% of total antibiotics used, respectively. In almost all cases, antibiotics were prescribed for prophylaxis rather than for treatment the ratio for prophylaxis vs. treatment intent was 3.9:1 and 3.6: 1 for cephalosporin and aminoglycoside, respectively. Thus, we performed a study to investigate the current usage of cephalosporin and aminoglycoside before and after the surgical procedures. METHODS: We retrospectively analyzed the appropriateness of prophylactic use of antibiotics on 14 major operative procedures (26.4% of total operations) for patients discharged during July, 1997. RESULTS: Among 8 kinds of operative procedure performed on 105 cases, in which prophylactic antibiotic use was recommended, appropriate antibiotic use was observed in only 2 cases of non- perforating appendectomy. For 7 operative procedures, in which use of 1st generation cephalosporin is recommended, 1st cephalosporins were used only on 37.8% (44/92) of cases, whereas 2nd cephalosporins were used for most of other cases. An average of 2.5 DDD of 2nd cephalosporin, which was a pertinent dose, was used on non-perforating appendectomy. However, on all the other 7 operative procedures, the dose exceeded the recommended dose. Inappropriate antibiotic use was observed for 6 operative procedures, for which prophylactic antibiotic use was not recommended. The combination of cephalosporin and aminoglycoside was used in all but 3 types of operative procedures. CONCLUSION: During most of the pre- and post-operative period, antibiotics were combined, overused, misused, and inappropriately used.
Aminoglycosides* ; Anti-Bacterial Agents ; Appendectomy ; Cephalosporins* ; Dichlorodiphenyldichloroethane ; Humans ; Retrospective Studies ; Surgical Procedures, Operative

BACKGROUND: According to previous investigation on antibiotic use at Dankook University Hospital, cephalosporin and aminoglycoside were the most commonly used antibiotics accounting for 52.8% and 30.4% of total antibiotics used, respectively. In almost all cases, antibiotics were prescribed for prophylaxis rather than for treatment the ratio for prophylaxis vs. treatment intent was 3.9:1 and 3.6: 1 for cephalosporin and aminoglycoside, respectively. Thus, we performed a study to investigate the current usage of cephalosporin and aminoglycoside before and after the surgical procedures. METHODS: We retrospectively analyzed the appropriateness of prophylactic use of antibiotics on 14 major operative procedures (26.4% of total operations) for patients discharged during July, 1997. RESULTS: Among 8 kinds of operative procedure performed on 105 cases, in which prophylactic antibiotic use was recommended, appropriate antibiotic use was observed in only 2 cases of non- perforating appendectomy. For 7 operative procedures, in which use of 1st generation cephalosporin is recommended, 1st cephalosporins were used only on 37.8% (44/92) of cases, whereas 2nd cephalosporins were used for most of other cases. An average of 2.5 DDD of 2nd cephalosporin, which was a pertinent dose, was used on non-perforating appendectomy. However, on all the other 7 operative procedures, the dose exceeded the recommended dose. Inappropriate antibiotic use was observed for 6 operative procedures, for which prophylactic antibiotic use was not recommended. The combination of cephalosporin and aminoglycoside was used in all but 3 types of operative procedures. CONCLUSION: During most of the pre- and post-operative period, antibiotics were combined, overused, misused, and inappropriately used.
Aminoglycosides* ; Anti-Bacterial Agents ; Appendectomy ; Cephalosporins* ; Dichlorodiphenyldichloroethane ; Humans ; Retrospective Studies ; Surgical Procedures, Operative

BACKGROUND/AIMS: Bleeding peptic ulcer in elderly patients is believed to differ from that found in younger patients. The purpose of this study was to evaluate the characteristics of bleeding peptic ulcer in elderly Korean patients. METHODS: We retrospectively evaluated 113 patients who were admitted to an emergency room for peptic ulcer bleeding from January 2006 to August 2008. For each patient, we investigated the clinical manifestations, the treatments and the hospital course. RESULTS: Peptic ulcer bleeding was more prevalent in elderly patients (n=63) than in younger patients (n=50). The elderly group had a higher incidence of comorbidities such as hypertension, stroke and ischemic heart disease, which might have be attributable to higher usage of aspirin and antiplatelet agents. There were no differences in the chief complaints or laboratory findings. The rate of Helicobacter pylori infection was lower in the elderly patients than that in the younger patients (41.3% vs. 62.0%, respectively, p=0.029). Four elderly patients and one younger patient died while in hospital, with one patient in each group dying due to bleeding. CONCLUSIONS: Peptic ulcer bleeding in elderly patients was associated with higher usage of aspirin and antiplatelet agents. There were no significant differences between the elderly and younger patients for the initial clinical presentation, the hospital course or the mortality due to bleeding.
Aged ; Aspirin ; Comorbidity ; Emergencies ; Helicobacter pylori ; Hemorrhage ; Humans ; Hypertension ; Incidence ; Myocardial Ischemia ; Peptic Ulcer ; Platelet Aggregation Inhibitors ; Referral and Consultation ; Retrospective Studies ; Stroke

BACKGROUND: This study examined moderating effects of optimism and family support on the depression of family caregivers of cancer patients aged 55 and over by adopting stress process model. METHODS: 359 family caregivers who accompanied with cancer patients to out-patient clinics were recruited and completed questionnaire at three university hospitals located in Seoul and Gyeonggi province. Exploratory factor analysis was applied to test validity of the construction of the scale. Hierarchical multiple regression analysis was used to determine moderating effects of optimism and family support on depression after making mean centering of each variable. RESULTS: Results showed that spouse caregivers have more depression than do adult children as the nursing period gets longer. Education and income status were significant variables affecting depression of family caregivers. Optimism and family support for family caregivers have moderating effects on the association between stressors (emotional functioning of cancer patients and role overload of family caregivers) and depression of family caregivers. CONCLUSIONS: The findings suggest that more attentions are needed to the depression of spouse caregivers. Interventions are strongly recommended for health professionals to provide cancer patients and their family caregivers with "holding environments" caring for emotions and facilitating adjustment.
Adult Children ; Attention ; Caregivers* ; Depression* ; Education ; Gyeonggi-do ; Health Occupations ; Hospitals, University ; Humans ; Nursing ; Optimism* ; Outpatients ; Seoul