BACKGROUND: This study investigated the effectiveness of reinforced contact precautions and active surveillance cultures (ASCs) in reducing the incidence of methicillin-resistant Staphylococcus aureus (MRSA) and other healthcare-associated infections (HAIs). METHODS: A before- and after-experimental study was performed at the intensive care unit (ICU) in a university-affiliated hospital. Reinforced contact precautions were applied to all patients, and ASCs for MRSA were performed for newly admitted patients at the time of admission and once a week thereafter. The HAIs were investigated in accordance with the National Nosocomial Infections Surveillance (NNIS) definitions and compared before and after the interventions. The data were analyzed using descriptive statistics. RESULTS: The number of HAIs caused by MRSA decreased from 2.2 to 0.5 per 100 patients discharged (P=0.02) and from 3.6 to 1.0 per 1,000 patient-days (P=0.032). The number of overall HAIs decreased from 7.6 to 4.0 per 100 patients discharged (P=0.011) and from 12.7 to 7.3 per 1,000 patient-days (P=0.034). The invasive device-associated infections caused by MRSA and other pathogens decreased, but the decrease was not statistically significant. CONCLUSION: Reinforced contact precautions and ASCs were effective in decreasing both MRSA infections and overall HAIs in the ICU. Further, it was assumed that the incidence of device-associated infections would have decreased if the intervention period was extended.
Cross Infection ; Humans ; Incidence ; Critical Care ; Intensive Care Units ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus

Purpose: The purpose of this study was to identify the factors that affect lung cancer survivors’ awareness of well-dying. Methods: Data were collected from November 8, 2022 to December 23, 2022. Participants were 105 lung cancer survivors university hospital located in Chungcheongnam-do. Data was analyzed using independent t-test, one-way ANOVA, Scheffétest, Pearson correlation coefficient and stepwise multiple regression with the SPSS/WIN 25.0 program. Symptom experience, resilience, awareness of well-dying, general cancer-related variables were measured. Results: Multiple regression analysis, the factors influencing awareness of well-dying were identified as symptomexperience (intensity), presence or absence of a spouse, andgender. The explanatory power of well-dying awareness through the three variables was 30.9%. The factor that has the greatest influence on the awareness of well-dying was symptom experience (intensity) (β=-.44), followed by spouse (β=.29) and gender (β=-22) in order. Conclusion Lung cancer survivors’ symptom experienceis a key factor influencing awareness of well-dying. Therefore, in order to increase awareness of well-dying among lung cancer survivors, symptom management should be actively provided to male patients and those who have received radiation therapy.

BACKGROUND: There have been a few reports suggesting involvement of neutrophil as well as eosinophil in inducing bronchoconstriction aft,er inhalation of TDI. OBJECTIVE: In order to observe the source of chemokines in TDI-induced asthma, this investigation was designed to determine whether IL-8 and RANTES could be produced by human bronchial epithelial cells and whether dexamethasone had any effects on their production. Materials and METHODS: We cultured Beas-2B, a bronchial epithelial cell line, with five concentrations of TDI-human serum albumin (HSA) conjugate and compared them with those having no conjugate. The levels of IL-8 and RANTES in the supernatant were measured by ELISA. To evaluate the effect of pro-inflammatory cytokines, cells were incubated with peripheral blood mononuclear cell (PBMC) culture supernatant, which was derived from PBMC culture of a TDI -induced asthmatic subject under exposure to TDI-HSA conjugate, and then compared to those without PBMC supernatant addition. To evaluate the effect of dexamethasone, four concentrations of dexamethasone were pre-incubated and the same steps were repeated. RESULTS: There was significant production of IL-8 from bronchial epithelial cells with addition of TDI-HSA conjugate in a dose-dependent manner (p<0.05, respectively), which was significantly augmented with additions of PBMC supernatant (p<0.05, respectively) at each concentration. RANTES production was negligible, however, it increased significantly with addition of PBMC supernatant and TDI-HSA conjugate in a dose response manner(p<0.05, respectively). Compared to the untreated sample, pre-treatment of dexamethasone induced remarkable inhibitions of IL-8 and RANTES production. CONCLUSION: These results suggest that IL-8 and RANTES released from bronchial epithelial cells may contribute to neutrophil and eosinophil recruitment occurring in TDI-induced airway.
Asthma ; Bronchoconstriction ; Chemokine CCL5* ; Chemokines ; Cytokines ; Dexamethasone ; Enzyme-Linked Immunosorbent Assay ; Eosinophils ; Epithelial Cells* ; Humans ; Inhalation ; Interleukin-8 ; Neutrophils ; Serum Albumin ; Toluene 2,4-Diisocyanate* ; Toluene*

Primary intracranial hemangiopericytoma is rare and resemble meningioma on imaging study. It shows meningeal attachment, and is usually isointense with gray matter on T1-weighted MR image with heterogeneous enhancement and prominent vascular flow voids on T2-weighted image. Cystic type of hemangiopericytoma is very rare and only 3 cases have been reported in the literature which arised in the middle fossa, cerebellum, and occipital area. Ventricular hemangiopericytomas were reported in 9 cases, and all of them were solid type. Authors experienced a peculiar case of cystic hemangiopericytoma in the 3rd ventricle and report it with review of the literature.
Cerebellum ; Hemangiopericytoma* ; Meningioma ; Third Ventricle*

PURPOSE: To evaluate the clinical results of arthroscopic inside-out repair leaving posterior horn tear. MATERIALS AND METHODS: Among the patients taken arthroscopic meniscal repair due to meniscus longitudinal tear from Jan. 1999 to Dec. 2004, total 32 patients were evaluated, and followed at minimum of two years(mean 32 months). Meniscal repair was done as maximum 3mm interval. The length of unrepaired posterior horn was mean 7.5mm. RESULTS: Preoperative Lysholm score was mean 62.5 and postoperative improved to 91.0. Twenty eight cases(87.5%) showed excellent or good results by Tapper and Hoover criteria. In 4 cases, symptoms recurred at 4 to 12 months after repair and 2 cases were combined with ACL deficiency. Second look arthroscopy was performed in 10 cases, 4 cases for recurred symptom and 6 cases for determining whether healing of untreated posterior horn occurred or not. We observed complete healing of 4 cases and incomplete healing of 2 cases on the acquisition of stability. CONCLUSION: It was suggested that meniscal repair leaving posterior horn tear may be healed if both stabilities of the torn area and the knee joint were maintained.
Animals ; Arthroscopy ; Horns* ; Humans ; Knee Joint

Holoprosencephaly is a rare and complex malformation affecting the cleavage of the developing forebrain and is usually associated with defects of the mid Face. We have experienced a case of holoprosencephaly, diagnosed prenatally by ultrasound examination at 31 weeks of pregnancy in a 31-year-old primigravida woman. This case is characterized by holoprosencephaly, cleft palate, cleft lip, left renal aplasia and right renal hypertrophy. The chromosomal study showed a deletion of the long arm of chromosome 7, 46, XX, del(7)(q32), We report with a terminal deletion of chromosome 7q associated with atypical clinical picture and holoprosencephaly.
Adult ; Arm ; Chromosomes, Human, Pair 7 ; Cleft Lip ; Cleft Palate ; Female ; Holoprosencephaly* ; Humans ; Hypertrophy ; Pregnancy ; Prosencephalon ; Ultrasonography

BACKGROUND: Bronchoconstriction is known to be induced by hypocarbia or hypercarbia. But the above effect has not been studied during general anesthesia. This study was proposed to investigate the effects of hypocarbia and hypercarbia on the respiratory system mechanics in 0.5 MAC enflurane anesthetized cats. METHODS: Six cats, weighing 3.0~3.6 kg were used. Pentobarbital sodium was intraperitonially injected to induce anesthesia and endotracheal intubation was followed. The anesthesia was maintained by 0.5 MAC enflurane, oxygen, and air (FiO2; 0.5). Intermittent mandatory ventilation was applied with Siemens Servo 900C ventilator. The inspiratory flow rate and tidal volume were fixed througout the experiment. Only the respiratory rate was adjusted to achieve normocarbia(PaCO2; 31~38 mmHg), hypercarbia(PaCO2; 38~45 mmHg) and hypocarbia(PaCO2; 24~31 mmHg), which were done not in the order. We used the flow-interruption technique to measure respiratory mechanics. The course of changes in the pressure along with the prefixed flow rate and volume were monitored and recorded with Bicore CP100 pulmonary monitor. The data were transfered to a PC and analyzed by Anadat processing software. Total respiratory system, airway and tissue viscoelastic resistances, and dynamic and static compliances were calculated for normocarbia, hypercarbia and hypocarbia. RESULTS: There are no significant differences of resistances and compliances of respiratory system among hypocarbia, normocarbia and hypercarbia. CONCLUSIONS: The changes in PaCO2 do not influence significantly the resistances and compliances measured by the flow interruption technique used in the study.
Airway Resistance ; Anesthesia ; Anesthesia, General ; Anesthetics ; Animals ; Bronchoconstriction ; Carbon Dioxide* ; Carbon* ; Cats* ; Compliance ; Enflurane* ; Intubation, Intratracheal ; Lung ; Mechanics* ; Oxygen ; Pentobarbital ; Respiratory Mechanics ; Respiratory Rate ; Respiratory System* ; Tidal Volume ; Ventilation ; Ventilators, Mechanical

The traumatic middle meningeal arteriovenous fistula is a rare condition complicated from head injury and usually found incidentally by carotid angiography. A few articles reported previously showed this condition if formed due to tearing of the walls of middle meningeal vessels by skull fracture and regarded as a wonderful defence mechanism keeping from a big intracranial hematoma. We have encountered 3 cases of them, all of which were accompanied by skull fracture. On of them had a big epidural hematoma and others only small amount. We show these cases in detail with the review of literatures.
Angiography ; Arteriovenous Fistula ; Craniocerebral Trauma ; Hematoma ; Skull Fractures

BACKGROUND: The clinical features of adverse drug reactions are various and the incidence is increasing. However, there has been no published data on the prevalence of adverse reactions to drug in Korea. METHODS: There were 301 adverse drug reactions occurring in 287 patients in Ajou University Hospital from May, 2002 through November, 2003. We analyzed the frequency of each causative drugs and clinical manifestations of adverse drug reactions. RESULTS: The most prevalent causative drug was nonsteroidal anti-inflammatory drugs (NSAIDs) (66.5%), followed by antimicrobials (17.8%), anticonvulsant (3.6%) and anti-cancer drug/immunosuppressant (3.3%). The leading clinical feature was cutaneous manifestations (83.1%), especially urticaria/angioedema, followed by respiratory manifestations (16.3%) and anaphylaxis (4.3%). The most common clinical manifestation of adverse drug reactions to NSAIDs was urticaria and/or angioedema (73.8%). Beta-lactams were the most common antimicrobials causing adverse drug reactions, and maculopapular exanthema (53.1%) was the most frequent manifestation. CONCLUSION: The most common causative drug of adverse drug reactions was NSAIDs and the leading clinical feature was cutaneous manifestations in this hospital. Further epidemiologic studies will be needed to extend the overall incidence of adverse drug reactions in this country.
Anaphylaxis ; Angioedema ; Anti-Inflammatory Agents, Non-Steroidal ; beta-Lactams ; Drug-Related Side Effects and Adverse Reactions* ; Epidemiologic Studies ; Exanthema ; Humans ; Incidence ; Korea* ; Prevalence ; Tertiary Healthcare* ; Urticaria

OBJECTIVES: This study was conducted to evaluate the public's awareness of the importance of hand washing and to compare perceptions on the habit of hand washing with actual hand washing behavior. METHODS: Data were collected by observing 2,800 participants washing their hands after using public restrooms in seven cities nationwide and by surveying 1,000 respondents (age > 14 years) through telephone interviews using a structured questionnaire. RESULTS: Although 94% of the survey respondents claimed to mostly or always wash their hands after using public restrooms, only 63.4% of the observed participants did wash their hands after using public restrooms. Significant factors related to increased adherence to hand washing were female gender, approximate ages of 20 to 39 years by their appearance, and the presence of other people from the observation. About 79% of the survey respondents always washed their hands after using bathrooms at home, 73% washed their hands before handling food, and 67% washed their hands upon returning to their home. However, 93.2% and 86.3% of the survey respondents did not wash their hands after coughing or sneezing and after handling money, respectively. Although most of the survey respondents (77.6%) were aware that hand washing is helpful in preventing communicable diseases, 39.6% of the survey respondents did not do so because they were 'not accustomed' to washing their hands and 30.2% thought that washing their hands is 'annoying'. CONCLUSIONS: This is the first comprehensive report on hand washing behavior and awareness of the general population in Korea. The result of this study in terms of individual behavior and awareness of hand washing are comparable with similar studies conducted in other countries. However adherence to hand washing is still low and needs to be increased. The results of this study can be used as a baseline in setting up strategies and activities to Bpromote adherence to hand washing.
Adolescent ; Adult ; Child ; Female ; *Handwashing ; *Health Knowledge, Attitudes, Practice ; Humans ; Korea ; Male ; Middle Aged ; Toilet Facilities