BACKGROUND: The propose of this study was to identify the level of medical technologists' perception of and compliance with hospital infection control guidelines. METHODS: A questionnaire survey was conducted for 65 medical technologists working at three university hospitals in Seoul and Kyunggi areas. The questionnaire was composed of 34 questions on the general characteristics (14 items) of individual responders and about infection control guidelines (20 items). Their response was marked on the basis of 5 points for each question. RESULTS: The mean scores of the perception of and compliance with the infection control guidelines were 4.62+/-0.34 and 3.85+/-0.42, respectively. The female technologists scored significantly higher than did the male counterparts in the participation level of the infection control guidelines (P<0.05). The medical technologists who had participated in an infection control educational program were more likely than those who had not to show a higher compliance level on the infection control guidelines (P<0.05). CONCLUSION: The study demonstrated that the development of infection control educational programs for medical technologists and a supportive policy of the hospital administration should contribute to the prevention of nosocomial infections.
Compliance* ; Cross Infection* ; Female ; Gyeonggi-do ; Hospital Administration ; Hospitals, University ; Humans ; Infection Control ; Male ; Medical Laboratory Personnel ; Seoul ; Surveys and Questionnaires

BACKGROUND: Clonidine, an 2-adrenergic agonist, shows the analgesic effect and potentiates the analgesic effect of opioid. However, when it is injected with bolus technique, it reveals the short duration of inadequate analgesia and induces hypotension, bradycardia or sedation. We examined the analgesic and side effects of clonidine administered by continuous epidural infusion over 24 hrs, following epidural morphine injection. METHODS: Sixty parturients, scheduled for elective cesarean section under epidural anesthesia were randomly allocated into three groups. They received an infusion of saline alone (group 1, n= 20), clonidine 20 g/hr (group 2, n= 20), or 40 g/hr (group 3, n= 20) respectively, following epidural morphine 3 mg injection at the end of operation. The total doses and number of request for supplemental analgesic, blood pressure, heart rate, and degree of sedation were measured during 24 hrs. RESULTS: There were significant differences in pain relief between clonidine groups and group 1. The total doses and number of patient's request for supplemental analgesic in clonidine groups, compared to group 1 were significantly decreased (p<0.05), but no significant differences between the two clonidine groups. The diastolic pressure of group 3 was significantly lower than that of group 1 over 24 hrs, and that of group 2 at 18 hr, 24 hr (p<0.05). However, there was no severe hypotension, bradycardia or sedation in the three groups. CONCLUSION: Clonidine administered by continuous epidural infusion over 24 hrs enhances the analgesic effect of epidural morphine, and the infusion of clonidine with 20 g/hr rather than 40 g/hr shows minimal changes of blood pressure. Therefore, administration of epidural clonidine (20 g/hr) following epidural morphine may be considered as a regimen for pain management after cesarean section.
Analgesia* ; Anesthesia, Epidural ; Blood Pressure ; Bradycardia ; Cesarean Section* ; Clonidine* ; Female ; Heart Rate ; Hypotension ; Morphine ; Pain Management ; Pregnancy

No abstract available.
Smoke* ; Smoking Cessation* ; Smoking*

This study was taken to measure the serum aminotransferase level and its correlation with clinical symptoms from Human Rotavirus gastroenteritis. This report is based on analysis of 434 patients who were admitted to the Pediatric department at Wonju Christian Hospital because of watery diarrhea and vomiting during 2-year period from July, 1991 to June 1993. The stool specimen on admission was tested for Rotavirus Ag by Rotazyme test. And then serum aminotransferase were checked. The result are as follows: 1) Rotavirus Antigens were detected in 194 cases (44.7%) among total 434 patients with gastroenteritis 2) The number of patients with AST elevation above the normal value in RTZ+group was 126 cases(64.9%) and, in RTZ-group was 65 cases(27.0%). 3) The mean value of AST in RTZ+ group was 41.7U/L and, in RTZ-group was 31.1U/L. The mean value of AST between the two groups were significantly different. 4) The mean value of ALT and GGT in the two groups were not different. 5) The patients with AST elevation above normal level in the RTZ+group was significantly increased in frequency and duration of diarrhea than RTZ+ group with normal AST level.
Diarrhea ; Gangwon-do ; Gastroenteritis* ; Humans* ; Reference Values ; Rotavirus* ; Vomiting

PURPOSE: To compare the results of open fixation and closed percutaneous pinning in managing Jakob stage II lateral condylar fractures of children's elbow. MATERIALS AND METHODS: Since Febuary 2000, We operated 21 children with Jakob stage II lateral condylar fractures of elbow. Eleven of the 21 were treated with closed percutaneous pinning, open fixation was done to the other 10 children. Each patient was evaluated about range of motion, carrying angle, scar satisfaction and radiologic findings for comparison between closed pinning and open fixation groups. RESULTS: Open fixation group showed 3.8 degrees decrease of elbow motion while closed pinning group showed no significant decrease. Carrying angle and radiologic findings were not different between the two groups. Open fixation group expressed dissatisfaction to their scars (average 5.2 cm) whereas all the patients of closed pinning group were satisfied with their functional and cosmetic outcomes. CONCLUSION: In managing Jakob stage II lateral condyle fractures of children's elbow, closed percutaneous pinning was thought to be superior to open fixation because of the same functional outcome and much better cosmetic results.
Child* ; Cicatrix ; Elbow ; Humans ; Range of Motion, Articular

OBJECTIVE: Rapid and effective hemostasis at femoral puncture sites minimizes both the hospital stay and patient discomfort. Therefore, a variety of arterial closure devices have been developed to facilitate the closure of femoral arteriotomy. The objective of this prospective study was to compare the efficacy of two different closure devices; a collagen plug device (Angio-Seal) and a suture-mediated closure device (the Closer S). MATERIALS AND METHODS: From March 28, 2003 to August 31, 2004, we conducted a prospective study in which 1, 676 cases of 1, 180 patients were treated with two different types of closure device. Angio-Seal was used in 961 cases and the Closer S in 715 cases. The efficacy of the closure devices was assessed, as well as complications occurring at the puncture sites. RESULTS: Successful immediate hemostasis was achieved in 95.2% of the cases treated with Angio-Seal, and in 89.5% of the cases treated with the Closer S (p < 0.05). The rates of minor and major complications occurring between the two groups were not significantly different. In the Closer S group, we observed four major complications (0.6%), that consisted of one massive retroperitoneal hemorrhage (surgically explored) and three pseudoaneurysms. In the Angio-Seal group, we observed three major complications (0.3%) that consisted of one femoral artery occlusion, one case of infection treated with intravenous antibiotics and one pseudoaneurysm. CONCLUSION: The use of Angio-Seal was found to be more effective than that of the Closer S with regard to the immediate hemostasis of the femoral puncture sites. However, we detected no significant differences in the rate at which complications occurred.
Treatment Outcome ; *Sutures ; Prospective Studies ; Postoperative Complications ; Middle Aged ; Male ; Humans ; Hemostatic Techniques/*instrumentation ; Femoral Artery/*surgery ; Female ; *Collagen ; Aged ; Adult ; Adolescent

BACKGROUND: Pulmonary embolism is associated with varying degrees of pulmonary vascular obstruction. This study was undertaken to establish whether the extent of perfusion defect in lung scintigraphy can be predicted from analysis of echocardiographic measurements in patients with pulmonary embolism. METHODS: We retrospectively studied 28 patients who presented with clinical evidence of pulmonary embolism. In order to compare the extent of perfusion defect in lung scintigraphy, we devised a scoring system (echocardiographic severity index, ESI) for various echocardiographic parameters, which include right ventricle size, area, shape, systolic function, and pulmonary artery pressure. [ESI=sum of scores/number of parameters measured]. RESULTS: The mean values (+/-SD) of each parameter were as follow; right ventricular end-diastolic dimension (RVedD), 34.5+/-5.7 mm; LVedD, 40.9+/-5.2 mm; ratio of RVedD to LVedD, 0.87+/-0.2; right ventricular end-diastolic area (RVedA), 24.7+/-9.5 cm2; right ventricular end-systolic area (RVesA), 17.8+/-7.8 cm2; fractional area change, 28.8+/-9.7%; angle between IVS and RV, 96.0+/-14.8degrees; RV hypokinesia, absence or mild in 29%, moderate in 50%, severe in 21%; TR grade, absence or mild in 25%, moderate in 43%, severe in 32%; pulmonary artery systolic pressure, <30 mmHg in 21%, 30 to 50 mmHg in 68%, >50 mmHg 11% of patients. The echocardiographic severity index (ESI) in patients with pulmonary embolism was 0.52+/-0.24, and the perfusion defect score was 0.21+/-0.14. There was a close correlation between the ESI and the extent of perfusion defect (r=0.622, p<0.01). CONCLUSION: The echocardiographic severity index may reflect the extent of the perfusion defects in patients with pulmonary embolism, therefore it is potentially applicable in clinical practice for evaluating patients with pulmonary embolism and furthermore in their follow-up over a period of time.
Blood Pressure ; Echocardiography* ; Follow-Up Studies ; Heart Ventricles ; Humans ; Hypokinesia ; Lung ; Perfusion ; Pulmonary Artery ; Pulmonary Embolism* ; Radionuclide Imaging ; Retrospective Studies

This study was conducted to observe effects of two methods of setting positive endexpiratory pressure (PEEP) based on the pressure-volume (PV) curve. After lung injury was induced by oleic acid in six mongrel adult dogs, the inflation PV curve was traced and the lower inflection point (LIP) was measured. The 'PEEP(INF)' was defined as LIP+2 cmH2O. After recruitment maneuver to move the lung physiology to the deflation limb of PV curve, decremental PEEP was applied. The lowest level of PEEP that did not result in a significant drop in PaO2 was defined as the 'PEEP(DEF)'. Arterial blood gases, lung mechanics, hemodynamics, and lung volumes (measured on computed tomography during end-expiratory pause) were measured at PEEP of 0 cmH2O, PEEP(INF) and PEEP(DEF) sequentially. The median PEEP(INF) was 13.4 cm H2O (interquartile range, 12.5-14.3) and median PEEP(DEF) was 12.0 cm H2O (10.0-16.5) (p=0.813). PEEP(DEF) was associated with significantly higher PaO2 and lung volumes, and significantly lower shunt fraction and cardiac index when compared to PEEP(INF) (p<0.05). Setting the PEEP based on the deflation limb of the PV curve was useful in improving oxygenation and lung volumes in a canine lung injury model.
Animals ; Dogs ; Lung/pathology ; *Lung Injury ; Lung Volume Measurements/*methods ; Male ; Oxygen/metabolism ; Positive-Pressure Respiration/*methods ; Pressure ; Pulmonary Gas Exchange ; Radiography, Thoracic/methods ; Tomography, X-Ray Computed/*methods

BACKGROUND: Bronchoscopy in patients on mechanical ventilation is being performed much more frequently. However, there is little data on the changes in physiologic parameters and no established mechanical ventilation protocol during bronchoscopy. A decreasing or the removal of positive end-expiratory pressure (PEEP) during bronchoscopy may precipitate severe hypoxemia and/or derecruitment. METHODS: Our standardized mechanical ventilation protocol, without changing the PEEP level, was used during bronchoscopy. The physiological parameters were measured during the bronchoscopic procedure. RESULTS: During bronchoscopy, respiratory acidosis, elevation of peak pressure, elevation of heart rate and auto-PEEP were developed, but were reversible changes. Procedure-related gross barotraumas or other severe complications did not developed. CONCLUSION: No serious complications developed during bronchoscopy under our standardized mechanical ventilation protocol when the PEEP level remained unchanged. The procedure time should be kept to a minimum to decrease the exposure time to undesirable physiological changes.
Acidosis, Respiratory ; Anoxia ; Barotrauma ; Bronchoscopes ; Bronchoscopy* ; Heart Rate ; Humans ; Intensive Care Units ; Intubation, Intratracheal ; Positive-Pressure Respiration ; Positive-Pressure Respiration, Intrinsic ; Pulmonary Gas Exchange ; Respiration, Artificial ; Respiratory Mechanics

BACKGROUND: Thoracic actinomycosis is a relatively uncommon anaerobic infection caused by Actinomyces israelii. There have been only a few case reports of endobronchial actinomycosis. The aim of this study was to evaluate the clinical manifestation and treatment of endobronchial actinomycosis. MATERIAL AND METHODS: Seven patients with endobronchial actinomycosis, who were diagnosed in the past 10 years, were retrospectively reviewed. RESULTS: Cough and sputum were the most common symptoms. The chest radiograph and computed tomography showed necrotic consolidation (n=3), atelectasis (n=2), mass (n=1) and an endobronchial nodule (n=1). Proximal broncholithiasis was observed in five patients. All cases were initially suspected to have either lung cancer or tuberculosis. In these patients, the median duration of intravenous antibiotics was 3 days (range 0-12 days) and the median duration of oral antibiotics was 147 days (range 20-412 days). Two patients received oral antibiotic therapy only. There was no clinical evidence of a recurrence. CONCLUSION: Endobronchial actinomycosis frequently manifests as a proximal obstructive calcified endobronchial nodule that is associated with distal post-obstructive pneumonia. The possibility of endobronchial actinomycosis is suggested when findings of broncholithiasis are present at chest CT. The traditional recommendation of 2-6 weeks of intravenous antibiotics and 6-12 months of oral antibiotic therapy are not necessarily essential in all cases of endobronchial actinomycosis.
Actinomyces ; Actinomycosis* ; Anti-Bacterial Agents ; Bronchoscopy ; Cough ; Diagnosis* ; Humans ; Lung Neoplasms ; Pneumonia ; Pulmonary Atelectasis ; Radiography, Thoracic ; Recurrence ; Retrospective Studies ; Sputum ; Tomography, X-Ray Computed ; Tuberculosis