BACKGROUND: Disinfection is essential for the prevention of hospital infoction. Tego-51, one of the amphoteric surfactants based on the dodecyl-di( aminoethyl)-glycine, has been considered as an effctive disinfectant having a broad specturn of antimicrobial activity. We evaluated the disinfective activity of Tego-51 against several clinical isolates of bacteria and yeasts including Helicobacter pyiori. METHODS: Twenty three strains of vacteria including H. pylori, and a strain of yeast were exposed to the various concentrations (0.05%, 0.01%, 0.005%) of Tego-51 for the various periods (0.5, 1, 2, 4, 8, 16min). After the exposure to Tego-51 disinfectant, 0.01 mL of mixture of microorfanisms and Tego-51 was inoculated into brain-heart infusion broth, into Sabouraud dextrose agar. or Wilkins-Chalgren agar with 10% sheep blood, and incubated at 37 degrees C for 48 hours or in the Campy Pouch microaerophilic system. RESULTS: Most strains were killed within 30 seconds after an exposure to 0.01% of Tego-51, but Proteus mirabilis was eradicated after two minutes of exposure. At the concentration of 0.005 % concentration. P. mirabilis and Bacillus subtilis were killed after eight minutes od exposure. H. pylori was killed with 0.005% Tego-51within 30 seconds. Conslusions: This study showed that Tego-51disinfectant was effective for the disinfection of commonly isolated bacteria and yeast from hospital. It may be recommended that Tego-51 should be used at concentration greater than 0.1% for the effective disinfection of skin, instruments and hospital floors.
Agar ; Bacillus subtilis ; Bacteria ; Cross Infection ; Disinfection ; Glucose ; Helicobacter ; Mirabilis ; Proteus mirabilis ; Sheep ; Skin ; Surface-Active Agents ; Yeasts

Methicillin-resistant Staphylococcus aureus colony variants (SCVs) are frequently auxotrophic for hemin, menadione, thiamine, and CO2 involved in biosynthesis of the electron transport chain element. This phenotype grows slowly, and forms very small, nonhemolytic colonies in routine culture, so it may be led to the misidentification of this organism. We isolated an organism with catalase-positive, gram-positive cocci in cluster from the urine of a 55-years-old woman with persistent and relapsing bladder stone, who had undergone the antibiotic treatment with cefotaxime, ceftizoxime, amikacin, and/or micronomicin, intermittently for three years. The possibility of SCVs should have been ruled out because this organism didn't grow on Mueller-Hinton agar (MHA) for the susceptibility test. It formed small colonies on blood agar plate overnight, and grew only on MHA with supplement of hemin, or with 5% CO2. This organism was coagulase-positive, DNase-positive, manitol-salt positive, and identified as S. aureus with VITEK GPI card. The susceptibility test could be performed after adding hemin(1mg/mL) into bacterial suspension and showed susceptibility against vancomycin, teicoplanin, and rifampin. Because these phenotypes can be misidentifide as other non-pathogenic organisms due to their atypical characteristics, we should consider SCVs in case of small, nonhemolytic colonies with catalase-positive, gram-positive cocci in cluster, showing no growth on MHA. In addition, infections caused by SCVs are recently recognized in relation to persistent and relapsing infection, so they could be isolated from the patients with long-term antibiotic therapy.
Agar ; Amikacin ; Cefotaxime ; Ceftizoxime ; Electron Transport ; Female ; Gram-Positive Cocci ; Hemin ; Humans ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Phenotype ; Rifampin ; Teicoplanin ; Thiamine ; Urinary Bladder Calculi* ; Urinary Bladder* ; Vancomycin ; Vitamin K 3

No abstract available.
Thanatophoric Dysplasia*

PURPOSE: Kawasaki disease is notorious for coronary arterial complication which is usually developed as a febrile disease in early childhood. Increased polymorphonucleus(PMN) cell levels in acute phases may be associated with the pathophysiology of Kawasaki disease. We studied the relationship between coronary arterial dilatation and elastase activity which was excreted from PMN cell and roles as an important factor for vasculitis. METHODS: Ten patients diagnosed with Kawasaki disease in Yonsei University Medical Center were examined between November, 2001 and January, 2002. In addition, 15 patients with other febrile diseases were also examined. Echocardiography was done in patients with Kawasaki disease on the first day of admission and four weeks after the onset of the disease. At each time, venous samples were drawn and separated into plasma and leukocytes. In patients with other febrile disease, samples were drawn on admission. Elastase activities in plasma and neutrophil extracts were measured. RESULTS: The significant increased plasma elastase activity, 6.19+/-0.74 U/mL, found in Kawasaki disease patients compared with the other febrile disease patients, 4.86+/-1.17 U/mL(P<0.05). And there was no significance between the above two diseases in terms of the elastase activity in neutrophil extracts. The relationship between initial elastase activity and the coronary arterial complication which was shown in subacute phase wasn't significant. CONCLUSION: Plasma elastase activity was increased in Kawasaki disease significantly, but the initial plasma elastase activity in the acute phase could not reflect the range of coronary arterial complication.
Academic Medical Centers ; Dilatation* ; Echocardiography ; Humans* ; Leukocyte Elastase* ; Leukocytes ; Mucocutaneous Lymph Node Syndrome* ; Neutrophils* ; Pancreatic Elastase ; Plasma ; Vasculitis

OBJECTIVES: Sleep problems has been consistently reported as a suicidal risk factor in adults and, recently, also in adolescents. In this study, dividing study subjects by the previous suicidal behaviors (suicidal vs non-suicidal), we compared the group differences of suicidal risk factors, and examined the possibility of sleep as a suicidal risk factor. METHODS: Study subjects were 561 (271 boys and 290 girls) from a community sample of high school students. Suicidal Risk Behavior Checklist, Center for Epidemiological Study-Depression (CES-D), Symptom Checklist-90-Revision (SCL-90-R) Anxiety and Aggression subscale, Pittsburg Sleep Quality Index (PSQI) were done. RESULTS: Forty six students (8.1%) reported previous actual self-harm behavior as a suicidal attempt, 181 students (32.4%) reported having suicidal thought only. Three hundred thirty four students (59.5%) reported no previous suicidal behavior (thought and attempt, both). Suicidal behavior group showed higher score on risk behaviors such as school violence, substance use and internet addiction. CES-D, SCL-90-R, PSQI showed significant group difference. Logistic regression analysis showed suicidal risk were significantly associated with depression, stress in suicidal risk factors and sleep latency, daytime dysfunction in PSQI. Analysis of variance (ANOVA) shows the most prolonged sleep latency and increased index of all PSQI components except sleep efficiency in suicidal attempt group. CONCLUSIONS: Sleep Problems had a strong association with the suicidal risk behavior in adolescents. Sleep problems, especially, prolonged sleep latency, daytime dysfunction might be important markers for suicidal behavior. Screening for sleep problems in adolescents are encouraged for the parents, school teachers, and related medical physicians.
Adolescent ; Adult ; Aggression ; Anxiety ; Checklist ; Depression ; Humans ; Internet ; Logistic Models ; Mass Screening ; Parents ; Risk Factors ; Risk-Taking ; Suicide ; Violence

BACKGROUND: Ventilator associated pneumonia (VAP) is the most serious nosocomial infection of intensive care units. Several studies have investigated the relationship between the interval of ventilator circuit changes and the incidence of pneumonia in foreign countries, but there are no reports about it in Korea yet. So we performed this study to compare the clinical and cost impact between 3 days and 7 days interval in ventilator circuit changes. METHODS: Seoul National University Hospital is a 1,500-bed, university affiliated, tertiary and acute care hospital. All patients admitted to medical intensive care unit (MICU) and surgical intensive care unlt (SICU) between April 1, 1998 and October 31, 1998, requiring mechanical ventilation were included. Patients were divided into two groups of a-cay circuit changes and weekly changes. Daily surveillance was conducted using the criteria of VAP of the National Nosocomial Infection Surveillance System. Incidence of VAP and risk factors for VAP were evaluated. Standard microbiologic methods were used for the identification of clinical and environmental isolates. Statistical analysis was done by SAS Program (version 6.12), analysis of difference in variables was performed using chi-square test and t-test. Analysis of odds ratios was done with logistic regression analysis. RESULTS: VAP developed at a rate of 12.2 per 1,000 ventilator-days in the 3 days change group and 15.6 per 1,000 ventilator-days in the weekly change group (P=0.7240). The only statistically significant risk factor of VAP was duration of mechanical ventilation, The risk of VAP in patients with more than 7 days was 2.23 times higher than in patients with 7 days and below (OR; 2.2296). Estimated annual savings of nursing time by extending ventilator circuit change interval from 3 days to 7 days were 26,806 min 48 sec and estimated savings of cost by reduction of nursing times was calculated as 6,701,700 won. CONCLUSIONS: Weekly ventilator circuit changes in patients undergoing ventilation therapy in the ICU do not contribute to increased the rates of VAP and are cost-effective.
Cross Infection ; Humans ; Incidence ; Income ; Critical Care ; Intensive Care Units ; Korea ; Logistic Models ; Nursing ; Odds Ratio ; Pneumonia ; Pneumonia, Ventilator-Associated* ; Prospective Studies* ; Respiration, Artificial ; Risk Factors ; Seoul ; Ventilation ; Ventilators, Mechanical

The authors have been developed a menu-driven FoxBASE system for surgical pathology reporting and automatic encoding in Systematized Nomenclature of Medicine. The system requires no prior knowledge of FoxBASE and is readily installed on any IBM or it's compatible personal computer. Working sheet generation is automatically accompanied by data from previous cases on the same patient. Important data which include patient name, age, sex, surgical number, hospital unit number and encoded diagnoses, are stored on the hard disk permanently; complete reports are saved on floppy diskettes. Cases can be retrieved by patient name, surgical number, hospital unit number and SNOMED codes within 0.1 second. Daily work lists and listings of incomplete cases are easily obtained. This FoxBASE system has been in use for 1 year and 6 months and resulted in increased efficiency of retrieval and gathering of basic information for specific study, cost effectiveness, markedly diminished workload of typist and very short wasting time during complete restoration of data file for hard disk failure.

PURPOSE: To compare the causes and clinical manifestations of pediatric ocular injuries according to grade level. METHODS: We retrospectively reviewed the medical records of 78 children, 15 years and younger, who had been hospitalized for pediatric ocular injuries, classified them into three groups according to grade level, and compared their clinical manifestations. RESULTS: Eighteen (23.1%) were preschoolers, 39 (50.0%) were elementary school students, and 21 (26.9%) were middle and high school students. The most common causes of injury included toys and household goods at home in the preschool group, toys and sporting activity at home and school in the elementary school group, and sporting activity at school in the middle and high school group. The incidence of ocular injury was higher in the 'without supervision group' (57.7%); however, in the preschool group, it was higher (72.2%) even in the 'supervision group' (P<0.05). In the preschool group, the incidence of perforating ocular injury (P<0.05) and the rate of surgical treatment (P<0.05) were higher than those of other groups. CONCLUSIONS: The causes and clinical manifestations of pediatric ocular injury were different according to school degree. The incidence of pediatric ocular injuries can be decreased more efficiently by recognizing these differences.
Child ; Family Characteristics ; Humans ; Incidence ; Medical Records ; Organization and Administration ; Play and Playthings ; Retrospective Studies ; Sports

BACKGROUND: Although the pro-convulsant or anticonvulsant properties of propofol remain a matter of controversy, it is evident that propofol can produce involuntary movement. Such movement is a relatively common side effect, especially in children, and may be dose-related or injection rate-related. The goal of this study was to evaluate the effect of injection rate upon involuntary movement during propofol induction in children. METHODS: Children (age 3-14 yr) undergoing elective Eye and ENT surgery were randomly allocated to one of 4 groups based on the propofol injection rate (A, manual/15 s; B, 360 ml/hr; C, 200 ml/hr, D, 100 ml/hr) using a manual injection method and syringe pumps. No premedication was used. The induction dosage of propofol was 3 mg/kg in all groups. Fentanyl 1mcg/kg and 1% lidocaine 1-2ml were given I.V. before propofol. Involuntary movement was graded 0-2 on severity. The infused dose of propofol at movement was measured. Movement due to pain or mask fitting was not regarded as an involuntary movement. All results were analyzed using the Chi-Square Test and ANOVA. RESULTS: 595 children were studied. Age, gender, and weight were similar in the 4 groups. Involuntary movements were apparent in 179 (30.1%) of the 595 subjects. Movements were significantly less in group A (12.4%) and B (16.4%) compared to group C (46.6%) and D (45.3%). The grades of movement were not different among the 4 groups. The durations of movement in group A and B were significantly short compared to group C and D. The infused dose of propofol (mg/kg) at movement was higher in group C (2.65+/-0.62) than in A (1.99+/-0.62) and B (2.43+/-0.78). There were no significant hemodynamic and SPO2 changes during and after the propofol injection. CONCLUSIONS: We concluded that slow injection may increase the incidence of involuntary movement during propofol induction in children. Since the bolus injection rates are usually slow in most syringe pumps, manual injection for 10 15 s may be a better choice for smoother induction, as it requires fewer interventions to prevent venous catheter displacement in children.
Catheters ; Child* ; Dyskinesias* ; Fentanyl ; Hemodynamics ; Humans ; Incidence ; Lidocaine ; Masks ; Premedication ; Propofol* ; Syringes

BACKGROUND: Shiga toxin-producing Escherichia coli (STEC) was found in several serotypes of E coli including 0157 serotype. Sorbitol-MacConkey agar: may be useful for the detection of E. coli 0157, but is not helpful for the detection of sorbitol-fermenting STEC other than 0157. Moreover, some strains of E. colt 0157 can ferment sorbitol. In this study, in situ hybridization using DNA probe of shiga toxin was used for the isolation of STEC from the PCR-positive stool and -Sequenbe analysis of a part of shiga toxin gene was performed. METHODS: The stool was incubated in LB broth overnight and DNA was extracted from the culture fluid. Multiplex PCR was performed with primers for stxl and stx2 genes. Specimen showed PCR-positive was incubated on MacConkey agar and colonies were blotted with nitrocellulose membrane. Digoxigenin-labelled DNA probe for shiga toxin was made by PCR and the positive colonies were detected with anti-digoxigenin-alkaline phosphatase conjugate and nitroblue tetrazolium. Agglutination test with antisera was performed for the serotying and VTEC-RPLA kit was used for the toxin production. Sequence analysis of PCR products was performed with automatic sequence analyser. RESULTS: An stxl-negative, but stx2-positive PCR was observed in a three-year-old girl, who visited Kumi Hospital on July 19, 1999 complaining of vomiting and diarrhea. The positive colonies were isolated by in situ hybridization using stx2-specific DNA probe. The titers of stxl and stx2 by VTEC-RPLA test were negative and 1:64, respectively. Agglutination for the serotyping was not observed with all of the 0 antisera. 160-nucleotide sequence of stx2 of this isolate was identical with bacteriophage 933W (GenBank X07865), except for the change (T-C) of 957th nucleotide and amino acid sequence was identical each other. CONCLUSIONS: For the sensitive detection of STEC from the stool of patients with diarrhea, multiplex PCR is recommended with stxl- and stx2-specific primers. And in situ hybridization should be performed in PCR-positive specimen for the isolation of STEC. This method may be helpful for the detection of STEC as the causative microorganisms in food-borne outbreak.
Agar ; Agglutination ; Agglutination Tests ; Amino Acid Sequence ; Bacteriophages ; Collodion ; Diarrhea ; DNA ; Escherichia coli ; Female ; Gyeongsangbuk-do ; Humans ; Immune Sera ; In Situ Hybridization ; Membranes ; Multiplex Polymerase Chain Reaction ; Nitroblue Tetrazolium ; Polymerase Chain Reaction ; Sequence Analysis* ; Serotyping ; Shiga Toxin ; Shiga-Toxigenic Escherichia coli* ; Sorbitol ; Vomiting