Central lines are indispensable in hospital care. The main complication resulting from their use is central line-associated bloodstream infection (CLABSI). CLABSI is one of the most frequent healthcare-associated infections associated with high costs, morbidity, and potential lethality. Recent studies on CLABSI prevention show that a multifaceted approach to improving central line insertion and maintenance practices results in decreased CLABSI rates. The question today, then, is not 'what to do,' but 'how to do it.'
Catheter-Related Infections ; Central Venous Catheters ; Comprehensive Health Care

No abstract available.
Methicillin ; Methicillin Resistance ; Staphylococcus ; Staphylococcus aureus

Computed tomography(CT) has enabled early recognition and treatment of focal injuries in patients with head trauma. However, CT has been less beneficial in identifying diffuse brain injury(DBI). The authors have analyzed retrospectively, a series of 132 patients with OBI observed for 2 years from Aug. 1986 to Jul. 1988 to evaluate the significance of the factors affecting outcome. Eighty-three patients were selected as being compatible with moderate and severe diffuse axonal injury(DAI) classified by Gennarelli, defined by coma without a CT lesion that is an obvious cause and coma greater than 24 hr with or without decerebration. The results are summarized as follows: 1) The 38(45.7%) out of 83 patients were found below age of 20, but there was no statistical significance between age distribution and outcome. 2) In case of initial Glasgow coma scale(GCS) of 7 or 8, 32(86.5%) out of 37 patients revealed good outcome, but 18(90%) of 20 patients with a score of 3 or 4 revealed poor outcome(p<0.01). 3) With regard to brain swelling in CT, there was significant statistical difference to outcome(p<0.05). 4) Small hemorrhages on corpus callosum, basal ganglia, basal cistern, peritentorial, lateral ventricle that is characteristic CT findings for DAI were showed 58(70%) out of all cases. It might be concluded that initial GCS, brain swelling and small hemorrhages in CT were significant factors affecting outcome in DAI.
Age Distribution ; Axons ; Basal Ganglia ; Brain ; Brain Edema ; Brain Injuries* ; Coma ; Corpus Callosum ; Craniocerebral Trauma ; Diffuse Axonal Injury ; Hemorrhage ; Humans ; Lateral Ventricles ; Retrospective Studies ; Tomography, X-Ray Computed

No Abstract available.
Cross Infection* ; Korea*

No abstract available.
Angiogenesis Inducing Agents* ; Intracranial Aneurysm*

Gaucher disease is caused by a deficiency of glucocerebrosidase. Patients with Gaucher disease are divided into three major phenotypes: chronic nonneuronopathic, acute neuronopathic, and chronic neuronopathic, based on symptoms of the nervous system, the severity of symptoms, and the age of disease onset. The characteristics of patients with acute neuronopathic- and chronic neuronopathic-type Gaucher disease include oculomotor abnormalities, bulbar signs, limb rigidity, seizures and occasional choreoathetoid movements, and neuronal loss. However, the mechanisms leading to the neurodegeneration of this disorder remain unknown. To investigate brain dysfunction in Gaucher disease, we studied the possible role of inflammation in neurodegeneration during development of Gaucher disease in a mouse model. Elevated levels of the proinflammatory cytokines, IL-1alpha, IL-1beta, IL-6, and TNF-alpha, were detected in the fetal brains of Gaucher mice. Moreover, the levels of secreted nitric oxide and reactive oxygen species in the brains of Gaucher mice were higher than in wild-type mice. Thus, accumulated glucocerebroside or glucosylsphingosine, caused by glucocerebrosidase deficiency, may mediate brain inflammation in the Gaucher mouse via the elevation of proinflammatory cytokines, nitric oxide, and reactive oxygen species.
Up-Regulation/genetics ; Tumor Necrosis Factor-alpha/genetics/secretion ; Reverse Transcriptase Polymerase Chain Reaction ; Reactive Oxygen Species/metabolism ; RNA, Messenger/genetics/metabolism ; Nitric Oxide/metabolism ; Microglia/cytology/metabolism ; Mice, Knockout ; Mice, Inbred ICR ; Mice, Inbred C57BL ; Mice ; Interleukin-6/genetics/secretion ; Interleukin-1/genetics/secretion ; Inflammation/immunology ; Glucosylceramidase/genetics ; Gaucher Disease/*genetics/metabolism/pathology ; Cytokines/*genetics/immunology/secretion ; Cells, Cultured ; Brain/embryology/*metabolism/pathology ; Animals

No abstract available.
Infection Control* ; Seoul*

BACKGROUND: As information technology evolves rapidly computer-based surveillance systems for nosocomial infection have been developed. Well designed computerized system could provide an opportunity for improving, enlarging, and conducting hospital-wide surveillance more efficiently in the situation with limited resources. Recently, we launched a new computerized monitoring system in a hospital where digital medical information system has been operated without paper chart. METHODS: We developed a new surveillance program based on the total Electronic Medical Record (EMR) system. Numerous critical medical information can be easily accessible through this system without further work. This includes major demographic data, essential information from the inpatient medical record, the laboratory information system, and the pharmacy information, Comprehensive Clinical Data Repository (CDR) system was also developed. CDR is potentially very useful to conduct a hospital-wide surveillance by integrating all the available information. RESULTS: This system consists of several programs in the EMR and the CDR environment. In the EMR system, inquiry for patients with fever, case ascertainment and registration of nosocomial infections, inquiry for patients with indwelling devices, microbiological reports, and data on antibiotic prescriptions were included. The CDR has integrated comprehensive inquiries for frequency of major pathogens in clinical isolates and their trends of antibiotic resistance, nosocomial infection rates based on the duration of the devices or hospitalization, and the history of antimicrobial usage based on defined daily dosage. Data obtained from the EMR and the CDR systems could be easily accessed by infectious diseases specialists and healthcare workers of infection control services at any place within the hospital. A new reporting system has been built up to facilitate identification of notifiable diseases among the list of diagnoses on the EMR. In addition, the "Alert" notice was designed to highlight isolation precautions for indicated cases. CONCLUSION: This new computerized surveillance program might be a valuable model to which other hospitals can refer to develop newer version of programs in the future.
Clinical Laboratory Information Systems ; Communicable Diseases ; Cross Infection ; Delivery of Health Care ; Diagnosis ; Drug Resistance, Microbial ; Electronic Health Records* ; Fever ; Hospitalization ; Humans ; Infection Control ; Information Systems ; Inpatients ; Medical Records ; Pharmacy ; Prescriptions ; Specialization

Frequent large outbreaks of food poisoning or foodborne diseases are emerging problems in Korea. As for individual cases, most of food poisoning or foodborne diseases are difficult to diagnose based solely on clinical features. On the other hand, in case of large outbreaks, clinical features such as the incubation period, presence or degree of fever and the severity of upper gastrointestinal tract symptoms could be useful for the differential diagnosis. In this review, we suggest key clinical characteristics and standard laboratory diagnostic methods of epidemiologically important food poisoning or foodborne diseases.
Diagnosis* ; Diagnosis, Differential ; Disease Outbreaks ; Fever ; Foodborne Diseases* ; Hand ; Korea ; Upper Gastrointestinal Tract

Intracranial meningioma is one of the most easily detectable tumor in the preoperative period with the brain computerized tomographic(CT) scan. Although most of them are of benign nature, they present tendency to invade surrounding brain tissue and to recur in spite of complete surgical removal. Authors analysed the clinical features of 27 cases of histologically verified meningiomas and attempted to study the correlation between CT findings and histological types to predict their clinical invasiveness and aggressiveness. Female was predominated in occurance than male in the ratio of 17:10. Mean age of occurance was 40.5-year-old. The most frequent symptoms and signs were headache, papilledema and visual disturbance in order. The most frequent histological type was meningotheliomatous type(55.6%) which was followed by transitional(18.5%), fibroblastic(18.5%) and angioblastic(7.4%) types. In the finding of the brain CT scan, perifocal brain edema was noticed in nearly almost cases and high density of the tumor mass in the precontrast CT scan was predominated in transitional and fibroblastic types. But, marked perifocal brain edema, irregular tumor margin, loss of homogeneity of the tumor density and marked contrast enhancement, which were considered to be more aggressive and invasive findings, were predominated in the meningotheliomatous and angioblastic types. So, these types seemed to be more aggressive and invasive than other types. Large cystic meningiomas were 14.8% in author's cases.
Brain ; Brain Edema ; Female ; Fibroblasts ; Headache ; Humans ; Male ; Meningioma ; Papilledema ; Preoperative Period ; Tomography, X-Ray Computed