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*

The idiopathic hypereosinophilic syndrome (HES) represents a heterogenous group of disorder characterized by prolonged eosinophilia of undetectable cause and multiorgan system dysfunction. Bone marrow is the most frequentry involved organ, but the most severe clinicopathologic involvement is heart. The major cause of death in patients with the HES is cardiac dysfunction especially congestive heart failure resulted from endocardial fibrosis and restrictive cardiomyopathy. We have experienced a case of DES with both cardiac and pulmonary involvements. The patient was an 18-month-old infant with poorly controlled lung abscess who complained of fever and productive cough. On the microscopic examination of pleural effusion, eosinophilic infiltration was noted. M-mode echocardiogram showed diffuse thickening of interventricular septum and left ventricular posterior wall. On the peripheral blood smear, prolonged eosinophilia was observed. We confirmed this case with bone marrow aspiration which showed eosinophilic hyperplasia.
Bone Marrow ; Cardiomyopathy, Restrictive ; Cause of Death ; Cough ; Eosinophilia ; Eosinophils ; Fever ; Fibrosis ; Heart ; Heart Failure ; Humans ; Hypereosinophilic Syndrome* ; Hyperplasia ; Infant ; Lung Abscess ; Pleural Effusion

No abstract available.
Epidemiology ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Staphylococcus aureus

Acoustic neurinoma are the most frequent tumors in the region of the cerebellopontine angle. They usually present with a gradual onset of symptoms and slow progression. Development of spontaneous hemorrhage with sudden aggravation of symptoms is rare. The authors present a case of acoustic neurinoma associated with a spontaneous intratumoral hemorrhage. Sudden aggravation of symptoms was noticed. The cranial computed tomography revealed multiple blood-fluid levels within the cysts of the tumor which was located in the region of the right cerebellopontine angle. Operation was performed, which confirmed recent hemorrhage within the tumor. Pathological study revealed a typical neurilemmoma associated with hemorrhage, vascular proliferation and macrophages which phagocytosed hemosiderin pigments. The rare sudden aggravation of symptoms in cases of acoustic neurinoma may suggest hemorrhage.
Acoustics* ; Cerebellopontine Angle ; Hemorrhage* ; Hemosiderin ; Macrophages ; Neurilemmoma ; Neuroma, Acoustic*

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*