BACKGROUND: This study tested the efficacy of 0.12% chlorhexidine gluconate for improving oral hygiene in intubated intensive care patients. METHODS: In a group of 57 ventilated patients, 29 received normal saline (NS) for oral hygiene, and 28 were treated with chlorhexidine gluconate (CHG). Data on oral bacterial colonization was collected for 11 months from October 2005 to August 2006. Tests of oral hygiene and oral microorganism culture were performed on the day of the ventilation, and repeated on days 4, 8, and 12. RESULTS: Oral hygiene was significantly improved in the CHG group compared to that in the NS group (P<.001). Further, all patients (100%) in the NS group tested positive for Staphylococcus aureus on the 12th day after the endotracheal intubation, whereas only 42.9% (P=0.026) of the CHG group were positive. The NS group also had higher isolation rates of Pseudomonas aeruginosa at 66.7% on the 8th day after intubation and 87.5% on the 12th day. At these same intervals, the CHG group had isolation rates of 29.4% (P=.028) and 14.3% (P=.010) respectively. CONCLUSION: The longer the period of endotracheal intubation, the more effective the 0.12% CHG treatment was for improved oral hygiene and reduction of S. aureus and P. aeruginosa colonization when compared to treatment with NS.
Chlorhexidine ; Colon ; Humans ; Critical Care ; Intensive Care Units ; Intubation ; Intubation, Intratracheal ; Oral Hygiene ; Pseudomonas aeruginosa ; Sodium Chloride ; Staphylococcus aureus ; Ventilation

Cardiac size of 291 new-born infants was measured using the method illustated on Fig 1. Among the 291 infants,53 were asphyxiated, and asphxia was only regared from Apgar score below 6 on 1 min. and 5 min. Remaining 238infants were normal, and classified to group with lung abnormalities and without lung abnormalities on chest A-Pfilm. The results are as follows; 1. The average CTR. of normal group was 52.37(C/T1;54.89, C/T2;49.43, C/T3;49.15, C/T;55.97) 2. The average CTR. of asphxiated group was 54.91 (C/T1;57.13, C/T2;51.69, C/T3;51.94,C/T4;58.25) 3. Consequently, asphyxiated infants revealed larger cardiac size than normal infant group.
Apgar Score ; Heart ; Humans ; Infant ; Lung ; Methods ; Thorax

A 62-year-old woman without vascular risk factors presented with left-sided weakness and numbness. Magnetic resonance imaging (MRI) brain depicted acute right hemispheric infarcts in the cortical and subcortical white matter. Initial MR angiography (MRA) showed large thrombus at the right carotid bifurcation. Valvular atrial fibrillation (vAF) with severe tricuspid regurgitation (TR) was found on two-dimensional echocardiography. Serial follow-up computed tomography angiography (CTA) or MRA at 3, 9, and 15 days after anticoagulation alone showed complete resolution of the thrombus with no neurological deterioration. Our case suggests that prompt institution of anticoagulantion alone may result in radiologic resolution of the thrombus with improvement in patient’s clinical status.
Carotid Arteries

PURPOSE: The purpose of this study was to investigate the effects of a action-learning based simulation practice program on nursing students' interpersonal communication competence and problem solving ability.METHOD: The action-learning based simulation practice program was developed by using the ADDIE mode. A single group pre-post test and time series design was used. Data was collected from senior in nursing university. 89 students participated in pretest group and 116 students participated in posttest group.RESULTS: Interpersonal communication competence and problem solving ability were significantly higher in posttest group than pretest group.CONCLUSION: Action-learning based simulation practice program is an effective teaching strategy to enhance communication competence and problem solving ability.
Evaluation Studies as Topic ; Humans ; Mental Competency ; Methods ; Nursing ; Problem Solving ; Students, Nursing

No abstract available.
Endometriosis* ; Female

MELAS (mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes) is one of the mitochondrial encephalomyopathy, A rare disease caused by a disturbance of the mitochondrial chain of respiration. MELAS is confirmed by typical light and electron microscopic findings : "ragged red fibers" by modified Gomori trichrome stain on light microscope and numerous abormal mitochondria on electron microscope. We experienced a boy with the characteristic clinical and pathologic findings of MELAS. Our patient demonstrated bilateral basal ganglia calcifications and infarction at right parieto-occipital and thalamic areas on CT and MR We found that MRI was more sensitive and represented the infarcted lesions better than CT. Detection of cerebral insults of MELAS by MRI is important in making decision on patient treatment and also in predicion of the patient prognosis.
Acidosis, Lactic ; Basal Ganglia ; Brain Diseases ; Child* ; Humans ; Infarction ; Magnetic Resonance Imaging ; Male ; MELAS Syndrome* ; Mitochondria ; Mitochondrial Encephalomyopathies ; Muscular Diseases ; Rare Diseases ; Respiration

BACKGROUND: One of the factors that affect the anesthetic risk is preoperative status especially in geriatric patients. So we studied about followings; 1) Can we use APACHE scoring index when we assess the physical status of geriatric patients preoperatively? 2) Is it meaningful in saying the risk of anesthesia? 3) Which one is more significant in predicting the morbidity and mortality: acute physiologic status vs chronic health status? METHOD: Preoperative status of the geriatric patients (above 65 years old), who were received operation from June 1994 to March 1996 at Hanil General Hospital, were assessed by APACHE scoring index and ASA classification. Age, sex, type of operation, emergency or elective, method of anesthesia, duration of procedure, APACHE scoring index, ASA classification, perioperative complication, postoperative complication is coded by grading or type. RESULT: Perioperative complication was showed statistically significant with acute physiologic score (APS) and duration of procedure. Postoperative complication was showed statistically significant with APACHE score or ASA class. Total complication was affected by duration of procedure and APS score. There was also correlation between ASA class and total complication. Among 265 cases, 1 case expired during operation and 7 cases expired after operation. Causes of postoperative death were pneumonia, hemorrhagic shock etc. CONCLUSION: In geriatric patients, 1) APACHE scoring index is available for preoperative assessment. 2) APACHE scoring index is meaningful in predicting the risk of anesthesia. 3) Perioperative complication was more correlated with acute physiologic status than chronic health evaluation.
Anesthesia ; APACHE* ; Classification ; Emergencies ; Hospitals, General ; Humans ; Mortality ; Pneumonia ; Postoperative Complications ; Shock, Hemorrhagic

BACKGROUND: Cardiac troponin T (cTnT) is a new serological marker for use as a diagnostic toots for acute myocardial infarction (AMI). This study was designed to evaluate tee diagnostic efficiency of troponin T in AMI. METHODS: We determined the reference range of troponin T in 20 healthy adults without previous cardiovascular diseases and chest pain. We evaluated troponin-T, CK, LD, AST and CK-MB in serum of 13 AMI and 5 angina pectoris patients. The patients were arrived at the hospital within 3 hours after onset of (most recent) acute symptoms. Samples were drawn individually at the times of 0, 1, 3, 7, 18 and 24 hours after admission and continued at 6-h intervals for 2 days and 24-h intervals fort 2 weeks. Troponin T was determined by an enzyme-linked immuno-sorbent assay (one step sandwich assay) on an ES-300 analyzer. RESULTS: We found that serum troponin-T concentrations in healthy control adults were below 0.07microgram/L. The peak level of troponin-T concentration of patients with AMI was 22.0microgram/L, mean value, at 7 hours after admission and showed 110 times its discrimination limit value (0.2microgram/L). CK-MB value was normalized within 3 days after admission, but cTnT value remained high above its discrimination limit value until 2 weeks after admission during this study. CONCLUSIONS: The data indicate that the measurement of serum cTnT improves efficiency of serological testings of AMI as compared with conventionally used cardiac enzymes.
Adult ; Angina Pectoris ; Cardiovascular Diseases ; Chest Pain ; Discrimination (Psychology) ; Humans ; Myocardial Infarction* ; Reference Values ; Serologic Tests ; Troponin T* ; Troponin*

Hysterosalpingograms of 375 patients with infertility were reviewed with reference to radiological features of each pathology and a comparative study of hysterosalpingography and laparoscopy in 36 patients was presented. The results were as follows; 1. In 375 cases infertility, 191 cases (50.9%) were primary infertility and 181 cases(49.1%) were secondary infertility. 2. The peak age distribution was 26 to 30 year old group in 211 cases (56.3%),and the peak duration of infertility was less than 3 years in 256 cases (68.3%). 3. Abnormal uterine findings were 115 cases (30.7%) and there were 73 cases of filling defects, 13 cases of irregularity , 12 cases of uterineflexion, 11 cases of congenital anomaly, and 9 cases of hypoplasia among them. 4. Abnormal tubal findings were 196 cases (52.3%) and there were 103 cases of simple obstruction, 69 cases of hydrosalpinx, and 50 cases of peritubal adhesion among them. 5. Intravasation of contrast media was noted in 42 cases (11.2%). 6. In 36 cases of laparoscopy, 23 cases (63.7%) was agreed to hysterosalpingography. 7. Aothough laparoscopy was better than hysterosalpinography in external anatomy of salpinx and relationship to overay, hysterosalpingography should be important for fundamental study of infertile women because of lower failure rate, lower risk of complications,therapeutic effect, and lower cost.
Age Distribution ; Contrast Media ; Fallopian Tubes ; Female ; Humans ; Hysterosalpingography ; Infertility ; Laparoscopy ; Pathology

HIV-1 p24 was cloned into multiple cloning site of pMV261, extrachromosomal expression vectors carrying BCG replication origin and BCG-specific heat-shock promoter, and then introduced into BCG and E. coli. Western blot experiments showed that the p24 efficiently expressed in recombinant BCG (rBCG), but not in E. coli. Recombinant p24 expression induced by a single heat-shock of rBCG was maintained longer than 3 weeks. Immunoblot experiments with intact rBCG did not show any distinctive positive signal, suggesting that the recombinant protein was not secreted or exposed at the surface of BCG. The guinea pigs immunized with live rBCG showed delayed type hypersensitivity (DTH) by the systemic area as well as an effective humoral immunity, suggesting that tbis rBCG is believed to elicit eKcient immune responses against p24, even though the expression is restricted only in the cytoplasm as reported previously with other antigen. These results demonstrate that BCG can be developed as a live recombinant vaccine vector against a broad spectrum of infectious disease.
Animals* ; Blotting, Western ; Clone Cells ; Cloning, Organism ; Communicable Diseases ; Cytoplasm ; Guinea Pigs ; HIV* ; HIV-1 ; Hypersensitivity ; Immunity, Humoral ; Mycobacterium bovis* ; Replication Origin