Background: There have been many reports on microbial contamination of antiseptics and disinfectant used in the hospitals. Mid to low level disinfectants such as chlorhexidine gluconate, quaternary ammonium, phenols and benzalkonium are reported to be the one with high risk of microbial contamination. We investigated microbial contamination of 0.05% chlorhexidine gluconate solution used in our hospital. Methods: 0,05% chlorhexidine gluconate solution and 0.05% chlorhexidine gluconate cotton balls used in the general ward and intensive care unit were randomly collected for microbial culture. Also, sterile water, 20% chlorhexidine gluconate and staining solution, which is mixed in the preparation room to make 0,05% chlorhexidine gluconate solutions, were collected for bacterial culture to evaluate the focus of microbial contamination. Results: Total of 31 chlorhexidine gluconate samples was randomly collected from general wards. intensive care unit and preparation room for microbial culture. Seven of thirteen 0.05% chlorhexidine gluconate solution and 5 of twelve 0.05% chlorhexidine soaked cotton balls kept in a canister were contaminated by Burkholderia cepacia. Sterile water used for dilution of 20% chlorhexidine gluconate to make 0.05% chlorhexidine and originally purchased 20% chlorhexidine gluconate were not contaminated by microorganism. But staining solution that is used as an additive to differentiate from other diluted disinfectants was contaminated by Bukholderia cepacia. 0.05% chlorhexidine gluconate solutions that were mixed in the preparation room were also contaminated by same organism. Source of contamination was thought to be staining solution. All the previously made chlorhexidine. solutions and staining solution were discarded. Staining solution was not used afterward. Several processes in the handling of chlorthexidine solution were corrected and no microbial contamination was found afterward. Conclusion: Diluted chlorthexidine gluconate solutions are always under a risk of microbial contamination if any of the process in the handling is overlooked. Staining solution as an additive to disinfectants should be used carefully.
Ammonium Compounds ; Anti-Infective Agents, Local ; Benzalkonium Compounds ; Burkholderia cepacia ; Chlorhexidine* ; Disinfectants ; Intensive Care Units ; Patients' Rooms ; Phenol ; Phenols ; Water

BACKGROUND: Family counseling is an essential part of family practice in which patients are cared in psychosocial dimension as will as in physical dimension and the family is dealt with as a whole unit. However, it is little applied in practice. The department of family medicine has made efforts to activate family counseling. This study was done to estimate the patients response on the effect of family counseling that we have performed, and to investigate what clinical problems counseling was held and in what situations the counseling was perceived to be useful by the patients. We hope this study will be useful to establish some useful data and ideas for the development of family counseling in family practice in Korea. METHODS: The subjects of this study are 53 households who received family counseling at the department of family medicine from Oct. 1, 1994 to May 31, 1995. 64 households received counseling during this peroid, but 11 persons who could not be reached by the phone were excluded. Patients demographic charateristics, patients chief complaints, physicians assessrnent on the complaints and major prolems presented in the counseling sessions were identified from the medical records. Patients own estimation of the effect of counseling and the reasons for termination of counseling were inquired through the telephone interview. Finally the association between the usefulness of counseling and some factors was statistically analyzed. RESULTS: Subjects were predominently women(84.9%), especially middle aged. The most common chief complaint was headache complained by 10 subjects (18.9%), and the second and the third were abdominal pain complained by 8 (15.1%) and chest discomfort complained by 7(13.2 %), respectively. The list of physicians assessment included depression(34.0%), physical symptom per se without any assessment(20.8%), family problem(15.1%), somatization(13.2%), and anxiety(9.45). More than half of the subjects(60.4%) had only one session, 26.4% two sessions and 7.5% more than 4 sessions. The most common problem presented in the counseling was marital conflict(28.3%), the second was trouble with in-laws(15.1%), and the third was chronic illness in the family(9.4%). 32.1% replied that the counseling was very helpful, 28.3% somewhat helpful, 17% little helpful, 20.8% never helpful, and 1.9% not sure. The session was experienced to be more useful in the group of duration of symptom less than 6 months, than in the group of longer duration(p<0.05), and in the group with motivation for counseling than in the group without motivation(p<0.05). CONCLUSIONS: About 60% of subjects replied the counseling was useful to them. Symptom duration and patients motivation to participate in counseling showed significant association with the effect of family counseling.
Abdominal Pain ; Chronic Disease ; Counseling* ; Family Characteristics ; Family Practice ; Headache ; Hope ; Humans ; Interviews as Topic ; Korea ; Medical Records ; Middle Aged ; Motivation ; Thorax

BACKGROUND: Family counseling is an essential part of family practice in which patients are cared in psychosocial dimension as will as in physical dimension and the family is dealt with as a whole unit. However, it is little applied in practice. The department of family medicine has made efforts to activate family counseling. This study was done to estimate the patients response on the effect of family counseling that we have performed, and to investigate what clinical problems counseling was held and in what situations the counseling was perceived to be useful by the patients. We hope this study will be useful to establish some useful data and ideas for the development of family counseling in family practice in Korea. METHODS: The subjects of this study are 53 households who received family counseling at the department of family medicine from Oct. 1, 1994 to May 31, 1995. 64 households received counseling during this peroid, but 11 persons who could not be reached by the phone were excluded. Patients demographic charateristics, patients chief complaints, physicians assessrnent on the complaints and major prolems presented in the counseling sessions were identified from the medical records. Patients own estimation of the effect of counseling and the reasons for termination of counseling were inquired through the telephone interview. Finally the association between the usefulness of counseling and some factors was statistically analyzed. RESULTS: Subjects were predominently women(84.9%), especially middle aged. The most common chief complaint was headache complained by 10 subjects (18.9%), and the second and the third were abdominal pain complained by 8 (15.1%) and chest discomfort complained by 7(13.2 %), respectively. The list of physicians assessment included depression(34.0%), physical symptom per se without any assessment(20.8%), family problem(15.1%), somatization(13.2%), and anxiety(9.45). More than half of the subjects(60.4%) had only one session, 26.4% two sessions and 7.5% more than 4 sessions. The most common problem presented in the counseling was marital conflict(28.3%), the second was trouble with in-laws(15.1%), and the third was chronic illness in the family(9.4%). 32.1% replied that the counseling was very helpful, 28.3% somewhat helpful, 17% little helpful, 20.8% never helpful, and 1.9% not sure. The session was experienced to be more useful in the group of duration of symptom less than 6 months, than in the group of longer duration(p<0.05), and in the group with motivation for counseling than in the group without motivation(p<0.05). CONCLUSIONS: About 60% of subjects replied the counseling was useful to them. Symptom duration and patients motivation to participate in counseling showed significant association with the effect of family counseling.
Abdominal Pain ; Chronic Disease ; Counseling* ; Family Characteristics ; Family Practice ; Headache ; Hope ; Humans ; Interviews as Topic ; Korea ; Medical Records ; Middle Aged ; Motivation ; Thorax

communicable diseases. The purposes of the study is to estimate reporting proportion of National Notifiable Infectious Diseases(NNIDs) and investigate characteristics related to reporting using KAP(knowledge, attitude, practice) model. METHOD: We surveyed randomly selected 2,185 physicians (speciality: internal medicine, family medicine, pediatrics, dermatology, general physicians) of their knowledge, attitude, and practice of NNIDs reporting through self-administered mail questionnaires. Of them, 231 physicians responded (response proportion: 10.6%). RESULT: The reporting proportion was estimated to 27.0%. Recognition level (knowledge) of NNIDs was relatively high with proportion of 69.4%, and attitude (public health importance) of reporting was 65.8%. Multiple logistic regression analysis showed that knowledge, attitude significantly affected physicians' reporting in a positive direction (O.R. 6.2, 6.2 respectively). Whereas, senior age group, specialty (family medicine, pediatrics, dermatology) showed significantly lower reporting. General (tertiary care) hospital level of care showed significantly higher reporting practice (alpha=0.05). CONCLUSION: The NNIDs reporting proportion, 27.0% is similar with those studied recently. Continuous efforts to increase the performance level of communicable diseases surveillance system. Of those, restructuring surveillance systems considering characteristics of notifiable diseases classes must be stressed. Educational approach of physicians needs to be tailored specially to newly-designated diseases such as Group II, Designated Group NNIDs.
Communicable Diseases* ; Dermatology ; Humans ; Internal Medicine ; Logistic Models ; Pediatrics ; Postal Service ; Surveys and Questionnaires

BACKGROUND: A fully automated enzyme-immunoassay (EIA) analyzer, Enzymun System, ES-300 (Boehringer Mannheim, Germany) uses streptavidin technology and performs single test or panels of up to 12 tests per run. We evaluated the results of ES-300 for anti-HCV by comparing the results with microplate-EIA, radioimmunoassay (RIA), and confirmatory test. METHODS: Total 79 sera (51 positive, 24 negative, 4 indeterminate results confirmed by Lucky HCD Confirm) were analysed. ES-300 with Enzymun-Test(R) Anti-HCV (Boehringer Mannheim, Germany) and microplate-EIA (Green Cross Center Innotest HCV 3.0(R)) were used. Fifty one sera were examined additionally by 2nd-generation RIA method, NANBDINE 125C(General Biologicals Corp., R.O.C.). And all results were compared to the results of Lucky HCD Confirm. RESULTS: The overall concordance rate of ES-300 and Innotest(R) was 72/79 (91.1%). The results of Lucky HCD Confirm on seven discrepant samples were five negative and two indeterminate. The results of ES-300 and NANBDINE 125C showed concordance rate of 90.2%. The sensitivity and specificity of ES-300 with regard to Lucky HCD Confirm were 94.5%, and 87.5%, respectively, and that of Innotest(R) were 98.2% and 66.7%, respectively. Clear distinction of positive and negative results by signal/cut off ratio was available in both EIAs. The positive predictive values of ES-300 and Innotest(R) were 94.5%, and 87.1%, respectively. CONCLUSIONS: ES-300 showed relatively good results in sensitivity and positive predictive value with regard to confirmatory test. In EIA-positive persons, however, follow-up study would be necessary for reliable evaluation of HCV infection.
Humans ; Radioimmunoassay ; Sensitivity and Specificity ; Streptavidin

The purpose of this study is to identify the effects of sexual rehabilitation education on the knowledge of sexual activities and satisfaction of sexual activities of spinal cord injury clients by the method of Nonequivalent control group pretest-posttest group. The study period was between Jan. 6th and Apr. 11th, 1999. The experimental group was 21 spinal cord injury clients from one general hospital, and the control group was 21 spinal cord injury clients from three University hospital. Sexual rehabilitation education was done with manuals and video-tapes. Education time was 90 minutes a week for 4 weeks. The study tool was 20 questionnaires about sexual knowledge, designed Song, Chung Sook(1990) and 10 questionnaires from Derogatis's Derogatis Sexual Function Inventory for satisfaction of sexual activities(1979) translated by Jang, Soon Boke(1989). Analysis of data was done by x2 -test, t-test, repeated measures ANOVA and simple main effect with SAS/PC. The results are as follows. The 1st. hypothesis, "The group educated about the sexual rehabilitation has more sexual activities knowledge than those of the uneducated group." is significant statistically(F=12.06, p=0.001). The 2nd. hypotheses, "The group educated about the sexual rehabilitation has more satisfaction of sexual activities than those of the uneducated group." is significant statistically(F=5.04, p=0.030). According to the results, sexual rehabilitation education helps spinal cord injury clients to gain knowledge of sexual activities and satisfaction of sexual activities.
Education* ; Hospitals, General ; Music ; Surveys and Questionnaires ; Rehabilitation* ; Sexual Behavior* ; Spinal Cord Injuries* ; Spinal Cord*

No abstract available.
Plasma Exchange* ; Plasma* ; Seoul*

No abstract available.
Plasma Exchange* ; Plasma* ; Seoul*

No abstract available.
Trophoblastic Neoplasms* ; Trophoblasts*

PURPOSE: Tacrolimus (FK506) is a new potent immunosuppressive agent which has been used as a primary immunosuppressive agent and rescue therapy for refractory rejection in kidney transplantation. In vitro, on a molecular basis, tacrolimus is 10 to 100 times more potent than cyclosporine. Complications associated with tacrolimus are similar to those seen in cyclosporine, including nephrotoxicity. An early marker of tacrolimus-induced nephropathy is tubular vacuolization, whereas long-term administration of tacrolimus is associated with striped interstitial fibrosis and arteriolar hyalinosis. However, morphological changes and pathogenesis of fibrosis in chronic tacrolimus-induced nephropathy remain poorly understood. Transforming growth factor (TGF)-beta1 has been implicated in the fibrosis of a number of chronic diseases of the kidney and other organs. This study was designed to clarify the ultrastructural changes of tacrolimus-induced nephropathy, and to evaluate the relationship between tacrolimus- induced nephropathy and expression of TGF-beta1. METHODS: Male ICR mice received tacrolimus daily at a dose of 2.5 mg/kg by intraperitoneal route for 12 weeks and sacrified 1, 4, 8, 10, and 12 weeks after the initiation of the study, respectively. The kidneys were removed, the cortex is carefully dissected from the medulla, and the tissues are processed for evaluation by light microscopy, electron microscopy, immunohistochemistry and RT-PCR for RNA analysis. RESULTS: Characteristic histological changes of tacrolimus-induced nephropathy were peritubular capillary and intraglomerular capillary congestions, vacuolizations of the tubular epithelium, pericapillary focal fibrosis, and tubular atrophy. Tacrolimus- treated kidneys had a progressive increase in the expression of TGF-beta1, especially in the glomerular and interstitial capillary endothelial cells and atrophied tubular epithelial cells. TGF-beta1 mRNA is expressed persistently in tacrolimus- treated mice for 12 weeks. CONCLUSION: It can be concluded that TGF-beta1 may be involved in the fibrogenesis in the tacrolimus-induced nephropathy.
Animals ; Atrophy ; Capillaries ; Chronic Disease ; Cyclosporine ; Endothelial Cells ; Epithelial Cells ; Epithelium ; Estrogens, Conjugated (USP) ; Fibrosis ; Humans ; Immunohistochemistry ; Kidney ; Kidney Transplantation ; Male ; Mice ; Mice, Inbred ICR ; Microscopy ; Microscopy, Electron ; RNA ; RNA, Messenger ; Tacrolimus ; Transforming Growth Factor beta1 ; Transforming Growth Factors