BACKGROUND: We evaluated the effectiveness of isolation measures using cohorting rooms and antimicrobial use in reducing the isolation rate of methicillin-resistant Staphylococcus aureus (MRSA) and multidrug-resistant Acinetobacter baumannii (MDR-AB). METHODS: Four cohorting rooms (16 beds) for patients colonized or infected with multidrug-resistant organisms (MDRO) have been created in the general wards of our 894-bed hospital since October 2003. We prospectively evaluated the isolation rates of MRSA and MDR-AB, and amount of antimicrobial use during the 8-year study period. We also investigated the relationship between antimicrobial use density (AUD) and the isolation rates of MRSA and MDR-AB. RESULTS: After creating cohorting rooms, the isolation rates of MRSA decreased from 1.56 cases per 1,000 patient-days from 2004-2005 to 1.24 from 2006-2007 (P=0.57). The isolation rates of MDR-AB also decreased from 0.72 from 2004-2005 to 0.36 from 2010-2011 (P<0.01). The mean quarterly AUDs of glycopeptides and carbapenems were 30.17+/-6.80 and 19.5+/-7.10, respectively. There were no significant correlations between AUD values and the isolation rate of MRSA or MDR-AB. CONCLUSION: This study suggests that isolation measures using cohorting rooms to help limit the transmission of MDRO infection and colonization, especially MDR-AB, in resource-limited settings is feasible and efficacious.
Acinetobacter ; Acinetobacter baumannii ; Carbapenems ; Cohort Studies ; Colon ; Drug Resistance ; Glycopeptides ; Humans ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Patient Isolation ; Patients' Rooms ; Prospective Studies

No abstract available.
Colon* ; Diverticulitis*

No abstract available.
Krukenberg Tumor*

No abstract available.
Krukenberg Tumor*

OBJECTIVE: Fibromyalgia (FM) is a rheumatic disorder characterized by widespread bodily pain, tenderness at multiple sites, and fatigue. It has a major impact on the quality of life. However, there has been no report regarding the health-related quality of life (HRQOL) in Korean patients with FM. The objective of this study was to assess the HRQOL and the correlation among each measurement and to identify the predictors for HRQOL in Korean patients with FM. METHODS: The HRQOL and clinical parameters were assessed by Short Form Health Survey-36 (SF-36), EuroQol 5 Dimensions (EQ-5D), time trade off (TTO), standard gamble (SG), Centers for Epidemiologic StudiesDepression (CES-D), social support, self-efficacy scale, Fibromyalgia Impact Questionnaire (FIQ), and tender points, respectively, from 104 outpatients with FM. RESULTS: Of the 104 subjects, 99 (95.2 %) were women with mean (+/-SD) age of 49.2 years (+/-11.1). The mean (+/-SD) years of disease onset was 8.06 (+/-7.38). The mean (+/-SD) scores of SF-36 global, mental component summary (MCS) and physical component summary (PCS) were 41.6 (+/-19.8), 47.4 (+/-25.0), and 43.5 (+/-23.7), respectively. The SF-36 GH, PCS, MCS scores of FM patients were lower than that of healthy controls (p<0.001). The mean (+/-SD) EQ-5D utility and visual analog scale (VAS) were 0.52 (+/-0.32) and 55.6 (+/-19.4). The mean (+/-SD) scores of the TTO and SG were 0.49 (+/-0.44) and 0.47 (+/-0.42). The mean (+/-SD) scores of CES-D, self-efficacy scale, social support and social network were 16.0 (+/-10.2), 55.9 (+/-19.4), 2.37 (+/-0.27), and 2.07 (+/-0.58), respectively. The mean (+/-SD) scores of FIQ was 46.4 (+/-17.7). The FIQ total score was negatively correlated with the scores of SF-36 GH, MCS, PCS, EQ-5D utility and VAS, TTO, SG, social support, social network, and self-efficacy scale (r=-0.63, r=-0.60, r=-0.48, r=-0.59, r=-0.56, r=-0.32, r=-0.27, r=-0.25, r=-0.31, r=-0.54, respectively. all p's<0.001), and positively correlated with the CES-D (r=0.67, p<0.001). In multivariate models, the predicting variables of SF-36 GH and PCS were age, FIQ, and self-efficacy and the predicting variables of SF-36 MCS were income, FIQ, and social support. CONCLUSION: These results suggest that the HRQOL in Korean patients with FM is lower than healthy subjects. In a simple correlation analysis, FIQ, CES-D, social support, and self-efficacy were meaningful variables correlated with HRQOL. In multivariate model, age, FIQ, and self-efficacy were independent variables correlated with HRQOL. Therefore, the efforts to improve HRQOL in Korean patients with FM should be designed to improve the self-efficacy and depression in addition to conventional approach.
Depression ; Fatigue ; Female ; Fibromyalgia* ; Humans ; Outpatients ; Quality of Life* ; Surveys and Questionnaires ; Visual Analog Scale

Epstein's syndrome is a rare disease whish is characterized by the association of thrombocytopenia, macrothrombocytopathia, nephritis and deafness. We experienced a case of Epstein's syndrome in a 12 years old male patient who was presented with a life long history of bleeding, usually as epistaxis, bilateral sensorineural deafness and hematuria with proteinuria starting in late childhood. Hematologic studies showed thrombocytopenia with giant platelets and anemia. A bone marrow aspirate revealed the megakaryocytes to be adequate in number and many giant size platelets. Platelet do not respond to addition of A and epinephrine; collagen and ristocetin induced agglutination response is decreased. It is difficult to be certain the association of thrombocytopenia with giant platelets, nephritis and deafness constitutes a new hereditary disease with a distinct pathogenesis or if it is an expansion of the well recognized Alport's syndrome of hereditary nephritis deafness. We report a case of Epstein's syndrome syndrome with brief review of related literatures.
Agglutination ; Anemia ; Blood Platelets ; Bone Marrow ; Child ; Collagen ; Deafness ; Epinephrine ; Epistaxis ; Genetic Diseases, Inborn ; Hematuria ; Hemorrhage ; Humans ; Male ; Megakaryocytes ; Nephritis ; Nephritis, Hereditary ; Proteinuria ; Rare Diseases ; Ristocetin ; Thrombocytopenia

The rationale for proximal tibial osteotomy is to correct the abnormal loading stresses on the knee that are caused by an abnormal tibiofemoral axis in the coronal plane. Aithough there are many methods of fixation including cast, staple and external fixation, Coventry staple has been used widely. But Coventry staple has some disadvantages such as inadequate fixation, long term cast immobilization and rehabilitation. The purpose of this study is to demonstrate the superior performance of Miniplate staple which was designed by authors(Johnson & Johnson Orthopaedics, New Milton, UK) over the conventional Coventry staple. We have analyzed the clinical results including postoperative rehabilitation course of 3I cases who had proximal tibial osteotomy fixed with Miniplate staple. Preoperative diagnosis was osteoarthritis(OA) in 24 cases(77.4%) and physiologic genu varum in 7 cases(22.6%). 1. Hospital for Special Surgery knee score was average 72.2 points preoperatively, 90.1 points postoperatively in osteoarthritis and average 94.1 points preoperatively, 99.7 points postoperativeiy in physiologic genu varum. 2. The average tibiofemoral angle was varus 5.8 degrees preoperatively and valgus 8.7 degrees postoperati vely. 3. The active ROM exercise started at 5.3 days, standing at 13.3 days, crutches ambulation at 20.2 days and ambulation without crutches at 46.3 days after operation. In conclusion, more rigid fixation and rapid mobilization was possible with newly designed Miniplate staple in proximal tibial osteotomy.
Axis, Cervical Vertebra ; Crutches ; Diagnosis ; Genu Varum ; Immobilization ; Knee ; Osteoarthritis ; Osteotomy* ; Rehabilitation ; Walking

OBJECTIVES: The reported incidence rate of varicella infection in Jeju-do is higher compared with the national average. This study aimed to examine varicella vaccination history and evaluate clinical manifestation of varicella cases in Jeju-do.METHODS: Based on the guideline suggested by the Korea Centers for Disease Control and Prevention (KCDC), two epidemic investigations for varicella infection were conducted in the first half of 2017. The history of varicella vaccination was confirmed using the Integrated Control System for Diseases and Health operated by the KCDC.RESULTS: Out of a total of 60 elementary school children as the study subjects, all had been previously vaccinated against varicella. Twenty cases (33%) showed mild clinical manifestations and no complications.CONCLUSIONS: As the government of Jeju-do has supplied a single-labeled vaccine since 2011, there is a need to evaluate the type of vaccination failure such as primary or secondary.
Centers for Disease Control and Prevention (U.S.) ; Chickenpox Vaccine ; Chickenpox ; Child ; Humans ; Immunization ; Incidence ; Jeju-do ; Korea ; Vaccination

OBJECTIVES: The reported incidence rate of varicella infection in Jeju-do is higher compared with the national average. This study aimed to examine varicella vaccination history and evaluate clinical manifestation of varicella cases in Jeju-do. METHODS: Based on the guideline suggested by the Korea Centers for Disease Control and Prevention (KCDC), two epidemic investigations for varicella infection were conducted in the first half of 2017. The history of varicella vaccination was confirmed using the Integrated Control System for Diseases and Health operated by the KCDC. RESULTS: Out of a total of 60 elementary school children as the study subjects, all had been previously vaccinated against varicella. Twenty cases (33%) showed mild clinical manifestations and no complications. CONCLUSIONS: As the government of Jeju-do has supplied a single-labeled vaccine since 2011, there is a need to evaluate the type of vaccination failure such as primary or secondary.
Centers for Disease Control and Prevention (U.S.) ; Chickenpox Vaccine ; Chickenpox* ; Child* ; Humans ; Immunization ; Incidence ; Jeju-do ; Korea* ; Vaccination*

Systolic time interval measurements were made sequentially during second, third trimesters and postpartum period. Recordings were made in the supine position after bed rest for at least five minutes in order to obtain a steady state. In second trimester, pre-ejection period index (PEPI) was significantly shortened and left ventricular ejection period index(LVETI) remained normal while PEP/LVET decreased. Four possible mechanisms may be involved to account for the alterations in hemodynamic changes during this period(late stage of second trimester) : (1) increased metabolic demands of pregnancy: (2) hemodynamic effects of hypervolemia: (3) circulatory adjustments secondary to an arteriovenous shunt-like effect of the placental circulation: (4) cardiovascular effect of steroid hormone. The third trimester was characterized-by a markedly shortened LVETI, a prolonged PEPI and PEP/LVET. This findings are consistent with impaired left ventricular performance and are probably due to decreased left ventricular preload resulting from diminished venous return secondary to inferior vena caval obstruction by the large gravid uterus. In the postpartum period, the PEPI and PEP/LVET remained elevated and the LVETI shortened in the supine position. It is concluded that alterations in systolic time intervals occur normally during the course of uncomplicated pregnancy and persist into the postpartum period.
Bed Rest ; Female ; Hemodynamics ; Humans ; Placental Circulation ; Postpartum Period* ; Pregnancy ; Pregnancy Trimester, Second ; Pregnancy Trimester, Third* ; Supine Position ; Systole* ; Uterus