Thirty patient with essential hypertension were administered Manidipine, a new calcium antagonist, 10~20mg once daily to evaluate the hypotensive efficacy and safety for 8 weeks. And the followings were the result. 1) Patients were consists of 14 male, 16 female, aged 53 in average and classified as mild in 21 and moderate in 9 patients. 2) Optimum intial dose was 10mg and 10 to 20mg were the doses recommended. 3) Blood pressure dropped after 8 weeks 24/13mmHg in average, rewarding 80% effectiveness and normalized in 87%. 4) Most frequent side reaction was facial flushing in 5 patiens followed by palpitation and dizziness, all of which did not disturb the continuation of medication. 5) Most of routine laboratory parameter were normal and unchanged between before and after the trial. 6) Overall rating of usefulness was 77%. In conclusion, Manidipine 10 to 20mg once daily regimen is well tolerated and effective in the treatment of mild to moderate essential hypertension.
Blood Pressure ; Calcium ; Dizziness ; Female ; Flushing ; Humans ; Hypertension* ; Male ; Reward

Anti-E and anti-c is one of the clinical significant irregular antibodies developing a delayed hemolytic transfusion reaction and hemolytic disease of the newborn. Since anti-c occurs frequently with anti-E in immunized people whosoe cells are E-and c-, it has been recommended to select blood of the patient's own R1 phenotype for transfusion, even when the presence of anti-c cannot be demonstrated in his/her serum. To determine the utility of this approach, we reviewed the blood bank laboratory records of patients identified anti-E and anti-c in his/her serum in Severance hospital over a 12 year period (1985-1996). During the 12-year period of study, 53 patients were identified with anti-E and/or anti-c; 30(56.6%) patients had anti-E alone, 6(11.3%) had anti-c, and 17(32.1%) had both. Thirty eight of forty two patients whose Rh-hr phenotypes were tested were R1R1. Of these 38 R1R1 patients, 16 patients (42.1%) presented with anti-c concomitant with anti-E. Ouru study showed that the incidence of antni-c in R1R1 patients with anti-E is similar to that of studies reported in Caucasian groups. We highly suggest the transfusion protocol of prophylactic use of c negative blood for R1R1 patients with anti-E. Furthermore, because anti-c may be present in concentrations too low to be detected, the enzyme technique is recommended in parallel with standard serologic methods for the identification of irregular antibodies.
Antibodies ; Blood Banks ; Blood Group Incompatibility ; Humans ; Incidence ; Infant, Newborn ; Phenotype

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

No abstract available.
Gram-Positive Bacterial Infections* ; Teicoplanin*

PURPOSE: Herpes zoster appears in all ages and its incidence progressively increase. It is more common in elderly people or immunocompromised people and can be accompanied by serious complications. This study was performed to investigate the clinical manifestation of herpes zoster according to immune status in children. METHODS: This study was retrospectively included 307 children under 18 years who were diagnosed and treated with herpes zoster at Inha University Hospital from 1997 to 2017 based on medical records. These patients were divided into two groups according to their immunity and their clinical features were compared. RESULTS: The mean age of the total 307 patients was 10.2 years, 151 (49.2%) in males. Eighty-seven patients were hospitalized and 220 patients were treated in an outpatient clinic. Most patients received antiviral treatment. The most common dermatomal distribution of the skin lesion was the thoracic region, followed by trigeminal, lumbar and sacral, cervical region. Twenty-one patients were immunocompromised and fifteen of them were hematologic disorders. Admission rate, history of chickenpox and mean duration of treatment were significantly higher in immunocompromised group (P < 0.05). There was no significant difference in age, dermatomal distribution and complication between the two groups. Complications were observed in 50 cases and more than half of them were zoster ophthalmicus. Another complication was Ramsay-Hunt syndrome, meningitis and skin infection. CONCLUSION: Immunocompromised patients had a longer duration of treatment and a higher history of chickenpox. The incidence of complications, dermatomal distribution and age did not differ from that of immunocompetent children.
Adolescent ; Aged ; Ambulatory Care Facilities ; Chickenpox ; Child* ; Herpes Zoster* ; Humans ; Immune System ; Immunocompromised Host ; Incidence ; Male ; Medical Records ; Meningitis ; Retrospective Studies ; Skin

No abstract available.
Humans*

BACKGROUND: Hybrid coronary revascularization (HCR) was developed to combine the advantages of coronary artery bypass graft (CABG) with percutaneous coronary intervention (PCI). However, it is still controversial whether it is more optimal to perform CABG or PCI first. The purpose of this study was to compare the clinical outcomes of these 2 approaches. METHODS: Eighty patients who underwent HCR from May 2010 to December 2015 were enrolled in this retrospective analysis. The CABG-first group comprised 12 patients and the PCI-first group comprised 68 patients. Outcomes of interest included in-hospital perioperative factors, major adverse cardiac and cerebrovascular events (MACCEs), and the incidence of repeated revascularization, especially for the target vessel lesion. RESULTS: No significant difference was found in the amount of postoperative bleeding (p=0.239). The incidence of MACCEs was similar between the CABG-first and PCI-first groups (1 of 12 [8.3%] vs. 5 of 68 [7.4%], p>0.999). Repeated revascularization was performed on 3 patients (25%) in the CABG-first and 9 patients (13.2%) in the PCI-first group (p=0.376). CONCLUSION: There were no significant differences in postoperative and medium-term outcomes between the CABG-first and PCI-first groups. Based on these results, it can be inferred that it is safe to opt for either CABG or PCI as the primary procedure in 2-stage HCR.
Coronary Artery Bypass* ; Coronary Artery Disease ; Coronary Vessels* ; Hemorrhage ; Humans ; Incidence ; Percutaneous Coronary Intervention ; Retrospective Studies ; Transplants

INTRODUCTION: To prevent hemodialysis-related infections, it is important to maintain hemodialysis system without microbial contamination. In May 2003, routine surveillance showed that dialysis water from dialysis port was contaminated with bacteria. To identify the causes of the contamination, we conducted an investigation as follows. METHODS: Patients undergoing dialysis were carefully monitored to see whether evidences of pyrogenic reactions or infections were present. Factors that could have influence on bacterial contamination in hemodialysis systems were thoroughly examined. In addition, microbiologic surveillances were done 7 times in 1 month. RESULTS: Although pyrogenic reactions or bacteremia did not occur, R. pickettii was repeatedly isolated above the Association for the Advancement of Medical Instrumentation (AAMI) standards from almost all dialysis units. Bacterial counts of specimens were higher in the proximal part of the water supply tube than the other parts in all dialysis machines. The colony count of R. pickettii exceeded the maximum level of technical limit in the specimens collected from the dialysis machines in the early morning after intermission of 48 hours. The structure of the supply tube was suspected as the origin of the colonization because stagnant water is a reservoir for bacterial multiplication. After remodeling the structure of the water supply tube, neither R. pickettii nor any other bacteria were isolated. CONCLUSION: Our investigation successfully identified the source of R. pickettii contamination of reverse osmosis water. Appropriate corrective measures for water distribution systems of hemodialysis center could prevent outbreak of dialysis-associated illnesses.
Bacteremia ; Bacteria ; Bacterial Load ; Colon ; Dialysis ; Humans ; Osmosis ; Ralstonia ; Ralstonia pickettii ; Renal Dialysis ; Water ; Water Supply

In 2007, the Korean Society of Infectious Diseases recommended an immunization schedule for adults residing in Korea. This recommendation includes four categories: standard immunization for healthy persons, supplementary immunization for persons with underlying illnesses, recommendations for health-care personnel and for international travelers. The Standard Immunization Schedule consists of universal vaccination (tetanus-diphtheria/tetanus-diphtheria-pertussis (Td/Tdap); hepatitis A vaccine for persons aged 20s; human papilloma virus vaccine for women under 26 years old; meningococcal vaccine for military recruits and college students in dormitories; influenza vaccination for persons aged 50 years or more and pregnant women; and pneumococcal vaccination for persons aged 65 years or more) and catch-up vaccination (hepatitis A vaccine for persons aged 30s; hepatitis B vaccine, varicella and MMR vaccines for persons who have uncertain specific immunities). The Supplementary Immunization Schedule recommends 4 vaccines, i.e., pneumococcal, influenza, meningococcal, and Haemophilus influenzae type b, appropriate to the underlying illnesses, and confirmation of the presence of antibodies to hepatitis A and hepatitis B. The Recommendation for Health-Care Personnel includes universal vaccination (influenza and pertussis) and catch-up vaccination (hepatitis B, measles-mumps-rubella and varicella for seronegative health-care personnel). The Recommended Immunization for International Travelers focuses reinforcement of vaccinations for healthy persons and includes certain immunizations necessary for international travel (yellow fever, meningococcal, plaque, tick-borne encephalitis, and cholera). These guidelines can be seen at www.ksid.or.kr.
Adult ; Aged ; Antibodies ; Chickenpox ; Collodion ; Communicable Diseases ; Encephalitis, Tick-Borne ; Female ; Fever ; Haemophilus influenzae type b ; Hepatitis A ; Hepatitis A Vaccines ; Hepatitis B ; Hepatitis B Vaccines ; Humans ; Immunization ; Immunization Schedule ; Influenza, Human ; Korea ; Meningococcal Vaccines ; Military Personnel ; Papilloma ; Reinforcement (Psychology) ; Vaccination ; Vaccines ; Viruses