BACKGROUND: This is a retrospective, descriptive study, evaluating the observed agreement between 1996 & 2002 Centers for Disease Control and Prevention (CDC) definitions of nosocomial pneumonia (NP) for medical intensive care unit (MICU) and surgical intensive care unit (SICU) patients. METHODS: A total of 476 adult patients who were over 15 years of age and had been admitted to the MICU & SICU of a university hospital between August 1, 2005 and August 1, 2007 were enrolled. Data were collected from electronic medical records according to the 1996 & 2002 CDC definitions of NP. RESULTS: According to the 1996 CDC definitions of NP, there were a total of 116 NP cases and incidence rate was 11.6 per 1,000 patient-days; when analyzed with the 2002 CDC definitions of NP, 75 cases met the criteria and the incidence rate was 7.5 per 1,000 patient-days. Kappa value measuring agreement between the two definitions was 0.67 (95% confidence interval 0.601-0.706). When 1996 CDC definitions were compared with 2002 CDC definitions, sensitivity, specificity, positive predictive value, and negative predictive value were 93.3, 88.5, 60.3, and 98.6%, respectively. CONCLUSION: Even though the aforementioned NP criteria had been applied to the same study population, the number of patients that met the definitions changed depending on which criteria had been used. Therefore, it is necessary to consider the differences when making a comparison.
Adult ; Centers for Disease Control and Prevention (U.S.) ; Electronic Health Records ; Humans ; Incidence ; Critical Care ; Intensive Care Units ; Pneumonia ; Retrospective Studies ; Sensitivity and Specificity

Vaccination has been used for the prevention and eradication of communicable diseases such as smallpox, polio, and measles. Herd immunity and immunity threshold have already been conceptualized for the prevention of outbreaks and pandemicity of these diseases. Coronavirus infectious disease-19 (COVID-19) is the second pandemic coronavirus disease of the 21st century. Vaccination has been conducted since December 2020 in an attempt to control the pandemic. The morbidity and incidence of COVID-19 has decreased since the initiation of the vaccination program within Israel, the United Kingdom, and the United States. However, irregular vaccine rollout and uneven distribution of vaccine is a major barrier to vaccine access. Moreover, genetic variants of the severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) could be a barrier to immunity.

The clinical trial was carried out with Bunazosin in 31 patients with essential hypertension. The results were as follows : 1) Before and after 1, 2, 4, 6, and 8 weeks of medications, the overall average systolic and distolic blood pressure were 166.5+/-21.8/105.7+/-10.6, 152.7+/-17.2/99.8+/-11.1, 149.5+/-18.1/98.4+/-11.7, 148.5+/-16.9/97.3+/-11.3, 148.5+/-16.7/95.6+/-10.9 and 144.0+/-14.9/94.2+/-11.1mmHg. As a result, blood pressure significantly fell within 1week of medication, and marked and moderate degree of hypetensive effect was observed within 8weeks og medication in 45% of all cases. 2) Before and after 1, 2, 4, 6, and 8weeks of medication, the overall average heart rates were 79.7+/-10.1, 78.3+/-9.1, 79.4+/-7.4, 80.8+/-8.3, 79.2+/-8.9 and 80.1+/-8.3 beats/minute. There were no significant change in heart rates before and after medication. 3) There were no significant changes in values of complete blood counts, GOT, GDT, blood urea nitrogen, serum creatinine and total cholesterol before and after medication. On the basis of these results, we observed that Bunazosin was effective hypertensive drug.
Blood Cell Count ; Blood Pressure ; Blood Urea Nitrogen ; Cholesterol ; Creatinine ; Heart Rate ; Humans ; Hypertension

PURPOSE: There has been an epidemic of measles in Korea since 2000. Therefore, we analyze the epidemiologic haracteristics of measles in Gwangju Metropolitan City. METHODS: We reviewed the epidemiologic investigation records and laboratory data of the measles patients reported in Gwangju Metropolitan City from January 1st 2000. RESULTS: 1) Demographic characteristics: Totally, 3,392 cases were surveyed and 3,300 cases were enrolled (3,300/3,392, 97.3%). Fifty-four percents of the patients were male (1,771/3,300) and forty-six percents of the patients were female (1,529/3,300). Average age of the patients was 8.20 years (8.20 5.56 years). Forty-seven percents of the patients were reported in the interval from November 2000 to December 2000 (1,582/3,298, 47.9%). 2) Clinical manifestations of the patients: Common symptoms of measles patients were fever (3,300/3,300, 100.0%), skin rash (3,068/3,300, 93.0%), cough (2,889/3,300, 87.5%), rhinorrhea (1,883/3,300, 57.1%), headache (1,445/3,300, 43.8%), conjunctival injection (1,182/3,300, 35.8%), and oral thrush (832/3,300, 25.2%). Among the patients, 250 patients had complications (250/3,300, 7.6%) and most of them were respiratory complications (220/250, 88.0%). 3) Vaccination: Eighty-six percent of the enrolled patients answered the question about vaccination (2,854/3,300, 86.4%); 808 patients were not taken a shot (808/2854, 28.3%), 1,762 patients received one dose (1,762/2,854, 61.7%), and 284 patients received additional dose (284/2,854, 9.9%). 4) Laboratory data: Laboratory confirmed cases were 780 patients (780/3,300, 23.6%); 603 cases were confirmed serologically, 185 cases were positive in PCR, and virus was isolated in 6 cases. Genetic sequencing of the isolated viruses was clade H1 and closely related to that of China. CONCLUSION: Therefore, adequate surveillance and maintenance of high coverage rate of the vaccination would be the crucial factors to eradicate measles
Candidiasis, Oral ; China ; Cough ; Exanthema ; Female ; Fever ; Gwangju ; Headache ; Humans ; Korea ; Male ; Measles* ; Polymerase Chain Reaction ; Vaccination

No abstract available.
Guillain-Barre Syndrome ; Humans ; Immunization, Passive ; Immunoglobulins

Cardiac tumors are rare. Benign myxoma is the most common among them. Malignant fibrous histiocytoma is a tumor originating from primitive mesenchymal cell and found most commonly in four extremities. Since this disease was first described by Shah in 1978, there have been a lot of case reports of cardiac malignant fibrous histiocytoma. If originating in the heart, it is usually found in left atrium which is unusual for malignant cardiac tumor. Since the advent of the echocardiography as a diagnostic tool in the cardiac disease, a lot more cases of cardiac tumor have been reported. Here, we report a case of cardiac malignant fibrous histiocytoma in a 67 year old man presenting with dyspnea who, at first sight, seemed to have benign myxoma but turned out to have malignant fibrous histiocytoma. However, strictly speaking,the case we found is a cardiac invasion of the retroperitoneal malignant fibrous histiocytoma.
Aged ; Dyspnea ; Echocardiography ; Extremities ; Heart Atria ; Heart Diseases ; Heart Neoplasms ; Heart* ; Histiocytoma, Benign Fibrous ; Histiocytoma, Malignant Fibrous* ; Humans ; Myxoma*

BACKGROUND: High risk myelodysplastic syndrome has various clinical courses and refractoriness to various therapies. It is important to analyze clinical characteristics and therapeutic responses in high risk myelodysplastic syndrome. METHODS: Sixty nine cases of primary high risk myelodysplastic syndrome at diagnosis were enrolled in this study at Kyungpook National University Hospital and Taegu Hyosung- Catholic University Hospital from January 1987 to June 1996. We have investigated the clinical characteristics and therapeutic outcomes after low dose cytarabine chemotherapy. RESULTS: 1) The median age of the patients was 48 years. Male to female ratio was 2.1:1. The each numbers of RAEB, CMML and RAEB-T patients were 38, 11 and 20, respectively. 2) The most common chief complaint was dyspnea on exertion. General weakness, fever and dizziness were also observed. The most common physical finding was pallor. 3) The peripheral blood findings showed anemia in 65 cases (94.2%), thrombocytopenia in 64 cases (92.8%), leukopenia in 32 cases (46.4%) and pancytopenia in 26 cases (37.7%). 4) Twenty two cases transformed to acute myelogenous leukemia during the follow-up periods. Chemotherapy was done in 18 cases among 22 cases of transformed acute myelogenous leukemia. Complete remission was achieved in 3 cases (16.7%), partial remission in 4 cases (22.2%) and no response in 11 cases (61.1%). 5) Forty seven cases were treated by low dose cytarabine chemotherapy. Complete response was achieved in 11 cases (23.4%), partial response in 13 cases (27.7%) and no response in 23 cases (48.9%). Median duration of complete response was 12 weeks. 6) We made score system, which based on Sanz score and Gattermann score, according to age, hemoglobin, platelet and bone marrow blast. Overall survival was higher in group A (score< or = 5) than group B (score> or = 6). Complete response of low dose cytarabine chemotherapy was higher in group A than group B but overall survival according to low dose cytarabine chemotherapy was not different in group A and group B. CONCLUSION: Low dose cytarabine chemotherapy was not effective in survival benefit. Score system according to prognostic factors was important to predict therapeutic response and prognosis. In the future, more intensive therapeutic plan and analysis of prognostic factors should be considered.
Anemia ; Anemia, Refractory, with Excess of Blasts ; Blood Platelets ; Bone Marrow ; Cytarabine* ; Daegu ; Diagnosis ; Dizziness ; Drug Therapy ; Dyspnea ; Female ; Fever ; Follow-Up Studies ; Gyeongsangbuk-do ; Humans ; Leukemia, Myeloid, Acute ; Leukopenia ; Male ; Myelodysplastic Syndromes* ; Pallor ; Pancytopenia ; Prognosis ; Thrombocytopenia

PURPOSE: The administration of 5-fluorouracil (5-FU) by protracted intravenous infusion is an alternative to the bolus administration of 5-FU in patients with advanced colorectal cancers. This study was performed to evaluate the response rate and toxicities of protracted infusion of 5-FU in patients with advanced or recurrent colorectal cancers who had been treated with 5-FU by bolus or shortterm continuous administration. MATERIALS AND METHODS: Between March 1995 and June 1997, twenty-eight patients with advanced colorectal cancer previously exposed to 5-FU based chemotherapy were enrolled in this triaL Patients received 5-FU (250 mg/m(2)/day days 1-28) or 5-FU plus leucovorin (5-FU; 200 mg/m/day days 1-28, leucovorin; 20 mg/m IV days 1, 8, 15, 21) by ambulatory infusion pump. Treatment course was repeated every 42 days until disease progression. RESULT: Twenty-eight patients entered. All 28 patients were assessable for response and toxicity. Five (19%) patients achieved a partial response, with the median response duration of 15 weeks (range; 7-22 weeks), and median survival time of entire patients was 54 weeks (range 7-151+ weeks). Gastrointestinal toxicity, specifically stomatitis was a major toxicity (grade 2, 12%; grade 3, 4%), but hand-foot syndrome was less frequent (5%) compared with other trials with protracted infusion of 5-FU reported in the literature. Hematologic toxicity was generally of low grade. CONCLUSION: Prolonged intravenous infusion of 5-FU can produce a response rate of 19% with low toxicity among patients refractory to bolus or short-term infusion of S-FU.
Colorectal Neoplasms* ; Disease Progression ; Drug Therapy* ; Fluorouracil* ; Hand-Foot Syndrome ; Humans ; Infusion Pumps ; Infusions, Intravenous ; Leucovorin ; Stomatitis

Phytobezoar is rare disease in the stomach and small bowel of the patient without underlying previous gastroenterologic pathology. Because it usually occurs secondarily to peptic ulcer surgery, poor mastication, diabetes mellitus, hypothyroidism and connetive tissue disease. In morden medicine, phytobezoars found in the stomach and/or intestines in humans, are known to be associated with considerable morbidity and even mortality. Patients with gastric bezoar present with chronic postprandial epigastic pain, nausea, and vomitihg. It is diagnosed by endoscopic examination or radiologic study and treated by surgical removal or non-surgical methods including conservative treatment, enzymatic dissolution, and endoscopic removal. We have experienced a case of small intestinal obstruction due to a fragment of gastric bezoar of the patient without underlying etiologic cause. So we report the case with a brief review of literatures.
Bezoars ; Diabetes Mellitus ; Humans ; Hypothyroidism ; Intestinal Obstruction* ; Intestines ; Mastication ; Mortality ; Nausea ; Pathology ; Peptic Ulcer ; Rare Diseases ; Stomach

Amniotic fluid embolism is rare but is one of the most catastrophic complications in the peripartum period. This syndrome is caused by a maternal anaphylactic reaction to the introduction of fetal material into the pulmonary circulation. When amniotic fluid embolism is suspected, the immediate application of extracorporeal mechanical circulatory support such as veno-arterial extracorporeal membrane oxygenation (ECMO) or cardiopulmonary bypass should be considered. Without the application of extracorporeal mechanical circulatory support, medical supportive care might not be sufficient to maintain cardiopulmonary stabilization in severe cases of amniotic fluid embolism. In this report, we present the case of a 36-year-old pregnant woman who developed an amniotic fluid embolism immediately after a cesarean section. Her catastrophic event started with the sudden onset of severe hypoxia, followed by circulatory collapse within 8 minutes. The veno-arterial mode of extracorporeal membrane oxygenation was initiated immediately. She was successfully resuscitated but with impaired cognitive function. Thus, urgent ECMO should be considered when amniotic fluid embolism syndrome is suspected in patients presenting acute cardiopulmonary collapse.
Adult ; Amniotic Fluid* ; Anaphylaxis ; Anoxia ; Cardiopulmonary Bypass ; Cesarean Section ; Cognition ; Embolism, Amniotic Fluid* ; Extracorporeal Membrane Oxygenation* ; Female ; Humans ; Peripartum Period ; Pregnancy ; Pregnant Women ; Pulmonary Circulation ; Shock