BACKGROUND: Rapid screening of vancomycin-resistant enterococci (VRE) is very important for controlling and preventing the spread of VRE in hospitals. We compared the performance characteristics of a chromogenic agar (ChromID VRE, bioMerieux, France: CA) to that of Enterococcosel agar (supplemented with 6 microgram/mL of vancomycin :EA) for direct detection of VRE from stool swabs. METHODS: Total 125 rectal swabs were collected from 57 patients in the intensive care units of an 850-bed university hospital over a period of 3 months. The samples were inoculated on EA, CA and into broth enrichment containing 6 microgram/mL of vancomycin (BE). BE was subcultured on CA after overnight incubation. RESULTS: Eighty two samples from 22 patients were positive for VRE by BE. At 24 h, the sensitivity/specificity of EA and CA were 89%/100% and 72%/100%, respectively. At 48 h, the sensitivity/specificity of EA and CA were 94%/89% and 89%/100%, respectively. CONCLUSION: CA provides equivalent sensitivity comparable to EA for the recovery of VRE at 48 h incubation, and has additional advantage of being able to differentiate between vancomycine resistant E. faecium and E. faecalis.
Agar ; Humans ; Imidazoles ; Intensive Care Units ; Mass Screening ; Nitro Compounds ; Vancomycin

Septic arthritis is rarely caused by anaerobic bacteria, which is mostly secondary to hematogenous dissemination among the immunocompromised host. We report a patient of septic arthritis on the right knee joint caused by Bacteroides thetaiotaomicron. To the best of knowledge, this is the first report of septic arthritis caused by Bacteroides spp. in Korea.
Arthritis, Infectious* ; Bacteremia* ; Bacteria, Anaerobic ; Bacteroides* ; Humans ; Immunocompromised Host ; Knee Joint ; Korea ; Multiple Myeloma*

BACKGROUND: Impairments of language function represent patients with Alzheimer's disease (AD) from the early stage and as the disease progresses the damage spreads over a much broader range of cognition and communicative functions. And, performances of the naming tasks in AD patients may reveal the gradual deterioration of their naming ability. METHODS: In this study, naming ability was studied in patients with questionable AD (CDR 0.5, n=10), mild AD (CDR 1, n=10), moderate AD (CDR 2, n=10) and 10 healthy controls matched for age, gender and educational level using confrontation naming and naming by verbal definition tasks. The purpose of present study was 1) to investigate whether the confrontation naming and naming by verbal definition in Alzheimer's disease is different depending on the severity, 2) to examine the effects of the syllabic cue on the two naming ability for the errors questions. RESULTS: The results from this study are as follow: 1) The two naming performances of the all AD groups were lower than those of normal people and showed significant difference. 2) There were differences between the two naming tasks, significantly lower performance on confrontation naming task than naming by verbal definition. 3) The effects of syllabic cue decreased gradually as severity progressed. 4) The effects of syllabic cue were no significant differences between the two naming tasks. CONCLUSIONS: The results suggest that anomia in patients with AD is due to various impairment including to lexico-semantic system, visual processing, phonological processing and auditory comprehension.
Alzheimer Disease ; Anomia ; Cognition ; Comprehension ; Cues ; Humans

METHODS: We investigated and compared the epidemiologic characteristics of the E. cloacae isolation in the period of outbreak (April-June, 1998) with those in the control period (January-March, 1998). To identify the risk factors for E. cloacae sepsis, we retrospectively conducted a chart review for the patients who had E. cloacae sepsis during the period of outbreak. On the basis of these results, environmental culture was performed hospital wide. RESULTS: Ten clinical isolates E. cloacae were recovered from the blood of ten patients from April to June. 1998. Seven out of 10 patients recieved ERCP procedure just before E. cloacae sepsis. Hence, we performed surveillance study in the endoscopy room before and after the procedure. The survey showed that distilled water which was used for washing the endoscopy was contaminated with E. cloacae, which was suspected to be the common source of this outbreak. Therefore, we changed distilled water into sterilized distilled water on washing the endoscopy. After this correction was performed, the incidence of ERCP-associated E. cloacae sepsis declined markedly (P<0.011). CONCLUSION: We investigated an outbreak of ERCP-related E. cloacae sepsis and the outbreak was successfully controlled by removing the source of infection.
Cholangiopancreatography, Endoscopic Retrograde* ; Cloaca ; Endoscopy ; Enterobacter cloacae* ; Enterobacter* ; Humans ; Incidence ; Methods ; Retrospective Studies ; Risk Factors ; Sepsis* ; Water

BACKGROUND: Vibrio parahaemolyticus belonged to the new 03:K6 serotype was demonstrated an unusual potential to spread and an enhanced propensity to cause infection in the worldwide. Recently, increased numbers of V. parahaemolyticus 03:K6 had been isolated in Korea, and we analyzed the prevalence and molecular genetic characteristics of V. parahaemolyticus 03:K6 isolates. METHODS: V. parahaemolyticus were isolated from clinical specimens of patients with diarrhea in Hanyang University Hospital, Seoul, Korea, from 1998 to 2005. The serovars of isolates were determined by slide agglutination test with specific antisera. All isolates were examined for the presence of tdh/trh genes. AGS-PCR method detecting the new 03:K6 clone was used in this study. We analyzed clonality of these isolates by infrequent restriction site-polymerase chain reaction (IRS-PCR). RESULTS: Thirty-six strains were isolated from 1998 to 2005. The main serotype of isolates were 03:K6 (24/36: 67%), All of them have tdh gene but not trh gene and an unique toxRS gene of the new 03:K6. The morphotypes of 03:K6 isolates show a same pattern of IRS-PCR, but can easily be differentiated from non-03:K6 and 04:K68 isolates. CONCLUSION: The 03:K6 was a main serotype of V. parahaemolyticus isolated from 1998 to 2005 and they show same molecular characteristics.
Agglutination Tests ; Clone Cells ; Diarrhea ; Humans ; Immune Sera ; Korea ; Molecular Biology* ; Prevalence* ; Seoul ; Vibrio parahaemolyticus* ; Vibrio*

Purpose: The purpose of this study is to investigate the effect of work environment on health problems of nurses. Methods: The subjects of the study were 395 nurses who were wage workers among KWCS (Korean Working Conditions Survey) respondents in 2014. The work environments were measured by the KWCS questionnaire. Results: 48.5% of the 395 nurses had health problems. The prevalence of musculoskeletal diseases (34.7%) was the highest among all health problems. The ergonomic work environment was significantly related to musculoskeletal disorders, headache and eye strain, and fatigue. In addition, the increase in work-individual interface area was significantly related to fatigue. Conclusion The work environment of nurses affects health problems. It is therefore important to develop strategies that improve the health problems of nurses by reducing ergonomic and psycho-social risk factors.

The change in people's dietary life has led to an increase in an intake of processed foods and food chemicals, raising awareness about taste education for preschoolers whose dietary habits start to grow. This study aims to evaluate the effectiveness and satisfaction of parents and childcare personnel after developing a taste education program and demonstrating it in class. A part of the curriculum developed by Piusais and Pierre was referred for the program. After educating 524 preschoolers in child care facilities in Seoul, a satisfaction survey was conducted on the program. The data in this study were analyzed using SPSS 14.0. Statistical analysis was conducted based on the frequency after collecting the data. Mean +/- SD used to determine satisfaction with taste education, with preferences marked on a five-point scale and the alpha was set at 0.05. The program includes five teachers' guides with subjects of sweetness, saltiness, sourness, bitterness and harmony of flavor, and ten kinds of teaching tools. For the change in parents' recognition of the need for taste education based on five-point scale, the average of 4.06 +/- 0.62 before the program has significantly increased to 4.32 +/- 0.52 (P < 0.01). Regarding the change in the preferences for sweetness, saltiness, sourness, and bitterness, the average has increased to 3.83 +/- 0.61, 3.62 +/- 0.66, 3.64 +/- 0.66, and 3.56 +/- 0.75 respectively. In an evaluation of instructors in child care facilities, the average scores for education method, education effect, education contents and nutritionists, and teaching tools were at 4.15 +/- 0.63, 3.91 +/- 0.50, 4.18 +/- 0.50, and 3.80 +/- 0.56 respectively. In addition, the need for a continuous taste education scored 4.42 +/- 0.67. This program has created a positive change in preschoolers' dietary life, therefore the continuation and propagation of the taste education program should be considered.
Child ; Child Care ; Curriculum ; Food Habits ; Humans ; Parents

Human immunodeficiency virus (HIV) is one of the less common triggers of secondary hemophagocytic lymphohistiocytosis (HLH) in which coagulation disorder is a frequent manifestation. Here, we present a case of HIV-triggered secondary HLH presenting with severe bleeding tendency and fever. Despite high-dose dexamethasone infusion (10 mg/body surface area/day), progressive disseminated intravascular coagulation and thrombocytopenia resulted in massive hemathochezia: the bleeding episode ceased after endoscopic hemoclipping. After then, he took a highly-active antiretroviral therapy (HAART). Eventually, body temperature and overall laboratory findings normalized in response to HAART.Clinicians should not overlook HIV infection as a possible trigger of secondary HLH. In such cases, HAART is the core treatment.

BACKGROUND: According to previous investigation on antibiotic use at Dankook University Hospital, cephalosporin and aminoglycoside were the most commonly used antibiotics accounting for 52.8% and 30.4% of total antibiotics used, respectively. In almost all cases, antibiotics were prescribed for prophylaxis rather than for treatment the ratio for prophylaxis vs. treatment intent was 3.9:1 and 3.6: 1 for cephalosporin and aminoglycoside, respectively. Thus, we performed a study to investigate the current usage of cephalosporin and aminoglycoside before and after the surgical procedures. METHODS: We retrospectively analyzed the appropriateness of prophylactic use of antibiotics on 14 major operative procedures (26.4% of total operations) for patients discharged during July, 1997. RESULTS: Among 8 kinds of operative procedure performed on 105 cases, in which prophylactic antibiotic use was recommended, appropriate antibiotic use was observed in only 2 cases of non- perforating appendectomy. For 7 operative procedures, in which use of 1st generation cephalosporin is recommended, 1st cephalosporins were used only on 37.8% (44/92) of cases, whereas 2nd cephalosporins were used for most of other cases. An average of 2.5 DDD of 2nd cephalosporin, which was a pertinent dose, was used on non-perforating appendectomy. However, on all the other 7 operative procedures, the dose exceeded the recommended dose. Inappropriate antibiotic use was observed for 6 operative procedures, for which prophylactic antibiotic use was not recommended. The combination of cephalosporin and aminoglycoside was used in all but 3 types of operative procedures. CONCLUSION: During most of the pre- and post-operative period, antibiotics were combined, overused, misused, and inappropriately used.
Aminoglycosides* ; Anti-Bacterial Agents ; Appendectomy ; Cephalosporins* ; Dichlorodiphenyldichloroethane ; Humans ; Retrospective Studies ; Surgical Procedures, Operative

BACKGROUND: According to previous investigation on antibiotic use at Dankook University Hospital, cephalosporin and aminoglycoside were the most commonly used antibiotics accounting for 52.8% and 30.4% of total antibiotics used, respectively. In almost all cases, antibiotics were prescribed for prophylaxis rather than for treatment the ratio for prophylaxis vs. treatment intent was 3.9:1 and 3.6: 1 for cephalosporin and aminoglycoside, respectively. Thus, we performed a study to investigate the current usage of cephalosporin and aminoglycoside before and after the surgical procedures. METHODS: We retrospectively analyzed the appropriateness of prophylactic use of antibiotics on 14 major operative procedures (26.4% of total operations) for patients discharged during July, 1997. RESULTS: Among 8 kinds of operative procedure performed on 105 cases, in which prophylactic antibiotic use was recommended, appropriate antibiotic use was observed in only 2 cases of non- perforating appendectomy. For 7 operative procedures, in which use of 1st generation cephalosporin is recommended, 1st cephalosporins were used only on 37.8% (44/92) of cases, whereas 2nd cephalosporins were used for most of other cases. An average of 2.5 DDD of 2nd cephalosporin, which was a pertinent dose, was used on non-perforating appendectomy. However, on all the other 7 operative procedures, the dose exceeded the recommended dose. Inappropriate antibiotic use was observed for 6 operative procedures, for which prophylactic antibiotic use was not recommended. The combination of cephalosporin and aminoglycoside was used in all but 3 types of operative procedures. CONCLUSION: During most of the pre- and post-operative period, antibiotics were combined, overused, misused, and inappropriately used.
Aminoglycosides* ; Anti-Bacterial Agents ; Appendectomy ; Cephalosporins* ; Dichlorodiphenyldichloroethane ; Humans ; Retrospective Studies ; Surgical Procedures, Operative