BACKGROUND: This study aims to obtain basic data regarding the proper maintenance and potential role of humidifiers in the development of nosocomial pneumonia. We investigated into a spectrum of bacteria that grew after disinfection in humidifiers that were used in intensive care units (ICUs). The bacteria were isolated at different time points after disinfection. METHODS: We randomly selected 6 humidifiers that were used in an ICU and conducted a series of bacterial culture studies at 24 hr, 48 hr, 72 hr and 168 hr after disinfecting the six humidifiers. The fluid from the humidifider was cultured in the same manner as the dialysate. RESULTS: No bacteria were isolated in most of the 6 humidifiers 24 hr after the disinfection of the instruments. Gram-negative bacilli such as Acinetobacter baumannii, Burkholderia cepacia, and Stenotrophomonas maltophilia were cultured at 48 hr after disinfection. CONCLUSION: Regular and thorough disinfection of humidifiers is necessary to prevent possible spread of infection via humidifiers in the ICU.
Acinetobacter baumannii ; Bacteria ; Burkholderia cepacia ; Disinfection ; Critical Care ; Intensive Care Units ; Pneumonia ; Stenotrophomonas maltophilia

OBJECTIVES: the aim of this study was to evaluate plasmin system in placenta fiom women with normal and preeclamptic pregnancy. METHODS: The levels of urokinase-type plasminogen activator(uPA), tissue-type plasrninogen activator(tPA), uPA receptor(uPAR) and plasminogen activatar inhibitor-1(PAI-1) mRNAs were measured by Northern blotting in placenta hom sixteen women with normal (n""8) and preeclamptic (n""8) pregnancy. The levels of tPA protein and PAI-1 protein were also measured by Westerrn blotting. RESULTS: Densitometric measurements revealed no difference in the levels of uPA mRNA, uPAR mRNA, tPA protein and PAI-1 protein in placentas fiom normal and preeclamptic pregnancies. There was, however, a significant decrease in the level of 3.2 kb PAI-I mRNA in placentas from preeclamptic women compared to normal pregnant women. CONCLUSION: To the contrary of our expectation, 3.2 kb PAI-1 mRNA level was significantly lower in placenta from women with preeclampsia compared to normal pregnancy. This seems to reflect differential accumulation of PAI-1 mRNAs due to environmental intluences or decreased differentiation potential of villous trophoblasts to invasive trophoblasts in placenta from preeclamptic women compared to normal pregnant women. The mechanism that regulates plasmin system in human placenta needs further investigations.
Blotting, Northern ; Female ; Fibrinolysin* ; Humans ; Placenta* ; Plasminogen ; Plasminogen Activator Inhibitor 1 ; Plasminogen Activators ; Pre-Eclampsia ; Pregnancy* ; Pregnant Women ; RNA, Messenger ; Trophoblasts

Persistent trigeminal artery is an embryonic remnant of the anastomotic channel linking the internal carotid artery and the basilar artery. Cases of vertebrobasilar insufficiency caused by the persistent trigeminal artery with internal carotid artery stenosis has been described previously, but vertebrobasilar insufficiency entirely due to in situ stenosis of the persistent trigeminal artery has not been reported. A 71-year-old man presented with frequent dizzy episodes. The brain MRI showed no parenchymal lesions. MR angiography showed poor visualization of vertebrobasilar system. He was diagnosed as having vertebrobasilar insufficiency. Cerebral angiography revealed that there was complete occlusion at the vertebrobasilar junction, and the basilar artery was supplied by the persistent trigeminal artery which had severe stenosis at its origin. There was no stenosis of the internal carotid artery of both sides. We believe that this is the first report of vertebrobasilar insufficiency due to stenosed persistent trigeminal artery, without internal carotid artery stenosis.

A global increase in the incidence of tuberculosis has prompted the need for earlier diagnosis, treatment, and isolation of the disease. In tuberculosis, concomitant tuberculous meningitis and vascular complications such as intracranial aneurysms and subarachnoid hemorrhage are very rare. Because of the poor prognosis of tuberculous meningitis as well as intracranial aneurysm and subarachnoid hemorrhage, early diagnosis and management are crucial. We present the case of a 76-year-old woman who had two intracranial aneurysms complicated by subarachnoid hemorrhage, who had concomitant tuberculous meningitis. She remained well with medical management.

Eighty children who had horizontal strabismus were examined with Titmus and random-dot stereogram(TNO) for the stereoacuity. The patients were analyzed about visual acuity and types of strabismus. In addition, we also analyzed thirty three patients who received correction surgery for the strabismus for evaluation of the changes of postoperative visual acuity and its relationship to the stereoacuity. The results were as follows: 1. The stereoacuity tested by the TNO was proportional to the change of visual acuity, but that of the Titmus was not proportional. 2. The stereoacuity in the exodeviation was higher than the esodeviation. The stereoacuity in the intermittent exotropia was higher than the constant exotropia, and there was no difference in stereoacuity between the accommodative and nonaccommodative esotropia. 3. The visual acuity was improved postoperatively. 4. The postoperative stereoacuity was also improved. The patients with esodeviation showed more improvement in the stereoacuity compared with that of the patients with exodeviation.
Child* ; Esotropia ; Exotropia ; Humans ; Strabismus* ; Visual Acuity

Carotid bruit is a physical sign derived from the turbulence of carotid blood flow and has been rgarded as one of the imponant risk factor of ischemic stroke. To estimate a crude prevalence of carotid bruit in ischemic stroke in Korea at present time, and evaluate the correlation of carotid bruit with carotid stenosis and site of ischemic lesion, we investigated the brain imaging studies (computed tomography and / or magnetic resonance imaging)and cerebral angiographict finding of fifty patiens with caoti bruit.Thirty-nine (3.9 %) ot of nine hundred and ninety-six ischemic stroke patients had bruit around the carotid bifurcation. And the other eleven cases who did not have ischemic stroke were detected to have carotid bruit during the routine neurological examination at the bedside.Th presence of infarction in one side of carotid territory was not significantly differentwhether the bruit was heard or not in that side, but the presece of carotid stenosis in angiographY had a tendency to be significantly different by the audible bruit on that side. Carotid bruit does not necessarily reflect the infarction of that side, but can only be used as a predictor of ipsilateral extracranial carotid occlusive disease in this preliminary study. Further extensive prospective study is needed for the exact prevalence of rate and the clinical usefulss of the carotid bruit in Korea.
Angiography ; Carotid Stenosis ; Humans ; Infarction ; Korea ; Neuroimaging ; Neurologic Examination ; Prevalence ; Risk Factors ; Stroke

PURPOSE: The epicanthal fold in Korean children is a common cause of pseudoesotropia. Therefore, the present study was undertaken to evaluate the clinical characteristics of strabismus in children diagnosed with pseudoesotropia. METHODS: We reviewed the charts of children diagnosed with strabismus from February 2004 to January 2005. Strabismic children with a history of pseudoesotropia were included in this study. We recorded the age and chief complaints at the time of pseudoesotropia diagnosis as well as the type of strabismus, the visual acuity, chief complaints, and refractive error at the time of strabismus diagnosis. RESULTS: One hundred and two of 734 children with strabismus (13.9%) had a history of pseudoesotropia. The mean age at the time of pseudoesotropia diagnosis was 2.9 years. The mean age at the time of strabismus diagnosis was 4.4 years. The type of strabismus was exotropia in 58 (56.9%) and esotropia in 39 (38.2%) cases. Refractive accommodative esotropia was seen in 89.7% of esotropia cases and the basic type was seen in 86.2% of exotropia cases. The concurrence rate between chief complaints of pseudoesotropia and the type of strabismus diagnosed was lower in exotropia than in esotropia. There was hyperopia in all the esotropia cases, and the distribution of refractive error was variable in exotropia. The frequency of amblyopia was 19.6%. CONCLUSIONS: The incidence of strabismus is high in the case of children diagnosed with pseodoesotropia. Therefore, regular examinations for strabismus, refractive error and amblyopia may be necessary.
Amblyopia ; Child* ; Diagnosis ; Esotropia ; Exotropia ; Humans ; Hyperopia ; Incidence ; Refractive Errors ; Strabismus ; Visual Acuity

BACKGROUND: The purpose of this study is to examine whether the blood cells in the platelet concentrate (PC) and the PC arrangement method can affect the pH which is one of the important factors influencing the survival and function of the preserved PCs. METHOD: Two groups of CPDA-1 added PC were preserved at 20 ~ 24degrees C for 7 days. The PCs in group I were overlapped one another while those in group II were not overlapped and arranged separately during the preservation period. The number of RBC, WBC and platelets were measured at the first day of the preservation period while the pH was measured at the 1st, 3rd, 5th and 7th day. RESULTS: The number of blood cells in the PC was 0.6x109 for WBC, 1.6x109 for RBC and 800x109 for platelet. As for the average pH, the 1st day's average pH was 7.4 for group I and 7.3 for group II, while at the 7th day, both decreased by 0.6. According to the correlation analysis between the blood cells and the pH changes, as for group I, the more the number of platelets were, the lower the pH decreased, and as for group II, the more the WBC and platelets were, the lower the pH decreased. (p<0.01) CONCLUSION: This study indicates that the major parameter affecting the pH of the preserved PCs is the number of platelets. In addition to platelet, the number of WBCs affected the pH when PCs were overlapped during storage. Conclusionally the key factor which affects pH of stored PCs was the number of platelets. And the number of contaminated WBCs also were thought to be an important factor.
Blood Cells ; Blood Platelets* ; Hydrogen-Ion Concentration*

To evaluate croneal haze related to amount of correction, age and sex following excimer laser photorefractive keratectomy(PRK) in myopic eyes, 39months follow-up study on 358 eyes was performed prospectively. The preoperative spherical equivalent refraction ranged from -1.0D to 11.25D(mean -6.18D). The subjective corneal haze grading showed a maximum with mean grading of 0.92 at 2 months and a gradual decrease to 0.14 at 24 months after PRK. The degree of haze was statistically greater with higher amount of correction(p<0.05). No difference was found related to age and sex(p>0.05). Clinically significant corneal haze and scarring was frequent in higher myopia group(p<0.05). Individual variation in corneal haze after PRK was found. However, high myopia is a risk factor of the corneal haze following PRK, and further study to decrease the corneal haze after PRK is necessary.
Cicatrix ; Follow-Up Studies ; Lasers, Excimer* ; Myopia* ; Photorefractive Keratectomy* ; Prospective Studies ; Risk Factors

85 cases of neurosyphilis were observed in Seoul National University Hospital over 6-year period (1979-1984). They were analyzed with respect to clinical symptoms and signs in individual types, serological data in both blood and CSF, changes of cytochemical compositions in CSF, and other significant findings. And some coparisons with other reports were made. They ranged from 22 to 66 years in age with the peak incidence in the forties (41%). Ratio of male to female was observed to be 4.3:1. There were 27 cases of asymptomatic neurosyphilis (NS) (32%), 14 cases of tabes dorsalis (16%), 18 cases of general paresis (21%), 2 cases of taboparesis (2%), 7cases of vascular NS (8%), 6 cases of meningeal NS (7%), 4 cases of syphilitic eight nerve involvement (5%), 4 cases of late syphilitic ocular involvement including optic atrophy (5%), and 3 cases of spinal form (4%). Except in 4 self-referral cases, alimentary system symptoms or illnesses were the main prolbems in asymptomatic neurosyphilitics (48%). Most symptomatic cases had the similar clinical pictures as described in the previous reports but some cases appeared to be combined with symptoms and signs of different types. In tabes dorsalis, patients presented paresthesia and hypoactive DTRs in lower limbs as the most frequent features. According to predominant manifestations, there were 4 cases of dementic form and 14 cases of psychotic form in general paresis but in most cases both features overlapped each other. In 8 cases of general paresis brain CT scans were performed, which revealed diffuse cerebral atrophy in five. Focal abnormalities of vascular NS were most frequently found in temporal areas (4 in 7 cases). Meningeal irritation signs were observed only in one among 6 cases 6 meningeal NS. All cases of eighth nerve involvement showed sensorineural hearing loss at high-tone level. Compared with TPHA, which was used as a criterion for the patient selection, VDRL reactivity was 98% in serum and 49% in CSF. It is notable that as for general paresis and meningeal NS, higher reactivity and elevated titers of CSF VDRL were associated with increase of cells and total protein in CSF, suggesting higher disease activity in both types. Unlike those from other countries, the domestic studies including this report show that general paresis occupies a relatively higher proportion than tabes dorsalis in Korea.
Atrophy ; Brain ; Digestive System ; Female ; Hearing Loss, Sensorineural ; Humans ; Incidence ; Korea ; Lower Extremity ; Male ; Neurosyphilis* ; Optic Atrophy ; Paresthesia ; Patient Selection ; Seoul ; Tabes Dorsalis ; Tomography, X-Ray Computed