BACKGROUND: This study was undertaken to compare nosocomial infection rates between intensive care units of military and civilian hospitals. METHODS: From July to December 2000, we surveyed the intensive care unit of Armed Forces Capital Hospital (AFCH). We compared device use ratios and device-day infection rates with those of Korean Society for Nosocomial Infection Control (KOSNIC) and National Nosocomial Infections Surveillance (NNIS) system. RESULTS: During the period of study, 185 cases were admitted and 24 nosocomial infections were detected: 7 cases of pneumonia, 6 urinary tract, 3 blood stream, 3 cardiovascular system, 3 surgical site infections, 1 skin and soft tissue, and 1 central nervous system infection. Ventilator, urinary catheter and central venous catheter use ratios were 0.14 (95% confidence interval, 0.12-0.16), 0.58 (0.56-0.60) and 0.33 (0.31-0.35). The ratios of NNIS were 0.41, 0.67 and 0.50. Ventilator-, urinary catheter- and central venous catheter-day infection rates were 18.69(11.36-53.32), 6.65 (3.36-14.20) and 1.95 (1.44-9.92). However, the rates of KOSNIC were 9.93, 5.29 and 3.62. The rates of NNIS were 11.24, 6.14 and 5.55. CONCLUSIONS: In AFCH ventilators were used less frequently than NNIS, but more ventilator-associated pneumonia were developed than KOSNIC and NNIS.
Arm ; Cardiovascular System ; Central Nervous System Infections ; Central Venous Catheters ; Cross Infection* ; Hospitals, Military ; Humans ; Intensive Care Units* ; Critical Care* ; Military Personnel* ; Pneumonia ; Pneumonia, Ventilator-Associated ; Rivers ; Skin ; Urinary Catheters ; Urinary Tract ; Ventilators, Mechanical

Human cytomegalovirus (HCMV) isolated from Korean patients is different in the antigenic and genomic structure of gB from the laboratory-adapted strain. To dissect the reactivity to HCMV glycoprotein B (gB) domains, each domain gene of gB of HCMV SNUCH1, Korean isolate, was amplified from the extracted DNA of the virus-infected fibroblasts with the specific primers by polymerase chain reaction (PCR). Amplified DNA was cloned into pcDNA3. Immunofluorescent staining and western blot analysis revealed that the expressed gB in mammalian cells was immunoreactive and equivalent to the naturally expressed gB in virus-infected fibroblasts. The antigenic component reactive with monoclonal antibodies, MCMVA 57, 88, and 98 appeared at the D3 domain of gB molecule, and that with MCMVA 66 and 135 at the D2b domain. Antibody titer was measured with HCMV-infected fibroblasts and the domains of gB expressed in mammalian cells. There was no correlation between the antibody titer to the whole HCMV and neutralizing antibody titer, and between the antibody titer to whole HCMV and whole gB. It was more reasonable to use whole gB than whole HCMV in the comparison with the neutralizing antibody titer. D3 was representative domain in gB molecule in the anti-gB reactivity. Conclusively it is highly recommendable to use the representing isolates in Korea and its domains for the detection of antibody or the analysis of antigen in the aspect of immunological properties and molecular structures.
Antibodies, Monoclonal ; Antibodies, Neutralizing* ; Blotting, Western ; Clone Cells ; Cytomegalovirus* ; DNA ; Epitopes* ; Fibroblasts ; Glycoproteins ; Humans* ; Korea* ; Molecular Structure ; Polymerase Chain Reaction

No abstract available.
Classification* ; Humans ; Spinal Cord* ; Urodynamics*

Cleft Lip ; Congenital Abnormalities ; Humans ; Palate ; Rhinoplasty

BACKGROUND: The diagnosis of malaria has been usually made using microscopic examination of Wright stained thin blood films in Korean army. This method is labor-intensive, time consuming and requires the microscopic expertise. Therefore, the alternative techniques, rapid diagnostic test, have been sought for use in Korean army. We performed a comparison of the OptiMAL test with GENEDIA Malaria (P. vivax) Ab Rapid I, II to assess its sensitivity and specificity of Plasmodium vivax malaria. METHODS: Blood specimen were collected from 51 patients who were presented and initially diagnosed for P. vivax by the microscopy of blood smears and from 30 control patients without malaria infection at the Capital Armed Forces General Hospital (CAFGH) between October 2000 and February 2001. Among the 51 patients, we also collected 24 samples from 24 patients at 2 or 3 days after therapy. The OptiMAL test and GENEDIA Malaria (P. vivax) Ab Rapid I, II were performed according to the manufacturer's instructions on all samples respectively. RESULTS: Compared with the blood film, sensitivities and specificities of the OptiMAL test, GENEDIA Malaria (P. vivax) Ab Rapid I and GENEDIA Malaria (P. vivax) Ab Rapid II were 94.1~100% (29/29), 80.4~83.3%, 96.1~96.7% respectively. One case was interpreted as 'undetermined' by OptiMAL test. In 24 patients during therapy, the sensitivities of the OptiMAL test, GENEDIA Malaria (P. vivax) Ab Rapid I and GENEDIA Malaria (P. vivax) Ab Rapid II on 8 specimens with mean 120/microliter parasitemia and 16 specimens with negative parasitemia were 75~43.8%, 87.5~81.3%, 100~100% respectively. CONCLUSION: Our data demonstrated that the sensitivity and specificity of the GENEDIA Malaria (P. vivax) Ab Rapid I were not satisfactory, but the sensitivity and specificity of the OptiMAL test and GENEDIA Malaria (P. vivax) Ab Rapid II were relatively high and useful diagnostic tests for diagnosis of P. vivax in areas like the militaries where laboratory facilities are poor or non-existent.
Arm ; Diagnosis* ; Diagnostic Tests, Routine ; Hospitals, General ; Humans ; Malaria* ; Malaria, Vivax ; Microscopy ; Military Personnel* ; Parasitemia ; Plasmodium vivax* ; Plasmodium* ; Sensitivity and Specificity

BACKGROUND: The Technicon Immuno I utilizes various enzymatic kinetic analysis with colorimetric detection and magnetic particles. We evaluated this fully automated random-access immunoassay system which can perform latex agglutination and magnetic-separation sandwich/ competitive immunoassay. METHODS: We evaluated the assay precision, lower limits of detection, linearity, recovery, sample to sample carry-over, analytical interferences and comparison with other various methods for the following analytes: thyroxine (T4), thyroid stimulating hormone (TSH), free thyroxine (FT4), luteinizing hormone (LH), follicular stimulating hormone (FSH), prostate specific antigen (PSA), alpha-fetoprotein (AFP), carcino-embryonic antigen (CEA), CA 19-9, and digoxin. RESULTS: Satisfactory results were obtained for within-run and between-day precision in most analytes. Lower limits of detection were slightly higher than claimed by the manufacturer. The linearity was acceptable, but there were proportional errors for CEA and FT4. The recovery rates were also good except for PSA. Sample to sample carry-over was not detected. No significant analytical interference was caused by hemoglobin (up to 2,000 mg/L), lipid (up to 85 mmol/L) and bilirubin (up to 325 mol/L) except for digoxin, FT4 and PSA. The Technicon Immuno I assay correlated well with the comparison methods in most analytes, but the proportional biases were found for PSA and LH. CONCLUSIONS: The Technicon Immuno I is a satisfactory system for clinical use in most cases but more study would be requried for FT4. Especially, this system can replace the radioimmunoassay for FSH and LH.
Agglutination ; alpha-Fetoproteins ; Bias (Epidemiology) ; Bilirubin ; Digoxin ; Immunoassay* ; Latex ; Limit of Detection ; Luteinizing Hormone ; Prostate-Specific Antigen ; Radioimmunoassay ; Thyrotropin ; Thyroxine

BACKGROUND: Automated border detection (ABD) echocardiography is a convenient and objective tool in the estimation of left atrial (LA) area and function when compared to the off-line, two-dimensional echocardiographic method that requires manual tracing of the endocardial border. In addition, the applicability of the ABD system to instantaneously derive LA area and function may provide a noninvasive method to assess the diastolic interaction between the left ventricle and the left atrium. METHOD: 53 patients with a normal sinus rhythm and an apical four chamber view of LA area (in which at least 75% of the endocardium was clearly visible) were selected for this study. The on-line echocardiographic assessment of LA areas and function with automated boundary detection was performed and compared with the off-line estimation. From the instantaneous cavity area displayed by the ABD system, the extents of left atrial area decrease resulting from rapid ventricular filling (D) and atrial contraction (AC) were measured. The D/AC ratio was compared with the transmitral Doppler flow velocity E/A ratio. RESULTS: 1) The end-systolic area (ESA) and the end-diastolic area (EDA) of the left atrium, diastolic atrial emptying index (AEMI) and the systolic atrial expansion index (AEXI) with the ABD system were not different from those with the off-line, manually trace method. 2) ESA, EDA, AEMI and AEXI determined by the ABD system and the off-line method showed strong correlations (r=0.87, 0.79, 0.52 and 0.49 respectively). 3) D/AC ratio with the ABD system correlated significantly with the transmitral Doppler velocity E/A ratio (r=0.70). CONCLUSION: The ABD system may be used in the assessment of LA area and LA function and the diastolic interaction between the left atrium and the left ventricle.
Echocardiography* ; Endocardium ; Heart Atria ; Heart Ventricles ; Humans

Long-term indwelling catheters constitute a risk factor for the development of bladder malignancy. Our study was designed to compare the incidence of bladder cancer and histological changes in the urinary bladder of spinal cord injury patients who had been catheterized for more than 11 years (group 1) and less than 10 years (group 2). Mean duration of catheterization was 17.7 years (range 11-38 years) and 6.5 years (range 2-10 years), respectively in both groups. Our study was performed by cystoscopic evaluation and random bladder biopsy in 23 patients in group 1 and 25 patients in group 2 followed at the Korea Veterans Hospital. The follow-up interval, mechanism, level and degree of injury for both groups were similar. The suprapubic cystostomy was the most common voiding method in both groups (73.9% and 60.0%, respectively). Transitional cell carcinoma in one patient and adenocarcinoma in two patients were found in group 1 and transitional cell carcinoma in one patient was found in group 2. Two patients in group 1 showed squamous metaplasia. 18 patients in group 1 and 24 patients in group 2 showed chronic cystitis. Microscopic hematuria (greater than 2-4 RBC/HPF) was present in all patients. IVPs demonstrated no filling defect of upper tracts in all patients. Overall, the incidences of bladder cancer were 13.0% (3/23) in group 1 and 4.0% (1/25) in group 2. But there was no significant difference in the incidence of bladder cancer between both groups (p=0.279). We suggest that any spinal cord injury patient with hematuria needs a complete bladder evaluation and should undergo cystoscopy and random bladder biopsy.
Adenocarcinoma ; Biopsy ; Carcinoma, Transitional Cell ; Catheterization ; Catheters ; Catheters, Indwelling ; Cystitis ; Cystoscopy ; Cystostomy ; Follow-Up Studies ; Hematuria ; Hospitals, Veterans ; Humans ; Incidence ; Korea ; Metaplasia ; Risk Factors ; Spinal Cord Injuries* ; Spinal Cord* ; Urinary Bladder Neoplasms* ; Urinary Bladder*

We report here three cases of Amanita virosa induced toxic hepatitis. Two of the three cases recovered but the other died 10 days after mushroom ingestion. Since the mortality of Amanita mushroom induced toxic hepatitis is very high, prompt diagnosis and aggressive therapeutic measures should be initiated as soon as possible. Our cases showed that the initial serum aminotransferase levels might not predict the clinical outcome of the patient, but that the prothrombin time (PT) seemed to be a more useful prognostic marker. Close monitoring of aminotransferase levels and PT as well as appropriate therapy are recommended. All three cases showed signs of proteinuria and we were able to characterize mixed tubular and glomerular type proteinuria at 3 or 4 days after ingestion in two cases. Among the previously reported Korean cases of suspected Amanita induced toxic hepatitis, most species could not be identified except for four cases of Amanita virosa. No cases of Amanita phalloides induced toxic hepatitis have been identified in Korea so far.
Adult ; Amanita* ; Amanitins/poisoning* ; Case Report ; Female ; Hepatitis, Toxic/urine ; Hepatitis, Toxic/etiology* ; Human ; Male ; Middle Age ; Mushroom Poisoning/complications* ; Proteinuria/etiology

Human cytomegalovirus (HCMV)-specific monoclonal antibody, SCMVM 34, recognizes early antigen confined to the nucleus of HCMV-infected cells. This study was performed to identify the antigen reactive to SCMVM 34 with purification and amino acid sequencing. The nuclear and cytoskeletal fraction of HCMV-infected cells was subjected to 0.4 M NaCl extraction, DEAE-Sephacel ion exchange chromatography, DNA-cellulose chromatography and SDS-PAGE. The molecular weight of the reactive proteins was 52 kD, 40 kD and 34 kD. The modified or blocked amino termini of 52 kD and 40 kD showed resistance to Edman degradation. The internal peptide fragments were isolated by tryptic digeytion and reverse-phase HPLC. The internal amino acid sequence analysis of the peptides from HPLC profile revealed that the antigens recognized by SCMVM 34 was ppUIA4.
Chromatography ; Chromatography, High Pressure Liquid ; Chromatography, Ion Exchange ; Cytomegalovirus* ; Electrophoresis, Polyacrylamide Gel ; Humans* ; Molecular Weight ; Peptide Fragments ; Peptides ; Sequence Analysis, Protein