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

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

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

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

PURPOSE: The use of flumazenil administration in the emergency department is still controversial because of concerns about adverse effects. The present study was conducted to re-evaluate the risk-benefit ratio associated with flumazenil administration to patients suspected of having acute hypnotics and sedatives poisoning in the emergency department. METHODS: A retrospective chart review study was conducted for patients whose final diagnoses were “poisoning” and “benzodiazepine” or “sedatives-hypnotics” from Mar. 2006 to Feb. 2015. The basal characteristics of the patients, including past medical history, ingredients and dose of ingested drug and co-ingested drugs were investigated. For patients administered flumazenil, responsiveness and time from admission to flumazenil administration were investigated with supplement. All collected data were analyzed in aspect terms of risk/benefit. RESULTS: A total of 678 patients were included in our study. Benzodiazepine was the most common sedative/hypnotic drug prescribed, and the frequency of prescription continuously increased. The proportion of TCA as co-ingestion decreased from 13.1% to 3.9% in patients with acute sedative/hypnotic poisoning. Flumazenil was administered to 55 patients (8.1%), of which 29 patients (52.7%) were applied to contraindications. Fifty-three patients (96.4%) showed positive responsiveness, including partial responsiveness after flumazenil administration. No severe adverse events were identified. CONCLUSION: Based on the current trends in prescription patterns for sedative/hypnotic drugs, increased use of non-TCA antidepressants, and responsiveness to administration of flumazenil, benefit seemed weighted more in this study, although the observed benefits were based on limited results. Further prospective multicenter studies will be needed to optimize benefit-risk ratio.
Antidepressive Agents ; Benzodiazepines ; Diagnosis ; Emergency Service, Hospital ; Flumazenil* ; Humans ; Hypnotics and Sedatives* ; Poisoning* ; Prescriptions ; Prospective Studies ; Retrospective Studies ; Risk Assessment

We report a case of prostatic abscess in a 46-year old man with chronic myelocytic leukemia. Preoperative transrectal ultrasonography and computerized tomography confirmed the diagnosis of prostatic abscess, which was treated with pus drainage via transurethral resection of prostate and broad-spectrum antibiotics.
Abscess* ; Anti-Bacterial Agents ; Diagnosis ; Drainage ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive* ; Middle Aged ; Suppuration ; Transurethral Resection of Prostate ; Ultrasonography

PURPOSE: In order to avoid functional disability that may be caused by radical excision or amputation in extremity soft tissue sarcomas, authors employed limb-conserving surgery together with extemal radiation therapy plus interstitial brachytherapy. MATERIALS AND METHODS: From June 1995 to Febrary 1997, 10 extremity soft tissue sarcoma patients were treated with limb-conserving surgery and external radiation therapy plus interstitial brachytherapy. In six patients, whose histologic diagnoses were made at the time of surgery, wide or marginal excision and interstitial brachytherapy was done 4 weeks before postoperative external radiation therapy. In four patients whose histologic confinnations were done before definitive treatment, preoperative external radiation therapy was given 4 weeks before surgery and interstitial brachytherapy. The types of surgery were wide excision in five patients, and marginal excision in five patients. Gross or microscopic residual was left at the surgical resection margins in four patients. The brachytherapy dose ranged from 17.5 Gy to 24 Gy and external beam radiation did from 40 Gy to 45 Gy. RESULTS: With the median follow-up duration of 21.5 months(range: 13 to 29 months); one local recurrence, and three new distant metastases were observed. There were three patients with wound complications attributable to the current treatment regimen. CONCLUSION: Satisfactory local tumor control may be achievable with limb-conserving surgery and external radiation therapy plus brachytherapy in patients with extremity soft tissue sarcomas, while more caution should be used to avoid wound problems.
Amputation ; Brachytherapy* ; Diagnosis ; Extremities* ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Recurrence ; Sarcoma* ; Wounds and Injuries