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

Respiratory syncytial virus (RSV) is the major cause of lower respiratory tract infection in infants. Life-threatening RSV infection is often reported in young children and immunocompromised hosts. Since there is no report on ribavirin therapy for RSV pneumonia in pediatric cancer patients in Korea, we report one case of RSV pneumonia that developed in an infant with acute lymphoblastic leukemia (ALL). Despite administration of oral ribavirin and intravenous immunoglobulin, the patient's respiratory distress worsened and admission to an intensive care unit was necessary. Chest x-ray showed multifocal consolidation, pneumothorax, and pneumomediastinum. Treatment with aerosolized ribavirin led to significant clinical improvement. The role of aerosolized ribavirin is still controversial, but it might have a therapeutic potential for severe RSV pneumonia in children with leukemia.
Child ; Humans ; Immunocompromised Host ; Immunoglobulins ; Infant ; Intensive Care Units ; Korea ; Leukemia ; Mediastinal Emphysema ; Pneumonia ; Pneumothorax ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Respiratory Syncytial Viruses ; Respiratory Tract Infections ; Ribavirin ; Thorax

The Odontoid process fracture has been treated by prolonged external immobilization of by internal fixation and fusion. We reported congential and traumatic odontoid process fracture which were successfully treated by transoral fusion. Operative preparation, technique and postoperative management are described by in detail.
Immobilization ; Odontoid Process*

OBJECTIVE: In patients with spinal cord injury, it is more susceptible to osteoporosis because bone resorption is more prominent than bone formation. Thus we evaluated the change of biochemical markers and bone mineral densities (BMDs) according to the duration of injury, the spinal cord injury level, and the injury severity. METHOD: The subjects were included 26 patients with spinal cord injury and 22 healthy men. We measured serum osteocalcin and urine deoxypyridinoline (DPYD) in 2 hours after awakening and measured BMDs in lumbar vertebrae, femur, and distal forearm in patients and control group. The patients were 21 men, 5 women, mean age 43.2+/-14.3 years, and mean duration 28.3+/-45.0 months, who were divided by injury level and injury severity respectively. RESULTS: The biochemical markers of bone metabolism in patients group had significant differences comparing to control group (p<0.05). The urine DPYD and BMDs in femur showed significantly negative correlation with the duration of spinal cord injury (p<0.05). CONCLUSION: In patients with spinal cord injury, urine DPYD and BMDs in femur had significant correlation with the duration of injury. But, the injury level and injury severity had no significant correlation with the markers of bone metabolism and BMDs.
Biomarkers ; Bone Density* ; Bone Resorption ; Female ; Femur ; Forearm ; Humans ; Lumbar Vertebrae ; Male ; Metabolism* ; Osteocalcin ; Osteogenesis ; Osteoporosis ; Spinal Cord Injuries* ; Spinal Cord*

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

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*

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

337 spinal cord injured patients had been followed up for urologic management in Korea Veterans Hospital. 106 spinal cord injured patients, admitted due to urologic complications from 1990 to 1995, were analyzed. The level of cord injury was cervical in 26, thoracic in 63 and lumbar in 17 patients. The voiding method was suprapubic cystostomy in 32, clean intermittent catheterization in 27, self-voiding in 25, condom catheter in 14, urethral catheter in 6 and others in 2 patients. The common urologic complications were acute pyelonephritis, bladder stone, epididymitis, vesicoureteral reflux, low vesical compliance, autonomic dysreflexia and bladder tumor. Medical treatments for urologic complications were performed for 79 cases (46%) and surgical treatments for 92 cases (54%) We conclude that periodic urologic follow-up will be needed for early detection and management of urologic complications due to spinal cord injury.
Autonomic Dysreflexia ; Catheters ; Compliance ; Condoms ; Cystostomy ; Epididymitis ; Follow-Up Studies ; Hospitals, Veterans ; Humans ; Intermittent Urethral Catheterization ; Korea ; Male ; Pyelonephritis ; Spinal Cord Injuries ; Spinal Cord* ; Urinary Bladder Calculi ; Urinary Bladder Neoplasms ; Urinary Catheters ; Vesico-Ureteral Reflux

To identify acanthocephala found in 'Changran-pickles' and 'Myungran-pickles' each organ was measured in permanent slides. In the present report, the results obtained were as follows: 1. Morphology of male worms: Worms possessed 18-19 longitudinal rows, with 4 hooks per row, which became smaller towards the base of proboscis. Each worm contained two testis and six cement glands arranged linearly. Body 22.0 by 0.8-0.6 mm and 15.0 by 0.6-0.4 mm, proboscis 284.8 by 227.6 microgram and 524.9 by 151.4 microgram, proboscis sheath 1570.7 by 72.7 microgram and 751.9 by 280.4 microgram, lemnisci length 2566.7 and 1085.6, testis 2202.9-1860.5 by 737.0-575.7 microgram and 1033.8-981.1 by 463.1-351.6 microgram, cement glands 940.2 by 441.2 microgram and 610.0 by 369.1 microgram. 2. Morphology of female worms: Worms possessed 14-18 longitudinal rows, with 6-10 hooks per row and become smaller toward the base of proboscis. Each worm contained an uterine bell and uterus in the posterior portion and the eggs filled the body cavity. Body 14.0~51.0 mm by 0.7-0.5~2.2-1.4 mm, proboscis 466.1-268.9 microgram by 259.9-252.0 microgram, proboscis sheath 1550.7-506.0 by 298.8-231.1 microgram, lemnisci length 1325.7-473.1 microgram, eggs 112.4 by 28.5 microgram~51.7 by 14.0 microgram. In this present study, the acanthocephala collected in 'Changran-pickles' and 'Myungran-pickles' were identified as Echinorhynchus gadi by morphological features.
Acanthocephala/anatomy & histology/classification/*isolation & purification ; Animals ; Female ; Fish Diseases/*parasitology ; Fishes ; Helminthiasis, Animal/*parasitology ; Korea ; Male ; Seafood/*parasitology

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