No abstract available.
Carcinosarcoma* ; Female ; Ovary*

BACKGROUND: Direct observation of healthcare workers is commonly used in hospitals to investigate hand hygiene compliance. However, the hand hygiene compliance rate may increase due to the Hawthorne effect, which is the modification of behavior simply because subjects become aware that they are being observed. The objective of this study was to investigate the occurrence of the Hawthorne effect when directly observing hand hygiene compliance in intensive care unit (ICU) healthcare personnel. METHODS: A total of 87 staff members from the coronary care unit and cardiac surgery ICU of a general hospital in Seoul were included in this study: 24 residents and interns, 55 nurses, and 8 nursing assistants. Both covert and overt observations, where subjects were either unaware or aware of any direct observation, were performed on separate occasions. RESULTS: A total of 1,052 covert and 1,336 overt observations were documented over 30 and 34 occasions, respectively. Overall hand hygiene compliance was significantly higher with overt observation than with covert observation (1,041/1,336, 77.9% vs. 659/1,052, 62.6%, P<0.001). The Hawthorne effect was present in all professions and behaviors, with the exception of nursing assistants, and prior to touching a patient. CONCLUSION: Direct observation of hand hygiene compliance was associated with the Hawthorne effect when observations were made overtly and this was likely to contribute to an overestimation of compliance rate.
Compliance ; Coronary Care Units* ; Delivery of Health Care* ; Effect Modifier, Epidemiologic* ; Hand Hygiene* ; Health Personnel ; Hospitals, General ; Humans ; Intensive Care Units* ; Nursing ; Seoul ; Thoracic Surgery*

PURPOSE: We studied to determine whether the degenerative spondylolisthesis has rotary deformity in addition to forward displacement. MATERIALS AND METHODS: We have made an analysis of difference of rotary deformity between the 31 study groups of symptomatic degenerative spondylolisthesis and 31 control groups without any symptom,statistically. We also reviewed CT findings in 15 study groups. RESULTS: The mean rotary deformity in study groups was 6.1 degree(the standard deviation is 5.20), and the mean rotary deformity in control groups was 2.52 degree(the standard deviation is 2.16)(p <0.01) CONCLUSION: The rotary deformity can be accompanied with degenerative spondylolisthesis. We may consider the rotary deformity as a cause of symptomatic degenerative spondylolisthesis in case that any other cause is not detected.
Congenital Abnormalities* ; Spondylolisthesis*

The authors reported the cases of 23 patients with aneurysms measuring 2.5 cm or greater in diameter found during 7 years period in which we performed 596 operations for aneurysm of the 23 patients, 14 were treated by direct operation, 3 by internal carotid ligation with or without bypass surgery, 2 by trapping, 1 by wrapping and the other 3 by conservative therapy. The overall incidence of giant aneurysms was 3.9% but varied according to location; 9 cases were located on the internal carotid artery; 8 were on the anterior communicating artery; 5 were on the middle cerebral artery. 14 patients had hemorrhagic attacks, 7 had mass effects from the aneurysm, and 2 had ischemic events. Overall favorable outcome was 65% and the mortality was 13%. Based on the review of the literature, the appropriateness of surgery and surgical methods are discussed.
Aneurysm ; Arteries ; Carotid Artery, Internal ; Humans ; Incidence ; Intracranial Aneurysm* ; Ligation ; Middle Cerebral Artery ; Mortality

Based on the review of literatures, this article discussed the frequency and timing of rebleeding after initial subarachnoid hemorrhage (SAH), and the risk factors and preventive strategy for rebleeding. In view of the active policy of early aneurysm surgery, the peak interval for rebleeding was the first 24 hours after the aneurysmal SAH. Patients with poor grades, ventricular drainage, angiography within 6 hours post-SAH, time interval between the last attack and admission, and reduced platelet function were proposed as a risk factor of rebleeding. Rebleeding from giant aneurysms occurred at a rate comparable to that associated with smaller aneurysm. The efficacy of short-term antifibrinolytic drugs was expected to minimize ultraearly rebleeding. When ventriculostomy is necessary, intracranial pressure should be maintained between 15 and 25 mmHg to minimize transmural pressure gradients. Securing ruptured aneurysm on an emergency basis remained open to debate.
Aneurysm ; Aneurysm, Ruptured ; Angiography ; Blood Platelets ; Drainage ; Emergencies ; Humans ; Intracranial Pressure ; Risk Factors ; Subarachnoid Hemorrhage* ; Ventriculostomy

Gouty arthritis is a common crystal arthropathy, but gout tophus in the bipartite patella is a rare condition. This report presented a traumatic separation of bipartite patellar fragment caused by mild trauma in a patient with comorbid gout. When a patient with bipartite patella and underlying gouty arthritis complains of pain after trauma, clinical suspicion is needed about fragment separation of the bipartite patella.

PURPOSE: Children with acute colonic diverticulitis(ACD), can be misdiagnosed with acute appendicitis. METHODS: We reviewed 15 cases of ACD during five years, from January 1998 to June 2002 retro spectively. RESULTS: Most patients(80%) with ACD in children presented with right lower quadrant pain. The primary diagnosis on admission was mostly acute appendicitis(87%), and all ACD in children occurred in the right colon. Fourteen patients were managed by conservative treatment including antibiotics. A follow-up study was performed in 15 patients. There were symptomatic recurrences in two patients, but no significant complication was noted. The frequency of ACD was 11.7 per 1000 acute appendicitis. CONCLUSION: ACD in children can mostly be cured by conservative treatment. It is prudent to choose the management through the diagnostic work up, including abdominal sonography and computed tomography, because there was no significant difference of clinical findings between ACD and acute appendicitis.
Anti-Bacterial Agents ; Appendicitis ; Child* ; Colon* ; Diagnosis ; Diverticulitis ; Diverticulitis, Colonic* ; Follow-Up Studies ; Humans ; Recurrence

PURPOSE: This study was performed to characterize sepsis with thrombocytopenia in premature infants to determine if thrombocytopenia is a prognostic factor in sepsis in premature infants. METHODS: We retrospectively analyzed the medical records of sepsis in premature infants admitted to the neonatal intensive care unit(N=41) at the Hallym University Sacred Heart Hospital from January 1999 to December 2002. The incidence, risk factors, symptoms, hematologic and bacteriologic findings were analyzed during episodes of sepsis. RESULTS: Of the 41 cases, 29(72%) were associated with thrombocytopenia. The ratio of male to female was 1.2 : 1. The vast majority(98%) were late-onset sepsis. The risk factors of the thrombocytopenic group were low birth weight and low gestational age. Major symptoms were poor activity (72%), apnea/tachypnea(52%), but were not significantly different between two groups. In the thrombocytopenic group(N=29), low total WBC count and high CRP level were discovered(P=0.03, P<0.01). The mean platelet count was 70.17(x103/mm3) at diagnosis of sepsis, and a mean platelet nadir was 43.10(x103/mm3). The severe thrombocytopenia(below 50x103/mm3) in the thrombocytopenic group was discovered in 69% and the duration of thrombocytopenia was about eight days. The majority of pathogens were gram-negative bacteria and candida. The thrombocytopenic group showed a pro longed length of stay and a high mortality rate. According to comparisons between the survived and expired groups, low birth weight, low gestational age, neutropenia and thrombocytopenia were significantly correlated with mortality(P<0.05). CONCLUSION: The sepsis with thrombocytopenia in premature infants showed late-onset sepsis and high morbidity and mortality, although differences were not significant statistically. Especially, low birth weight and low gestational aged infants should be cautiously treated and monitored.
Blood Platelets ; Candida ; Diagnosis ; Female ; Gestational Age ; Gram-Negative Bacteria ; Heart ; Humans ; Incidence ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature* ; Intensive Care, Neonatal ; Length of Stay ; Male ; Medical Records ; Mortality ; Neutropenia ; Platelet Count ; Retrospective Studies ; Risk Factors ; Sepsis* ; Thrombocytopenia*

BACKGROUND: In spite of harmfulness of smoking, the rate of adult man's smoking is high in Korea and that of young people and women has risen recently. Although the number of hospitals operating smoking-cessation clinic has risen year by year, there is little research on smoking cessation. In this study, we tried to find the factors associated with successful smoking cessation and have attempted to contribute to developing effective smoking cessation strategy and help to continue cessation state. METHOD: Three hundred smokers, who had visited the Dankook Univ. Hospital from May 1999 to December 1999, were consulted. After doing a survey with a basic questionnaire and smoking cessation consultation, we asked them to revisit on the date of appointment with continued use of nicotine patch as much possible. Six months later, we selected 272 people and analyzed the factors of difference between the two groups ; one is the successful group and the other is the failure group. RESULT: The success group included 77 people (28.3%), and the failure group 195 people (71.7%). In view of demographic profiles such as age, sex, marital status, education, and job, there was no significant difference between the two groups. In view of smoking pattern and factors that can influence them such as age of starting to smoke, duration of smoking, motive of smoking, reason of failure to stop smoking, reason of trying to stop smoking, the presence of smoking family number, confidence in smoking cessation, dependence on nicotine and the number of alcohol drinking, there was no significant difference between the two groups. In the results of univariate analysis, daily mean smoking amount, the presence of smoking-associated disease, expiratory CO level at initial visit to hospital, period of using nicotine patch and total times of visiting clinic were significant difference between the two groups. Therefore, the total number of visits to the clinic was the only significant factor according to multivariate analysis. CONCLUSION: The results of multivariate analysis has shown that the factor that is most associated with success of smoking cessation is the total number of visits to smoking-cessation clinic. This means that the more people who smoke consult with doctor and the longer the period of utilizing the smoking-cessation clinic is, the more successful they in smoking cessation.
Adult ; Alcohol Drinking ; Education ; Female ; Humans ; Korea ; Marital Status ; Multivariate Analysis ; Nicotine ; Smoke* ; Smoking Cessation* ; Smoking* ; Tobacco Use Cessation Products ; Surveys and Questionnaires

OBJECTIVE: There is no proven regimen to reduce the severity of stroke in patients with acute cerebral infarction presenting beyond the thrombolytic time window. Ozagrel sodium, a selective thromboxane A2 synthetase inhibitor, has been known to suppress the development of infarction. The antiplatelet effect is improved when aspirin is used together with a thromboxane synthetase inhibitor. METHODS: Patients with non-cardiogenic acute ischemic stroke who were not eligible for thrombolysis were randomly assigned to two groups; one group received ozagrel sodium plus 100 mg of aspirin (group 1, n=43) and the other 100 mg of aspirin alone (group 2, n=43). Demographic data, cardiovascular risk factors, initial stroke severity [National Institute of Health Stroke Scale (NIHSS) and motor strength scale] and stroke subtypes were analyzed in each group. Clinical outcomes were analyzed by NIHSS and motor strength scale at 14 days after the onset of stroke. RESULTS: There were no significant differences in the mean age, gender proportion, the prevalence of cardiovascular risk factors, stroke subtypes, and baseline neurological severity between the two groups. However, the clinical outcome for group 1 was much better at 14 days after the onset of stroke compared to group 2 (NIHSS score, p=0.007, Motor strength scale score, p<0.001). There was one case of hemorrhagic transformation in group 1, but there was no statistically significant difference in bleeding tendency between two groups. CONCLUSION: In this preliminary study, thromboxane A2 synthetase inhibitor plus a low dose of aspirin seems to be safe and has a favorable outcome compared to aspirin alone in patients with acute ischemic stroke who presented beyond the thrombolytic time window.
Aspirin ; Cerebral Infarction ; Hemorrhage ; Humans ; Infarction ; Methacrylates ; Prevalence ; Risk Factors ; Sodium ; Stroke ; Thromboxane A2 ; Thromboxane-A Synthase ; Tissue Plasminogen Activator