No abstract available.

BACKGROUND: Hospital-wide surveillance showed an up to 9% increase in the incidence rate of the nasal transmission of methicillin-resistant Staphylococcus aureus (MRSA) among health care workers (HCWs) in a tertiary care hospital where MRSA is endemic. The purpose of this study was to investigate the knowledge of and attitude towards nasal transmission of MRSA and hand-washing practice among HCWs and determine the behavioral factors associated with the nasal transmission of MRSA. METHODS: In a 750-bed tertiary care hospital, nasal swabs from HCWs were obtained, and questionnaires with 25 questions were distributed to HCWs who were divided into 2 different groups: MRSA carriers and non-carriers. The questionnaires focused on the HCWs' knowledge about the mode of MRSA transmission and precautions against MRSA infection and their self-reported compliance for hand hygiene. RESULTS: The total number of respondents for the surveillance culture and survey were 253 (51 MRSA carriers and 202 non-carriers). There was significant difference between the 2 groups on the knowledge of precautionary measures used for the MRSA patients in the hospital (P=0.026). Compared to the MRSA carriers, the non-carriers washed their hands significantly more frequently after ventilator care (P=0.004) and used more alcohol sanitizers (P=0.023). However, no significant difference was observed in hand-washing practices of both the groups before the medical procedures, their knowledge about the mode of transmission of MRSA, and the duration of hand washing. CONCLUSION: Non-carriers replied more accurately to the questions on knowledge about the management and treatment of MRSA, and they considered interventions such as surveillance cultures and questionnaires to be an effective method in lowering the incidence of nosocomial infections. Compared to the MRSA carriers, the non-carriers showed higher hand-washing compliance.
Compliance ; Cross Infection ; Cross-Sectional Studies ; Surveys and Questionnaires ; Delivery of Health Care ; Drug Resistance ; Hand ; Hand Disinfection ; Humans ; Incidence ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Tertiary Healthcare ; Ventilators, Mechanical

No abstract available.
Carcinoma, Non-Small-Cell Lung* ; Fingers*

BACKGROUND/AIMS: Liver biopsy has been used to evaluate the degree of hepatic fibrosis in patients with chronic liver diseases. It is important to assess liver fibrosis when following the course of chronic liver diseases. Histopathological examination of percutaneous biopsy specimens is invasive and is also of questionable value because of the heterogenous distribution of pathological changes in the liver. Therefore, non-nvasive methods to determine the progress of liver fibrosis are needed. Serum hyaluronic acid and type IV collagen are known to be related to hepatic fibrosis. This study was performed to evaluate the clinical usefulness of serum hyaluronic acid and type IV collagen measurement as a differential point in patients with chronic liver diseases and early cirrhosis. METHODS: This study included 109 patients with chronic liver diseases caused by various etiologies. Liver biopsy and histopathological classification were done in all patients. Serum hyaluronic acid and type IV collagen were measured by one-tep sandwich binding protein assay and one-tep sandwich enzyme immunoassay. RESULTS: The concentrations of hyaluronic acid and type IV collagen in the early cirrhosis group (208.5+/-186.4 ng/mL, 242.1+/-162.8 ng/mL) were significantly higher (p<0.01) than those in the normal and fatty liver group (26.3+/-21.7 ng/mL, 79.2+/-28.8 ng/mL), mild chronic hepatitis group (22.8+/-15.4 ng/mL, 125.5+/-79.7 ng/mL), moderate to severe hepatitis group (66.3+/-60.5 ng/mL, 148.5+/-78.7 ng/mL). At the cutoff value of 100 ng/mL for hyaluronic acid and 200 ng/mL for type IV collagen, the sensitivities were 66.7% and 55.6%, and specifities were 82.9% and 89%, and diagnostic efficiencies were 78.9% and 80.7% respectively for discriminating patients with cirrhosis (4 points) from the mild to severe fibrosis (0~3 points). CONCLUSIONS: The serum levels of hyaluronic acid and type IV collagen may be sensitive markers of fibrotic process in chronic liver diseases and useful biochemical markers in differentiation of the patients with early cirrhosis from those with chronic liver diseases.
Biomarkers ; Biopsy ; Carrier Proteins ; Classification ; Collagen Type IV* ; Fatty Liver ; Fibrosis ; Hepatitis ; Hepatitis, Chronic* ; Humans ; Hyaluronic Acid* ; Immunoenzyme Techniques ; Liver Cirrhosis* ; Liver Diseases ; Liver*

BACKGROUND: Typhoid fever, caused by Salmonella enterica serotype Typhi, remams an important public health problem in Korea, and asymptomatic chronic carriers play a role in the endemicity. However, the molecular studies of S. typhi isolates are very limited. We characterized clinical isolates of S. typhi by molecular and phage typing tools for the extent of genetic diversity and relatedness among the isolates. METHODS: A total of 49 S. typhi isolates from sporadic cases of typhoid fever were collected in 3 university hospitals in Seoul during 1992 to 1998 and examined for in vitro susceptibility to 14 antimicrobials by disk diffusion method, ribotyping using PstI restriction enzyme, and pulsed-field gel electrophoresis (PFGE) using XbaI and Vi phage typing. The distribution of the epidemiological types and genomic DNA relatedness were analyzed. RESULTS: Forty-five out of 49 isolates were susceptible to all drugs tested. Thirty-two out of 47 were typable by phage typing and 56.3% possessed the phage type El or Ml. Forty-nine isolates divided into 6 different ribotypes (A to F) and 19 different PFGE types (AO through A17, BO) by ribotyping and PFGE analysis, respectively. Based on the 3 typing systems, 32 isolates divided into 17 different epidemiological types. The E1-A-A12 (phage type-ribotype-PFGE type) was most prevalent (18.8Fo) and isolated only in 1998, but distributed in various areas of isolation. The next prevalent M1-A-A1 (15.6%) was isolated from 1992 through 1998. The genetic relatedness based on PFGE analysis revealed that F (coefficient of similarity) values are 0.64 to 1.0 and 0.52 for A subtypes and BO type, respectively. CONCLUSIONS: We conclude that the circulating S. typhi strains in Seoul city show considerable genetic diversity, whereas most of them seems to be clonally related.
Bacteriophage Typing ; Bacteriophages ; Diffusion ; DNA ; Electrophoresis, Gel, Pulsed-Field ; Genetic Variation ; Hospitals, University ; Korea ; Public Health ; Ribotyping ; Salmonella enterica* ; Salmonella typhi ; Salmonella* ; Seoul* ; Typhoid Fever

OBJECTIVE: This study investigates the morbidity of adnexal surgery through minilapatotomy by comparing with adnexal surgery through laparotomy. METHODS: From January 2000 to December 2001, 84 patients with adnexal diseases were managed through minilaparotomy and 80 patients treated with adnexal surgery through laparotomy. RESULTS: Fifty-three (69.0%) of the adnexal diseases were ectopic pregnancies. Fifty-seven patients (67.9%) were treated with salpingectomy. Other patients were treated with the following operations: salpingotomy (3 cases, 3.6%); salpingostomy (3 cases, 3.6%); fimbrioplasty (2 case, 2.4%); ovarian cyst enucleation (4 cases, 4.8%); ovarian resection (6 cases, 7.1%); parovarian cystectomy (5 cases, 6.0%); salpingooophorectomy (4 case, 4.8%). The average operation time for minilaparotomy was 30.5 +/- 9.2 minutes. The average bowel function recovery time for minilaparotomy was 28.2 +/- 15.6 hours (p<0.05). The average postoperative pain control was 29 cases (34.5%) lower than that of controls (p<0.05). The average postoperative hospital stay for minilaparotomy was 3.4 +/- 1.0 days (p<0.05). The procedure morbidity was lower than that of controls. CONCLUSION: It is suggested that minilaparotomy is a quick, convenient method to decrease patient morbidity and postoperative stay and that it could be considered an alternative to laparotomy for the treatment of adnexal diseases.
Adnexal Diseases ; Cystectomy ; Female ; Humans ; Laparotomy* ; Length of Stay ; Ovarian Cysts ; Pain, Postoperative ; Pregnancy ; Pregnancy, Ectopic ; Recovery of Function ; Salpingectomy ; Salpingostomy

Background: The integrase strand transfer inhibitor dolutegravir has been indicated in Korea since 2014 for the treatment of human immunodeficiency virus type 1 (HIV-1) infection in combination with other antiretroviral agents. This regulatory post-marketing surveillance (PMS) study evaluated the real-life safety and effectiveness of dolutegravir in patients with HIV-1 in clinical practice in Korea. Materials and Methods: This open-label PMS study examined data from consecutive patients (aged ≥12 years) with HIV-1 infection receiving dolutegravir according to locally approved prescribing information; treatment-naïve and treatment-experienced patients were permitted. Data regarding patient demographics, medical history, clinical characteristics, medications (HIV-related and concomitant), and comorbidities were extracted from patient records over a 1-year treatment period. Outcomes included the safety of dolutegravir (primary endpoint) and real-life effectiveness according to the Physician Global Assessment (PGA) and the proportion of patients with plasma HIV-1 RNA count <50 copies/mL at 48 weeks. Results: Of 147 patients treated with dolutegravir at 18 centers in Korea (August 2014 – August 2020), 139 were eligible for the safety analyses and 75 for effectiveness analyses.Patients (mean age 47 years) were mostly male (92.8%) and received dolutegravir in combination with nucleoside reverse transcriptase inhibitor (70.5%) or protease inhibitors (21.6%). Adverse events (AEs) (n = 179 in total) were mostly mild in severity, with the most common being nasopharyngitis (5.0%), dyspepsia (5.0%), pruritus (4.3%), and rash (4.3%).Of 16 adverse drug reactions (ADRs), the most frequent were rash, diarrhea, headache, insomnia, and somnolence (1.4% each). Of 2 serious ADRs, only 1 (gastroenteritis) was unexpected, and both resolved. The risk of experiencing an AE while receiving dolutegravir appeared to be especially increased in patients receiving concomitant medications for other conditions. Dolutegravir effectively suppressed HIV-1 (93.3% of patients had plasma HIV-1 RNA <50 copies/mL), and 100% of patients showed symptom improvement based on physician global assessment. Conclusion Results of this PMS study showed that dolutegravir administered as highly active antiretroviral therapy was well tolerated and effective in patients with HIV-1 infection.

No abstract available.
Aged ; Cysticercosis/*diagnosis/radiography ; Humans ; Immunocompetence ; Incidental Findings ; Male ; Neurocysticercosis/diagnosis/radiography

OBJECTIVE: To find out general characteristics, common problems, outcomes of delivery of unmarried mothers and related social factors, and to provide basic information based on the results in order to change social systems and to have a correct understanding of unmarried mothers. METHODS: We studied 196 unmarried mothers who delivered from Jan. 2003 to Aug. 2004. All data were collected by survey whose groups were divided into three by ages, and they were analyzed by Fisher's exact test obstetrically and socially. It verified 95% significant level. RESULTS: Cesarean section rate was 14.3% which is remarkably lower than married mothers. However, it is getting higher (p=0.003) as they are older, and the rate of group of 30s is similar to that of married mothers. Also, the average birth weight of unmarried mothers' babies is 3,056 gm and it is similar to that of married mothers. They took prenatal care only 3.27 times and 22% of them did not commence it until the 3rd trimester. Fifty seven percent drank alcohols, 51% smoked, and 49% used drugs during pregnancy. Most unmarried mothers who took this survey had a lower level and economic status. After delivery, 16.3% of them raise their babies and 83.7% of them had their babies adopted through welfare facilities. CONCLUSION: We conclude that it is necessary to have a social system, welfare facilities, and financial supports that educate contraceptive measures to potential unmarried mothers, let them recognize their situations, and protect them.
Alcohols ; Birth Weight ; Cesarean Section ; Female ; Financial Support ; Humans ; Illegitimacy* ; Linear Energy Transfer ; Mothers ; Pregnancy* ; Prenatal Care ; Single Person* ; Smoke ; Social Welfare*

OBJECTIVE: This study was designed to compare the characteristics of demographic data, clinical features, and personality in male and female alcoholics and to identify the clinically meaningful differences in the etiologies and the clinical features between the two groups. METHODS: The study group was composed of 30 males and 21 females who were recruited into the inpatient treatment. The researchers used self-reporting questionnaire composed of demographic data and drinking patterns, Michigan alcoholism screening test(MAST), self-rating anxiety scale(SAS) and self-rating depression scale(SDS) of Zung, Minnesota Multiphasic Personality Inventory(MMPI), symptom Checklist-90-revision(SCL-90-R), and Eysenck personality questionnaire(EPQ) . The differences between the two groups were tested by chi-square test and independent-samples t-test. RESULTS: 1) Education level of female alcoholics was significantly less than that of male alcoholics(p<0.05) and the birth order of female alcoholics was significantly higher than that of male alcoholics(p<0.05). 2) The level of socioeconomic status of female alcoholics was significantly lower than that of male alcoholics(p<0.01). 3) The initial motivations of female alcoholics were mainly due to social, psychological, and intrafamilial problems while those of male alcoholics were due to social problems. There were significant differences between the two groups(p<0.05). 4) The onset of initial drinking in female alcoholics was significantly earlier than that of male alcoholics(p<0.001). 5) The average amount of daily drinking in female alcoholics was significantly less than that of male alcoholics(p<0.01). 6) Withdrawal symptoms, physical disorders, and social or legal problems induced by alcohol drinking in female alcoholics were significantly less than those of male alcoholics(p<0.05) 7) The mean scores of PY scale of SCL90R and of L scale of EPQ in female alcoholics were significantly higher than those of male alcoholics(p<0.05). CONCLUSION: Demographic and psychosocial factors differed to a significant degree between male and female alcoholism. We suggest that these factors are more important in female alcoholism than in male one in the etiologies and the clinical features. These differences are due to more complex factors rather than simple ones, thus the further evaluations are needed to elucidate the differences in the etiologies between male and female alcoholism.
Alcohol Drinking ; Alcoholics* ; Alcoholism ; Anxiety ; Birth Order ; Depression ; Drinking ; Education ; Female* ; Humans ; Inpatients ; Male* ; Mass Screening ; Michigan ; Minnesota ; Psychology ; Surveys and Questionnaires ; Social Class ; Social Problems ; Substance Withdrawal Syndrome