Cystic lymphangiomas of the stomach are extremely rare. These usually present as asymptomatic, polypoid lesion consisting of cystically dilated lymphatic vessels, which are submucosal in location. We report a case of cystic lymphangioma of the stomach. The patient is a 55 year-old woman who has complained of dull pain on epigastrium for 10 years. The mass measures 6x5 cm in cross diameter and is mainly located in the subserosal layer along lesser curvature. Microscopically, the tumor reveals a large number of dilated lymphatic cysts containing serous fluid, lined by a layer of flattened endothelial cells. Ultrastructurally, lining endothelial cells show thin discontinuous basal lamina, in contrast to normal lymphatics.
Female ; Humans ; Cysts

No abstract available.
Infection Control* ; National Health Programs*

BACKGROUND: The purpose of this study is to evaluate the evidence for the effectiveness of different isolation policies in reducing the incidence of methicillin-resistant Staphylococcus aureus (MRSA) infection in hospital in-patients. METHODS: We prospectively evaluated the effectiveness of an isolation policy on transmission of MRSA in the 745-beds hospital. First period, all patients with MRSA (March - July 2000) were not isolated Second period, strict isolation policies were performed (August 2000 - January 2002). All patients with MRSA were isolated in separated room, hand hygiene using alcohol handrub, gowning and g1oving, apply of MRSA notice sticker, criteria in isolation remove, separated disinfection and wastement. Third period, semi strict isolation policies were performed (February 2002 - August 2005). Some patients with MRSA were isolated in separated room and others were admitted in general ward for bed shortage. Only some practices were performed in hand washing and separated disinfection in general ward. RESULTS: The rates of MRSA nosocomial infection per patients during 1st, 2nd, and 3rd surveillance were reported 0.56, 0.23, and 0.42 (P<0.05). Patient-days rate of MRSA nosocomial infection during 1st, 2nd, and 3rd surveillance were reported 0.62, 0.27, and 0.38 (P<0.05). CONCLUSION: With many different isolation policies, it was possible to reduce nosocomial infection of MRSA. In this study, strict isolation policies (2nd period) were the most effective practices in reducing MRSA infection.
Cross Infection ; Disinfection ; Hand Disinfection ; Hand Hygiene ; Humans ; Incidence ; Infection Control ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Patients' Rooms ; Prospective Studies

An analysis of domestic and foreign cohort studies of disaster victims can suggest directions for domestic cohort studies of disaster. Research papers on disaster cohorts were found with search engines such as PubMed and RISS. The key words used were disaster, trauma, cohort, and posttraumatic stress disorder (PTSD). Foreign research papers on human-made disaster (n=16), technological disaster (n=11), natural disaster (n=12), and domestic research papers on disaster (n=6) were reviewed. Analysis revealed that domestic cohort research on disaster victims is lacking compared to foreign countries. This results in the current limitations in planning for active intervention and support for disaster victims. To establish appropriate crisis intervention and management plans for disaster situations, a cohort study of disaster victims should be actively implemented through epidemiologic survey and assessment of risk factors on mental health, PTSD, depression, anxiety and other deleterious outcomes.
Anxiety ; Cohort Studies* ; Crisis Intervention ; Depression ; Disaster Victims* ; Disasters* ; Mental Health ; Risk Factors ; Search Engine ; Stress Disorders, Post-Traumatic

PURPOSE: To assess the effect of handwashing improving program and MRSA carrier detection program on MRSA(methicillin resistant Staphylococcus aureus) infection rate in a intensive care unit. METHOD: The intervention was Nosocomial Infection(NI) control program consisted of hand washing improving program and identification and treatment of MRSA carrier. Data on the NI and MRSA infections were collected by an infection control nurse based on the definition of CDC. MRSA infection rates were calculated by the number of MRSA infection per 100 admissions or 1,000 patients-days. The difference of MRSA infection rates between pre and post intervention was tested by Chi-square at =.05. RESULT: MRSA infection rates 3.0% or 3.2 per 1,000 patient-days at the pre, 4.6% or 3.7 per 1,000 patient-days at the post, and the differences were not statistically significant (p=.411, p=.769 respectively). CONCLUSION: The handwashing improving program and MRSA carrier detection program was not effective in reducing the Nosocomial Infection(NI) or MRSA infection rates. It is recommended further studies with a longer intervention and follow-up period.

BACKGROUND: The objective of this study was to determine whether severity and severity change of coexisting psychiatric symptoms might affect change of complicated grief (CG) regarding the Sewol ferry disaster. METHODS: Data from a cross-sectional survey were obtained 18 months (Time 1) and 30 months (Time 2) after the disaster. We ascertained sociodemographic variables and variables obtained from self-reporting questionnaires (i.e., CG, depression, anxiety, post-traumatic stress disorder [PTSD], insomnia, embitterment, and suicidal risk) among 56 bereaved family members. RESULTS: Severity of other psychiatric symptoms at Time 1 had no effect on change of CG at Time 2. However, changes in severity of PTSD over a year affected change of CG. CONCLUSION: It is important to evaluate changes in severity of PTSD and its treatment during management of CG, especially when it involves bereaved families experiencing a traumatic accident.
Anxiety ; Bereavement ; Cross-Sectional Studies ; Depression ; Disasters ; Follow-Up Studies ; Grief ; Humans ; Sleep Initiation and Maintenance Disorders ; Stress Disorders, Post-Traumatic

Background: The purpose of this study was to establish effective measures and preventive managements to the cases of bloodborne exposures among the health care workers. Method: We reviewed 331 cases that were reported to the infection control services of five hospitals from March 2000 to February 2002. The SPSS PC 10.0 was used to analyze the date. Result: The proportion of registered nurses, doctors, housekeepers, unrse aid and technicians were 48.0%, 27.8%, 10.0%, 6.0%, and 5.4% in order. The proportion of female exposures was 75.2%. Fifty six point eight percent of exposure have been working less than 3 years. The data also indicated that there were differences by their Occupations. Thirty nine point six percent of the exposures occurred at the general ward, and 16.6% of them occurred at the operation room and 13.0% of them occurred at the intensive care unit. Most of the bloodborne exposures occurred during blood sampling (26.3%), putting away the needle including the recapping(18.4%). and giving injection (14.5%). The major instruments of exposures were syring-needle (79.6%), blade (7.3%), suture needle (6.1%), and direct contact with blood (2.7%). The hands were the most common body parts of exposures (95.2%). The bloodborne pathogens were hepatitis B virus (HBV, 38.1%(126/331), hepatitis C virus (10.3%), syphilis (4.5%), and human immuno-dificiency virus (2.7%). Forty one point three percent(52/127) of health care workers(HCWs) usually didn't realize whether they had antibody to the HBV or not at the time of exposure; Seventy five percent (39/52) of them found out later to be positive for HBV antibody. Only 48.7% (19/39) of them could get the medical treatment since they didn't know about immunity before the test. The cases with completion of management at the time of exposure, those of follow-up evaluations, and the cases with lost follow-up were 40.7%, 38.6% and 20.7%. in order. None of the cases were led to actual infections. Conclusion: The results from this study can be applied to establish effective measures of prevention and managements of the bloodborne exposures among the HCWs. If the laboratory data of HCWs were available at the time of exposure, more effective management would be possible. Also the results from this study emphasized the need for the systematic and practical follow-up.
Blood-Borne Pathogens ; Delivery of Health Care* ; Female ; Follow-Up Studies ; Gyeonggi-do* ; Hand ; Hepacivirus ; Hepatitis B virus ; Human Body ; Humans ; Infection Control ; Intensive Care Units ; Needles ; Occupations ; Patients' Rooms ; Seoul* ; Sutures ; Syphilis

Purpose: The purpose of this study is to determine the risk adjusted nosocomial infection (NI) rate and distribution of Nls and their causative pathogens in adult lCU. Methods: Prospective surveillance was performed at 12 lCU's of 5 acute care hospitals in Seoul and Kyonggi Do during a 3-months period from May to July 2002. The case finding was done by direct reviews of medical charts regularly for all patients by ICPs using CDC definitions. Results: Total NI rate was 10.18/1,000 patient-days in Medical-surgical ICU (MSICU) and 12.35/1,000 patient-days in Neurosurgucal ICU(NCI). Risk adjusted infection rate was 3.44 in indwelling catheter associated UTI 2.12 in central line associated BSI. 3.51/1,000 device-days in ventilator associated pneumonia in MSICU. There were 3.72, 2.26, 6.06/1,000 device-days in NCU. The infection rate by leu type showed no significant difference. The distribution of Nls were PNEU (28.99%). UTI (28.99%), BSI (18,84%), SSI(4.35%) in MSICU, and UTI(48.0%), PNEU(24.0%), BSI (14.0%), SSI(6.I) in NCU. The most commonly isolated organisms were Candida spp (38.6%), Enterococcus spp. (13.4%) in UTI, Staphylococcus aureus(36.2%), p. aeruginosa(18.8%) in PNEU and Coagulase negative staphylococcus(44.1%). S. aureus (14.7%) in BSL, S. aureus (19.8%) was the most common organism from overall nosocomial infections in the ICU, and 96.3% of S. aureus were MRSA. Conclusion: Distribution of site-specific nosocomial infection and isolated organisms were similar to the results of KOSNIC (Korea society for nosocomial infection control) surveillance in 1996. However, the total infection rate and a risk adjusted infection rate at MSJCU is lower than 1996's. This decrease is considered to be a result of efforts to prevention and control nosocomial infections.
Adult ; Candida ; Catheters, Indwelling ; Centers for Disease Control and Prevention (U.S.) ; Coagulase ; Cross Infection* ; Enterococcus ; Gyeonggi-do ; Humans ; Korea* ; Methicillin-Resistant Staphylococcus aureus ; Pneumonia, Ventilator-Associated ; Prospective Studies ; Seoul ; Staphylococcus

BACKGROUND: Molecular detection of Middle East respiratory syndrome coronavirus (MERS-CoV) using real-time reverse transcription (rRT)-PCR assays is the method of choice for diagnosis of MERS. We evaluated the performance of the PowerChek MERS (upE & ORF1a) real-time PCR Kit (PowerChek MERS assay; Kogene Biotech, Korea) a one-step rRT-PCR assay for the qualitative detection of MERS-CoV. METHODS: We evaluated PowerChek MERS assay performance in comparison with nested RT-PCR and sequencing of the RNA-dependent RNA polymerase (RdRp) and N genes. To evaluate diagnostic sensitivity and specificity, 100 clinical specimens (50 positive and 50 negative for MERS-CoV) were simultaneously tested by using the PowerChek MERS and sequencing assays. Assay performance, including limit of detection and precision, was evaluated in vitro by using MERS-CoV RNA transcripts. Analytical specificity was evaluated with a diverse collection of 16 respiratory virus–positive clinical specimens and 14 respiratory bacterial isolates. RESULTS: The 95% limits of detection of the PowerChek MERS assay for the upE and the open rading frame (ORF)1a were 16.2 copies/µL and 8.2 copies/µL, respectively. No cross-reactivity was observed. The diagnostic sensitivity and specificity of the PowerChek MERS assay were both 100% (95% confidence interval, 91.1–100%). CONCLUSIONS: The PowerChek MERS assay is a straightforward and accurate assay for detecting MERS-CoV RNA. The assay will be a useful tool for the rapid diagnosis of MERS and could prove especially important for MERS outbreak control.
Coronavirus Infections* ; Diagnosis ; In Vitro Techniques ; Limit of Detection ; Methods ; Middle East Respiratory Syndrome Coronavirus* ; Middle East* ; Real-Time Polymerase Chain Reaction* ; Reverse Transcription ; RNA ; RNA Replicase ; Sensitivity and Specificity

While constipation is a common symptom in Korea, there are no existing treatment guidelines. Although constipation may occur as a result of organic cause, there is no obstructive mucosal or structural cause in the vast majority of patients with constipation. The present paper deals with only the management of functional constipation: lifestyle changes; bulking agents and stool softeners; osmotic agents; stimulant laxatives; prokinetics; biofeedback and surgical treatments. Exercise and dietary fiber are helpful in some patients with constipation. Laxatives including bulking agents, stool softeners, osmotic agents, and stimulant laxatives have been found to be more effective than placebo at relieving symptoms of constipation. New enterokinetic agents that affect peristalsis through selective interaction with 5-hydroxytryptamine-4 receptors can be effective in patients with constipation who cannot get adequate relief from current laxatives. Biofeedback can relieve symptoms in selected patients with pelvic floor dyssynergia. Surgical treatments can be helpful in some patients with refractory constipation.
Biofeedback, Psychology ; Cathartics/therapeutic use ; Constipation/surgery/*therapy ; Dietary Fiber/therapeutic use ; Electric Stimulation Therapy ; Exercise Therapy ; Health Behavior ; Humans ; Laxatives/therapeutic use ; Serotonin 5-HT4 Receptor Antagonists/therapeutic use ; Surface-Active Agents/therapeutic use