BACKGROUND: When going into the intensive care unit (ICU), health care workers (HCWs) and visitors are required to put on cover-gowns and change into slippers, which is considered by some hospitals as one of the customary infection control practices. The purpose of this study was to evaluate the efficacy of cover-gowns and slippers in reducing nosocomial infections in the medical ICU (MICU). METHODS: The study was carried out in four periods. In the period-I (January to June, 2002), all HCWs and visitors put on cover-gowns when entering the MICU, but not in the period-II (July to December, 2002). They were required to change into slippers in the period-III (January to April, 2004), but not in the period-IV (May to August, 2004). RESULTS: Nosocomial infection rates during the period-I and period-II were 14.8 and 12.6 per 100 discharges (P>0.05) or 14.1 and 13.6 per 1,000 patient days (P>0.05), respectively. During the period-III and period-IV respective infection rates were 9.4 and 12.6 (P>0.05) or 10.2 and 15.7 (P>0.05). There were no statistical differences in device utilization ratios, device-associated infection rates, and site of infections (P>0.05) between the periods of I and II or between the periods of III and IV. CONCLUSION: These results showed that the intervention of cover-gown and slipper change is a non-effective factor in reducing nosocomial infections in the MICU; therefore, the infection control practice of cover-gown and slipper changes for HCWs and visitors entering the ICU should be eliminated.
Cross Infection* ; Delivery of Health Care ; Humans ; Infection Control ; Intensive Care Units* ; Critical Care*

BACKGROUND: The shelf life should be determined by health care facility's infection control program. The current standards for preserving the sterility can be changing. So, to measure and compare the recontamination time of sterile packs among wrappers and storage conditions, and develop a practical standard for the shelf life and storage conditions of sterile products. The purpose of this study was placed on measurement of the recontamination time in packs wrapped in all kinds of wrapping materials used in Il-San hospital and extra-costs. METHODS: The first phase study was from June to November 2002 and tile second phase study was planned to extend further the shelf life of the pouch bag from December 2002 to June 2003. Total 504 sterile sample packs containing cotton ball (5 cm-length) prepared and wrapped in four wrapping materials (randomized reprocessed two folds of lines, a fold of new craft paper, a fold of new nonwoven fabric, a fold of new pouch bag) and stored in three location (open shell of one of typical wards, open shelf of one of ICUs, open shelf of CSSD). Each type of packs were opened weekly and the cotton balls inoculated into thioglycollate broth at 35degrees C for seven days by infection control nurse. The temperature and relative humidity was monitored monthly. RESULTS: There was on growth found for any types of the pack and storage conditions studied. The temperature and relative humidity of storage locations were 24.8degrees C and 35.5 %. The extra-cost of reprocessing in Ethylene-Oxide gas sterilization was \32,800,000 and Steam sterilization was \36,900,000 by year. CONCLUSION: This study was conducted in attempt to identify the possibility of extending the current shelf life for sterile goods we use in a sense of cost effectiveness. It was possible to extend shelf life from four weeks to six months in the study hospital. We are going to continue this study and take all steps need to apply this new concept to our practice, and then trying to extend to other hospitals.
Cost-Benefit Analysis ; Costs and Cost Analysis* ; Delivery of Health Care ; Humidity ; Infection Control ; Infertility ; Steam ; Sterilization

BACKGROUND: The purpose of this study was to survey hygiene behavior of healthcare personnel according to the Hygiene Inventory 23 (HI23) and to use the results in education and research for promoting hygiene behaviors. METHODS: We sampled a total of 400 people with 50 from each job category. The sample was obtained through convenient sampling among 8,200 employees working at a tertiary-care hospital with 2,600 beds in Seoul. The HI23 consisted of 5 subscales and 8 questions on general hygiene, 3 on household hygiene, 3 on food-related hygiene, 5 on hand hygiene methods, and 4 on personal hygiene, resulting in a total of 23 questions. The researcher also added 14 questions on the general characteristics of the subjects. The self-administered questionnaires were distributed on October 2009 and analyzed blindly. RESULTS: The average total score for hygiene behavior was 3.04+/-0.44 (maximum of 4). In the subcategory of hygiene behavior, the mean score was 3.20+/-4.24 for general hygiene, 3.07+/-0.68 for household hygiene, 3.07+/-0.68 for food-related hygiene, 2.91+/-0.69 for hand hygiene methods, and 2.97+/-0.48 for personal hygiene. When factors affecting the level of hygiene behavior were identified through multivariate regression analysis, independent factors were found to be gender (female), job category (food-related job), experience in hand hygiene education, and experience in teaching hand hygiene or general hygiene. CONCLUSION: Programs and education adapted to the characteristics of each job category in hospitals are needed to promote hygiene behaviors such as general hygiene, hand hygiene methods, household hygiene, food-related hygiene, and personal hygiene.
Delivery of Health Care ; Family Characteristics ; Hand Disinfection ; Hand Hygiene ; Humans ; Hygiene ; Surveys and Questionnaires

No abstract available.
beta-Thalassemia*

BACKGROUND: Epidural morphine has been commonly used to provide postoperative pain relief, but it has many side effects such as nausea, vomiting, respiratory depression, and pruritus. The purpose of this study was to evaluate the analgesic efficacy and side effects by combination use of epidural morphine and butorphanol. METHODS: Forty five patients were randomly divided into 3 groups. For group I, a bolus of 4.7 ml of saline and 3 mg of morphine were administered. For group II, a bolus of 4.2 ml of saline and 3 mg of morphine and 1 mg of butorphanol were administered. For group III, a bolus of 3.2 ml of saline and 3 mg of morphine and 3 mg of butorphanol were administered. Continuous epidural analgesia were administered for all groups; group I (saline 99.4 ml and morphine 6 mg), group II (saline 98.4 ml, morphine 6 mg, and butorphanol 2 mg), group III (saline 96.4 ml, morphine 6 mg, and butorphanol 6 mg) by two day infuser, 2 ml/hr. We compared the side effects and analgesic effect of the three groups for 2 days. RESULTS: The incidence of pruritus, nausea and vomiting was reduced significantly in the group II and III, but the incidence of somnolence increased in the group III. There were no significant differences in analgesic effect and the other side effects among the three groups. CONCLUSION: Above results suggest that the addition of butorphanol to morphine in epidural infusion reduce the incidence of pruritus, nausea and vomiting, but increase the incidence of somnolence.
Analgesia* ; Analgesia, Epidural ; Anesthesia, Epidural* ; Butorphanol* ; Humans ; Incidence ; Morphine* ; Nausea ; Pain, Postoperative ; Pruritus ; Respiratory Insufficiency ; Vomiting

BACKGROUND: Epidural morphine has been commonly used to provide postoperative pain relief, but it has many side effects such as nausea, vomiting, respiratory depression, and pruritus. The purpose of this study was to evaluate the analgesic efficacy and side effects by combination use of epidural morphine and butorphanol. METHODS: Forty five patients were randomly divided into 3 groups. For group I, a bolus of 4.7 ml of saline and 3 mg of morphine were administered. For group II, a bolus of 4.2 ml of saline and 3 mg of morphine and 1 mg of butorphanol were administered. For group III, a bolus of 3.2 ml of saline and 3 mg of morphine and 3 mg of butorphanol were administered. Continuous epidural analgesia were administered for all groups; group I (saline 99.4 ml and morphine 6 mg), group II (saline 98.4 ml, morphine 6 mg, and butorphanol 2 mg), group III (saline 96.4 ml, morphine 6 mg, and butorphanol 6 mg) by two day infuser, 2 ml/hr. We compared the side effects and analgesic effect of the three groups for 2 days. RESULTS: The incidence of pruritus, nausea and vomiting was reduced significantly in the group II and III, but the incidence of somnolence increased in the group III. There were no significant differences in analgesic effect and the other side effects among the three groups. CONCLUSION: Above results suggest that the addition of butorphanol to morphine in epidural infusion reduce the incidence of pruritus, nausea and vomiting, but increase the incidence of somnolence.
Analgesia* ; Analgesia, Epidural ; Anesthesia, Epidural* ; Butorphanol* ; Humans ; Incidence ; Morphine* ; Nausea ; Pain, Postoperative ; Pruritus ; Respiratory Insufficiency ; Vomiting

Eccrine nevus is a rare benign cutaneous lesion, frequently present at birth or at an early age. Herein we report on a 1-year-old girl with erythematous papules in a zosteriform arrangement associated with hyperhidrosis on the left side of her trunk.
Female ; Humans ; Hyperhidrosis ; Nevus* ; Parturition

This study was designed to evaluate the effect of pelvic floor muscle exercise using biofeedback and electrical stimulation after normal vaginal delivery. The data were collected from November 1999 to April 2000 at a university hospital located in Seoul, Korea. Out of 49 women with normal vaginal delivery, 25 of experimental group(with exercise) and 24 of control group(without exercise) were questioned about lower urinary symptoms, discomfort during sexual intercourse and daily life. The maximum pressure of pelvic floor muscle contraction(MPPFMC) and duration of pelvic floor muscle contraction(DPFMC) were measured at pre-treatment, the end of treatment and 8 weeks after a treatment program. The pelvic floor muscle exercise program(using biofeedback and electrical stimulation) was applied to the experimental group twice a week for 4 weeks at the incontinence clinic and the pelvic floor muscle exercise at home for that time and more 8 weeks. Data were analyzed by t-test, X(2)-test, Fisher's exact test and the repeated measures ANOVA. The results were as follows; 1) MPPFMC(p=0.000) and DPFMC(p=0.021) were significantly increased in the experimental group. 2)In the lower urinary symptoms, daily frequency(p=0.001), nocturia(p=0.002), incontinence episode(p=0.016), stress incontinence(p=0.012), quantity of incontinence(p=0.026), straining(p=0.041), and strength of stream(p=0.009) were significantly decreased in the experimental group. 3)Discomfort during sexual intercourse had not a significant difference between the two groups, which was not significantly decreased as time passed. 4) In the discomfort during daily life, activity restriction(p=0.042), exercise restriction (p=0.008), interpersonal relationship restriction(p=0.046), and discomfort of general life(p=0.027) showed a significant difference between the two groups, which were not significantly decreased as time passed. In conclusion, it is suggested that the pelvic floor muscle exercise using biofeedback and electrical stimulation might be a safer and more effective program for the improvement of postpartum pelvic muscle contraction.
Biofeedback, Psychology ; Coitus ; Electric Stimulation ; Female ; Humans ; Korea ; Muscle Contraction ; Pelvic Floor* ; Postpartum Period ; Seoul ; Urogenital System*

This study was designed to assess the antihypertensive efficacy and overall tolerance of doxazosin in patients with mild-to-moderate essential hypertension. Doxazosin was administered in once-daily dose from 1 to 3mg to 97 patients both in a general hospital and a local clinic in rural area. These patients are composed of three groups. One group has 49 Patients treated with doxazosin monotherapy, another group with 31 patients treated with doxazosin as well as other antihypertensive drugs combined and a third group is composed of 17 patients with renal insufficiency n addition to hypertension. The patients in the third group with renal insufficiency had 2.5mg/dl-5.0mg/dl in serum creatinine. Results are as follows : 1) The study sample is composed of 37 males (38.1%) and 60 females (61.9%) with mean age 51.4 years. Among three subasmples no statistically significant difference is observed in age, sex, mean body weight and heigh at 0.05 error level. 2) A total of 47 patients (48.5%) of the 97 patients have completed twelve-week doxazosin antihypertensive treatment. At a mean dose of 4.4+/-0.4mg at twelfth week, 37 patients (78.7%) responded to doxazosin therapy. Twenty-nine(61.7% patients achieved "excellent" blood pressure control(mean sitting DBP of < or =90mmHg), and 8 patients (17.0%) showed "good respone" (10mmHg or more DBP reduction from baseline). Whereas remaining 10 patients (21.3%) showed only "fair response" (5-9mmHg DBP reduction) or "failed"(0-4mmHg DBP reduction). In doxazosin monotherapy group thirteen(68.4%) of nineteen patients showed "excellent" or "good response" at a mean dose of 4.8mg/day. Combination therapy group with eighteen patients showed 100% therapeutic success. This group had fourteen(77.8%) "excellent" and four(22.2%) "good respinse" at a mean daily dose of doxazosin 3.9mg. Renal insufficiency group with ten patients showed six(60.0%) "excellent" and four (40.0%) "failure"cases at a mean daily dose of 4.6mg. 3) The mean baseline sitting blood pressures of doxazosin monotherapy group were 175/109 whose blood pressure at twelfth week were 150/94 at a mean daily dose of 4.8mg. The baseline blood pressure of combined therapy group 180/111 were reduced to 145/91 at twelfth week at a mean daily dose of 3.9mg. Those of renal insufficiency group were 177/112 and 156/98 respectively at a mean doxazosin daily dose of 4.6mg. 4) Of the 97 study cases, adverse effect were reported in 19.6%. The most prevalent adverse effects were dizziness(11.3%), blurred vision(9.3%), headache(5.2%), most of which were mild or moderate and disappeared with or were tolerated on continued therapy. But three cases(3.1%) had to refrain from doxazosin administration due to blurred vision, dizzines, and headache. 5) The change of lipid analysis between before and after treatment in the monotherapy group with doxazosin showed 3.8% decrease of total cholesterol and 4.6% increase of HDL cholesterol and 11% increase of triglycerides, which were not statistically significant. In the combination therapy group 0.4% decrease of total cholesterol, 24.1% decrease of HDL cholesterol and 44.3% increase of triglycerides were observed. In the renal insufficiency group 4.9% decrease of total cholesterol, 22.1% decrease of HDL cholesterol, 0.1% decrease of triglycerides were observed. But all these findings have limitation in generalization due to small number of sample and a short period of observation. 6) Laboratory chemistry test results revealed no apparent treatment-related abnormalities.
Antihypertensive Agents ; Blood Pressure* ; Body Weight ; Chemistry ; Cholesterol ; Cholesterol, HDL ; Creatinine ; Doxazosin* ; Female ; Generalization (Psychology) ; Headache ; Hospitals, General ; Humans ; Hypertension ; Male ; Renal Insufficiency ; Triglycerides