No abstract available.
Asthma*

No abstract available.
Humans ; Inpatients*

The Acknowledgements was published incorrectly.

BACKGROUND: This study aimed at identifying the effects of improved methods of endotracheal suction and hand washing on incidence of nosocomial pneumonia (NP) in the neurosurgical ICU. METHOD: Repeated training of nurses about hand washing and adherence of the single use of suction catheter and sterile normal saline of endotracheal suction was provided. Then hand washing compliance of nurses before and after training was investigated. and the incidence of NP in all patients hospitalized for more than 72 hours in the neurosurgical ICU was investigated from Sep 1, 2000 to Jan 31, 2001 (2nd surveillance). The NP rate of that period was compared with the incidence of the 1st surveillance period, from Sep 1, 1999 to Jan 31, 2000. The data were analyzed with chi-square-test. Fisher's exact test and logistic regression analysis by SAS 8.0. RESULT: The proportion of hand washing performance increased from 15.6% to 46.8%. The rates of NP per patient during 1st surveillance and 2nd surveillance were 10.3%, 3.9%(p=0.01) patient-days rates of NP were 10.0 cases/1,000 patient days, 4.1 cases/1,000 patient days(p=0.04), and ventilator-days rates of NP were 67.6 cases/1.000 ventilator days, 16.2 cases/1,000 ventilator days(p=0.00) respectively. Out of 29 isolates, 18 were methicillin-resistant Staphylococcus aureus, which was the most frequently isolated microorganism. The risk factors associated with incidence of NP were age, length of stay, Glasgow coma scale, diabetes mellitus, duration of intubation, insertion of endotracheal tube, duration of tracheostomy, presence of tracheostomy, duration of ventilator, use of ventilator, and insertion of nasogastric tube. CONCLUSION: These results showed that single use of suction catheters and sterile normal saline and increased compliance of hand washing were important factors to decrease the incidence of NP.
Catheters ; Compliance ; Diabetes Mellitus ; Glasgow Coma Scale ; Hand Disinfection* ; Hand* ; Humans ; Incidence* ; Intensive Care Units* ; Critical Care* ; Intubation ; Length of Stay ; Logistic Models ; Methicillin-Resistant Staphylococcus aureus ; Pneumonia* ; Risk Factors ; Suction* ; Tracheostomy ; Ventilators, Mechanical

BACKGROUND: Controversy exists as to whether or not inhalation anesthetics and intravenous anesthetics impair arterial oxygenation (PaO2) during one lung ventilation (OLV). Accordingly, we examined the effect of enflurane and propofol on PaO2 and pulmonary vascular resistance (PVR) during OLV. METHODS: Forty patients, who had prolonged periods of OLV anesthesia with minimal trauma to the nonventilated lung were studied in a cross over design. Patients were randomized to four groups; Group 1 received 1 MAC of enflurane and oxygen from induction until the first 20 min after complete lung collapse, then were switched to propofol 100 g/kg/min (P100). In group 2, the order of the anesthetics was reversed. Group 3, Group 4 received the same order of the anesthetics as Group 1, Group 2, respectively but received propofol 200 g/kg/min (P200). RESULTS: During OLV, the PaO2 values were lower than those with two lung ventilation (TLV), there were no significant differences among each groups and between propofol and enflurane in PaO2, but in the selected patients (n=10, PaO2<120 mmHg during OLV), PaO2 in propofol group was higher than that of enflurane group (p<0.05). Conversion from TLV to OLV caused a significant increase in PVR, but there were no difference in PVR between propofol and enflurane group. CONCLUSIONS: These results suggest that the usual clinical dose of propofol affords no advantage over 1 MAC of enflurane anesthesia except low PaO2 patients during OLV. Propofol might be of value in risk patients of hypoxemia during thoracic surgery when OLV is planned.
Anesthesia ; Anesthetics ; Anesthetics, Inhalation ; Anesthetics, Intravenous ; Anoxia ; Cross-Over Studies ; Enflurane* ; Humans ; Lung ; One-Lung Ventilation* ; Oxygen* ; Propofol* ; Pulmonary Atelectasis ; Thoracic Surgery ; Vascular Resistance ; Ventilation

Prader-Willi(PW)syndrome is characterized by obesity, hypotonia, mental retardation, hypogonadism, short stature, excessive eating and characteristic facial appearance. Diabetes mellitus has been considered a component of PW syndrome. Recently this syndrome is caused by the absence of paternally derived genes normally located on chromosome segment 15 q11-q13 or may be the result of maternal uniparental disomy with the absence of paternally derived 15 q11-q13 region. The developement of probes containing segments of DNA from chromosome region 15 q11-q13 provides the oppotunity to confirm the diagnosis of PW syndrome by fluorescence in situ hybridization(FISH). We experienced a 15-year-old boy of PW syndrome with diabetes mellitus, who revealed mental retardation, hypogonadism, obesity and microdeletion of chromosome 15 q11-q13 comfirmed by FISH.
Adolescent ; Chromosomes, Human, Pair 15* ; Diabetes Mellitus ; Diagnosis ; DNA ; Eating ; Fluorescence ; Humans ; Hypogonadism ; Intellectual Disability ; Male ; Muscle Hypotonia ; Obesity ; Prader-Willi Syndrome* ; Uniparental Disomy

PURPOSE: To examine the degree of depression and anxiety in Korean patients with age-related macular degeneration (AMD) and to evaluate the influence of mood disturbance on patient's treatment satisfaction and compliance. METHODS: Forty-four patients with AMD and thirty-three controls comprised the study populations. Patients and controls rated themselves on the Korean Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI). The effect of mood disturbance on the patient's satisfaction and compliance was evaluated. RESULTS: The depression and anxiety scores were significantly higher in patients with AMD. The mood disturbance was negatively correlated with the patient's satisfaction and compliance. 14 patients (31.8%) were lost to follow-up 1 year later. The depression and anxiety scores of these patients were higher than those of remaining thirty patients. CONCLUSIONS: Depression and anxiety of patients with AMD affect on patient's satisfaction and compliance. So recognition and management of mood disturbance may help improving visual function and maintaining quality of life in patients.
Anxiety ; Compliance ; Depression ; Humans ; Lost to Follow-Up ; Macular Degeneration ; Quality of Life

Although many methods have been developed to correct the aging process of the head and neck, the correction of nasolabial folds still remains a difficult area. The difficulty of correcting nasolabial fold is due to the anatomical location and the difference of aging process. From March 2000 to February 2001, the authors operated on 10 aging face patients using face lift with SMAS and FAME(Finger-assisted malar fat pad elevation) technique. The authors repositioned the SMAS-platysma flap posterosuperiorly and used finger dissection of the malar fat pad enabling a 3-dimensional correction and repositioning of the fat pad without detachment of the zygomatic ligament. The finger dissection of the malar fat pad attached to the skin enables a more anatomical correction of the malar fat pad with a more natural looking layer and longer lasting results in addition to decreased hematoma, edema and postoperative pain compared to previous methods.
Adipose Tissue ; Aging ; Edema ; Fingers ; Head ; Hematoma ; Humans ; Ligaments ; Nasolabial Fold ; Neck ; Pain, Postoperative ; Rhytidoplasty* ; Skin

OBJECTIVE: In order to confirm the local production of total and specific IgE antibodies in the nasal polyp tissues. MATERIAL AND METHOD: We measured total IgE and house dust mite(Dermatophagoides pteronpssinus .' DP)-specific IgE antibody using enzyme-linked immunosorbent assay(ELISA) in the supernatant of nasal polyp homogenates from 72 subjects undergoing nasal polypectomy. The subjects were divided into three groups according to skin reactivity to DP: 20 strongly atopic subjects to group I(mean wheal diameter) 3mm), 19 weakly atopic subjects to group II (mean wheal diameter 1-3mm) and 33 negative skin responders to group III. RESULT: Group I showed significantly higher levels of total and DP-specific IgE levels in the nasa
Antibodies ; Dust* ; Immunoglobulin E* ; Nasal Polyps* ; Pyroglyphidae* ; Skin ; United States National Aeronautics and Space Administration

PURPOSE: The purpose of this study was to compare the rehabilitation nursing services what nurses recognize to be important and what they do in practice of the industrial workers. METHOD: The subjects were 150 nurses who were working at the industrial hospital. The questionnaire was made up with 43 items about the perception on importance and performance of rehabilitation services. RESULT: The highest services in the perception on importance and performance subscale were physical and therapeutic services. The highest difference between perception on importance and performance was the social and occupational services. The perception on importance of rehabilitation services had positive correlation with performance. The group take care of general patients had a higher level of perception on importance than the other group, and level of performance had significant difference with age and position. CONCLUSION: We need to develop the strategy for promoting the performance of services that recognize it will be important services, but not to do. Further study on system for promoting the nurse practitioner who responsible for rehabilitation nursing.
Humans ; Nurse Practitioners ; Occupational Health ; Surveys and Questionnaires ; Rehabilitation Nursing