The 5th year KONSAR surveillance in 2001 was based on routine test data at 30 participating hospitals. It was of particular interest to find a trend in the resistances of enterococci to vancomycin, of Enterobacteriaceae to the 3rd generation cephalosporin and fluoroquinolone, and of Pseudomonas aeruginosa and acinetobacters to carbapenem. Resistance rates of Gram-positive cocci were: 70% of Staphylococcus aureus to oxacillin; 88% and 16% of Enterococcus faecium to ampicillin and vancomycin, respectively. Seventy-two percent of pneumococci were nonsusceptible to penicillin. The resistance rates of Enterobacteriaceae were: Escherichia coli, 28% to fluoroquinolone; Klebsiella pneumoniae, 27% to ceftazidime, and 20% to cefoxitin; and Enterobacter cloacae, > or =40% to cefotaxime and ceftazidime. The resistance rates of P. aeruginosa were 21% to ceftazidime, 17% to imipenem, and those of the acinetobacters were > or =61% to ceftazidime, aminoglycosides, fluoroquinolone and cotrimoxazole. Thirty-five percent of non-typhoidal salmonellae were ampicillin resistant, and 66% of Haemophilus influenzae were -lactamase producers. Notable changes over the 1997-2001 period were: increases in vancomycin-resistant E. faecium, and amikacin- and fluoroquinolone-resistant acinetobacters. With the increasing prevalence of resistant bacteria, nationwide surveillance has become more important for optimal patient management, for the control of nosocomial infection, and for the conservation of the newer antimicrobial agents.
Anti-Bacterial Agents/*pharmacology ; Cephalosporins/pharmacology ; *Drug Resistance, Microbial ; Enterococcus faecium/metabolism ; Human ; Imipenem/pharmacology ; Klebsiella pneumoniae/metabolism ; Korea ; Pseudomonas aeruginosa/metabolism ; Time Factors ; Vancomycin/*pharmacology

PURPOSE: To assess the effectiveness of a care map for a fast-track discharge program after colorectal cancer surgery. METHODS: Ninety-nine patients who underwent colorectal surgery were retrospectively analyzed: 45 patients who were placed in a conventional program (January 3 to March 13, 2013) and 44 patients who were placed in a fast-track program using the care map (July 26 to September 24, 2014). Patients in the fast-track program started eating on postoperative day 1, while those in the conventional program started eating on post-operative day 2. complications, and pain were compared between the two groups. RESULTS: A slight decrease in the average duration of hospitalization was observed for the fast-track group (5.31+/-0.98 days) compared to the conventional group (5.38+/-2.80 days), although this difference was not statistically significant. All other outcomes for the fast-track group were scored as 0. Furthermore, there was no statistically significant differences between pain, narcotics administration, and non-narcotic analgesics (aside from patient-controlled analgesia). CONCLUSION: The care map for the colorectal surgery fast-track program was effective and program validation and supplementation of the active standardization early recovery program should be performed using multi-disciplinary research.
Analgesics, Non-Narcotic ; Colorectal Neoplasms* ; Colorectal Surgery ; Eating ; Hospitalization ; Humans ; Narcotics ; Retrospective Studies

OBJECTIVES: The purpose of this study was to observe the reaction kinetics and the degree of polymerization of composite resins when cured by different light sources and to evaluate the effectiveness of the blue Light Emitting Diode Light Curing Units (LED LCUs) compared with conventional halogen LCUs. MATERIALS AND METHODS: First, thermal analysis was performed by a differential scanning calorimeter (DSC). The LED LCU (Elipar Freelight, 320 mW/cm2) and the conventional halogen LCU (XL3000, 400 mW/cm2) were used in this study for curing three composite resins (SureFil, Z-250 and AEliteFLO). Second, the degree of conversion was obtained in the composite resins cured according to the above curing mode with a FTIR. Third, the measurements of depth of cure were carried out in accordance with ISO 4049 standards. Statistical analysis was performed by two-way ANOVA test at 95% levels of confidence and Duncan's procedure for multiple comparisons. RESULTS: The heat of cure was not statistically different among the LCUs (p > 0.05). The composites cured by the LED (Exp) LCUs were statistically more slowly polymerized than by the halogen LCU and the LED (Std) LCU (p < 0.05). The composite resin groups cured by the LED (Exp) LCUs had significantly greater degree of conversion value than by the halogen LCU and the LED (Std) LCU (p = 0.0002). The composite resin groups cured by the LED (Std) LCUs showed significantly greater depth of cure value than by the halogen LCU and the LED (Exp) LCU (p < 0.05).
Composite Resins* ; Hot Temperature ; Kinetics ; Polymerization* ; Polymers* ; Spectroscopy, Fourier Transform Infrared

PURPOSE: Positive ratio of routine EEG in adult epilepsy was widely known, but small number was reported in child epilepsy. Thus, we studied the difference of positive ratios between ages. METHODS: We reviewed the clinical records of 756 patients, who visited the pediatric neurology clinic with more than 2 afebrile seizures except neonatal seizures, from March 1997 to December 2004. Excluded were children with previous history of antiepileptic medication or failure of EEG. Clinical aspects and EEG findings of left 609 patients were evaluated retrospectively. RESULTS: Median age of EEG examination was 7.0 years (range, 3 months to 19.8 years) and male was 339. Number of child under 2 years was 112, 2-4 was 96, 5-9 was 233, 10-14 was 160 and over 15 was 8. All 279 positive past history was known in 222 persons, 98 of them had previous febrile seizures, 37 had CP or MR, 11 had neonatal seizures, 11 had birth asphyxia, 28 was prematurity. Waking EEG was checked in 398, sleep EEG in 547. Abnormal findings were found in 443 (72.7%). Definite epileptiform discharges were found in 388 patients (63.7%), suspicious spike discharges in 37 (6.2%). Patients under 2 years had 50.0% positive ratio of epileptiform discharges, 2-4 had 62.5%, 5-9 had 85.8%, 10-14 had 66.3% and over 15 had 37.5%. CONCLUSIONS: High positive ratio of routine EEG was found in child epilepsy, thus routine EEG seems to be very useful for the first diagnostic examination in child epilepsy.
Adult ; Asphyxia ; Child* ; Electroencephalography* ; Epilepsy* ; Humans ; Male ; Neurology ; Parturition ; Retrospective Studies ; Seizures ; Seizures, Febrile

As it is difficult to perform biological study in the actual space, several researchers have tried to develop methods that could 'mimic' microgravity condition on Earth. During the free fall of the aircraft, so-called 'parabolic flight', objects in a plane could experience weightlessness during a short period of time (approximately 20 to 30 seconds). We first reviewed former studies using parabolic flight in a variety of research filed including vestibular, neurologic, cardiovascular, musculoskeletal and immune system. We also investigated the actual conditions of biologic research using parabolic flight in Korea, by performing a questionnaire survey for 19 experts in space biology.
Aerospace Medicine ; Aircraft ; Biology ; Immune System ; Korea ; Weightlessness

BACKGROUND/AIMS: Procalcitonin (PCT) may prove to be a useful marker to exclude or predict bloodstream infection (BSI). However, the ability of PCT levels to differentiate BSI from non-BSI episodes has not been evaluated in nosocomial BSI. METHODS: We retrospectively reviewed the medical records of patients ≥ 18 years of age with suspected BSI that developed more than 48 hours after admission. RESULTS: Of the 785 included patients, 105 (13.4%) had BSI episodes and 680 (86.6%) had non-BSI episodes. The median serum PCT level was elevated in patients with BSI as compared with those without BSI (0.65 ng/mL vs. 0.22 ng/mL, p = 0.001). The optimal PCT cut-off value of BSI was 0.27 ng/mL, with a corresponding sensitivity of 74.6% (95% confidence interval [CI], 66.4% to 81.7%) and a specificity of 56.5% (95% CI, 52.7% to 60.2%). The area under curve of PCT (0.692) was significantly larger than that of C-reactive protein (CRP; 0.526) or white blood cell (WBC) count (0.518). However, at the optimal cut-off value, PCT failed to predict BSI in 28 of 105 cases (26.7%). The PCT level was significantly higher in patients with an eGFR < 60 mL/min/1.73 m² than in those with an eGFR ≥ 60 mL/min/1.73 m² (0.68 vs. 0.17, p = 0.01). CONCLUSIONS PCT was more useful for predicting nosocomial BSI than CRP or WBC count. However, the diagnostic accuracy of predicting BSI remains inadequate. Thus, PCT is not recommended as a single diagnostic tool to avoid taking blood cultures in the nosocomial setting.

PURPOSE: Mycoplasma pneumoniae infection is relatively common in childhood. Its extrapulmonary manifestations have been reported so much, but hepatitis associated with it has been reported rarely in Korea. METHODS: A clinical study was performed on 556 patients of M. pneumoniae pneumonia diagnosed serologically at Gil hospital from January 2001 to December 2004. We reviewed 65 cases among these patients, who had elevated level of serum AST and ALT greater than 50 IU/L respectively without evidence of hepatitis A, B, C, Cytomegalovirus and Ebstein-Barr virus infections. RESULTS: Hepatitis occurred in 11.7% of Mycoplasma pneumoniae pneumonia, especially in fall and winter times. Male to female ratio was 1.2: 1 and the mean age was 4 years and 3 months. Besides hepatitis, cough (95.4%), sputum (52.3%) and dyspnea (12.3%) were common as pulmonary manifestations. And among gastrointestinal manifestations, nausea/vomiting (26.2%) was the most common symptom, followed by poor oral intake (12.3%), diarrhea (12.3%) and abdominal pain (6.2%). In addition to hepatomegaly (4.6%) and splenomegaly (4.6%), coarse breathing sound was the most common physical manifestation, followed by rale (63.1%), pharyngeal injection (26.2%), and rash (10.8%). Anemia was noted in 20.0%, neutrophilia in 10.8%, eosinphilia in 38.5% and thrombocytosis in 6.2%, respectively. Mean level of ESR and CRP was 32.02 mm/hr and 6.69 mg/dL, respectively. Mean level of AST and ALT was 293.80 IU/L and 181.48 IU/L, respectively. Hyperbilirubinemia was noted in 7.7% and hypoalbuminemia was noted in 58.5%. Lobar or lobular pneumonia (78.5%) was the most common finding in chest X-ray and left lower lobe (39.2%) was most commonly affected. Pleural effusion was noted in 26.2%. Mean duration of hospitalization was 9.91 days. Serum AST/ALT level was normalized within 9.94 days and pulmonary consolidation resolved within 14.29 days. CONCLUSION: The prognosis of M. pneumoniae hepatitis is good. However, liver function should be considerately checked in M. pneumoniae infection because its incidence is not so low.
Abdominal Pain ; Anemia ; Child* ; Cough ; Cytomegalovirus ; Diarrhea ; Dyspnea ; Exanthema ; Female ; Hepatitis A ; Hepatitis* ; Hepatomegaly ; Hospitalization ; Humans ; Hyperbilirubinemia ; Hypoalbuminemia ; Incidence ; Korea ; Liver ; Male ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pleural Effusion ; Pneumonia ; Pneumonia, Mycoplasma* ; Prognosis ; Respiratory Sounds ; Splenomegaly ; Sputum ; Thorax ; Thrombocytosis

OBJECTIVE: The causal link between oncogenic HPV(Human Papilloma Viruses) and the development of CIN (rvical intraepithelial neoplasia) and cervical cancer are now well established. Several medical therapeutic candidates aimd at the treatment of precancerous lesions and invasive carcinoma of the cervix. The objective of this study was to develop the pH-sensitive chitosan/alginate gels (pH=3.8-4.5) and temperature sensitive multiblock copolymers of PEG/PLA (poly (L-lactic acid)/polyethylene glycol) gels (temperature=37 degrees C) for controlled delivery of the paclitaxel (PTX). We had also evaluated whether PTX entrapped in chitosan/alginate gels or multiblock copolymers of PEG/PLA 1 could inhibit tumor growth in vivo. METHODS: PTX entrapped as microsphere in Chitosan/Alginate Microspheres were obtained using a spray-drying method. PTX-entrapped PEG/PLA gels were prepared by the solvent displacement method. We had prepared the multiblock copolymers of PEG/PLA which has the sol-gel-sol transition temperature at body temperature. The in-vivo efficacy of PTX in chitosan microphere or PTX in PEG/PLA mutiblock copolymer micelle were conducted in HeLa-tumor bearing Balb/c Nu/Nu athymic mice at an equivalent paclitaxel dose of 10 mg/kg with 48 hr interval. The inhibition of tumor growth was evaluated after 8 days of treatment. RESULTS: On 8 days after the transcutaneous treatment of PTX-containing chitosan microphere or PTX in PEG/PLA mutiblock copolymer micelle. significant inhibition in tumor growth was observed in balb/c nu/nu nude mouse carrying xenograft tumors (HeLa cells; HPV-18 positive state). Among these formulations, PTX in PEG/PLA mutiblock copolymer have shown improved therapeutic efficacy as compared to PTX-ivgroup. CONCLUSION: PTX-containing chitosan microphere or PTX in PEG/PLA mutiblock copolymer nanoparticles are a unique pH-sensitive and temperature sensitive drug delivery system. These formulations elicits enhanced efficacy as an effective and minimally invasive treatment in mice bearing human cervical cancer (HeLa Cells) xenograft.
Animals ; Body Temperature ; Cervix Uteri ; Chitosan ; Drug Delivery Systems ; Female ; Gels ; Heterografts ; Human papillomavirus 18 ; Humans ; Mice ; Mice, Nude ; Microspheres ; Nanoparticles ; Paclitaxel ; Papilloma ; Polymers* ; Transition Temperature ; Uterine Cervical Neoplasms

The authors calculated the number of blood cultures per 1,000 admitted patient days at seven university-affiliated hospitals in 2010, which ranged from 65 to 129 (mean 110). The number of blood cultures per 1,000 patient days could possibly be a good parameter for assessing the appropriateness of blood culture.
Humans ; Korea ; Quality Control ; Sepsis

PURPOSE: Helicobacter pylori (H. pylori) infection has been known to be vital in the pathogenesis of duodenal ulcer disease in children as well as in adults. But the relationship between H. pylori infection and the histopathologic findings of the duodenum has not been explained obviously in children yet. So the aim of this study is to determine whether duodenitis and/or gastric metaplasia in the duodenum increases the risk of duodenal ulcer disease in children infected by H. pylori. METHODS: From October 2001 to April 2004 gastric and duodenal biopsies were performed in 177 children who visited Department of Pediatrics, Gil Hospital, Gachon Medical School. Biopsy sections were stained with hematoxylin and eosin and also with Giemsa for identification of H. pylori. The grades of duodenitis and gastric metaplasia were classified from 0 to 3 and from 0 to 4, respectively. RESULTS: The incidence of H. pylori infection was 54% in total patients. Amongst 163 children with duodenitis there was a lack of correlation between H. pylori infection and the grade of duodenitis. Amongst 11 patients with duodenal ucler, only 4 children were infected by H. pylori. And amongst 5 patients with gastric metaplasia, H. pylori and duodenal ulcer were detected in 2 and 3 children, respectively. The occurrence of duodenal ulcer and gastric metaplasia were increased significantly in proportion to the grade of duodenitis (p<0.0001 and p=0.0365, respectively). CONCLUSION: As opposed to the results of previously reported articles, there were lacks of correlation between H. pylori infection and duodenitis, duodenal ulcer, and gastric metaplasia. So further study hould be done to clarify the effect of H. pylori on the duodenal histopathology in children infected by H. pylori.
Adult ; Biopsy ; Child* ; Duodenal Ulcer* ; Duodenitis* ; Duodenum ; Eosine Yellowish-(YS) ; Helicobacter pylori* ; Helicobacter* ; Hematoxylin ; Humans ; Incidence ; Metaplasia* ; Pediatrics ; Prospective Studies* ; Schools, Medical