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

No abstract available.
Fetal Blood* ; Humans ; Infant, Newborn* ; Insulin*

PURPOSE: The purpose of this study was to test the validity of a modified clinical performance examination (CPX) for preclinical students in nursing. METHOD: 70 nursing students in their second semester of the junior year at C University participated in CPX. Scenarios and checklists were developed by our research team from September to October 2005. Six stations were organized. Evaluation included physical examination of a patient with lung cancer, education on usage of a metered dosage inhaler, and lobectomy postoperative care. Students were randomly assigned to a station. RESULT: There was a difference in the CPX scores according to stations. The agreement of scoring between trained faculty members and SPs was more than moderate (r=.647). The correlation between the CPX score and the average grade in the previous semester and between the CPX score and the average grade of a paper and pen test of the pulmonary system of adults was low (r=.276; r=.048). CONCLUSION: Traditional CPX is generally recommended, however, modified CPX is appropriate for preclinical students in the current Korean Nursing school setting if there are additional scoring systems to balance the testing level at each station.
Administration, Inhalation ; Adult ; Education, Nursing, Baccalaureate/*standards ; Educational Measurement ; Female ; Humans ; Lung Neoplasms/nursing ; Male ; Medical History Taking ; Physical Examination ; Postoperative Care ; Reproducibility of Results ; Task Performance and Analysis

The purpose of this study was to develop a dental communication course in dental hygiene schools that included theory, practice, and skill for effective dental communication. Thirty-six senior dental hygiene students in a dental hygiene school took a dental communication course and responded to a questionnaire. The instrument used in the study was a modified form of Kim's communication skill self-assessment sheet. The self-assessment questionnaire about communication competencies was administered before and after the class, and the difference between scores at each time point was analyzed using the Wilcoxon signed rank sum test. Among seven elements of dental communication competencies, the competency of “information gathering” was significantly improved (p=0.008). Students' scores on perception of the importance (p=0.019) and necessity (0.016) of a communication course significantly increased after the course. Competencies in communication are essential requirement for dental hygienists. This study showed the possibility of communication skill training. An objective evaluation tool regarding students' communication competencies should be developed. Further studies with larger samples size are needed to develop a standardized comprehensive communication course in dental hygiene schools.
Curriculum ; Dental Hygienists ; Health Communication ; Health Education ; Humans ; Learning* ; Oral Hygiene* ; Self-Assessment

PURPOSE: The purpose of this study was to compare communication competence, nursing professionalism, work environment and job satisfaction between outpatient nurses and ward nurses, and to identify the correlation among variables.METHODS: The participants were 90 outpatient nurses and 98 ward nurses at the two general hospitals. Data were collected using self-administered questionnaires. Data were analyzed using descriptive statistics, χ2-test, independent t-test and Pearson's correlation coefficient.RESULTS: There were statistically significant differences between two groups in nursing professionalism, possibilities for development, commitment to the workplace, social support from colleagues, social community at work and job satisfaction, outpatient nurses showed higher level than ward nurses except commitment to the workplace. The work environment variables and nurses' job satisfaction were mostly correlated. Job satisfaction showed significant negatively correlated with quantitative demands, emotional demands and role conflicts in both groups nurses.CONCLUSION: These findings showed that nursing work environments were the most important factor for job satisfaction of both group nurses. Therefore, it is necessary to put efforts in improving nursing work environment and to develop diverse strategies for human resource management.
Hospitals, General ; Humans ; Job Satisfaction ; Mental Competency ; Nursing ; Outpatients ; Professionalism

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PURPOSE: To investigate the patterns of locoregional recurrence of pathologic T3N0 (pT3N0) lower rectal cancer omitting postoperative radiotherapy (RT) and explore the potential of modification of a RT field. MATERIALS AND METHODS: From Jan 2003 to Nov 2011, 35 patients omitting preoperative or postoperative RT for pT3N0 lower rectal cancer were included. We defined the lower rectal cancer as the tumor with the inferior margin located below the virtual line-a convergent level between rectal wall and levator ani muscle. All patients had radiologic examinations for recurrence evaluation during the follow-up duration. RESULTS: The median follow-up duration was 66.4 months (range, 1.4 to 126.1 months). Eight (22.9%) of the 35 patients had recurrence. Three (8.6%) was local recurrence (LR) only, 3 (8.6%) was distant metastasis (DM) only, and 2 (5.7%) was LR with DM. All LR were located at primary tumor sites. The overall survival rate, LR-free survival rate, and DM-free survival rate at 5 years was 79.8%, 83%, and 87%, respectively. All LR developed from tumors over 5 cm. However, there was no statistical significance (p = 0.065). There was no other risk factor for LR. CONCLUSION: Even though the patients included in this study had pathologically favorable pT3N0 rectal cancer, LR developed in 14.3% of patients. Most of the LR was located at primary tumor sites prior to surgery. Based on these findings, it might seem reasonable to consider postoperative RT with a smaller radiation field to the primary tumor site rather than the conventional whole pelvic irradiation.
Follow-Up Studies ; Humans ; Muscles ; Neoplasm Metastasis ; Neoplasm Recurrence, Local ; Radiotherapy, Adjuvant ; Rectal Neoplasms ; Recurrence ; Risk Factors ; Survival Rate

Purpose : The purpose of this study was to obtain epidemiologic data and overall risk of complications of short term peripheral intravenous catheters. METHODS: The data was collected prospectively from August 19 to september 13, 2002. The subjects of this study were 350 adult patients hospitalized to the internal medicine a surgical general ward. Catheter sites were inspected daily from insertion to removal by infection control nurses, and characteristics of patients and catheters were recorded. Phlebitis was defined as one of the followings along the course of the vein: erythema, warmth. swelling or tenderness. RESULTS: Overall incidence of the phlebitis associated with short-term catheter was 23.7%. Catheters were removed when routine catheter replacement (every 72 hours) was occurred in 24.9%, phlebitis 23.7%. discharge of patients 13.1%, change of heparin cap 9.7%, others 28.6%. There were no significant differences in the incidence of the phlebitis by sex, age, the type of dressing, the duration of catheter placement insertion site, the type of hospitalized ward' and the size of cannula. The incidence of phlebitis was the highest (36.1%) within 48-72 hours after insertion. There was significant difference in the incidence of phlebitis according to the types of infusate. 75 of 83 phlebitis cases (90.4%) were received chemical infusates. Especially glucose/aminoacid, TPN and intralipose were attributed to major risk factor of phlebitis associated with short-term catheter (P<0.05). CONCLUSION: The incidence rate of phlebitis associated with short-term catheter was 23.7%. In this study, the type of infusate was the significant risk. factor related to phlebitis. Consequently, in order to prevent and detect the phlebitis associated with short-term catheter early, a consistent, organized assessment and evaluation of the above factors during the intravenous therapy is needed.
Adult ; Bandages ; Catheters* ; Epidemiologic Studies* ; Erythema ; Heparin ; Humans ; Incidence ; Infection Control ; Internal Medicine ; Korea* ; Patients' Rooms ; Phlebitis* ; Prospective Studies ; Risk Factors ; Seoul* ; Veins

PURPOSE: The purpose of this study was to determine the proton MR spectroscopic features of liver cirrhosis and the different proton MR spectroscopic features between liver cirrhosis and the normal human liver by comparing the two different conditions. MATERIALS AND METHODS: The investigation involved 30 cases of in-vivo proton MR spectra obtained from 15 patients with liver cirrhosis demonstrated on the basis of radiologic and clinical findings, and from 15 normal volunteers without a past or current history of liver disease. MR spectroscopy involved the use of a 1.5T GE Signa Horizon system (GE Medical Systems, Milwaukee, U.S.A.) with body coil. STEAM (STimulated Echo-Aquisition Mode) with 3000/30 msec of TR/TE was used for signal acquisition; patients were in the prone position and respiration was not interrupted. Cases were assigned to either the cirrhosis or normal group, and using the proton MR spectra of cases of in each group, peak changes occurring in lipids (at 1.3ppm), glutamate and glutamine (at 2.4 -2 .5ppm), phosphomonoesters (at 3.0 -3 .1ppm), and glycogen and glucose (at 3.4 -3 .9ppm) were evaluated. Mean and standard deviation of the ratio of glutamate + glutamine/lipids, phospho-monoesters/lipids, glycogen + glucose/lipids were calculated from the area of their peaks. The ratio of various metabolites to lipid content was compared between the normal and cirrhosis group. RESULTS: The main characteristic change in proton MR spectra in cases of liver cirrhosis compared with normal liver was decreased relative intensity of lipid peak. Mean and standard deviation of ratio of glutamate + g-lutamine/ lipids, phosphomonoesters/lipids, glycogen + glucose/lipids calculated from the area of their peaks of normal and cirrhotic liver were 0.0204 +/-0.0067 and 0.0693 +/-0.0371 (p<0.05), 0.0146 +/-0.0090 and 0.0881 +/-0.0276 (p<0.05), 0.0403 +/-0.0267 and 0.2325 +/-0.1071 (p<0.05), respectively. The other character-istic feature of proton MR spectra of liver cirrhosis was the peak detected at 3.9 - 4.1 ppm with unknown nature. Mean and standard deviation of area ratio of the unknown peak to lipid peak in proton MR spectra of liver cirrhosis was 0.1504 +/-0 . 0 3 5 5 . CONCLUSION: Proton MR spectra of liver cirrhosis revealed decreased intensity of lipid with statistical signifi-cance compared with that of normal liver, and peak at 3.9 -4.1 ppm with unknown nature. In conclusion, liver cirrhosis can be diagnosed non-invasively by the analysis of observed proton MR spectroscopic features.
Fibrosis ; Glucose ; Glutamic Acid ; Glutamine ; Glycogen ; Healthy Volunteers ; Humans ; Liver Cirrhosis* ; Liver Diseases ; Liver* ; Magnetic Resonance Spectroscopy ; Prone Position ; Protons* ; Respiration ; Steam

PURPOSE: This study aimed to compare cerebral hemispheric volumes between pharmacologic treatment and supportive management of patent ductus arteriosus (PDA). METHODS: The study was conducted retrospectively. The subjects of period 1 group were very low birth weight infants whose PDA were treated with pharmacologic closure. Period 2 group were treated with supportive management. Regional brain volumes measured using magnetic resonance imaging were compared between the two groups. RESULTS: total of 12 infants were included. Their median gestational age was 27⁺⁶ (range: 24⁺¹–31⁺¹) weeks and birth weight was 1,065 g (range: 690–1,380). Between the two groups, there was no difference in Apgar score, incidence of bronchopulmonary dysplasia, necrotizing enterocolitis, and culture proven sepsis. The regional brain volumes such as gray matter (Period 1 group, 76,833 mm³ [55,759–100,388] vs. Period 2 group, 79,870 mm³ [59,957–113,018], P=0.59), white matter (82,993 mm³ [63,130–121,311] vs. 92,576 mm³ [77,200–104,506], P=0.18), cerebrospinal fluid (17,167 mm³ [9,279–22,760] vs. 14,348 mm³ [7,018–27,604], P=0.94), basal ganglia (2,065 mm³ [1,697–2,482] vs. 2,306 mm³ [2,065–3,009], P=0.18), and cerebellum (18,374 mm³ [14,843–24,657] vs. 18,096 mm³ [16,134–23,627], P=0.94) were not different between the two groups. CONCLUSION: Regional brain volumes were not different between pharmacological and conservative treatment in infants with PDA. Further wellcontrolled studies are required to evaluate the advantages or disadvantages of supportive management without pharmacologic treatment of PDA.
Apgar Score ; Basal Ganglia ; Birth Weight ; Brain* ; Bronchopulmonary Dysplasia ; Cerebellum ; Cerebrospinal Fluid ; Ductus Arteriosus, Patent* ; Enterocolitis, Necrotizing ; Gestational Age ; Gray Matter ; Humans ; Ibuprofen* ; Incidence ; Infant* ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight* ; Magnetic Resonance Imaging ; Pilot Projects* ; Retrospective Studies ; Sepsis ; White Matter