The purpose of this study was to compare the effect of different methods of hand washing by counting the number of bacteria on the hand surface. Eighteen clinicians were chosen and divided into three groups, consisting of six clinicians each. Culturing of the right raw palms of all individuals was performed. Individuals in the control group washed hands for 5 seconds with antimicrobial soap. Group 1 washed their hands for 10 seconds with antimicrobial soap. Group 2 washed with an instant alcohol-based hand sanitizer. After the respective washes, re-culturing of the right raw palm was done for each member of all groups. The colony-forming units (CFU) were calculated at each time point, and the reduction rate of CFU among the three groups were statistically evaluated using student t-test. All groups showed a significant decrease in CFU, according to the time applied (P<0.01). In addition, the reduction rate of CFU between the groups were statistically evaluated with ANOVA (P<0.01). It showed statistically difference between the control group and group 1, control group and group 2. The present study confirmed that the hand washing method with antimicrobial soap for 10 seconds and hand sanitizer, including alcohol, were excellent for decreasing the number of bacteria on the hand surface.
Bacteria ; Bacterial Load* ; Hand Disinfection* ; Hand* ; Humans ; Methods* ; Soaps ; Stem Cells

Effective and systematic sanitation management programs are necessary to prevent foodborne disease outbreaks in school foodservice operations. The purpose of this study was to identify the elements to improve in order to ensure the safety of school food service by evaluating sanitation management practices implemented under HACCP-based programs. The survey was designed to assess the level of hygiene practices of school food service by using an inspection checklist of food hygiene and safety. Fifty-four school foodservice establishments considered as poor sanitation practice groups from two year inspections by Seoul Metropolitan Office of Education were surveyed from September to December in 2005. Inspection checklists consisted of seven categories with 50 checkpoints; facilities and equipment management, personal hygiene, ingredient control, process control, environmental sanitation management, HACCP system and safety management. Surveyed schools scored 68.0+/-12.42 points out of 100 on average. The average score (% of compliance) of each field was 10.7/20 (53.3%) for facilities and equipment management, 7.4/11 (67.2%) for personal hygiene, 7.4/11 (74.1%) for ingredient control, 22.4/32 (69.8%) for process control, 8.9/12 (73.8%) for environmental sanitation management, 4.2/7 (59.7%) for HACCP systems management, and 7.2/8 (89.7%) for safety management, respectively. The field to be improved first was the sanitation control of facilities and equipment. The elements to improve this category were unprofessional consultation for kitchen layout, improper compartment of the kitchen area, lacks of pest control, inadequate water supply, poor ventilation system, and insufficient hand-washing facilities. To elevate the overall performance level of sanitation management, prerequisite programs prior to HACCP plan implementation should be stressed on the school officials, specifically principals, for the integration of the system.
Checklist ; Disease Outbreaks ; Education ; Food Safety* ; Food Services* ; Foodborne Diseases ; Hazard Analysis and Critical Control Points ; Humans ; Hygiene ; Pest Control ; Safety Management ; Sanitation ; Seoul* ; Ventilation ; Water Supply

No abstract available.
Heart Neoplasms*

OBJECTIVE: The purpose of this study was to evaluate the different patterns of bone loss between the lumbar spine and the femur after ovariectomy in rats. METHODS: Twenty-four female Sprague-Dawley rats underwent a sham operation (the sham group) or bilateral ovariectomy (the ovariectomized group). Four and eight weeks after operation, six rats from each of the two groups were euthanized. Serum biochemical markers of bone turnover including osteocalcin and alkaline phosphatase (ALP), which are sensitive biochemical markers of bone formation, and the telopeptide fragment of type I collagen C-terminus (CTX), which is a sensitive biochemical marker of bone resorption, were analyzed. Bone histomorphometric parameters of the 4th lumbar vertebrae and femur were determined by micro-computed tomography. RESULTS: Ovariectomized rats were found to have higher osteocalcin, ALP and CTX levels than sham controls. Additionally, 8 weeks after ovariectomy in the OVX group, serum levels of osteocalcin, ALP and CTX were significantly higher than those of 4 weeks after ovariectomy. Bone loss after ovariectomy was more extensive in the 4th lumbar spine compared to the femur. Bone loss in the 4th lumbar spine was mainly caused by trabecular thinning, but in the femur, it was mainly caused by trabecular elimination. CONCLUSION: The present study demonstrates different patterns of bone loss between the 4th lumbar spine and the femur in ovariectomized rats. Therefore, when considering animal models of osteoporosis, it is important that bone sites should be taken into account.
Alkaline Phosphatase ; Animals ; Biomarkers ; Bone Resorption ; Collagen Type I ; Female ; Femur ; Humans ; Lumbar Vertebrae ; Models, Animal ; Osteocalcin ; Osteogenesis ; Osteoporosis ; Ovariectomy ; Rats ; Rats, Sprague-Dawley ; Salicylamides ; Spine

We evaluated the relationship between preoperative risk factors[gestational age, birth weight, postconceptual age and weight at operation, duration of operation, duration of anesthesia, abnormalities in neurosonogram, bronchopulmonary dysplasia]and apnea with or without bradycardia, for which mechanical ventilation was necessary after general anesthesia in the surgical treatment of retinopathy of prematurity[ROP]. Thirty-eight patients [21%]developed apnea and thirteen patients[7%]had bradycardia out of 183 patients. Retrospective study was performed and risk factors were analyzed by logistic regression. Gestational age, birth weight, postconceptual age and weight at operation and bronchopulmonary dysplasia showed the positive correlation with postanesthetic apnea and bradycardia. Duration of operation showed the positive correlation with postanesthetic apnea but not with postanesthetic bradycardia. In logistic regression without confoundings, weight at operation and bronchopulmonary dysplasia were correlated with postanesthetic apnea. Receiver operating characteristic curve analysis revealed that patients with weight under 2, 600gm at operation suffered from apnea more frequently than those with weight over 2, 600gm. In conclusion, patients with weight under 2600gm or bronchopulmonary dysplasia are at greater risk for postanesthetic apnea and optimal pre-and postanesthetic management should be prepared for these patients.
Anesthesia ; Anesthesia, General* ; Apnea* ; Birth Weight ; Bradycardia ; Bronchopulmonary Dysplasia ; Gestational Age ; Humans ; Infant, Newborn ; Logistic Models ; Respiration, Artificial ; Retinopathy of Prematurity* ; Retrospective Studies ; Risk Factors* ; ROC Curve

Primary vesical actinomycosis is an extremely rare disease. In most cases it is misdiagnosed as vesical or urachal tumor and usually diagnosed through post-operative pathologic confirmation. Here we report a case of primary vesical actinomycosis confirmed by preoperative repeated multiple transabdominal biopsies. The patient was a 49-yr-old woman who presented with frequency, dysuria, and intermittent gross hematuria for 2 months. Computed tomography and cystoscopic examination showed broad-based, edematous, and protruding mass at the dome and anterior portion of the bladder. The clinical and imaging findings of the patient initially suggested vesical malignancy. Transurethral resection and multiple biopsies of the mass were performed. Pathologic examination demonstrated fibrosis with chronic inflammation. We performed repeated transabdominal multiple needle biopsies for further pathologic confirmation. Histopathologic examination demonstrated typical sulfur granules, which were consistent with actinomycosis.
Abdomen ; Actinomycosis/drug therapy/*pathology/surgery/ultrasonography ; Biopsy, Needle/methods ; Female ; Follow-Up Studies ; Humans ; Middle Aged ; Penicillins/therapeutic use ; Treatment Outcome ; Urinary Bladder/*pathology/surgery/ultrasonography ; Urinary Bladder Diseases/drug therapy/*pathology/surgery/ultrasonography

Although postherpetic neuralgia (PHN) is a common chronic pain syndrome, the pathophysiology of this disorder is not well known and management is often very difficult. N-Methyl-D-Aspartate (NMDA) receptor antagonists are known to be effective in PHN, and magnesium, a physiological blocker of NMDA receptors, is widely used to treat various chronic pain disorders. Here, we present a case of the PHN refractory to conventional treatment, which was treated successfully with transforaminal epidural injection of magnesium sulphate at the affected dermatome.
Chronic Pain ; Injections, Epidural ; Magnesium ; N-Methylaspartate ; Neuralgia, Postherpetic ; Receptors, N-Methyl-D-Aspartate

PURPOSE: To evaluate the side effects, pattern of failure, and survival rate according to the sequence of postoperative adjuvant radiotherapy and chemotherapy, patients with stages II and lll rectal cancer who had undergone curative resection were randomized to early radiotherapy group (arm I) or 'late radiotherapy group (arm II)', then we intend to determine the most effective sequence of the radiotherapy and chemotherapy. MATERIALS AND METHODS: From January 1996 to March 1999, 3 13 patients with curatively resected stages II and III rectal cancer have been randomized to early' or late radiation therapy group and recei ved combined chemotherapy (5-FU 375 mg/m/day, leucovorin 20 mg/m, IV bolus daily D1-5, 8 cycles) and radiation therapy (whole pelvis with 45 Gy/25 fractions/5 weeks). Arm I received radiation therapy from day 1 with first cycle of chemotherapy and arm II received radiation therapy from day 57 with third cycle of chemotherapy after completion of first two cycles. Preliminary analysis was performed with 228 patients registered up to Jun 1998. Two out of the 228 patients were excluded because of double primary cancer. Median follow-up period was 23 months. RESULTS: Local recurrence occurred in 11 patients (9.7%) for arm I and 9 patients (8%) for arm II. There was no significant difference between both groups (p=0.64). However, distant metastasis was found in 22 patients (19.5%) for arm I and 35 patients (31.0%) for arm II and which showed statistically significant difference between the two groups (p=0.046). And neither 3-year disease-free survival (70.2% vs 59.2%, p=0.2) nor overall survival (89.4% vs 88.0%, p=0.47) showed significant differences. The incidence of leukopenia during radiation therapy and chemotherapy was 78.3% and 79.9% respectively but leukopenia more than RTOG grade 3 was only 2.1% and 6.0% respectively. The incidence of diarrhea more than 10 times per day was significantly higher in the patients for arm I than for arm II (71.2% vs 4 1.6%, p=0.02) but this complication was controlled with supportive cares. CONCLUSION: Regardless of the sequence of postoperative adjuvant radiation therapy and chemotherapy a fter curative resection for rectal cancer, local recurrence rate was low with combined chemoradiotherapy. But distant metastasis rate was lower in early radiation therapy group than in late radiation therapy group and the reason is unclear. Most patients completed these treatments without severe complication, so these were thought to be safe treatments but the treatment compliance should be improved.
Arm ; Chemoradiotherapy ; Chemotherapy, Adjuvant* ; Compliance ; Diarrhea ; Disease-Free Survival ; Drug Therapy ; Follow-Up Studies ; Humans ; Incidence ; Leucovorin ; Leukopenia ; Neoplasm Metastasis ; Pelvis ; Prospective Studies* ; Radiotherapy* ; Radiotherapy, Adjuvant ; Rectal Neoplasms* ; Recurrence ; Survival Rate

No abstract available.
Humans* ; Multiplex Polymerase Chain Reaction* ; Papilloma*

Three siblings with congenital dilatation of the intrahepatic bile ducts (Caroli's disease) are presented. Bile duct pathology was associated with congenital hepatic fibrosis and polycystic renal disease in all three patients. On color Doppler imaging (CD imaingl, multiple small color Doppler signals were observed in or near the vascular radicles within the dilated bile ducts, besides other well-known sonographic findings such as bile duct dilatations, biliary calculi. Dopper frequency spectral analysis confirmed all these color Doppler signals as arterial origin in all patients, showing pulsatile wave pattern. Although portal venous radicles are well known in conventional sonograms or computed tomotraphy(CT), continuous wave patterns were not detected in all patients. In addition to previously reported sonographic findings about Caroli's disease, color Doppler signals showing arterial wave pattern in or around the portal venous radicles within dilated duets are another helpful diagnostic criteria and these findings are easily depicted on routine sonograms with color mapping.
Bile Ducts* ; Bile Ducts, Intrahepatic ; Bile* ; Caroli Disease* ; Dilatation ; Fibrosis ; Gallstones ; Humans ; Pathology ; Polycystic Kidney Diseases ; Siblings ; Ultrasonography