No abstract available.
Infection Control* ; Seoul*

BACKGROUND: As information technology evolves rapidly computer-based surveillance systems for nosocomial infection have been developed. Well designed computerized system could provide an opportunity for improving, enlarging, and conducting hospital-wide surveillance more efficiently in the situation with limited resources. Recently, we launched a new computerized monitoring system in a hospital where digital medical information system has been operated without paper chart. METHODS: We developed a new surveillance program based on the total Electronic Medical Record (EMR) system. Numerous critical medical information can be easily accessible through this system without further work. This includes major demographic data, essential information from the inpatient medical record, the laboratory information system, and the pharmacy information, Comprehensive Clinical Data Repository (CDR) system was also developed. CDR is potentially very useful to conduct a hospital-wide surveillance by integrating all the available information. RESULTS: This system consists of several programs in the EMR and the CDR environment. In the EMR system, inquiry for patients with fever, case ascertainment and registration of nosocomial infections, inquiry for patients with indwelling devices, microbiological reports, and data on antibiotic prescriptions were included. The CDR has integrated comprehensive inquiries for frequency of major pathogens in clinical isolates and their trends of antibiotic resistance, nosocomial infection rates based on the duration of the devices or hospitalization, and the history of antimicrobial usage based on defined daily dosage. Data obtained from the EMR and the CDR systems could be easily accessed by infectious diseases specialists and healthcare workers of infection control services at any place within the hospital. A new reporting system has been built up to facilitate identification of notifiable diseases among the list of diagnoses on the EMR. In addition, the "Alert" notice was designed to highlight isolation precautions for indicated cases. CONCLUSION: This new computerized surveillance program might be a valuable model to which other hospitals can refer to develop newer version of programs in the future.
Clinical Laboratory Information Systems ; Communicable Diseases ; Cross Infection ; Delivery of Health Care ; Diagnosis ; Drug Resistance, Microbial ; Electronic Health Records* ; Fever ; Hospitalization ; Humans ; Infection Control ; Information Systems ; Inpatients ; Medical Records ; Pharmacy ; Prescriptions ; Specialization

A case of foreign body (a black rubber string of 60cm in length used for masturbation) in the bladder was presented in a 17 years old Korean boy and reported with review of literature.
Adolescent ; Foreign Bodies* ; Humans ; Male ; Rubber ; Urinary Bladder*

In situ hybridization using biotinylated HPV(Human papillomaviruses) probes was performed to detect HPV DNA in 24 patients with genital wart-like lesions. The lesions were divided into two groups, with or without dysplastic changes histologically. We could detect HPV6/11 in 13 of 17 lesions(76.5%) without dysplastic changes. HPU16/18 was detected in a case with dysplastic changes. HPV6/ll was also detected in a case considered to be misdiagnosed as bowenoid papulosis. Oncogenic HPV such as HPV16/18 was found in one of histologically splastic lesions(14.3%).
Condylomata Acuminata* ; DNA* ; Humans* ; In Situ Hybridization

OBJECTIVES: Recently, the main focus of etiologic study in schizophrenia has been directed to molecular genetic approach including polymorphism analysis. Abnormal immunoreactivity to IL-4 promoter and IL-4Ralpha has been identified in patients with schizophrenia. This study was designed to investigate the relationship between schizophrenia and immunologic influences by analyzing the polymorphisms of IL-4 promoter and IL-4Ralpha gene that are involved in interaction between immunologic system and CNS. METHODS: 222 schizophrenic patients diagnosed by DSM-IV and data of 165 normal controls obtained from Catholic Hemopoietic Stem Cell Information Bank, College of medicine, the Catholic University of Korea, were used in this study. DNA was extracted from whole blood and the polymorphic loci of IL-4 promoter and IL-4Ralphagene were amplified by polymerase chain reaction. Gene typing was performed by using SSCP and the results were assessed. The frequencies of allele and genotype were compared between patients and normal controls and between paranoid group and non-paranoid group. All data were analyzed chi2-test with two-tailed Fisher's exact test. RESULTS: 1) There were no significant differences in allele or genotype frequencies of IL-4 promoter and IL-4Ralpha between the group of schizophrenic patients and controls. 2) There were no significant differences in allele or genotype frequencies of IL-4 promoter and of IL-4Ralpaha between the group of paranoid schizophrenic patients and non-paranoid schizophrenic patients. CONCLSUION: These results suggest that polymorphisms of IL-4 promoter and IL-4Ralpha genes are unlikely related with the pathogenesis of schizophrenia.
Alleles ; Diagnostic and Statistical Manual of Mental Disorders ; DNA ; Genotype ; Humans ; Interleukin-4* ; Korea ; Molecular Biology ; Polymerase Chain Reaction ; Polymorphism, Single-Stranded Conformational ; Schizophrenia ; Stem Cells

BACKGROUND: Bacterial contamination of platelets represents the highest infectious risk for a transfusion. In this study, we evaluated 2 culture-based systems that have been approved by the US FDA for bacterial screening. METHODS: Platelet concentrates were inoculated with 5 bacterial species to give a final concentration of 10(0), 10(1) and 10(2) CFU/mL. Samples for culture were taken immediately after inoculation (0 hr sample) and after 24 hrs (24 hr sample). For the BacT/ALERT 3D system, a 10 mL sample was inoculated into an aerobic culture bottle and incubated for 7 days. For the Pall eBDS system, 3 mL samples were taken from the 0 hr and 24 hr samples, respectively. The samples were incubated for 24 hrs and 30 hrs. RESULTS: Both systems detected all inoculated units both in the 0 hr and 24 hr samples, except for units inoculated with K. pneumoniae. Eleven units out of 30 units inoculated with K. pneumoniae were detected by the BacT/ALERT 3D system in the 24 hr samples. The Pall eBDS system detected 8 of 30 units in the 24 hr samples. CONCLUSION: Implementation of either system will decrease the risk of transfusing bacterially contaminated platelets. However, testing for bacterial contamination will not completely prevent septic transfusion reactions; pathogen inactivation that is now available should also be considered as an alternative method to reduce the risk of bacterial contamination.
Benzeneacetamides ; Blood Platelets ; Piperidones ; Pneumonia

Red cells that express extremely low levels of D antigen that cannot be detected by routine serologic tests are designated as DEL. Most DEL blood donors are typed as D-negative. However, DEL red blood cells can be recognized by serological adsorption and elution test or molecular RHD genotyping. Anti-D production in patients with D-negative who received transfusion containing DEL blood has reported, therefore distinction between DEL variant and true D- negative is clinically important. This review highlights a transfusion strategy and laboratory update on the DEL variant in the Korean population.
Adsorption ; Blood Donors ; Erythrocytes ; Humans ; Serologic Tests

INTRODUCTION: To prevent hemodialysis-related infections, it is important to maintain hemodialysis system without microbial contamination. In May 2003, routine surveillance showed that dialysis water from dialysis port was contaminated with bacteria. To identify the causes of the contamination, we conducted an investigation as follows. METHODS: Patients undergoing dialysis were carefully monitored to see whether evidences of pyrogenic reactions or infections were present. Factors that could have influence on bacterial contamination in hemodialysis systems were thoroughly examined. In addition, microbiologic surveillances were done 7 times in 1 month. RESULTS: Although pyrogenic reactions or bacteremia did not occur, R. pickettii was repeatedly isolated above the Association for the Advancement of Medical Instrumentation (AAMI) standards from almost all dialysis units. Bacterial counts of specimens were higher in the proximal part of the water supply tube than the other parts in all dialysis machines. The colony count of R. pickettii exceeded the maximum level of technical limit in the specimens collected from the dialysis machines in the early morning after intermission of 48 hours. The structure of the supply tube was suspected as the origin of the colonization because stagnant water is a reservoir for bacterial multiplication. After remodeling the structure of the water supply tube, neither R. pickettii nor any other bacteria were isolated. CONCLUSION: Our investigation successfully identified the source of R. pickettii contamination of reverse osmosis water. Appropriate corrective measures for water distribution systems of hemodialysis center could prevent outbreak of dialysis-associated illnesses.
Bacteremia ; Bacteria ; Bacterial Load ; Colon ; Dialysis ; Humans ; Osmosis ; Ralstonia ; Ralstonia pickettii ; Renal Dialysis ; Water ; Water Supply

Retrospective analysis of 46 patients with intracerebral hematoma showed that the attack was most frequent in sixth decade and more prevalent in female. The most common cause of the attack was hypertension(80%) and the site of hemorrhage was putamen 32%, thalamic area 15%, subcortical area 7%, cerebellum 17%, ventricle 3%, and brain stem 4%. Mortality of total cases was 36% and there was no difference of mortality in both conservatively or operatively treated group(38% in conservative group, and 35% in operative group). The prognosis of the patient was unfavorable in the group of poor pretreatment Glasgow coma scale(GCS) and those of cases demonstrated more than 30cc of hematoma on computerized tomography(CT) of the brain. The improvement of GCS after management was better in operative group than in the conservative group.
Brain ; Brain Stem ; Cerebellum ; Coma ; Female ; Hematoma* ; Hemorrhage ; Humans ; Hypertension ; Mortality ; Prognosis ; Putamen ; Retrospective Studies

BACKGROUND: Hemoglobin A1c (HbA1c) levels are widely used to monitor glycemic control in diabetes mellitus patients, and various methods are used for determining HbA1c levels. The ADAMS A1c HA-8180 (Arkray, Inc., Japan) is a fully automated HbA1c analyzer based on high-performance liquid chromatography (HPLC). METHODS: The analytical performance of the ADAMS A1c HA-8180 analyzer was evaluated on the basis of its precision, linearity, correlation with the Variant II Turbo (Bio-Rad Laboratories, USA), and agreement with the National Glycohemoglobin Standardization Program (NGSP) targets. All evaluations were performed according to Clinical and Laboratory Standard Institute (CLSI) guidelines EP05, EP06, and EP09. RESULTS: Coefficients of variation (CVs) for total precision at low and high levels were 0.99% and 1.16%, respectively. The linearity was excellent with R2 = 0.99 in the range of 4.98-15.10%. Its analytical performance was well correlated with that of Variant II Turbo (r = 0.9987). The 95% confidence interval of bias between the NGSP target and the levels measured using the ADAMS A1c HA-8180 was -0.402-0.225. CONCLUSIONS: The ADAMS A1c HA-8180 showed excellent precision, linearity, correlation with Variant II Turbo, and agreement with the NGSP target. Therefore, its analytical performance is satisfactory for diagnosis and treatment monitoring of diabetes.
Bias (Epidemiology) ; Chromatography, Liquid ; Diabetes Mellitus ; Hemoglobins ; Humans ; Organothiophosphorus Compounds