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

No abstract available.
Humans ; Outpatients*

Spontaneous pneumothorax is a known, but relatively rare complication of pulmonary metastases of sarcoma. A 19-year-old man was presented with chest pain and dyspnea for three days and was diagnosed as left pneumothorax. After bleb resection, microscopic examination revealed metastatic osteosarcoma forming subpleural fistula and dystrophic calcification. Four years ago, he had had limb salvage operation and chemotherapy for osteosarcoma of left femur. After two and a half years he had a bleb resection for right pneumothorax without any evidence of metastasis. Six months later, he was found to have a 4x3cm sized lung mass in the right lower lobe. After lobectomy, he was diagnosed as pulmonary metastasis of osteosarcoma. Pneumothorax is the common complication of metastatic osteosarcoma to the lung and it may be presented before the pulmonary metastasis is clinically evident. It is important to recognize a pneumothorax of the patients with osteosarcoma as a possible sign of metastases.
Blister ; Chest Pain ; Drug Therapy ; Dyspnea ; Femur ; Fistula ; Humans ; Limb Salvage ; Lung ; Neoplasm Metastasis* ; Osteosarcoma* ; Pneumothorax* ; Sarcoma ; Young Adult

PURPOSE: Headache is a common neurological condition for children to seek for medical care. The underlying causes of headache include migraine, tension type headache, intracranial masses, and sinusitis and so on. The study was aimed to analyze the clinical findings and the results of neuroimaging studies in children with headache. METHODS: A total of 120 children with headache were involved in the study who replied to the questionnaires at the department of pediatrics of Soonchunhyang University Hospital from March 2006 to October 2012. We evaluated the causes of headache by MRI scans and classified them based on the International Classification of Headache Disorders (2nd Edition, ICHD-II), 2004. RESULTS: Thirty one out of 120 children (25.8%) were classified as secondary headache with abnormal MRI findings such as sinusitis, pineal cyst, venous angioma, demyelinating disease and 89 (74.2%) patients were classified into primary headaches. Migraines without aura were diagnosed in 43 (48.3%) patients, migraine with aura in 18 (20.2%) patients, and tension type headache in 21 (23.6%) patients respectively. There was no significant difference on the median age between the patients with primary (10.5 years) and secondary (9.13 years) headache. When compared by gender ratio, primary and secondary headaches were 1.34:1 and 2.1:1 respectively. CONCLUSION: The correct diagnosis of headache may not be simple due to a variety of presentations of headache in children. We therefore have to pay a close attention to their complaints and get the neuroimaging study done if necessary.
Child ; Demyelinating Diseases ; Epilepsy ; Headache ; Headache Disorders ; Hemangioma ; Humans ; Magnetic Resonance Imaging ; Migraine Disorders ; Migraine with Aura ; Neuroimaging ; Pediatrics ; Surveys and Questionnaires ; Sinusitis ; Tension-Type Headache

Familial hypokalemic periodic paralysis (HOPP) is an autosomal dominant disorder characterized by episodic attacks of muscle weakness with concomitant hypokalemia (<3.5 mEq/L). The onset of HOPP usually occurs within the first and second decade of life. Mutations in the skeletal muscle calcium (CACNL1A3) and sodium channel (SCN4A) genes have been reported to be responsible for familial HOPP. Voltage-sensitive ion channels mediate action potentials in electrically excitable cells and play important roles in signal transduction in other cell types. Therefore, abnormalities in a channel's function lead to disarray of signal transduction and thus various neurological symptoms. Those are called channel diseases, which include familial HOPP. We report a 14-year-old boy with HOPP from a family in which two members of two generations are affected. Genetic examination identified a mutation causing a codon change from arginine to histidine at the amino acid portion #528 (R528H) in the calcium channel gene CACNL1A3.
Action Potentials ; Adolescent ; Arginine ; Calcium ; Calcium Channels ; Codon ; Family Characteristics ; Histidine ; Humans ; Hypokalemia ; Hypokalemic Periodic Paralysis ; Ion Channels ; Muscle Weakness ; Muscle, Skeletal ; Signal Transduction ; Sodium Channels

No abstract available.
Liver* ; Ultrasonography*

Purpose: This study was conducted to examine the effects of the oral care program for improving swallowing function of the elderly using welfare centers on depression, self efficacy, subjective oral health status and swallowing related quality of life. Methods: The intervention in this study was systematically developed through the six stages of Intervention Mapping Protocol (IMP) and was based on Mead’s symbolic interaction theory and Bandura's self efficacy theory. A non equivalent control group pre and post-test design was conducted on a total of 37 elderly people (experimental group: 19, control group: 18) from D city. The oral care program was administered to the experimental group once a week for five weeks, totaling five times, and the exact program ran for 50 minutes. The collected data were analyzed using the SPSS/WIN 25.0 program. Results: Following the intervention, subjective oral health score, and swallowing related quality of life were significantly improved in the experimental group. Conclusion The oral care program presented in this study was found to be effective in increasing subjective oral health status, and swallowing related quality of life for the elderly using welfare centers.

The incidence of a primary central nervous system (CNS) lymphoma in western countries is about 1% of all the intracranial tumors and has increased 2.2% over the last decade. A similar pattern of increased frequency is observed in Korea. Although most CNS lymphomas in western countries are high grade tumors carrying poor prognosis, the clinicopathologic features of the Korean CNS lymphoma have not been well studied. We report clinicopathological features of 18 cases of histologically proven primary brain lymphoma. The mean age of the patients was 50 years and there was no sex difference. The clinical and radiological characteristics included multiple site of occurrence, infrequent extracranial spread, and frequent seeding via cerebrospinal fluid. No patients were immune-compromised host. Of 18 cases, 15 cases were of B-lineage and 2 cases were of T-lineage. According to REAL classification, there were 12 cases of diffuse large B cell lymphoma, two cases of B cell lymphomas of small lymphoid cell, and two cases of peripheral T cell lymphoma, unspecified. The remaining subtypes were not subclassified because of inadequate material. Pleomorphic cytologic features and necrosis of varying extent were frequent in the cases of diffuse large B-cell lymphoma. These results suggest that overall clinicopathologic features of primary malignant lymphomas of the central nervous system in Korea are similar to those of western countries.
Brain ; Central Nervous System* ; Cerebrospinal Fluid ; Classification ; Humans ; Incidence ; Korea ; Lymphocytes ; Lymphoma* ; Lymphoma, B-Cell ; Lymphoma, T-Cell, Peripheral ; Necrosis ; Prognosis ; Sex Characteristics

No Abstract available.
Infection Control*

No abstract available.