BACKGROUND: Extended-spectrum beta-lactamase-producing (ESBL) Klebsiella pneumoniae is an important cause of nosocomial infections in neonatal intensive care units (NICUs). This study aimed to reduce ESBL-producing K. pneumoniae in the NICU by using infection control measures. METHODS: We performed prospective surveillance cultures, monitoring, and education for infection control in the NICU between May and August 2011. Specimens were collected from all infants and the environment including stethoscopes, thermometers, ventilators, incubators, etc. The anterior nares and hands of healthcare workers were also screened. We inspected infection control practices and provided feedback. The level of infection control awareness was measured using a questionnaire. RESULTS: The level of awareness and performance of hand washing increased significantly after intervention (both P<0.001). The environmental management of healthcare providers also improved significantly (P=0.001). The yield of ESBL-producing K. pneumoniae from clinical specimens decreased gradually throughout the study period (30.4% in May to 12.6% in August). Central catheter-related K. pneumoniae bacteremia decreased from 1.3/1000 to 0/1000 catheter-days. CONCLUSION: Infection control measures including education, monitoring, and surveillance can lower the incidence of ESBL-producing K. pneumoniae in the NICU.
Bacteremia ; beta-Lactamases ; Cross Infection ; Delivery of Health Care ; Hand ; Hand Disinfection ; Health Personnel ; Humans ; Incidence ; Incubators ; Infant ; Infant, Newborn ; Infection Control ; Intensive Care Units ; Intensive Care Units, Neonatal ; Intensive Care, Neonatal ; Klebsiella ; Klebsiella pneumoniae ; Pneumonia ; Prospective Studies ; Stethoscopes ; Thermometers ; Ventilators, Mechanical

The purpose of this study was to examine the heterophoria in emmetropia and ametropia. The subjects were 337 healthy men and women between the age of 20-41 years. In 337 cases, Emmetropia were 135 cases, Ametropia were 202 cases. The entire group was tested for heterophoria with synoptophore. In the ametropia, this test was performed before and after correction of refractive error with glasses. The results were as follows: 1. The incidence of heterophoria was 84.4% in emmertropia, 89.2% in myopia and 91.4% in hyperopia. 2. Exophoria was most common in myopia. But in emmetropia and hyperopia, there was no significant difference between the incidence of exophoria and esophoria. The incidence of hyperphoria and cyclophoria was not significantly different between emmetropia and ametropia. 3. In the ametropia, the size of heterophoria was slightly decreased after correction, but the difference was not significant (p>0.05). 4. There was no correlation between the amount of refractive error and the size of heterophoria (p>0.05).
Emmetropia* ; Esotropia ; Exotropia ; Eyeglasses ; Female ; Glass ; Humans ; Hyperopia ; Incidence ; Male ; Myopia ; Ocular Motility Disorders ; Refractive Errors*

PURPOSE: p53 gene mutations, one of the most common alterations found in human tumors, has also been detected in gastric carcinoma, and shown to have a crucial and early role in gastric carcinogenesis of intestinal type and mainly associated with tumor progression in the cancer of diffuse type. We tried to investigate the frequency of p53 mutations in 27 gastric carcinomas. MATERIALS AND METHODS: Fresh tumor tissue from a series of gastric carcinoma was screened for p53 mutations by polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) with silver staining and confirmed by direct-sequencing in 27 cases of gastric carcinoma. Immunohistochemical method for p53 protein accumulation was also performed in the same cases. RESULTS: Immunohistochemistry revealed 20 of 27 cases of gastric carcinoma, positive for p53. PCR-SSCP analysis of p53 exons 5-8 detected mobility shift in 4 out of 20 p53-positive tumors; three from exon 5 and the other from exon 7, respectively. DNA sequencing of exon 5 showed CGC to CAC point mutation in one of three cases; exon 7, ATC to AAC point mutation. It seemed that there was no correlation between genetic alterations of p53 gene detected by PCR-SSCP and expression of p53 protein by immunohistochemistry. CONCLUSIOAS: Our results suggest that mutations of the p53 gene are rare genetic events in carcinogenesis of gastric carcinomas. There was discrepancy between mutations screened by PCR-SSCP and overexpressions in immunohistochemical staining.
Carcinogenesis ; Exons ; Genes, p53 ; Humans ; Immunohistochemistry ; Point Mutation ; Polymerase Chain Reaction* ; Polymorphism, Single-Stranded Conformational* ; Sequence Analysis, DNA ; Silver Staining

Terrien's marginal degeneration is a rare bilateral condition. Most investigators have thought that it was a degenerative origin, and emphasized the lack of significant inflammatory signs and symptoms. Several reports in Korea, except one case of perforation reported only mild conjunctival injection. But, recent reports suggested the possibility of inflammatory process and immune phenomenon. We experienced one case of Terrien's marginal degeneration accompanied with the iritis and treated with topical steroid, conjunctival flap and therapeutic contact lens.
Cornea* ; Humans ; Iritis* ; Korea ; Research Personnel

Terrien's marginal degeneration is a rare bilateral condition. Most investigators have thought that it was a degenerative origin, and emphasized the lack of significant inflammatory signs and symptoms. Several reports in Korea, except one case of perforation reported only mild conjunctival injection. But, recent reports suggested the possibility of inflammatory process and immune phenomenon. We experienced one case of Terrien's marginal degeneration accompanied with the iritis and treated with topical steroid, conjunctival flap and therapeutic contact lens.
Cornea* ; Humans ; Iritis* ; Korea ; Research Personnel

Phthiriasis has been usually known as a sexually-transmitted disease. The majority of these cases are found in the hair of the genital lesion, however, infestation of the eyelashed may occur. Eyeld involvement frequently causes blepharitis or conjunctivitis. The authors found a crab louse, Phthirus pubis and their nits on the eyelashes of 22-year-old female who complained foreign body and itching sensation of her right upper lid. Treatment is accomplished by careful mechanical removal of the louse and nits followed by the epilation and alllication of antibiotic eyedrops. We report a case of Phthiriasis palpebrarum with a review of the literatures.
Blepharitis ; Conjunctivitis ; Eyelashes ; Female ; Foreign Bodies ; Hair ; Hair Removal ; Humans ; Ophthalmic Solutions ; Pediculus ; Phthiraptera ; Phthirus ; Pruritus ; Sensation ; Young Adult

No abstract available.
Cervix Uteri* ; Female ; Hysterectomy*

Mllerian adenosarcoma of uterus usually present as pedunculated endometrial masses in postmenopausal women with vaginal bleeding. Extraendometrial variants are much less common. A 50-year-old woman, after total abdominal hysterectomy with bilateral salpingo-oophorectomy due to adenomyosis and benign ovarian mass, presented with protruding mass through vagina. The mass, originated from vaginal stump, was diagnosed as Mllerian adenosarcoma. We report a case of extrauterine Mllerian adenosarcoma with a review of literatures.
Adenomyosis ; Adenosarcoma* ; Female ; Humans ; Hysterectomy* ; Middle Aged ; Uterine Hemorrhage ; Uterus ; Vagina

Sebaceous carcinoma of meibomian gland is not so common as is generally re ported. In general feature of this tumor may masquerade as a chronic blepharoconjunctivitis or a chalazion for many months before the true diagnosis is esta blished. In the case of orbital involvement secondarily the patient may occasion ally develop as solid nodule in the fossa of the lacrimal gland that may simulate a primary gland tumor, The authors experienced one case of sebaceous carcinoma which developed in the orbital area. This was a 23-rear-old female who had a growing large mass in the left orbital area, which caused proptosis and decreased vision. Computed tomography of the left orbit demonstrated a large soft tissue mass lesion, about 3 X 3 X 1.5 cm in size, in superotemporal side of the retroorbital portion. The patient underwent a lateral orbitotomy and excisional biopsy of the tumor. Microscopic examination showed intracytoplasmic lipoid vacuoles and mixed pattern which was an admixture of lobular and comedocarcinoma-like area. About 2 months later the tumor recurred, so subtotal orbital exenteration with preservation of lid, conjunctiva, cornea and sclera was undertaken and radiotherapy was taken. However, this tumor was extended to brain.
Biopsy ; Brain ; Chalazion ; Conjunctiva ; Cornea ; Diagnosis ; Exophthalmos ; Female ; Humans ; Lacrimal Apparatus ; Meibomian Glands ; Orbit ; Radiotherapy ; Sclera ; Vacuoles

Sebaceous carcinoma of meibomian gland is not so common as is generally re ported. In general feature of this tumor may masquerade as a chronic blepharoconjunctivitis or a chalazion for many months before the true diagnosis is esta blished. In the case of orbital involvement secondarily the patient may occasion ally develop as solid nodule in the fossa of the lacrimal gland that may simulate a primary gland tumor, The authors experienced one case of sebaceous carcinoma which developed in the orbital area. This was a 23-rear-old female who had a growing large mass in the left orbital area, which caused proptosis and decreased vision. Computed tomography of the left orbit demonstrated a large soft tissue mass lesion, about 3 X 3 X 1.5 cm in size, in superotemporal side of the retroorbital portion. The patient underwent a lateral orbitotomy and excisional biopsy of the tumor. Microscopic examination showed intracytoplasmic lipoid vacuoles and mixed pattern which was an admixture of lobular and comedocarcinoma-like area. About 2 months later the tumor recurred, so subtotal orbital exenteration with preservation of lid, conjunctiva, cornea and sclera was undertaken and radiotherapy was taken. However, this tumor was extended to brain.
Biopsy ; Brain ; Chalazion ; Conjunctiva ; Cornea ; Diagnosis ; Exophthalmos ; Female ; Humans ; Lacrimal Apparatus ; Meibomian Glands ; Orbit ; Radiotherapy ; Sclera ; Vacuoles