No abstract available.
Autopsy* ; Hydrops Fetalis*

OBJECTIVE: To document the common medical problems and clinical outcomes of near-term infants who were delivered between 35(+0) and 36(+6) weeks of gestation, in order to promote optimal health outcomes for these infants. METHODS: We performed a retrospective review of medical records of 113 near-term infants and 138 term infants as control, who were born at Chungbuk national university hospital in 2003~2004. RESULTS: When compared with term infants, near-term infants had a significantly lower Apgar scores (7.7 vs. 8.7 at 1 minute) and higher frequency of prolonged rupture of membrane (19.8% vs. 6.7%), preeclampsia (20.9% vs. 4.4%), jaundice (46.0% vs. 11.6%), respiratory distress (20.4% vs. 10.9%), feeding problems (19.5% vs. 5.8%), intravenous fluid infusion (63.7% vs. 24.6%), diagnostic work-up for possible sepsis (68.1% vs. 26.1%), and use of antibiotics (58.4% vs. 22.5%). There were no differences in frequency of cesarean section, hypoglycemia, hypothermia and clinical sepsis. More near-term infants were admitted to the neonatal intensive care unit (68% vs. 28%) and delayed in discharge home (60% vs. 27%) with longer hospital stay (7.77+/-5.63 days vs. 4.67+/-3.17 days). CONCLUSION: Near-term infants showed significantly more neonatal problems and longer and repeated hospital stays than full-term infants. Optimal care guidelines for near-term infants including scrupulous monitoring for the development of early complications and meticulous follow-up after discharge need to be developed.
Anti-Bacterial Agents ; Cesarean Section ; Chungcheongbuk-do ; Female ; Humans ; Hypoglycemia ; Hypothermia ; Infant* ; Infant, Newborn ; Intensive Care, Neonatal ; Jaundice ; Length of Stay ; Medical Records ; Membranes ; Pre-Eclampsia ; Pregnancy ; Retrospective Studies ; Rupture ; Sepsis

PURPOSE: To report a case of endogenous endophthalmitis due to Klebsiella ozaenae, which is a rare causative organism of endophthalmitis. CASE SUMMARY: A 61-year-old male who was undergoing chemotherapy for hepatocellular carcinoma complained of sudden visual loss and ocular pain in his left eye for 2 days. On the first examination, the patient's visual acuity was counting fingers at 10 cm and the intraocular pressure was elevated to 29 mm Hg. Partial scleral rupture and choroidal prolapse were observed. Subretinal abscess was detected with increased echogenicity using ultrasonography. The patient complained of burning sensation on voiding and urinary frequency; subsequent urinalysis showed pyuria and bacteriuria. Intravitreal and systemic antibiotics were administered under the impression of endogenous endophthalmitis caused by urinary tract infection. Despite treatment, visual acuity decreased to no light perception in 4 days and intraocular pressure and pain was uncontrollable. Enucleation was performed and pus culture from the eye during surgery revealed Klebsiella ozaenae. CONCLUSIONS: Klebsiella ozaenae is a rare causative organism of endophthalmitis and shows a rapid progress and poor prognosis. Endogenous endophthalmitis must be highly suspected in patients with urinary tract infection as well as pyogenic liver abscess.
Abscess ; Anti-Bacterial Agents ; Bacteriuria ; Burns ; Carcinoma, Hepatocellular ; Choroid ; Drug Therapy ; Endophthalmitis* ; Fingers ; Humans ; Intraocular Pressure ; Klebsiella* ; Liver Abscess, Pyogenic ; Male ; Middle Aged ; Prognosis ; Prolapse ; Pyuria ; Rupture ; Sensation ; Suppuration ; Ultrasonography ; Urinalysis ; Urinary Tract Infections ; Visual Acuity

PURPOSE: The purpose of this study was to determine the most appropriate shelf life for sterilized products according to their packaging material. METHODS: Samples were prepared to target six nursing units in one general hospital in Seoul. After steam and E.O gas sterilization, sterilized product, samples were supplied to wards. Data collection was conducted for 3 months, after the expiration date of 3 months had passed for samples packaged with crepe paper and nonwoven wraps. For samples packaged with paper-plastic pouches, data collection conducted for 3 months when the expiration date of 9 months had passed. The sterilized products were collected and tested for microbial contamination. Identification of the storage environment was done as samples were collected. RESULTS: This study confirmed that the storage environment met international standards such as CDC, except for temperature. For steam sterilized crepe paper packaging samples and steam and E.O gas sterilized for nonwoven packaging samples no contamination in all products was found for 3 months past the expiration date. However, in the E.O gas sterilized paper-plastic pouch packaging sterile samples, Gram-positive bacilli were detected in one sample from a surgical intensive care unit at 45 weeks and another sample from an operating room at 47 weeks. Furthermore, the results did not show any microorganisms for up to 52 weeks in all products. CONCLUSION According to the results of this study, sterilized product packaging made with crepe paper and nonwoven wraps is better able an extended shelf life from 3 months to 6 months, reducing unnecessary costs.

Purpose: To explore the scope and method of applying standardized nursing terminologies to nursing diagnosis and problems used in nursing practice. Methods: A descriptive study was done with a retrospective analysis of the nursing records of 141,420 patients that were hospitalized in 4 tertiary hospitals. The nursing diagnosis and problems collected from the records were standardized, and the standardized nursing diagnosis and problems cross mapped with NANDA-I, confirmed in a nursing focus group. Results: 65 (67.7%) of the 96 standardized nursing diagnosis and problems were equal with NANDA-I and included in the 10 domains of NANDA-I. Among 86 nursing diagnosis and problems excluded from the cross mapping with NANDA-I, the 63 terms (73.3%) related to surgery/procedure were the most common. Conclusion It is meaningful that multi-tertiary hospital nursing diagnosis and problems were standardized and cross mapping with standard nursing terminologies was performed. As for the method of applying standardized nursing terminologies in nursing practice, it is appropriate to use several standardized nursing terminologies complementarily.

Vitamin D dependent rickets type 1A (VDDR1A) is an autosomal recessive disorder caused by mutations in CYP27B1 . Clinical findings are growth retardation, hypotonia, muscle weakness, hypocalcemic seizures, and radiological features of rickets. We aimed to present the VDDR1A case with a genetic study of CYP27B1 . The 14-month-old boy was admitted to the hospital due to a seizure. Serum calcium, phosphorus, alkaline phosphatase, parathyroid hormone (PTH), 25(OH) vitamin D, and 1,25(OH)2 vitamin D values were 5.1 mg/dL, 3.7 mg/dL, 705 IU/L, 429 pg/mL, 24.9 ng/mL, and 8.8 pg/mL, respectively. Radiological study showed cupping and fraying of the distal ulna and radius. The molecular genetic study revealed that the patient had a compound heterozygous mutation, Phe443Profs*24 and c.589+1G>A, in CYP27B1 . Genetic analysis of the family members presented that the mother was heterozygous for the mutation c.589+1G>A, and that the father was heterozygous for Phe443Profs*24. The patient was treated with calcium lactate and calcitriol. Until now, six Korean patients with VDDR1A have been studied. Including this case, Korean patients with VDDR1A were found to have only three different mutations in 14 alleles, indicating that the mutation in the CYP27B1 gene is homogeneous in the Korean population.
25-Hydroxyvitamin D3 1-alpha-Hydroxylase ; Alkaline Phosphatase ; Alleles ; Calcitriol ; Calcium ; Fathers ; Humans ; Infant ; Lactic Acid ; Male ; Molecular Biology ; Mothers ; Muscle Hypotonia ; Parathyroid Hormone ; Phosphorus ; Radius ; Rickets ; Seizures ; Ulna ; Vitamin D ; Vitamins

The purpose of this study was to evaluate nurses' perception of clinical nutrition services. A cross-sectional survey design was performed. The research was accomplished by using questionnaires developed for this study and administered from September 12 to December 31, 2013 to 343 nurses at 43 tertiary hospitals and 20 general hospitals. The percentage of nurses who recognized clinical nutrition certificate as issued from nation was 27.8%. The mean scores of perceived usefulness on clinical nutrition services was 4.23/5.00, whereas that of perceived implementation was 3.76/5.00. The mean scores of necessity of disease-specialized clinical dietitian at capital hospitals were significantly higher for obesity (P<0.01), cancer (P<0.05), and infant & childhood disease (P<0.01) than at local hospitals. The rates of nurses' experience in group education on cancer at capital hospitals (21.7%) was significantly higher than that at local hospitals (10.3%) (P<0.05). The mean scores of perceived importance of clinical nutrition services were 4.46/5.00 for 'group nutrition education', 4.46/5.00 for 'individual consultation', and 4.40/5.00 for 'nutrition management for enteral nutrition (EN) patients'. The most common reason why clinical nutrition services are important was 'improving malnutritional status'. To activate clinical nutrition services especially at local hospitals, clinical dietitians should give systematic assistance to patients and also institutional supports are needed.
Cross-Sectional Studies ; Education ; Enteral Nutrition ; Hospitals, General ; Humans ; Infant ; Nutritionists ; Obesity ; Surveys and Questionnaires ; Tertiary Care Centers

PURPOSE: The aim of this research is to examine the abnormal liver function complicated with Kawasaki disease (KD) and to analyze its clinical characteristics and complications. METHODS: Ninty eight cases were diagnosed as having KD, among which thirty four cases had abnormal alanine aminotransferase (ALT) (>30 IU/L). These abnormal ALT cases were evaluated in terms of age and sex distribution, major symptoms, complications, laboratory and histopathologic findings. RESULTS: Male to female ratio was 2.4 : 1 and most patients (91.2%) were under 5 years of age. Cervical lymphadenopathy was observed in 3 cases (8.8%); and recurred cases were two (5.8%). Average fever duration was 8 days: average length of hospitalization was 9 days; and average recovery period was 13 days. Immediately after admission, positive CRP was observed in 31 cases (91.2%), leukocytosis (>10,000/mm(3)) in 26 cases (76.0%), thrombocytosis (>450,000/mm(3)) in 7 cases (20.6%), and anemia (<10 gm/dl) in 7 cases (20.6%), respectively. GB hydrops or cholecystitis were noted in 3 cases (8.8%) abnormal ECG finding in 1 case (2.9%), coronary dilatation or aneurysm in 2 cases (5.9%). Liver biopsy was done in four cases and revealed mild infiltration of lymphocytes on the portal area and mild bile duct proliferations. CONCLUSION: The abnormal liver function was noted in 34.7% of KD patients, and subsided all within one month. But the liver function test should be checked closely in patients of the abnormal liver function test complicated with KD despite of its good prognosis.
Alanine Transaminase ; Anemia ; Aneurysm ; Bile Ducts ; Biopsy ; Cholecystitis ; Dilatation ; Edema ; Electrocardiography ; Female ; Fever ; Hospitalization ; Humans ; Leukocytosis ; Liver Function Tests ; Liver* ; Lymphatic Diseases ; Lymphocytes ; Male ; Mucocutaneous Lymph Node Syndrome* ; Prognosis ; Sex Distribution ; Thrombocytosis

BACKGROUND: Although many laboratories use automated blood culture systems, adequate skin disinfection and optimal blood volume are still critical for successful culture. The authors undertook a nationwide survey to understand the current situation and problems of blood culture in Korea. METHODS: A survey of blood culture was performed in March and April 2010, including disinfectants, blood collection intervals, and recommended blood volumes. The laboratory physicians described the storage condition of culture bottles before delivery to the equipment. For quality control, the positive rate and skin contamination rate were studied. RESULTS: Replies to the survey were collected from 74 Korean hospitals. Povidone iodine after either isopropyl alcohol or ethanol application was the most common means of skin disinfection. Sampling of a second set of cultures was performed simultaneously in 38% of hospitals and after a 30-min interval in 50%. The recommended blood volume was 10 mL in most cases (69%), but was 20 mL in 24% of cases. The bottles were stored at 37degrees C before installation in 23% of cases and at room temperature in 16%, whereas 57% were placed directly in the equipment during the night shift. Positive rates ranged 8-10% in 32% of hospitals, 5-8% in 23%, and <5% in 12%. Skin contamination rates were 2-3% in 32% of hospitals, 1-2% in 27%, and >3% in 13%. CONCLUSION: Skin disinfection methods were rather variable. Sampling interval, blood volume, and storage of bottles should be standardized. More than 10% of the hospitals require quality improvement in terms of positive rate and skin contamination rates.
2-Propanol ; Bacteremia ; Blood Volume ; Disinfectants ; Disinfection ; Ethanol ; Povidone-Iodine ; Quality Control ; Quality Improvement ; Sepsis ; Skin

This study aimed to define a one portion size of food items frequently consumed for convenient use by Koreans in food selection, diet planning, and nutritional evaluation. We analyzed using the original data on 5,436 persons (60.87%) aged 20 ~ 64 years among 8,930 persons to whom NHANES 2005 and selected food items consumed by the intake frequency of 30 or higher among the 500 most frequently consumed food items. A total of 374 varieties of food items of regular use were selected. And the portion size of food items was set on the basis of the median (50th percentile) of the portion size for a single intake by a single person was analyzed. In cereals, the portion size of well polished rice was 80 g. In meats, the portion size of Korean beef cattle was 25 g. Among vegetable items, the portion size of Baechukimchi was 40 g. The portion size of the food items of regular use set in this study will be conveniently and effectively used by general consumers in selecting food items for a nutritionally balanced diet. In addition, these will be used as the basic data in setting the serving size in meal planning.
Adult ; Aged ; Animals ; Cattle ; Edible Grain ; Diet ; Food Preferences ; Humans ; Meals ; Meat ; Nutrition Surveys ; Single Person ; Vegetables