BACKGROUND: A rapid and sensitive surveillance culture has a pivotal role in infection control of methicillinresistant Staphylococcus aureus (MRSA). This study was aimed to compare the performance of MRSASelect (Bio-Rad, France) to that of mannitol salt agar containing 6 microgram/mL of oxacillin (MSA-OX) for detecting MRSA in surveillance cultures. METHOD: From May to June 2006, 86 nasal swabs and 21 sputum specimens were enrolled. All specimens were inoculated onto MRSASelect and MSA-OX, which were incubated for 2 days and 3 days, respectively, and colonies were read daily by a technologist. Pink colonies on MRSASelect and yellow colonies on MSA-OX were examined with Gram stain, Pastorex(R) Staph-plus (Bio-Rad) and mecA-PCR. After the final reading, both media were re-examined by a superviser. RESULTS: Of the 107 specimens cultured, 32 (29.9%) were positive for MRSA. Of these, 27 were detected by both media, one by MSA-OX only, and 4 by re-examination. The day-1 and day-2 sensitivities/specificities of MRSASelect were 78.1%/97.3% and 84.4%/97.3%, respectively, while those of MSA-OX were 53.1%/100% and 78.1%/92.1%, respectively. With MRSASelect, two more positives were detected at day 2, but their incubation was less than 18 hour at day 1. There were six false positive organisms detected: three Enterobacter spp., one Acinectobacter spp., and two coagulase-negative staphylococci (CNS). But, the two CNS grew on MSA-OX only. CONCLUSION: MRSASelect with 1-day incubation showed a sensitivity equivalent to and a specificity better than MSA-OX with 2-day incubation. MRSASelect should be a useful medium for MRSA surveillance when it is read after an incubation of 18-28 hours with the confirmatory Gram stain of screen-positives.
Agar ; Enterobacter ; Infection Control ; Mannitol ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Oxacillin ; Sensitivity and Specificity ; Sputum ; Staphylococcus aureus

PURPOSE: Membranoproliferative glomeulonephritis(MPGN) has been diagnosed in an increasing number of asymptomatic cases. These cases have been detected by school urinary screening test even though the total cases of MPGN show a decreasing trend. We have analyzed the clinical and pathological characteristics of children with MPGN according to the clinical manifestations at the time of disease presentation. METHODS: A total of 18 patients who had been diagnosed with idiopathic MPGN by percutaneous renal biopsy from January 1990 to February 2004 were involved in our study. The patients were divided into 2 groups as the school urinary screening(A) group and the symptomatic(S) group according to the clinical manifestations at the time of disease presentation. RESULTS: Out of the total 18 patients, 8(44.4%) were in the S group and 10(55.6%) were in the A group. The mean serum total protein, albumin and C3 levels in the S group were significantly lower than those levels of the A group, respectively(4.9+/-1.2 g/dL vs 7.0+/-0.5 g/dL P=0.002, 2.8+/-0.9 g/dL vs. 4.1+/-0.3 g/dL P=0.002, 63.9+/-36.4 mg/dl vs. 100.8+/-39.5 g/dl P=0.041). The mean total protein amount of 24 hour collected urine in the S group were significantly higher than that of the A group(3684.0+/-2601.3 mg/m2 vs. 559.4+/-406.9 mg/m2, respectively, P=0.001). Hypocomplementemia was observed in 11(61.1%) out of 18 patients at the time of disease onset, 7(87.5%) in the S group and 4(40%) in the A group. However the hypocomplementemia was decreased in 6(33.3%) out of 18 patients at the time of final follow-up, 3(37.5%) in the S group and 3(30%) in the A group. According to the pathologic type, hypocomplementemia was observed 8 patients(61.5%) with type I disease, 1 patients (100%) with type II disease, 2 patients(50%) in type III disease at the disease onset, but 4 patients(30.8%) in type I disease, 1 patient(100%) in type II disease, 1 patient(33.3%) with type III disease at the time of last follow-up. The incidence of cellular crescent formation and tubular atropy, as observed on light microscopy, were higher in the S group compared to the A group. Mean grade of capillary wall thickening and, mesangial proliferation were significantly higher in the S group. CONCLUSION: MPGN, as diagnosed in patients with only asymptomatic urinary abnormalities, has been increasing, it is more frequent in asymptomatic patients than in patients with presenting symptoms. Our result suggests that MPGN should be considered in the renal biopsy diagnosis regardless of serum C3 level when urinary abnormalities are found by school urinary screening test.
Biopsy ; Capillaries ; Child* ; Diagnosis ; Follow-Up Studies ; Glomerulonephritis, Membranoproliferative* ; Humans ; Incidence ; Mass Screening ; Microscopy

Cutaneous lung tissue heterotopia is a very rare disorder where mature lung tissues develop in the skin. This is only the second known report of cutaneous lung tissue heterotopia, with the first by Singer et al. in 1998. A newborn infant had a hemangioma-like, freely movable mass connected to the anterior aspect of the sternal manubrium. Pathologic findings showed mature lung tissues with bronchi, bronchioles, and alveoli through the dermis and subcutis, and it was diagnosed as cutaneous lung tissue heterotopia. Cutaneous lung tissue heterotopia is hypervascular, so grossly it looks like a hemangioma. It can be differentiated from pulmonary sequestration, teratoma, bronchogenic cyst, and branchial cleft cyst by histology and the location of the mass. We describe the clinical, radiologic, and pathologic findings of a cutaneous lung tissue heterotopia, the first reported in Korea.
Branchioma/pathology/surgery ; Bronchogenic Cyst/pathology/surgery ; Choristoma/*pathology/surgery ; Humans ; Infant, Newborn ; *Lung ; Magnetic Resonance Imaging ; Male ; Republic of Korea ; Skin Diseases/*pathology/surgery ; Skin Neoplasms/pathology ; Tomography, X-Ray Computed

Purpose: The purpose of this study was to identify related factors in the organizational socialization of new nurses, focusing on the reality shock of new nurses and social support by education specialist nurses. Methods: Participants were 122 new nurses with clinical experience of 1 year or less as nurses working in a general hospital that is carrying out a pilot project for a new nurse training system. Data were collected using self-report questionnaires which included identification of participants' characteristics, social support of education specialist nurse, reality shock and organizational socialization. Results: The organizational socialization score was 3.07±0.45 points. The results of the stepwise multiple regression showed that factors affecting organizational socialization of new nurses were social support by gender, education specialist nurse and reality shock. These three variables accounted for 72.0% of organizational socialization. Conclusion These findings suggest that the social support of education specialist nurses be enhanced to increase the organizational socialization of new nurses. There is also a need for a program to decreased the reality shock of new nurses.

BACKGROUND: Even though careful techniques is utilized and proper concentration of local anesthetics are used, tissue toxicity is common. METHOD: The fibroblast cell lines (NUGM) was exposed with each concentration of 10(-6), 10(-5), 10(-4) M lidocaine and bupivacaine in culture media for 24 hours. Glucose consumption rate and LDH activity in cultured media were measured for using as indicator of cellular damage on 0. 24, 48, 72 hours. By using that, we calculated the trend lines of the change of glucose consumption rate and LDH (lactic dehydrogenase) activity. On the trend lines, we searched out for decreasing time to 1/2 of glucose concentration and increasing time to 2 times of LDH activity compared to control. RESULTS: 1) In control group, Decreasing time to 1/2 of glucose concentration was 236.0 hours (p<0.05) and increasing time to 2 times of LDH activity was 1168.6 hours (p<0.05). 2) At each concentration of 10 6, 10 5, 10 4 M lidocaine, decreasing time to 1/2 of glucose concentration was 873.7 (370%), 938.7 (398%), 1101.6 (467%) hours compared with 236.0 (100%) hours of control (p<0.05) and then increasing time to 2 times of LDH activity was 135.1 (12%), 85.6 (7%), 93.9 (8%) hours when compared with 1168.6 (100%) hours of control (p<0.05). 3) At each concentration of 10(-6), 10(-5), 10(-4) M bupivacaine, decreasing time to 1/2 of glucose concentration was 706.7 (299%), 948.1 (402%), 1018.2 (431%) hours when compared with 236.0 (100%) hours of control (p<0.05) and then increasing time to 2 times of LDH activity was 111.6 (10%), 69.5 (6%), 59.1 (5%) hours when compared with 1168.6 (100%) hours of control (p<0.05). 4) On light microscopy, cells are showed destruction in each concentration of 10(-6), 10(-5), 10(-4) M lidocaine and bupivacaine with dose dependent fashion. CONCLUSIONS: 1) Glucose consumption rate and LDH activity in cultured media could be used as a useful index of cellular destruction by toxic effect on cultured cell. 2) Even at any concentration of lidocaine and bupivacaine could be toxic on cell. With all of above results, cell-line on 3 demensional cultured method could be use as another method for determining of cellular toxicity of local anesthetics.
Anesthetics, Local* ; Bupivacaine* ; Cell Line ; Cells, Cultured* ; Culture Media ; Fibroblasts ; Glucose* ; Lidocaine* ; Microscopy ; Oxidoreductases*

PURPOSE: This study was amied to identify the effects of a 12 week Korean traditional dance movement program on balance, depression, medical cost, medical institution's utilization and fall among elderly women. METHODS: Using a quasi-experimental design, the experimental group was composed of 130 subjects and the control group was composed of 123 subjects. The experimental group participated in a 12 week Korean traditional dance movement program 3 times a week from December 2002 to February 2003. Data was analyzed with descriptive statistics, the chi-square test, paired t-test and t-test. RESULTS: There was siginificant improvement in balance(right leg p=.000, left leg p=.004), depression(p=.000), and the medical institution's utilization(p=.001) and fall(p=.002) in the experimental group compared to the control group. CONCLUSION: A Korean traditional dance movement program improved balance, depression, and decreased fall and medical cost in elderly women. Therefore, we recommend this program be utilized as a health promoting program and falls preventing program for the elderly in the community.
*Musculoskeletal Equilibrium ; Middle Aged ; Korea ; Humans ; Female ; Depressive Disorder/*psychology ; *Dance Therapy ; Aged, 80 and over ; Aged ; Accidental Falls/*prevention & control

Nevus sebaceus is a hamartoma of the sebaceous gland that occurs congenitally, from which various secondary tumors can arise with a prevalence of 5%–6%. Benign neoplasms commonly arise from nevus sebaceous, but they have a very low malignant potential. Two neoplasms may occasionally arise within the same lesion, but it is rare for three or more neoplasms to occur in a nevus sebaceus simultaneously. A 61-year-old male patient was admitted to our hospital for a 4 cm×2.5 cm growing tumor in a verrucous form arising within a periauricular nevus sebaceus in the post auricle of the left ear that had developed 30 years earlier. The nodule was diagnosed as 3 different types of tumors: trichilemmoma, desmoplastic trichilemmoma, and basal cell carcinoma. To our knowledge, this is the first report of the coexistence of three different tumors arising from nevus sebaceous. It contain malignant neoplasm also. Surgeons should be aware of the need for close monitoring and early complete surgical excision of sebaceous nevus in order to improve patient outcomes.
Carcinoma, Basal Cell* ; Ear ; Hamartoma ; Humans ; Male ; Middle Aged ; Nevus* ; Prevalence ; Sebaceous Glands ; Surgeons

PURPOSE: Although the diagnosis of foreign bodies in the airway can be made early, retained and neglected foreign bodies are a common occurrence. The objective of this study was to characterize the clinical features of children diagnosed beyond 14 days following inhalation of a foreign body, long-standing foreign body in airway(LFB). METHODS: We reviewed the records of 180 cases of airway foreign body, noting the age, symptoms and signs, types and location of foreign body, chest radiographs, and lung perfusion scan findings, and compared these findings of children diagnosed within 14 day(short-term foreign body in airway : SFB, n=130) with those of LFB(n=50). RESULTS: Of chief complaints on admission, sputum was more frequent in LFB(24.0%) than in SFB(6.9%). The age distribution was similar, but the proportion of patients aged 3 to 6 years was higher in LFB(16.0%) compared with SFB(3.9%). Of the types of foreign body, plastic was more common in LFB. Abnormal chest radiographic findings were more frequent in LFB(94.0%) than in SFB(80.6%), while the location within the bronchial tree was similar. Hypoperfusion on lung scan was noted in all patients except one in LFB(93.8%). CONCLUSION: There was some difference in age distribution, sputum production, type of foreign body, and abnormal radiographic and perfusion scan findings between SFB and LFB. This suggests that retained foreign bodies may present atypical clinical manifestation and physicians should be alert to the possibility of airway foreign body in children with chronic respiratory symptoms or signs.
Age Distribution ; Child ; Diagnosis ; Foreign Bodies* ; Humans ; Inhalation ; Lung ; Perfusion ; Plastics ; Radiography, Thoracic ; Sputum

BACKGROUND: Procedures for rapid identification and susceptibility testing by direct inoculation (DI) from positive blood culture bottles into an automated system have not been standardized. This study was purposed to evaluate DI from BACTEC 9240 blood culture system (BD, USA) into MicroScan (Dade Behring, USA) or Phoenix (BD, USA). METHODS: From May to June 2006, bacterial pellets from positive aerobic bottles showing gram-positive cocci (GPC) or gram-negative rods (GNR) of single morphology were directly inoculated to MicroScan PosCombo1A and NegCombo32 and to Phoenix PMIC/ID-107 and NMIC/ID-53. In addition, the automated instruments were also inoculated from subcultures (standard inoculations, SI). Species identification and susceptibilities were compared between DI and SI and between MicroScan and Phoenix. RESULTS: A total of 108, 104, and 78 specimens were tested with MicroScan, Phoenix, and both, respectively. When DI and SI were matched, 94.8% of GPC were correctly identified with MicroScan, compared to 80.7% with Phoenix, and 93.9% of GNR were correctly identified with MicroScan, compared to 95.7% with Phoenix. DI with MicroScan and Phoenix showed correct susceptibilities in 94.6% of 1,150 and 96.5% of 660 tests (with very major error [VME] of 1.1% and 1.1%), respectively, among GPC and in 94.4% of 942 and 96.3% of 781 tests (with VME of 0.6% and 0%), respectively, of GNR. Correlation of identification/susceptibilities between MicroScan and Phoenix using DI were 81.8%/98.0% for Staphylococcus aureus and 100.0%/95.6% for Escherichia coli. CONCLUSIONS: DI warrants a reliable method for identification and susceptibility testing of both GPC and GNR in MicroScan, and those of only GNR in Phoenix.
Automation ; Bacterial Typing Techniques/instrumentation/*methods ; Culture Media ; Gram-Negative Bacteria/*classification/drug effects/isolation & purification ; Gram-Negative Bacterial Infections/blood/*microbiology ; Gram-Positive Bacterial Infections/blood/*microbiology ; Gram-Positive Cocci/*classification/drug effects/isolation & purification ; Humans ; Microbial Sensitivity Tests/instrumentation/*methods ; Reagent Kits, Diagnostic ; Sensitivity and Specificity

The purpose of this study was to compare food intakes between Korean breast cancer patients and a healthy control group. We compared the intake of nutrients of 117 food items between Korean breast cancer patients (n=97) and age matched healthy controls (n=97). Nutrient intake was estimated using a quantitative food frequency questionnaire. The mean caloric intake of breast cancer patients and healthy controls was not significantly different. Breast cancer patients consumed significantly less fat and antioxidant nutrients such as vitamin A, retinol, beta-carotene, vitamin C and vitamin E when compared to the control subjects. Among the food items, the intake of eggs (p<0.01), legumes (p<0.05), vegetables (p<0.05), seasonings (p<0.001), and oils and fats (p<0.01) in breast cancer patients was significantly lower than that in the controls. These results suggest that Korean breast cancer patients consumed less amount of soy and vegetables, which are rich source of antioxidant nutrients and phytosterols. Thus, dietary guidance to increase intake of these foods may be beneficial in the prevention of breast cancer.
Ascorbic Acid ; beta Carotene ; Breast Neoplasms* ; Breast* ; Eating* ; Eggs ; Energy Intake ; Fabaceae ; Fats ; Female ; Humans ; Oils ; Ovum ; Phytosterols ; Surveys and Questionnaires ; Seasons ; Vegetables ; Vitamin A ; Vitamin E ; Vitamins