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: In the United States, the Centers for Disease Control and Prevention recorded a 20-fold increase in the incidence of vancomycin-resistant enterococci (VRE) associated with nosocomial infections between 1989 and 1991. Although VRE has been reported in Korea since 1992, infections caused by these organisms are still extremely rare in Pusan, Korea. Therefore, a point prevalence culture survey was carried out to investigate the prevalence of intestinal colonization with VRE among patients admitted to Kosin Medical Center, which can predict the appearance of clinical infections with VRE. METHODS: Between July 1997 and August 1997, stool specimens were obtained from 303 patients. Specimens were placed in bile esculin azide broth containing vancomycin (64 microgram/mL) and aatreonam (60 microgram/mL). Cultures were done for 48 hours at 37degrees C, and turbid solutions were subcultured on blood agar. Minimal inhibitory concentrations (MIC) of vancomycin and teicoplanin to Enterococcus isolates were determined by Etest on Mueller-Hinton agar. For amplification of the vanA, vanB, and vanC genes, polymerase chain reactions were performed. RESULTS: VRE isolates were isolated from 6 of the patients (2%). Four of them were identified as E. faecium, and 1 was identified as E. avium, and 1 was identified as Enterococcus spp. All of them were highly resistant to vancomycin (MICs >256 microgram/mL), and they were also resistant to teicoplanin (MICs 32-->256 microgram/mL). All of 6 VRE strains carried vanA gene. CONCLUSION: The colonization of VRE was not infrequent among the patients of a university hospital in Pusan, Korea. Moreover, a large proportion of the colonizing VRE was revealed Enterococcus faecium with vanA gene, which implies quite a possibility of a sudden rising of infections by this organism in the near future. So we propose that the vancomycin susceptibility test should be done for every enterococcal isolate from clinical specimens and the intestinal colonization rate of VRE should be closely monitored at regular intervals for the purpose of surveillance 50 that proper establishment of plans for the prevention of this troublesome pathogen's spread can be promptly made.
Agar ; Bile ; Busan ; Centers for Disease Control and Prevention (U.S.) ; Colon* ; Cross Infection ; Enterococcus ; Enterococcus faecium ; Esculin ; Humans ; Incidence ; Korea ; Polymerase Chain Reaction ; Prevalence ; Teicoplanin ; United States ; Vancomycin

No abstract available.

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: 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

This study is designed to draw out new integrated subjects of the Korean Oriental Pharmacists' Licensing Examination (KOPLE). In 2004, for the revision of subjects, we have analyzed the curriculums of the Oriental Pharmacy department, the oriental pharmacist's (OP's) job description book, and the elementary items of KOPLE. We also examined the system of the Chinese Herb Pharmacists' Examination and other health personnel licensing examinations and studied the data of items and compared them with KOPLE. We heard the public opinion on the present KOPLE. We developed a subfield of 18 subjects, a middle category of 188 items, and a small category of 1,026 items. We proposed a new KOPLE that consists of three subjects: basic oriental pharmacy, applied oriental pharmacy, and laws and regulations.
Asian Continental Ancestry Group ; Curriculum ; Health Personnel ; Humans ; Job Description ; Jurisprudence ; Licensure* ; Pharmacy ; Public Opinion ; Social Control, Formal