BACKGROUND: This study was conducted to investigate whether the preoperative nasal carriage of methicillin-resistant Staphylococcus aureus (MRSA) was a risk factor for surgical site infections and nosocomial infections in open heart surgery patients. METHODS: From June 10, 2002 to October 30, 2002, data were collected by prospective surveillance carried out by infection control nurses. Nasal swabs were taken from patients (N= 106) on the day before surgery. The swabs were incubated in staphylococcal broth for 24 hours, and then it was incubated on mannitol salt agar for 24 hours. Muller-Hinton agar supplemented with oxacillin (6 microgram/mL) was used to identify MRSA. RESULTS: Among the study patients (N=106), four(4/106, 3.8%) were identified as MRSA carriers and nine (9/103 , 8.7%) developed nosocomial infections, including three patients (3/103 , 2.9%) who had postoperative mediastinitis Preoperative nasal carriage of MRSA was not associated with nosocomial infections nor surgical site infections (P>0.05). However, the length of hospital stay prior to nasal swab or surgery was found to be associated with MRSA carriage (OR=1.108, 95%CI: 1.026-1.197) or nosocomial infections (OR=1.087, 95%CI: 1.017-1.161). Additionally, the patients with nosocomial infections were more likely than those without to stay in the hospital for a longer period after surgery (P<0.00l). CONCLUSION: Preoperative nasal carriage of MRSA by the patient was not identified as a risk factor for surgical site infection and nosocomial infections in open heart surgery.
Agar ; Cross Infection* ; Humans ; Infection Control ; Length of Stay ; Mannitol ; Mediastinitis ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Oxacillin ; Prospective Studies ; Risk Factors ; Thoracic Surgery*

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is the major pathogen of nosocomial infections. There are many reports that MRSA nasal cariers play a major role in the transmission of MRSA. We studied to assess the nasal carriage rates, therapeutic effects of nasal carriers and control of MRSA outbreak in a tertiary, acute and educational hospital. METHODS: From 1990 to 1997, eight MRSA epidemics were detected and investigated for outbreak control. We surveyed the MRSA colonization of anterior nares and hands of health care workers (HCW). MRSA was identified by staphylococcal broth, mannitol-salt- agar, Muller-Hinton-oxacillin agar. To identify the permanent carriers in the HCWs, the nasal swab was done weekly for 3 weeks. Two percent povidone iodine ointment or 2% mupirocin ointment was applied topically to treat the permanent MRSA nasal carriers. RESULTS: Of eight MRSA outbreaks, five epidemics occurred in the intensive care unit, all of them occurred in surgical departments and five of them occurred in winter seasons. For eight MRSA outbreaks, 351 HCWs were surveyed. The rates of transient carriers was 10.8% (38/351) and the rates of that were 9.0% (10/111) in medical doctors (MD), 12.5% (24/192) in registered nurses (RN) and 11.4% (4/35) in aid nurses (P=0.470). The rate of permanent carrier in doctors was 1.8%, and that in RNs was 3.7% (P=0.490). After topical therapy with 2% povidone iodine ointment or 2% mupirocin ointment for permanent carriers, MRSA was not identified for 2 months follow up. CONCLUSION: In MRSA epidemics, the rate of the transient carrier rate of MRSA in HCWs was 10.8% and the rate of the permanent carrier was 2.6%. The difference of carrier rates in HCWs was not significant statistically. The therapy for the permanent nasal carriers in HCWs with two percent povidone iodine ointment or 2% mupirocin ointment was very effective. And MRSA outbreaks were ended and controlled for 6months follow up.
Agar ; Colon ; Cross Infection ; Delivery of Health Care* ; Disease Outbreaks ; Follow-Up Studies ; Hand ; Intensive Care Units ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Mupirocin ; Povidone-Iodine ; Seasons

PURPOSE: Airborne pollen is the most common causative agents of allergic disease. Since 2000, there isn't no more report about airborne pollen in Busan. This study is that pollen in one area of Busan was collected to investigate species, particle counts, seasonal distribution, and of its correlation with reactivity to skin prick test in children during 1998-2012. METHODS: Rotorod sampler was installed on the rooftop of St. Mary Hospital in Busan. A 24-hour sampling of airborne allergens over a fifteen-year period was conducted 6 days/wk from January 1, 1998 to December 31, 2012. After staining they were identified, counted and recorded with the weather in Busan. RESULTS: Major pollens collected were Pine, Alder, Oak, Juniperus, Humulus. The pollen season is relatively short and the pollen dispersed mainly during the period from March to May in case of tree pollen, from April to September in case of grass pollen and from August to October in case of weed pollen. Total annual pollen count ranged from 36,412 grains/m3 (2002) to 1,342 grains/m3 (2006). The peak pollen season was seen for spring and autumn, especially in May and September during 1998-2012. In skin prick tests, birch was the highest sensitization rate (15.1%), followed by alder (14.7%), hazel (14.1%) in the tree for 15 years. And in weed, mugwort and ragweed were the highest sensitization rate (10.6%, 10.3%), followed by humulus (5.5%) for 15 years, but since 2008, was increased. CONCLUSION: Analysis of pollens sampled in the atmosphere of Busan, Korea, for a 15-year period identified 24 species of pollens with seasonal variation of some clinically important pollen load. Analysis of data, it showed that alder and birch are main allergen in spring for 15 years, and in 1998-2008, ragweed and artemisia was main allergen in fall, since 2009, followed by humulus.
Allergens ; Alnus ; Ambrosia ; Artemisia ; Atmosphere ; Betula ; Busan ; Child ; Humans ; Humulus ; Hypersensitivity* ; Juniperus ; Korea ; Poaceae ; Pollen* ; Seasons ; Skin ; Weather

Traumatic aneurysm is known to be very rare vascular disease. The authors experienced one case of traumatic aneurysm that occured on pericallosal artery after closed head injury. Traumatic aneurysm was suspected by enlarged traumatic ICH on the corpus callosum in brain CT scan and presence of signal voiding at the center of the hematoma in brain MRI scan and then confirmed by transfermoral carotid angiography. Clipped neck of this traumatic aneurysm successfully via interhemispheric approach, we report a case of traumatic pericallosal artery aneurysm with review of literatures.
Aneurysm* ; Angiography ; Arteries* ; Brain ; Corpus Callosum ; Head Injuries, Closed ; Hematoma ; Magnetic Resonance Imaging ; Neck ; Tomography, X-Ray Computed ; Vascular Diseases

Scopulariopsis brevicaulis is a ubiquitous soil saprophyte that commonly causes onychomycosis, accounting for 1-10% of such infections. Rarely, it may be responsible for cutaneous lesions or more severe infections, especially after traumatic or surgical injuries. We report of a 54-year-old female patient who developed facial cellulitis caused by S. brevicaulis, which occurred one year after the patient underwent cosmetic surgery of the face. The patient suffered from febrile sense, pain and a growing mass lesion on her left cheek, which were diagnosed as facial cellulitis associated with foreign material that had been implanted at the time of cosmetic surgery. Three pus cultures from the mass lesion which performed at a week interval yielded the same S. brevicaulis. Surgical removal and drainage by using liposuction procedure resulted in a favorable outcome. To our knowledge this is the first report of S. brevicaulis infection associated with cosmetic surgery in Korea.
Cellulitis ; Cheek ; Drainage ; Female ; Humans ; Intraoperative Complications ; Korea ; Lipectomy ; Middle Aged ; Onychomycosis ; Scopulariopsis* ; Soil ; Suppuration ; Surgery, Plastic*

PURPOSE: Visceral adipose tissue may be strongly linked to increased metabolic risks in adults. However, because little is known regarding the effect of visceral adipose tissue in children and adolescents, we performed this study to determine the association between abdominal fat distribution and metabolic risk factors in this population. METHODS: One hundred one children and adolescents (78 males and 23 females; mean age, 10.8+/-2.4 years) were enrolled. The anthropometric data and metabolic risk factors were evaluated. Theabdominal fat distribution was assessed according to the CT measurement. Age-adjusted, partial correlations were performed among the visceral adipose fat area (VFA), subcutaneous adiposefat area (SFA), metabolic risk factors, and anthropometrics. RESULTS: The SFA increased more rapidly than the VFA with advancing years in both genders. In males, the VFA and SFA were positively correlated with anthropometrics. The VFA was correlated with low HDL-cholesterol and the SFA was correlated with diastolic blood pressure (DBP). However, there was no statistical significance between the VFA, SFA, anthropometrics, and other metabolic risk factors. The VFA and SFA were strongly linked to a number of metabolic risk factors, such as other anthropometrics. CONCLUSION: This study investigated how a low HDL-C was correlated with VFA and how a high DBP was associated with SFA in Korean male children and adolescents. Our results suggest that the correlation between the VFA, SFA, and metabolic risk factors was relatively weak compared to that reported in previous adult studies.
Abdominal Fat ; Adolescent ; Adult ; Blood Pressure ; Child ; Humans ; Intra-Abdominal Fat ; Male ; Obesity ; Risk Factors ; Subcutaneous Fat

PURPOSE: Visceral adipose tissue may be strongly linked to increased metabolic risks in adults. However, because little is known regarding the effect of visceral adipose tissue in children and adolescents, we performed this study to determine the association between abdominal fat distribution and metabolic risk factors in this population. METHODS: One hundred one children and adolescents (78 males and 23 females; mean age, 10.8+/-2.4 years) were enrolled. The anthropometric data and metabolic risk factors were evaluated. Theabdominal fat distribution was assessed according to the CT measurement. Age-adjusted, partial correlations were performed among the visceral adipose fat area (VFA), subcutaneous adiposefat area (SFA), metabolic risk factors, and anthropometrics. RESULTS: The SFA increased more rapidly than the VFA with advancing years in both genders. In males, the VFA and SFA were positively correlated with anthropometrics. The VFA was correlated with low HDL-cholesterol and the SFA was correlated with diastolic blood pressure (DBP). However, there was no statistical significance between the VFA, SFA, anthropometrics, and other metabolic risk factors. The VFA and SFA were strongly linked to a number of metabolic risk factors, such as other anthropometrics. CONCLUSION: This study investigated how a low HDL-C was correlated with VFA and how a high DBP was associated with SFA in Korean male children and adolescents. Our results suggest that the correlation between the VFA, SFA, and metabolic risk factors was relatively weak compared to that reported in previous adult studies.
Abdominal Fat ; Adolescent ; Adult ; Blood Pressure ; Child ; Humans ; Intra-Abdominal Fat ; Male ; Obesity ; Risk Factors ; Subcutaneous Fat

OBJECTIVES: To investigate the association between abnormal inhibin-A level in Quad test during the 15 and 18 weeks of gestation and adverse pregnancy outcomes. METHODS: From January 2005 to March 2007, women who delivered their babies at our institute after Quad test in second trimester of gestation (N=140) were enrolled. We measured inhibin-A levels (MoM) and other serum markers of the Quad test. And we analyzed the incidence of adverse pregnancy outcomes such as preterm birth, fetal growth restriction, pregnancy induced hypertension, fetal loss, and intrauterine fetal death. RESULTS: When the pregnancy outcomes are hypertensive disorders and fetal losses, the inhibin-A levels are is more elevated with statistically significance. Inhibin-A and hCG levels are elevated with significantly at hypertensive disorders and fetal losses. But inhibin-A levels are more significantly associated with abnormal pregnancy outcomes than hCG. CONCLUSIONS: Measurement of inhibin-A levels may be the most useful among other serum markers of the Quad test in predicting adverse obstetric outcomes.
Adenine ; Biomarkers ; Carbamates ; Deoxycytidine ; Drug Combinations ; Female ; Fetal Death ; Fetal Development ; Humans ; Hypertension, Pregnancy-Induced ; Incidence ; Inhibins ; Organophosphonates ; Pre-Eclampsia ; Pregnancy ; Pregnancy Outcome ; Pregnancy Trimester, Second ; Premature Birth ; Quinolones ; Thiazoles ; Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination

BACKGROUND: Donor leukocyte infusion (DLI) is an effective therapy for patients who relapse with leukemia after allogeneic bone marrow transplantation (BMT). This is due to the fact that the immune reactivity of infused allogeneic lymphocytes on relapsed leukemia cells plays a major role in the control of leukemia. However, severe graft-versus-host disease (GVHD) and pancytopenia compromise the success of this treatment in a substantial number of patients. METHODS: To evaluate the effect of DLI, we surveyed 6 BMT centers regarding their use of DLI for relapsed leukemia after BMT. Detailed forms were used to gather data regarding the original BMT, relapse, response to DLI, complication and survival. Reports of 11 patients were consequently available for analysis. RESULTS: Five (83.3%) of 6 patients with chronic myeloid leukemia (CML) achieved complete remission (CR) [time-to-CR; 116 (27~180) days after DLI], and currently 4 are alive in CR (49~436 days). Five patients (83.3%) developed GVHD, and 2 developed pancytopenia which was related to DLI. In acute leukemia, all patients received salvage chemotherapy prior to DLI. Only 1 of 3 patients with acute lymphoblastic leukemia (ALL) who had early relapse achieved CR, but durable remission was not yet confirmed (62+ days). Both 2 patients with acute myeloid leukemia (AML) achieved CR, and their CR durations were 242+ and 326 days after DLI, respectively. CONCLUSION: This study demonstrates that DLI can exert considerable effects against myeloid forms of leukemia, especially in CML. Further investigations of separating GVHD from the graft- versus-leukemia effect and finding more effective anti-leukemia approaches on acute leukemiaare necessary to improve the current DLI limitations.
Bone Marrow Transplantation* ; Bone Marrow* ; Drug Therapy ; Graft vs Host Disease ; Humans ; Leukemia* ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Leukemia, Myeloid, Acute ; Leukocytes* ; Lymphocytes ; Pancytopenia ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Recurrence ; Tissue Donors*