Reviewing the results of the blood cultures performed at Yeungnam University Hospital during 4-year-period through January, 1, 1984 to December 31, 1987, the following results were obtained. 1) Out of 8083 blood specimens cultured microorganisms grew in 582 specimens with positivity rate of 7.20%. Polymicrobial bacteremia was found in 16 patients. 2) Among 582 positive specimens, Gram-positive cocci grew in 189 specimens, and Gram-negative bacilli, in 393 specimens. Clinically significant microorganisms consisted of 82 Staphylococcus aureus, and 20 Streptococcus species in Gram-positive cocci group, 80 Salmonella typhi, 72 Escherichia coli, 72 Salmonella paratyphi A in Enterobacteriaceae, and 46 Pseudomonas cepacia, and 16 Pseudomonas aeruginosa in glucose non-fermenting microorganisms. 3) Increasing incidence of Serratia, Acinetobacter and Pseudomonas species as major nosocomial infection source is noteworthy. They showed increased tendency from 6.3% of 1984 to 17.7% of 1987 of total positive blood cultures. 4) High isolation rate of Pseudomonas species and Aeromonas hydrophila was noted in summer, while Salmonella typhi showed high prevalence from May to September and in January. 5) In susceptibility tests of isolated organisms, staphylococcus aureus was sensitive to basic antimicrobial agents except for ampicillin. The glucose non-fermenting microorganisms showed high resistance to basic antimicrobial agents in 32.2%. In conclusion, considering the relatively higher incidence of growth of Staphylococcus epidermidis than ideal level indicates that sampling technique should be improved. Secondly, all the hospital staffs in cooperation with Hospital Infection Committee are desirable to pay efforts to decrease the nosocomial infection.
Acinetobacter ; Aeromonas hydrophila ; Ampicillin ; Anti-Infective Agents ; Bacteremia ; Burkholderia cepacia ; Cross Infection ; Enterobacteriaceae ; Escherichia coli ; Glucose ; Gram-Positive Cocci ; Humans ; Incidence ; Prevalence ; Pseudomonas ; Pseudomonas aeruginosa ; Salmonella paratyphi A ; Salmonella typhi ; Serratia ; Staphylococcus aureus ; Staphylococcus epidermidis ; Streptococcus

Malignant hyperthermia is a dramatic syndrome that rarely arises during anesthesia and which is still fatal in the majority of cases. It is a hypermetabolic muscle condition characterized by hyperpyrexia and skeletal muscle rigidity. Any potent inhalation anesthetic agent or any skeletal muscle relaxant can trigger this acute catast rophic reaction. A case is presented of a 28 year old femal with a family history of malignant hyperthermia in herrelatives. She sunderwent repair of a retinal detachment under N2O-O2-halothane withcinduction by thiopenthal and succinylcholine. One and half hours after induction, arrhythmia developed and was followed by unstable blood pressure, hyperpyrexia, muscular rigidity. Anesthesia was ended and vigorous emergency treatment was attempted. But she died postoperatively on the 4th day after anesthesia. The etiologic factors, incidence, clinical feature, prevention, treatment and prognosis of malignant hyperthermia are discussed.
Incidence

Pure red cell aplasia in uncommon disorder characterized by finding of anemia, absence of nucleated red blood cell in the marrow, absence of reticulocytes in the peripheral blood and normal peripheral platelet and leukocytes counts. We experienced one case of pure red cell aplasia associated with hemolytic anemia characterized by hemoglobinuria, reticulocytopenia, and erythroid hypoplasia of the bone marrow. The cause of the illness was not definitely identified, but we concluded that this patient had simultaneous occurrence of PRCA and hemolytic anemia following administration of diphenylhydantoin after craniotomy rather than virus or bacteria induced. The simultaneous occurrence of PRCA and hemolytic anemia in uncommon and the mechanism for diphenylhydantoin induced PRCA and hemolytic anemia is unclear.
Anemia ; Anemia, Hemolytic ; Bacteria ; Blood Platelets ; Bone Marrow ; Craniotomy ; Erythrocytes ; Hemoglobinuria ; Humans ; Leukocytes ; Phenytoin ; Red-Cell Aplasia, Pure* ; Reticulocytes

No abstract available.

PURPOSE: The descriptive study was designed to examine the relationship of eating attitudes to the internalization of sociocultural attitudes, body shape satisfaction, anger and anger expression in college women. METHOD: 247 women were recruited from one college located in Seoul, Korea. The instruments used were the Internalization subscale of SATAQ-3R, BSQ for body shape satisfaction, Spielberger's state trait anger expression inventory-Korean version for anger and anger expression, and the Eating Attitude Test(EAT-26) for eating attitudes. RESULTS: The score of EAT significantly correlated with internalization, state anger, body shape satisfaction, and anger expression except trait anger. The significant predictors of eating attitudes in college women were body shape satisfaction and anger expression, explaining 55% of the variance in eating attitudes. CONCLUSION: This study showed that body shape satisfaction is an important predictor for an eating disorder. Therefore, various programs for cognitive changes correcting the understanding about body and weight need to be developed in the future.
Anger* ; Feeding and Eating Disorders ; Eating* ; Female ; Humans ; Korea ; Seoul

Comflicting results have been reported on whether ketamine potentiates the neuromuscular effect of succinylcholine or other non-depolarizing agents. Notably, there has been no reported clinical evatuation of the influence of ketamine upon the neuromuscular action of vecuronium a new muscle relaxant. The present study was undertaken to estimate the influence of ketamine upon the neuromuscular action of vecuronium with a single bolus injection of ED95. Forty-five ASA class l or ll surgical patients were divided into three groups: l, ll and lll and were given thiopental sodium(5mg/kg), ketamine 3mg/kg and ketamine 5mg/kg as induction agents, respectively. The duration and recovery index of group ll and lll (35.20+/-2.30 and 16.20+/-1.37 min., 52.60+/-3.98 and 25.47+/-3.78min., respectively) were longer than those in group l (24.87+/-1.59 and 10.66 +/- 1.23 min.). But group l had a lower TOF ratio(27.40+/-3.09%) at 75% single twitch recovery than group ll and lll (41.87+/-3.25 and 45.27+/-3.67%, respectively). The increase in duration and the recovery index of group lll were greater than that of group ll. It was concluded that ketamine woudly potentiate the neuromuscular action of vecuronium in a dose-dependent manner. We suggest that combination of ketamine and vecuronium requires careful postoperative neuromuscular monitoring for the recovery from a vecuronium induced neuromuscular block.
Humans ; Ketamine* ; Neuromuscular Agents ; Neuromuscular Blockade* ; Neuromuscular Monitoring ; Succinylcholine ; Thiopental ; Vecuronium Bromide

BACKGROUND AND PURPOSE: It is particularly difficult to differentiate dementia with Lewy bodies (DLB) from the related dementias of Alzheimer's disease (AD) and Parkinson's disease dementia (PDD). Few studies have been designed to comparatively analyze detailed neuropsychological assessments of DLB patients and patients with AD and PDD. METHODS: Three groups of patients participated in this study: 10 with DLB, 76 with AD, and 17 with PDD, who had been diagnosed as probable DLB, AD, and PDD, respectively, according to the clinical criteria of the consortium on DLB, National Institute of Neurological and Communicative Diseases and Stroke/Alzheimer's Disease and Related Disorder Association, and the clinical diagnostic criteria for PDD. All patients were evaluated by careful neurological examination with detailed neuropsychological testing. RESULTS: Significant differences among the three groups were found for attention, memory, and executive function, which included tasks of backward digit span, three-word recall, verbal delayed recall, and the Stroop test. Post hoc analysis revealed that the deficiencies of attention on the digit span task were greater in the DLB group than in the AD and PDD groups. The scores for episodic verbal memory tasks were significantly lower in the DLB and AD groups than in the PDD group. The performance in frontal executive function, as indicated by the Stroop test, was significantly worse in the DLB and PDD groups than in the AD group. CONCLUSIONS: The results of the present study show that the pattern of cognitive dysfunction, in terms of attention, episodic memory, and executive functions, differ between patients with DLB and patients with AD and PDD.
Alzheimer Disease ; Cognition ; Dementia ; Executive Function ; Humans ; Lewy Bodies ; Memory ; Memory, Episodic ; Neurologic Examination ; Neuropsychology ; Parkinson Disease ; Stroop Test

BACKGROUND: A national health care initiative recommends routine spirometry screening of all smokers over age 45 or patients with respiratory symptoms. In response to the recommendation, new, simple, and inexpensive desktop spirometers for the purpose of promoting widespread spirometric screening were marketed. The performance of these spirometers was evaluated in vivo testing with healthy subjects. However, the clinical setting allows spirometric assessment of various pathologic combinations of flow and volume. OBJECTIVE: The aim of this study was to compare the accuracy of a desktop spirometer to a standard laboratory spirometer, in a clinical setting with?pathologic pulmonary function. METHOD: In a health check-up center, where screening pulmonary funct test was performed using the HI-801 spirometer. Subjects who revealed the ventilation defect in screening spirometry, performed the spirometry again using the?standard Vmax spectra 22d spirometer in a tertiary care hospital pulmonary function laboratory. Pulmonary function test with both spirometer was performed according to the guidelines of the American Thoracic Society. RESULTS: 109 patients were enrolled. Pulmonary function measurements (FVC, FEV1, PEFR, FEF25%-75%) from the HI-801 correlated closely (r=0.94, 0.93, 0.81, 0.84, respectively) with those performed with the Vmax spectra 22d?and showed the good limits of agreement and differences between the 2 devices; FVC +0.35 L, FEV1 +0.16 L, PEFR +1.85 L/s, FEF25%-75% -0.13 L/s. With the exception of FEV1, FEF25%-75%, these differences were significant(p<0.05) but small. Conclusion: The HI-801 spirometer is comparable to the standard laboratory spirometer, Vmax spectra 22d, with high accurary for FEV1 and FVC and?acceptable differences for clinical use.
Delivery of Health Care ; Humans ; Mass Screening* ; Peak Expiratory Flow Rate ; Respiratory Function Tests ; Spirometry* ; Tertiary Healthcare ; Ventilation

BACKGROUND: Although the elderly patients who need coronary revascularization are increasing, the effecti- veness and benefit of percutaneous coronary intervention(PCI) or coronary artery bypass surgery(CABG) in the elderly patients have not been evaluated by using comprehensive geriatric assessment. METHODS: From January 2007 to May 2007, 47 patients aged 65 years or older, who had stable angina with more than one coronary artery stenosis, were included in the current study. Comprehensive geriatric assess- ment, including medical, psychosocial, and functional evaluation, was performed by geriatric team. Patients were managed by medical treatment, PCI or CABG according to the decision of attending physician. One year clinical and laboratory evaluations were performed in all the study patients. RESULTS: Baseline characteristics were not significantly different among the medical treatment, PCI, or CABG group, except the extent of coronary artery disease(p=0.007). In addition, comprehensive geriatric assess- ment showed no difference in the three groups. During the follow-up period, major adverse cardiac events (MACE) were observed in 9 patients including 2 cases of cardiac death. Compared with medical treatment and PCI group, CABG group showed impaired ADL status. ADL independency was significantly impaired in CABG group; medical treatment group(84.6%-->91.7%), PCI group(85.2%-->76.9%), and CABG group(71.4%-->33.3%)(p=0.025). However, there was no other difference in cognition, depression, and nutritional status among the groups. CONCLUSION: Compared with medical treatment and PCI group, patients treated by CABG appeared functional dependency in the elderly patients. Effort to identify the risk factor and vulnerable patients should be emphasized especially in the elderly patients who need CABG.
Activities of Daily Living ; Aged ; Angina, Stable ; Cognition ; Coronary Artery Bypass ; Coronary Artery Disease ; Coronary Stenosis ; Coronary Vessels ; Death ; Dependency (Psychology) ; Depression ; Follow-Up Studies ; Geriatric Assessment ; Humans ; Nutritional Status ; Risk Factors

BACKGROUND: We wanted to examine the clinical characteristics of adult patients with tracheobronchial foreign bodies (FBs) according to the risk of aspiration and the outcomes of intervention with using a fiberoptic bronchoscope. METHODS: From December 1994 through December 2004 at Kyung Hee Medical Center, we retrospectively analyzed the medical records of 29 adult patients with FBs that were identified by using a fiberoptic bronchoscope. RESULTS: 14 patients were not at risk of aspiration, whereas 15 had cerebrovascular diseases and they were at a high risk of aspiration. No history suggestive of FB aspiration was noted in 7 (24.1%) patients. Respiratory symptom(s) were noted in 22 patients, and these symptoms were cough (62.0%), dyspnea (44.8%), fever (20.7%), wheezing (13.8%), chest pain (10.3%) and hemoptysis (0.4%). Only 60% of those patients at a high risk of aspiration had symptom(s) (92.8% of those patients without a risk of aspiration had symptoms, p=0.005). Those patients at risk for aspiration had a longer duration of symptoms (median: 4 days vs. 2 days for those patients not at risk for aspiration, p=0.007) before diagnosis. Acute respiratory symptom(s) within 3 days after aspiration were more frequent in the patients without a risk of aspiration (9 vs. 4, respectively p=0.048). Chest x-ray revealed radiological abnormalities in 23 patients, and these were opacities suspicious of FB (n=11), pneumonia (n=8), air trapping (n=5) and atelectasis (n=3). There were no differences in radiological findings according to the risk of aspiration. FB aspiration developed most commonly during medical procedures (57.1% for the patients at risk) and during eating (35.7% for the patients without risk). The most common FB materials were teeth (n = 11). Alligator jaw biopsy forceps (n = 23) was the most commonly used equipment. All of the FBs were removed without significant complications. CONCLUSION: This study underlines that a tracheobronchial FB in the patients who are at a high risk of aspiration are more likely to overlooked because of the more gradual onset of symptoms and the symptoms develop iatrogenically in many cases.
Adult ; Alligators and Crocodiles ; Biopsy ; Bronchoscopes ; Chest Pain ; Cough ; Dyspnea ; Eating ; Fever ; Foreign Bodies ; Hemoptysis ; Humans ; Jaw ; Medical Records ; Pneumonia ; Pulmonary Atelectasis ; Respiratory Sounds ; Retrospective Studies ; Surgical Instruments ; Thorax ; Tooth