BACKGROUND: Enterococci exhibit intrinsic resistance or high-level minimum inhibitory concentration (MIC) to beta-lactams than other streptococci. This appears to be due to low affinity of penicillin-binding proteins and rarely production of beta-lactamase, which gives the reason of testing beta-lactamase for blood and cerebrospinal fluid isolates. Ampicillin is more effective than penicillin in vitro, and MIC of ampicillin is generally 1 dilution lower than that of penicillin. The purpose of this study is to detect beta-lactamase producing enterococci an6 to compare MICs of ampicillin and penicillin by Vitek system (bioMerieux, Hazelwood, MO, USA) with those by agar dilution method. METHODS: We collected 110 isolates of Enterococcus faecalis and 51 isolates of E. faecium from clinical specimens in 1998. MICs of antibiotics were determined by agar dilution method and Vitek system. We also performed beta-lactamase test by the Cefinase (Becton Dickinson, USA) for 512 isolates of E. faecalis and 189 isolates of E. faecium collected in 1998. RESULTS: The most common sites of isolates were blood, bile, surgical/traumatic wounds, closed and open pus and urine. MICs of ampicillin were 1 to 2 dilution lower than those of penicillin for E. faecalis (P=0.03). But there were no significant differences in MICs for E. faecium (P=0.19). Five isolates (4 E. faecalis and 1 E. faecium) were susceptible to ampicillin but resistant to penicillin. There were no beta-lactamase producing enterococci among 701 isolates tested. CONCLUSIONS: MIC by Vitek system tends to be 1 to 2 dilution lower than MIC by agar dilution method to beta-lactams, and MIC of ampicillin is 1 to 2 dilution lower than MIC of penicillin, which could result in discrepancy in interpretation of susceptibilty tests. A beta-lactamase test for enterococci is not recommeneded for routine test in Korea.
Agar ; Ampicillin ; Anti-Bacterial Agents* ; beta-Lactamases ; beta-Lactams ; Bile ; Cerebrospinal Fluid ; Enterococcus faecalis ; Enterococcus* ; Korea ; Microbial Sensitivity Tests ; Penicillin-Binding Proteins ; Penicillins ; Suppuration ; Wounds and Injuries

We report a case of a 44 year old femele with unilateral aldosterone-proudcing adrenal adenoma characterized by hypertension, plasma aldosterone excess, and low plasma renin, commonly but not invariably with hypokalemia. She also had asymmetric septal hypertrophy of left ventricle established with two-dimensional echocardiography. The electrocardiogram showed inverted T wave and prominent U wave with high QRS voltage on precordial leads. In the case of this patient, we are not sure whether asymmetric septal hypertrophy was caused by secondary hypertension and chronic aldosterone excess of primary aldosteronism, or hypertrophic cardiomyopathy per se, so further long=term follow-up is required to determine it. Following the successful unilateral adrenalectomy, however, the systemic pressure fell down to the normal level and electrolyte abnormalities were corrected immediaterly within a few days and the modest regression in septal hypertrophy was noted in one year, suggesting that the promary aldosteronism contributes to the development or porgression of asymmetric septal hepertrophy.
Adenoma ; Adrenalectomy ; Adult ; Aldosterone ; Cardiomyopathy, Hypertrophic* ; Echocardiography ; Electrocardiography ; Follow-Up Studies ; Heart Ventricles ; Humans ; Hyperaldosteronism* ; Hypertension ; Hypertrophy ; Hypokalemia ; Plasma ; Renin

This study was undertaken to investigate the physicochemical characteristics and intake rate of Kimchi provide to five foodservice elementary schools in Sungnam area selecting 4th and 6th grade students pH indicated 4.73~5.29 at before-serving state. Total acidity were 0.23~0.44% and salinity just before-serving state were 2.41~2.82%. Vitamin C were 6.88~8.12mg% and Total dietary fiber showed the range of 19.18~22.60. While the intake rate of kimchi of female students was higher than that of male students for 4th grade students, the intake rate of kimchi of male students was higher than that of female students for 6th grade students. As a whole, the intake rate of male students was higher than that of female students. The intake rate of male students correlated significantly that of female students, the preference rate of kimchi was almost the same regardless of sex distinction.
Ascorbic Acid ; Dietary Fiber ; Female ; Gyeonggi-do* ; Humans ; Hydrogen-Ion Concentration ; Lunch* ; Male ; Salinity

PURPOSE: The purpose of this study was to identify the attributes, antecedents, and consequences of nurse's work interruptions. METHODS: Walker and Avant's concept analysis method was used to analyze this concept. Relevant articles published before August 2018 were searched through MEDLINE, CINAHL, EMBASE, KISS, and RISS databases using “interruption,” “work or task,” and “nurse” as keywords. RESULTS: The attributes of work interruption by nurses were as follows: 1) new tasks to do; 2) cognitive transition of work priorities; 3) loss of work continuity; 4) tasks to be resumed. The antecedents of work interruption were intrusion of unplanned events, internal and external factors that result in nurses forgetting their original intentions, an unpredictable work environment, and cultural climate where interruptions are considered as a part of the work process. The consequences of work interruption were decline in job satisfaction, trigger of work errors, lengthening of work completion time, decline in work productivity, increase in work stress, and delay of transferring needed information in a timely manner. CONCLUSION: The results of this study provide basic data to reduce the negative consequences of nurses' work interruptions, and contribute to expanding the knowledge necessary for improving patients' safety and nurses' performance.
Climate ; Efficiency ; Intention ; Job Satisfaction ; Methods ; Walkers ; Work Performance

PURPOSE: This study aimed to evaluate the usefulness of a behavioral cue checklist (BCC) containing 17 items developed by Wilkes et al. (2010) for identifying potentially violent patients in emergency departments. METHODS: This was a prospective observational study to evaluate the usefulness of the Korean version of a BCC (K-BCC) as an assessment tool for predicting patient violence in emergency departments, and was conducted over 4 weeks in a regional emergency medical center located in B City. A total of 1,324 patients were finally analyzed. RESULTS: Logistic regression analysis was performed to investigate whether each item of the K-BCC predicts violence, and a parsimonious set of 8 statistically significant items was selected for the tool. Receiver operating characteristic analysis of the BCC showed that the area under the curve was .97 (95% confidence interval: .94~1.0). The sensitivity, specificity, positive predictive value, and negative predictive value at the cut-off score of 2 were 75.6%, 98.9%, 68.2%, and 99.2%, respectively. CONCLUSION: The K-BCC was found to be useful in predicting patient violence toward emergency department staff. This tool is simple, and fast to use and can play a significantly role identifying potentially violent patients. Owing to this advance identification, this tool can be helpful in preventing the potential for violence from manifesting as violent behaviors.
Checklist* ; Cues* ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Logistic Models ; Observational Study ; Prospective Studies ; ROC Curve ; Sensitivity and Specificity ; Violence*

Hemodialysis(HD)-associated hypotension is a frequent complication, but it is difficult to manage. Until now, several maneuvers have been tried to prevent the HD-associated hypotension. Of these, the sodium content of dialysate was regarded as an important factor for maintaining blood pressure during HD. In this study, we evaluated the effect of hypertonic dialysate on blood pressure, interdialytic weight gain and the incidence of thirst. The study was done for 6 weeks successively with 3 different groups. Each patient was dialysed with 3 different dialysates for 2 weeks: Group I(Conventional HD: sodium concentration: 137 mEq/L), Group II(Hypertonic HD: 147 mEq/L) and Group III (Sequential HD: from 147 to 140 mEq/L). Hemodynamic parameters(blood pressure, pulse rate and ultrafiltration rate), biochemical parameters(hematocrits, blood urea nitrogen, creatinine, osmolality, sodium, potassium, chloride, fasting blood sugar) and complications (interdialytic weight gain &thirsty sensation) were compared among 3 groups. The results were as follows: 1. Decline of systolic blood pressure and diastolic blood pressure at the time of a 3 hour check during hemodialysis was lower in the Group II than Group I and III (p=0.002; p=0.012). and decline of diastolic blood pressure at the time of a 4 hour check during hemodialysis was lower in the Group II and III than Group I(p=0.04). 2. ncidence of hypotensive episodes during dialysis was significantly lower in Group II than group I (p=0.0287). 3. The ultrafiltration in Group III at the time of 1 hour, 2 hour and 3 hour check during hemodialysis was higher than that in Group I and II at the time of 1 hour, 2 hour and 3 hour check during emodialysis respectively (p=0.0001; p=0.0001; p=0.0004). 4. Interdialytic weight gain was higher in Group II(3.1+/-0.8) than GroupI(2.8+/-0.8) and III (2.9+/-0.9) (p=0.0422). 5. Hematologic and biochemical results were not significantly different among 3 Groups. 6. Frequency of thirst was different in Group I, II and III, 0.05+/-0.12, 0.41+/-0.24 and 0.22+/-0.29 respectively (p=0.0259). The results suggest that hypertonic HD was effective in preventing HD-associated hypotension but interdialytic weight gain and thirst sensations were increased as compared with a conventional method. In this situation, sequential HD seems to be an alternative method to minimizes the side effect of hypertonic HD.
Blood Pressure* ; Blood Urea Nitrogen ; Creatinine ; Dialysis ; Dialysis Solutions ; Fasting ; Hemodynamics* ; Humans ; Hypotension ; Incidence* ; Osmolar Concentration ; Potassium ; Renal Dialysis* ; Sensation ; Sodium ; Thirst* ; Ultrafiltration* ; Weight Gain*

BACKGROUND: Diabetes has a critical effect on elderly diabetic patients' quality of life. Elderly diabetic patients have many difficulties in diabetes self-management because their physical, psychological and social functions are decreased as a result of the aging process. Therefore, we evaluated the current status of self-management and barriers in elderly diabetic patients METHODS: The sample was 124 elderly diabetic patients (over 61 years) who visited a hospital and two senior welfare centers in Seoul from July to August 2006. The results of the study were analyzed by descriptive statistics, ANOVA, T-test, and hierarchical regression. RESULTS: 1) Diabetes self-management was composed of insulin injection, diet, exercise, foot management, smoking and drinking alcohol. An average score of self-management in the elderly diabetic patients was 4.5784. In demographic variables, only job status showed a significant effect on self-management. 2) Barriers such as 'forgetting taking diet and medication', 'being interrupted by others', and 'lack of family and social support' were significant factors in diabetes self-management. 3) These barriers for diabetes self-management were still significant in the case of controlling demographic and clinical variables. CONCLUSION: Diabetic educator should identify the significant factors that affect patient's self-management such as whether they have a full-time job, or the type of their job. In addition, diabetes education should focus on assertiveness training to deal with various interpersonal barriers and empowerment for enhancing patient's self-efficacy. These approaches would benefit patients who experience barriers of diabetes self-management
Aged ; Aging ; Assertiveness ; Diet ; Drinking ; Foot ; Humans ; Insulin ; Power (Psychology) ; Quality of Life ; Self Care ; Smoke ; Smoking

Mycoplasma hominis is a commensal organism in the genitourinary tract. Extragenital infections by M. hominis are rare, and its occurrence is usually limited to immunocompromised patients. Here we report two patients with extragenital infection by M. hominis. The first patient, a woman with angioimmunoblastic T cell lymphoma, underwent autologous peripheral blood stem cell transplantation. The second patient, a woman with endometrial cancer, received laparoscopically-assisted vaginal hysterectomy. They both presented with septic symptoms, including fever, and M. hominis was isolated from pleural effusion and ascitic fluid, respectively. We are reporting these two cases of extragenital infection by M. hominis with a literature review to emphasize that the rapid isolation of M. hominis with early treatment can lead to a better prognosis.
Ascitic Fluid ; Endometrial Neoplasms ; Female ; Fever ; Humans ; Hysterectomy, Vaginal ; Immunocompromised Host ; Lymphoma, T-Cell ; Mycoplasma ; Mycoplasma hominis ; Peripheral Blood Stem Cell Transplantation ; Pleural Effusion ; Prognosis

BACKGROUND: Pericardiocentesis is not routinely recommended in most patients with pericardial effusion (PE), except for patients with cardiac tamponade. However, the long-term follow-up results in patients with clinically not significant PE are few. METHODS: Sixty-five consecutive patients (mean age:57 yrs, 26 males) out of 87 patients with PE, who were clinically not serious, were studied prospectively once in every two month for mean 6 months (2-12 months) without any specific treatment. The amount of PE was measured at the enddiastole period of parasternal long axis view and apical four chamber view. RESULTS: The incidence of insignificant PE in our echocardiographic laboratory is 3.4% (n=87 from 2461). The maximal accumulation site of PE was posterior (n=51, 79%). The next is anterior (n=11, 17%) and right ventricular side (3, 5%). The amount of PE is less (0.37+/-0.17cm vs 0.64+/-0.54cm, p=0.018) in localized PE (n=24, 37%) than that of diffuse form (n=41, 63%), which spreads to more than 2 chambers. The presumptive etiologies of PE were unknown (n=41), heart failure (n=5), myocardial infarction (n=6), viral (n=3), and others (n=10). The amount of PE was decreased from 0.54+/-0.46 cm to 0.30+/-0.26 cm, 0.23+/-0.24 cm, and 0.21+/-0.23 cm 2, 4, and 6 months after intial evaluation, respectively, without any complication. CONCLUSION: The patients with PE, not combining >KERN= Axis, Cervical Vertebra ; Cardiac Tamponade ; Echocardiography ; Follow-Up Studies* ; Heart Failure ; Humans ; Incidence ; Myocardial Infarction ; Pericardial Effusion* ; Pericardiocentesis ; Prospective Studies

PURPOSE: Interleukin (IL) -13 plays a pivotal role in the induction of immunoglobulin E (IgE) and in the pathogenesis of atopic dermatitis (AD). Recently, an association was reported between the polymorphism of the IL-13 promoter region (-1512A/C) and atopic asthma. We investigated the association between the IL-13 single nucleotide polymorphism (SNP) in the promoter region (-1512A/C) and atopic dermatitis in Korean children with AD. METHODS: We enrolled 204 allergic AD, 92 non-allergic AD, and 116 non-atopic healthy children. Evaluated phenotypes of atopic dermatitis included total IgE, total eosinophil count, and eosinophil fraction. We used a PCR-RFLP method to identify IL-13 genotypes. RESULTS: The allele frequencies of the IL-13 promoter polymorphism (-1512A/C) did not differ statistically among the three groups. Children with one or two copies of risk alleles in the promoter region (-1512C) did not show any significant association with the clinical phenotypes of atopic dermatitis including total IgE, eosinophil phenotypes and SCORAD score in the allergic or non-allergic atopic dermatitis. CONCLUSION: These data suggest that the -1512A/C polymorphism of IL-13 gene may not be associated with neither the development nor the clinical phenotypes of atopic dermatitis in Korean children.
Alleles ; Asthma ; Child* ; Dermatitis, Atopic* ; Eosinophils ; Gene Frequency ; Genotype ; Humans ; Immunoglobulin E ; Immunoglobulins ; Interleukin-13* ; Interleukins ; Phenotype ; Polymorphism, Single Nucleotide ; Promoter Regions, Genetic