Background: Reporting rate of notifiable communicable diseases has been assumed to be low in Korea. To encourage timely reporting of notifiable communicable diseases and to improve the reporting process by the Infection Control Unit, a disease code-based electronic surveillance and in-house electronic reporting system was developed and implemented in February 2003. We evaluated the reporting rates of notifiable communicable diseases before and after the implementation of the electronic reporting- system. METHODS: The electronic reporting system, which was integrated to the computerized physician order entry system, was designed to monitor KCD-4 codes at the time of every order entry. Whenever the system recognized the predetermined codes of notifiable communicable diseases, it generated an alert box to recommend reporting: and then a physician could fill up an electronic report form, which was collected and faxed to the local public health authority by the Infection Control Unit. Reporting rate of notifiable communicable diseases in 2002, when the conventional paper-based reporting system was used, was assumed comparing the number of cases reported actually and that of cases identified to be reported by reviewing the medical records and electronic database. RESULTS: From March to July 2003, 181 cases with tuberculosis and 14 with other communicable diseases were reported whereas 106 and 9 cases were reported respectively for the same 5-month period in 2002. Reporting rate using the conventional reporting system in 2002 was assumed to be 61% and 39% respectively. Conclusions: Using a disease code-based electronic reporting system, reporting of notifiable communicable diseases could be improved compared with conventional paper-based reporting system.
Communicable Diseases* ; Disease Notification ; Infection Control ; Korea ; Medical Informatics Applications ; Medical Order Entry Systems ; Medical Records ; Public Health ; Tuberculosis

No abstract available.
Humans

In Sprague Dawley (SD) rats, antibodies against strains of Orinentia tsutsugamushi, Kato, Karp and Gilliam, were produced in order to investigate their longevity and cross-reactivities to their corresponding homologous and heterologous antigens. By immunofluorescence assay (IFA) of IgG and IgM, it was shown that the immunity to the homologous strains persisted at a higher level (longevity of at least 34 weeks with higher IFA titers). On the other hand, the immunity to the heterologous strains persisted at a lower level (longevity of 10 to 34 weeks with lower IFA titers). Since infection with one strain of O. tsutsugamushi does not preclude reinfection with other strains, understanding of the antigenic diversity of O. tsutsugamushi and duration of the immunity to both homologous and heterologous strain is very important in diagnosis of scrub typhus.
Animals ; Antibodies* ; Antigenic Variation ; Antigens, Heterophile ; Diagnosis ; Fluorescent Antibody Technique ; Hand ; Immunoglobulin G ; Immunoglobulin M ; Longevity* ; Orientia tsutsugamushi* ; Rats ; Rats, Sprague-Dawley* ; Scrub Typhus

We report on the investigations and interventions conducted to contain an extended outbreak of Serratia marcescens bacteriuria that lasted for years in a neurosurgical intensive care unit (NSICU). A case-control study was performed to identify the risk factors for S. marcescens acquisition in urine. In case patients, urine sampling for tests and central venous catheterization were performed more frequently before the isolation of S. marcescens. Case patients were more frequently prescribed third-generation cephalosporins. Adherence to hand antisepsis was encouraged through in-service educational meetings and infection control measures, especially concerning the manipulation of indwelling urinary catheters, were intensified. The outbreak persisted despite the reinforcement of infection control measures. However, no patient has newly acquired the organism in the NSICU since December 2004. Multiple factors, including inadequate infection control practices and inappropriate antimicrobial usage, possibly contributed to the persistence of this S. marcescens outbreak. Healthcare workers should consistently follow infection control policies to ensure quality care.
Serratia Infections/*epidemiology/*prevention & control/transmission ; Risk Factors ; Risk Assessment/*methods ; Population Surveillance ; Neurosurgery/*statistics & numerical data ; Middle Aged ; Male ; Korea/epidemiology ; Intensive Care Units/*statistics & numerical data ; Infection Control/methods/statistics & numerical data ; Incidence ; Humans ; Follow-Up Studies ; Female ; Disease Transmission, Horizontal/prevention & control/statistics & numerical data ; Disease Outbreaks/prevention & control/statistics & numerical data ; Case-Control Studies ; Bacteriuria/*epidemiology/*prevention & control

We report on the investigations and interventions conducted to contain an extended outbreak of Serratia marcescens bacteriuria that lasted for years in a neurosurgical intensive care unit (NSICU). A case-control study was performed to identify the risk factors for S. marcescens acquisition in urine. In case patients, urine sampling for tests and central venous catheterization were performed more frequently before the isolation of S. marcescens. Case patients were more frequently prescribed third-generation cephalosporins. Adherence to hand antisepsis was encouraged through in-service educational meetings and infection control measures, especially concerning the manipulation of indwelling urinary catheters, were intensified. The outbreak persisted despite the reinforcement of infection control measures. However, no patient has newly acquired the organism in the NSICU since December 2004. Multiple factors, including inadequate infection control practices and inappropriate antimicrobial usage, possibly contributed to the persistence of this S. marcescens outbreak. Healthcare workers should consistently follow infection control policies to ensure quality care.
Serratia Infections/*epidemiology/*prevention & control/transmission ; Risk Factors ; Risk Assessment/*methods ; Population Surveillance ; Neurosurgery/*statistics & numerical data ; Middle Aged ; Male ; Korea/epidemiology ; Intensive Care Units/*statistics & numerical data ; Infection Control/methods/statistics & numerical data ; Incidence ; Humans ; Follow-Up Studies ; Female ; Disease Transmission, Horizontal/prevention & control/statistics & numerical data ; Disease Outbreaks/prevention & control/statistics & numerical data ; Case-Control Studies ; Bacteriuria/*epidemiology/*prevention & control

PURPOSE: Biofeedback is a major treatment method for constipated patients with non-relaxing puborectalis syndrome. However a significant percent of patients still showed poor outcome, and little has been known about the predictors associated with outcome of biofeedback. The aim of this study was to determine the outcome and identify predictors associated with poor outcome of biofeedback therapy for constipated patients with non- relaxing puborectalis syndrome. METHODS: Fifty-two constipated patients with non-relaxing puborectalis syndrome (median age, 47 years) who had more than one biofeedback session after defecography were evaluated by standardized questionnaire, before, immediately after treatment, and at follow-up. Clinical bowel symptoms and anorectal physiological studies were analyzed. Any differences in demographics, clinical symptoms, and parameters of anorectal physiological study were evaluated between success group (patients felt improvement in symptoms at follow-up) and failure group (patients felt no improvement). RESULTS: Follow up (mean follow-up; 17 months) results were evaluated by an independent observer in 45 patients. At post-biofeedback, 42 (81 percents) patients felt improvement in symptoms, including 7 (13 percents) with complete symptom relief. At follow-up, 25 (56 percents) patients felt improvement in symptoms, including 1 (2 percents) with complete symptom relief. There was a significant reduction in difficult defecation (from 81 to 44, 53 percent, from pre-biofeedback to post-biofeedback, and at follow up respectively; P<0.005, P<0.01), sensation of incomplete defecation (from 90 to 50, 40 percent; P< 0.00001, P<0.000005), laxative use (from 25 to 10, 11 percent; P<0.05), and enema use (from 13 to 0, 2 percent; P<0.01, P<0.05). Normal spontaneous bowel movement was increased from 42 percent pre-biofeedback to 81 percent post-biofeedback (P<0.0001), 80 percent at follow up (P<0.0005). Pre-biofeedback presence of symptoms of bowel habit change predict poor outcome (15 vs. 0 percent; failure vs. success, P<0.05). High pressure zone in prebiofeedback manometry was longer in failure group than in success group (2.80 vs 2.01 cm, P<0.05). In the success group, 11 (44 percent) had a rectocele, 1 (4 percent) had a rectal intussussception, 18 (72 percent) had a descending perineal syndrome, and 3 (12 percent) had a sigmoidocele. In the failure group, 4 (20 percent) had a rectocele, and 1 (5 percent) had a rectal intussusception, 14 (70 percent) had a descending perineal syndrome, and a sigmoidocele was not accompanied (P<0.05). Accompanied rectocele, rectal intussusception, descending perineal syndrome, and sigmoidocele did not influence outcome. CONCLUSIONS: Biofeedback is an effective option and should be considered as the first line therapy. Bowel habit change and long high pressure zone in pre-biofeedback manometry were predictors associated with poor outcome of biofeedback therapy for constipated patients with non-relaxing puborectalis syndrome.
Biofeedback, Psychology* ; Defecation ; Defecography ; Demography ; Enema ; Follow-Up Studies ; Humans ; Intussusception ; Manometry ; Surveys and Questionnaires ; Rectocele ; Sensation

ERCP may provide more definite diagnosis, preoperative guidance, and endoscopic therapy in many children with known and suspected disorders of the pancreas or biliary tract. To our knowledge, there has been rare case of ERCP in children and no reported case of ERCP performed in inf~int less than 2 years old in Korea. We report a case of KRCP performed in 26 month old girl who was admitted to evaluate jaundice. We diagnosed CBD stones and choledochal cyst, Todani type III containiaig stones by ERCP. After endoscopic sphincterotomy(EST), removal of stones, and endoscopic nasobiliary drainage(END) her bilirubin level normalized about 2 months later.
Biliary Tract ; Bilirubin ; Child ; Child, Preschool ; Cholangiopancreatography, Endoscopic Retrograde* ; Choledochal Cyst* ; Diagnosis ; Female ; Humans ; Infant* ; Jaundice ; Korea ; Pancreas ; Sphincterotomy, Endoscopic*

PURPOSE: To investigate the incidence and clinical characteristics of juvenile idiopathic arthritis (JIA)-associated uveitis in Korea and to identify the risk factors for developing uveitis and poor visual outcome. METHODS: We performed a retrospective chart review of 149 patients who were diagnosed as JIA between January 2001 and December 2012. Patients were classified based on the International League of Associations for Rheumatology (ILAR) criteria and the incidence and clinical course of uveitis according to each subtype was investigated. We also evaluated the risk factors for poor prognostic outcomes. RESULTS: The present study included 79 males and 70 females and the mean age was 7.42 +/- 3.82 years. In 13 patients (8.6%), uveitis manifested evenly among JIA subtypes, including 5 patients with oligoarthritis type, 4 patients with polyarthritis rheumatoid negative type, and 4 patients with systemic type. Anti-nuclear antibody (ANA) was detected more in the uveitic group (46.13%). The characteristics of uveitis were acute (85%), bilateral (85%), and anterior uveitis (92%). Chronic uveitis occurred in only 2 patients who had uveitis at an early age (mean age of 5 years) and had severe anterior chamber reaction at presentation. Poor visual outcome was associated with band keratopathy and posterior synechiae preceded by the chronic uveitis. CONCLUSIONS: JIA-associated uveitis occurred evenly in each subtype. Uveitis was increased in the presence of ANA. Most uveitis showed good visual outcomes but in cases of early uveitis onset and with severe anterior chamber reaction at presentation the risk of chronic uveitis increased resulting in poor visual outcomes.
Anterior Chamber ; Arthritis ; Arthritis, Juvenile Rheumatoid* ; Female ; Humans ; Incidence ; Korea* ; Male ; Retrospective Studies ; Rheumatology ; Risk Factors ; Uveitis* ; Uveitis, Anterior

A 44-year-old woman who comlpained of dizziness and generalized weakness was admitted. The hemoglobin was 6.6g/dL, hematocrit 25.5%, and serum ferritin 2.14 ng/mL Stool occult blood was positive and microcytic hypochromic anemia was found on periyheral blood smear. Gastroscopic examination showed about 2 x 1 cm sized hemispherical sebmucosal tumor on antrum. The patient underwent operatioh for confirmatory diagnosis and treatment. The final pathologic diagnosis of the resected lesion was hemangioma of stomach. Cavernous hemangioma of stomach is a rare disease.Mostly, it has a benign course clinically, but early diagnosis is important because massive hemorrhage and anemia by chronic blood loss can occur. We report a case of hemangioma of stomach with review of literature.
Adult ; Anemia ; Anemia, Hypochromic ; Diagnosis ; Dizziness ; Early Diagnosis ; Female ; Ferritins ; Hemangioma ; Hemangioma, Cavernous* ; Hematocrit ; Hemorrhage ; Humans ; Occult Blood ; Stomach*

This review underscores the integration of cognitive behavioral therapy (CBT) as a critical component of psychiatry residency programs essential for the comprehensive training of residents. The core competencies psychiatry residents should develop as CBT therapists, including specific skills and knowledge domains, are outlined. In addition, the review addresses the necessary attitudes and techniques for faculty engaged in CBT supervision, providing insight into effective educational and supervisory strategies. The application of these principles in clinical training settings is discussed, highlighting their potential to improve the quality and effectiveness of CBT training in psychiatry residency programs.