We produced two murine monoclonal antibodies designated S2E1 and S2C11, which recognize S antigen of hepatitis B virus (HBsAg). S2E1 could bind to denatured form of recombinant HBsAg as well as native form of HBsAg, but S2C11 could bind only to native form of HBsAg. Both antibodies reacted with HBsAg in the hepatocyte of patient infected with hepatitis B virus. Analyses of the nucleotide sequences encoding the variable regions of these antibodies revealed that S2E1 and S2C11 utilize variable gene segment which belong to V4/5 gene family and utilize the J5 and Jk4 gene segments, respectively. In addition, the heavy chain of S2E1 express a member of V14 gene family and a member of DSP2.9 and Jh3 gene families. S2C11 is related to the V1 gene family and expresses DFL16.1 gene regions in conjunction with the Jh3 gene segment.
Antibodies ; Antibodies, Monoclonal* ; Base Sequence ; Clone Cells* ; Cloning, Organism* ; Hepatitis B Surface Antigens ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Hepatocytes ; Humans

BACKGROUND: The usage of appropriate disinfectants is essential for infection control in a hospital. Inadequate use of disinfectants is the cause of human or environmental toxicity and is a waste of cost. The objective of this study was to describe the status of the usage of disinfectants in Korean hospitals. METHOD: One hundred and eighty three hospitals of over 300 beds were investigated by a questionnaire distributed by mall. Data collection was done on November 1999. The questionnaire was made by the Association of Infection Control Nurses in Korea, based on references and protocols of the Korean Society of Nosocomial Infection Control. Numerical and percentage data were analyzed by SPSS. RESULTS: The collection rate of the questionnaire was 43.7% (80/300). Thirty five hospitals (46.7%) had an official process in selecting disinfectants in their hospitals. Regarding skin antiseptics, 10% povidone iodine and 70% alcohol were commonly used in skin preparation for intravenous catheterization or pre-operative skin disinfection, For disinfection of mucosal membranes such as mouth and periurethral area, 3% boric acid solution or 3% H202 were used. Most of the hospitals decontaminated contaminated medical instruments manually with dodecyl diamino ethyl glycine (20.8%). glutaraldehyde (15.6%). quaternary ammonium compounds (13.8%), virkon (12.3%) and sodium hypochlorites (11.7%). Glutaraldehyde and virkon were frequently used for disinfection of endoscopes. Sodium hypochlorites (48.9%) and quaternary ammonium compounds (19.8%) were the most commonly used environmental disinfectants. Some noticeable problems in disinfectants were as follows. First, for mouth care, many hospitals (41.7%) over-used boric acid, which has cumulative toxicity for humans. Second, many hospitals had an incorrect protocol of disinfecting endoscopes. Third, for environmental decontamination and instrument cleaning, some hospitals used high level disinfectants such as glutaraldehyde, which is too costly and provides unnecessary safety problems. Fourth, after patient discharge, many hospitals did not use disinfectants at all. Considering the specific Korean medical environment of high incidence of multi-drug resistant microorganisms, use of disinfectants for discharged environments may be warranted. CONCLUSION: This study included only hospitals of over 300 beds, which has a limitation in representing the status of disinfectants usage in a country. However, significant problems from misunderstanding the basic principles of disinfectants and misusages of disinfectants were observed in this investigation. These observations will provide useful information for designing a guideline for the appropriate uses and for efficient education of disinfectants, and also for planning a national control program for proper disinfectants usage in this country.
Anti-Infective Agents, Local ; Catheterization ; Catheters ; Cross Infection ; Data Collection ; Decontamination ; Disinfectants* ; Disinfection ; Education ; Endoscopes ; Glutaral ; Glycine ; Humans ; Incidence ; Infection Control ; Korea* ; Membranes ; Mouth ; Patient Discharge ; Povidone-Iodine ; Quaternary Ammonium Compounds ; Skin ; Sodium ; Surveys and Questionnaires

PURPOSE: The purpose of this study was to investigate the status of infection control in long-term care facilities in Korea and educational needs of nurses in charge of infection control. METHODS: This was a descriptive study. A self-reported questionnaire was provided to the nurses in charge of infection control in 250 hospitals with long-term care. 209 nurses answered to the questionnaire. Data were collected from September 30 to November 7, 2016. Data were analyzed using SPSS/WIN 18.0, and the educational needs were analyzed by applying the Borich Needs Assessment Model. RESULTS: Only 17.4% of the hospitals had infection control departments, and only 1.0% of the hospitals had nurses who were fully-in-charge of infection control. Regarding the educational needs on infection control, level of knowledge was statistically significantly lower in all 50 items compared to the importance. Specifically, educational demand on air and water quality management, construction and infection control, indicator management, and infectious disease management were also high. CONCLUSION: The results of this study showed that organization and manpower were needed for effective infection control of long-term care facilities in Korea. In addition, it was deemed necessary to develop and applicate infection control education programs as reflected on the scores obtained in the educational needs on infection control.
Communicable Diseases ; Education ; Infection Control* ; Korea* ; Long-Term Care* ; Needs Assessment ; Water Quality

Purpose: The purpose of this study was to develop an infection control education program (ICEP) for infection control practitioners (ICPs) in long-term care hospitals (LTCH) and to test the effectiveness of the program. Methods: The ICEP was developed based on the Analysis, Design, Development, Implementation, and Evaluation (ADDIE) model. Focus group interviews, Borich needs assessment, and location of focus models were used to assess educational needs. To test the effectiveness of the developed ICEP program, one-group pretest-posttest design was used. Participants were 269 ICPs working at LTCH. Knowledge, skills, awareness, self-efficacy, and teaching efficacy on infection control were measured before and after the program using questionnaires. A paired t-test was performed to analyze the data. Results: Compared to pre-test, there was a significant improvement in knowledge (47.07±10.22 vs, 76.99±0.88, p<.001) and skills (32.11±12.48 vs. 62.11±14.08, p<.001). Awareness of infection control, self-efficacy, and teaching efficacy were also significantly improved. Conclusion We developed an ICEP for ICPs working at LTCH. Based on the results of this study, the ICEP is effective in improving infection control knowledge, skills, self-efficacy, and teaching efficacy for the ICPs. It is suggestive to provide an ICEP to improve hospital infection control activities.

Background: A clinician reported unusually high incidence of A. xylosoxidans isolation from aspirated tissues in outpatient clinic. Methods: A. xylosoxidans isolates from January 2002 to June 2002 were investigated. The infection control nurse reviewed medical records and observed the procedures of tissue aspiration and culture at the clinical microbiology laboratory. Specimens were obtained for investigational cultures from dye, aspiration gun, slide alcohol sponge, tray, sink. water of sink, buffer solution, microscope, computer, and telephone. Results: A. xyloxosidans was isolated from twenty-four patients during 6 months. None of 24 cases had any typical signs or symptoms of infections by A. xylosoxidans. Observation of tissue aspiration and culture procedure revealed that buffer solution was used for prevention of specimen drying after tissue aspiration. Culture of the buffer solution yielded a heavy growth of A. xylosoxidans from four out of ten specimens. A. xylosoxidans was not isolated from any other investigational specimens. Conclusions: This was supposed to represent pseudoepidemic. Contaminated buffer solution was documented as the cause of this pseudoepidemic. The usage of buffer solution was stopped. During the follow-up period of 2 months, no additional A. Xylosoxidans was cultured from aspirated tissues.
Alcaligenes* ; Ambulatory Care Facilities ; Follow-Up Studies ; Humans ; Incidence ; Infection Control ; Medical Records ; Methods ; Porifera ; Telephone ; Water

Neonatal ascites is an uncommon problem with many etiologies. The common causes include hematologic diseases, bowel perforation, obstructive uropathy, cardiovascular diseases, chylous ascites, intrauterine infection, and meconium peritonitis. Recently, the wide application of sonography has greatly narrowed the list of differential diagnosis of neonatal ascites. Meconium peritonitis is readily diagnosed if calcification in the abdomen or scrotum can be seen radiologically or sonographically in a neonate with abdominal distension at birth. We report a case of generalized meconium peritonitis without intraabdominal calcification by radiologic and sonographic study and notable meconium hydrocele at birth.
Abdomen ; Ascites ; Cardiovascular Diseases ; Chylous Ascites ; Diagnosis, Differential ; Hematologic Diseases ; Humans ; Infant, Newborn ; Meconium* ; Parturition ; Peritonitis* ; Scrotum ; Ultrasonography

PURPOSE: The clinical findings of early neonatal hypocalcemia are variable and it is difficult to find relationship between the symptoms and hypocalcemia due to complex causes. The purpose of this study is to establish the relationship between early neonatal hypocalcemia and clinical manifestations and to propose a guideline for appropriate treatment of early neonatal hypocalcemia, especially in asymptomatic cases. METHODS: Study subjects were all sick babies admitted to nursery and NICU and randornly selected 43 healthy babies at Sun General Hospital from January 1996 to December 1996. We examined serum calcium level within 72 hours after birth. Then we evaluated prospectively clinical findings according to each disease category in hypocalcemic cases and analysed the relationship of time course of clinical findings with hypocalcemia and compared serum calcium concentration followed by each therapy after 3 days. RESULTS: The results were as follows. 1) The incidence of early neonatal hypocalcernia was high in premature infants, low birth weight infants, infants with neonatal asphyxia, hyaline membrane disease and transient tachypnea. 2) Tremor, seizure, apnea, dyspnea, abdominal distension, cyanosis, and vomiting were frequently presented symptoms in early neonatal hypocalcemia. 3) In the cases of early hypocalcemia with symptoms, these symptoms persisted continuously after norrnalization of serum calcium concentration. 4) Among asymptomatic hypocalcernic group, mean serum calcium levels changed from 6.7 mg/dL to 8.7 mg/dL in 23 cases of no treatment, from 5.4 mg/dL to 10.3 mg/dL in 4 cases of calcium gluconate infusion, and from 6.3 mg/dL to 8.7 mg/dL in 7 cases of feeding low phosphorus containing milk. None persisted in hypocalcemic state irrespective of treatment methods. CONCLUSION: It is difficult to regard these symptoms as a rule to treatment because these symptoms were present after normalizaton of serum calcium concentration. In addition, asymptomatic hypocalcemia was improved shortly without any treatment without any problem. We conclude that for asymptomatic hypocalcemia, withholding dangerous calcium gluconate infusion would be perrnissible.
Apnea ; Asphyxia ; Calcium ; Calcium Gluconate ; Cyanosis ; Dyspnea ; Hospitals, General ; Humans ; Hyaline Membrane Disease ; Hypocalcemia* ; Incidence ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Milk ; Nurseries ; Parturition ; Phosphorus ; Prospective Studies ; Seizures ; Solar System ; Tachypnea ; Tremor ; Vomiting

Guillain-Barr syndrome is rarely complicated by hypertension, which has been ascribed to sympathetic nervous system hyperactivity. We report a 11 years old female with Guillain-Barr syndrome complicated by persistent hypertension associated with elevated renin-angiotensin. So we report this case with brief review of related literatures.
Child ; Female ; Humans ; Hypertension* ; Sympathetic Nervous System

BACKGROUND: The proper use of disinfectants has been a major issue in infection control programs. We performed a survey to evaluate the current usage of disinfectants in Korea. METHODS: A questionnaire was e-mailed to 95 hospitals that had infection control programs and data were collected between 10 and 28 October 2005. The questionnaire included questions about whether the hospital had official procedures for selection and use of disinfectants and an education program for proper use; also included were questions about the general characteristics of the hospitals. The types of disinfectants consisted of antiseptics and disinfectants for medical devices, endoscopes, and environments. The questionnaire was analyzed using SPSS 12.0 program. RESULTS: Thirty-nine (41.1%) of the 95 hospitals responded to the questionnaire. Thirty-six hospitals (84.6%) had an official decision making process in selecting disinfectants in their hospitals. Ten percent povidone iodine (PVI) (94.9% for central line) and alcohol (92.3% for peripheral line) were commonly used for skin preparation for intravenous catheterization. Most hospitals used 10% PVI for clean wound (97.4%), dirty/infected wound (94.8%) and sore wound (61.5%); 3% H2O2 (43.6%) for dirty/infected wound; and saline (25.6%) for sore wound. Waterless alcohol handrubs were used in general ward (92.3%), ICU (97.4%), and OR (43.6%). Over the 60% of the hospitals used sodium hypochlorites for cleansing the floors and bathrooms of patients' rooms. As a disinfectant for endoscopes, peracetic acid (40-60%) was used the most frequently, followed by orth-pthalaldehyde (25-36%), and superoxidized water (8-23%). Most hospital followed the manufactures' guidelines on the exposure time of gastroscopes to disinfectants such as orth-pthalaldehyde (100%) and peracetic acid (96%). But, some hospitals re-used peracetic acid (12.0%) and superoxidized water (28.6%) for a longer duration than was recommended by the manufacturers. Fifty to eighty percents of the hospitals used tap water for rinsing endoscopes after disinfection, and only about 80% of these dried with alcohol after rinsing. Most hospitals (84.6%) had teaching sessions for the proper use of disinfectants more than once a year. CONCLUSION: The current use of disinfectants has been improved since 1999 in its suitability and appropriateness Proper use of disinfectants ensures the safety of invasive and non-invasive medical processes; therefore, the current guidelines for disinfection should be strictly followed by the hospital. And continuous staff education will facilitate the correct use of disinfectants.
Anti-Infective Agents, Local ; Catheterization ; Catheters ; Decision Making ; Disinfectants* ; Disinfection ; Education ; Electronic Mail ; Endoscopes ; Gastroscopes ; Infection Control ; Korea* ; Patients' Rooms ; Peracetic Acid ; Povidone-Iodine ; Skin ; Sodium ; Water ; Wounds and Injuries ; Surveys and Questionnaires

BACKGROUND: This study was performed to improve the working competencies of novice infection control nurses (ICNs) and thereby prevent healthcare associated infection. We developed and implemented an education program and then evaluated its effectiveness. METHODS: The education program was developed by conducting a literature review and four expert group discussions. The program was implemented twice, and included 3 days of lectures and 1 day of practice in Seoul and Pusan, for 157 ICNs with less than 3 years of experience. The knowledge of the participants before and after the educational program and overall satisfaction were measured. Data were analyzed using the SPSS WIN 18.0 program. RESULTS: The education program consisted of 12 lectures and 2 practices in total. The post-program knowledge score increased to 77.99 compared to 45.91 prior to participating in the program (P<.001). The scores for overall satisfaction, knowledge acquirement, and usefulness in field practice were 9.05, 8.97, and 9.01, respectively. The overall satisfaction was higher for the practice component (9.37) than the lectures (9.00). There were significant differences in surveillance knowledge according to age (F=3.94, P=.021), hospital career (F=3.71, P=.027), hospital type (F=5.36, P=.006), and hospital size (F=6.19, P=.003); and there were significant differences in hand hygiene knowledge according to age (F=4.14, P=.018) and hospital type (F=4.84, P=.009). However, there was no difference in overall satisfaction with the program. CONCLUSION: To enhance working competencies and professionalism, education programs considering the characteristics and needs of the ICNs must be developed. Moreover, professional training courses are needed to nurture ICNs in small hospitals.
Busan ; Cross Infection ; Education* ; Hand Hygiene ; Health Facility Size ; Infection Control* ; Lectures ; Professionalism ; Seoul