No abstract available.
Child* ; Humans ; Lung*

METHODS: We investigated and compared the epidemiologic characteristics of the E. cloacae isolation in the period of outbreak (April-June, 1998) with those in the control period (January-March, 1998). To identify the risk factors for E. cloacae sepsis, we retrospectively conducted a chart review for the patients who had E. cloacae sepsis during the period of outbreak. On the basis of these results, environmental culture was performed hospital wide. RESULTS: Ten clinical isolates E. cloacae were recovered from the blood of ten patients from April to June. 1998. Seven out of 10 patients recieved ERCP procedure just before E. cloacae sepsis. Hence, we performed surveillance study in the endoscopy room before and after the procedure. The survey showed that distilled water which was used for washing the endoscopy was contaminated with E. cloacae, which was suspected to be the common source of this outbreak. Therefore, we changed distilled water into sterilized distilled water on washing the endoscopy. After this correction was performed, the incidence of ERCP-associated E. cloacae sepsis declined markedly (P<0.011). CONCLUSION: We investigated an outbreak of ERCP-related E. cloacae sepsis and the outbreak was successfully controlled by removing the source of infection.
Cholangiopancreatography, Endoscopic Retrograde* ; Cloaca ; Endoscopy ; Enterobacter cloacae* ; Enterobacter* ; Humans ; Incidence ; Methods ; Retrospective Studies ; Risk Factors ; Sepsis* ; Water

CT scans of 21 patients(intrathoracic goiter=7. Castleman disease=6, pulmonary carcinoid tumor=3, parathyroid adenoma=1, thyroid carcinoma=1, paraganglioma=1, benign pleural mesothelioma=1, sclerosing hemangioma=1) with mediastinal tumors that are known to be enhanced with intravenous injection of contrast media, were studied retrospectively to investigate the enhancing capabilities f those tumors and to describe their CT findings. The degree of enhancement was estimated by visual inspection with a grading system. All but one case of cystic parathyroid adenoma showed enhancement on post-contrast scan. The degree of enhancement was not helpful in differentiating these tumors. Characteristic location and pattern of tumor extension were found in cases of intrathoracic goiter, parathyroid adenoma, thyroid carcinoma and paraganglioma. Calcifications were found in intrathoracic goiter(5/7). Castleman disease(2/6). Pulmonary carcinoid(1/3), thyroid carcinoma. Necrotic low-attenuation areas were in intrathoracic goiter(7/7), parathyroid adenoma, thyroid carcinoma and paraganglioma. In conclusion, mediastinal tumors that are known to be enhanced in the literature were enhanced with rare exception, and if we consider the predilection site of those tumors, the scope of differential diagnosis can reasonably be narrowed.
Carcinoid Tumor ; Contrast Media ; Diagnosis, Differential ; Goiter, Substernal ; Injections, Intravenous ; Paraganglioma ; Parathyroid Neoplasms ; Retrospective Studies ; Thyroid Gland ; Thyroid Neoplasms ; Tomography, X-Ray Computed

PURPOSE: The prevalence of hepatitis A virus (HAV) in a certain community reflects that community's living standards and hygienic conditions. And the pattern of HAV infection differs over time and geography. Recently, a shift in prevalence has been observed in cases from chilhood to adulthood. We studied the HAV antibody prevalence in the general population in Busan. METHODS: From October 2004 to March 2005, total 472 subjects were tested for HAV antibodies. All samples were collected from patients in Maryknol Hospital. RESULTS: The overall seropositive rate was 22.8% (108/472). The seropositive rates were 1.7% in subjects aged 2-5 years, 1.7% in 6-10 years, 0% in 11-20 years, 40.5% in 21-30 years, 82.1% in 31- 40 years, 94.7% in 41-50 years, and 100% in subjects aged over 50 years. There was no significant gap between gender groups. CONCLUSION: As the socioeconomic conditions in Korea have improved, the HAV seropositive rate in school-aged children has dramatically decreased in the last 20 years. But, the seropositive rate of HAV didn't differ according to gender. The seropositive rate of HAV in the pediatric group was very low, which suggests the increasing possibility of clinical HAV infection in adults in the near future. Therefore, we should actively prevent the spread of hepatits A virus. In order to do that, we need to reorganize our lifestyle and personel hygiene and carry out active and passive immunization to high risk groups.
Adult* ; Antibodies ; Busan* ; Child* ; Epidemiologic Studies* ; Geography ; Hepatitis A virus* ; Hepatitis A* ; Hepatitis* ; Humans ; Hygiene ; Immunization, Passive ; Korea ; Life Style ; Prevalence ; Seroepidemiologic Studies ; Socioeconomic Factors

By expanding health insurance, customers will carry a smaller burden of medical costs. As a result, the number of visits to a physician increase and this result in the improvement of medical accessibility. But medical care utilization may be changed not only by insurance status but also by socio-demographic factor, economic status and other factors. The question thus remains, at which level of accessibility and what price of medical care service in health insurance will the customer and the medical care service be satisfied. The price of medical care service is comprised of the customer's out-of-pocket money and the costs not covered by health insurance. If the price of medical care services in health insurance are appropriate, medical care utilization should not differ because of the difference in income status or the acuteness of illness. But If the price is not adequate, low income groups will receive relatively low medical care utilization, particularly in the case of chronic disease. The purpose of this study is to evaluate the differences in medical care utilization among the various income groups and those with varying acuteness of illness. The major hypotheses to test in this study are : (I) whether there are differences in medical care utilization among different income groups exist, (II) whether differences in medical care utilization among different income groups exist with the hospital type. (III) whether differences in medical care utilization among different income groups exist with the acuteness of illness and with age. The data was collected from the JongRo District Health Insurance Society in Seoul. A total of 118,336 persons were selected as the final sample for this study. The major findings of this study were as follows ; 1. The volume of ambulatory utilization among users was statistically significant by income level. 2. Among different income groups, the volume of ambulatory utilization was statistically significant by the acuteness of illness. 3. Higher income groups with chronic diseases had a greater volume of ambulatory utilization than other groups.
Chronic Disease ; Humans ; Insurance Coverage ; Insurance, Health* ; Seoul

PURPOSE: The purpose was to evaluate the effects of a transtheoretical model (TTM) based exercise counseling offered with music skipping rope exercise on components of the TTM (stages of change, decisional balance, and self-efficacy), body mass index, glucose, and lipid profile of overweight/obese children in Korea. METHODS: This study used a nonequivalent pretest and posttest experimental study design. A total of 75 overweight/obese children participated in the study. Eight sessions of exercise counseling combined with music skipping rope exercise for 12 weeks were offered for children in the experimental group, while one session of exercise counseling with music skipping rope exercise for 12 weeks was offered for children in the control group. Outcomes were measured at baseline, and 6 months after the intervention. RESULTS: After the intervention, self-efficacy significantly improved among children in the experimental group (p = .049), while these children maintained their baseline BMI at 6-month follow-up (p > .05). Among children in the control group, BMI significantly increased (p < .05). Fasting blood sugar significantly increased for both groups after the intervention (p < .05). However, a greater increase was observed for the control group. CONCLUSIONS: Our study partially supports the hypothesis that a TTM-based exercise intervention is effective in maintaining BMI and improving self-efficacy of overweight/obese children. The TTM-based counseling combined with exercise classes has potential to control weight among overweight/obese children, while involvement of parents and children in the development of the theory-based intervention may generate further benefits regarding health and well-being of overweight/obese children.
Adolescent ; Attitude to Health ; Body Mass Index ; Child ; Combined Modality Therapy ; Counseling/*methods ; Exercise Therapy/*methods ; Female ; Humans ; Male ; Music Therapy/*methods ; Pediatric Obesity/*prevention & control ; Play and Playthings ; Self Efficacy ; Treatment Outcome

No abstract available.
Arthritis, Rheumatoid* ; Depression* ; Humans

Arteriovenous graft for hemodialysis vascular access is a widely used technique with many advantages. However, it has crucial complications with graft thrombosis and infection. We recently experienced an unusual case of arteriovenous graft complication involving graft thrombosis related to fistula formation between the graft and the natural vein with infection. We diagnosed this condition using Doppler ultrasound and computed tomography angiography. Successful surgical treatment including partial graft excision and creation of a secondary arteriovenous fistula using an inadvertently dilated cephalic vein was performed. The dialysis unit staff should keep this condition in mind and try to prevent this complication.
Angiography ; Arteriovenous Fistula ; Dialysis ; Fistula* ; Renal Dialysis ; Thrombosis* ; Transplants* ; Ultrasonography ; Veins*

PURPOSE: The purpose of this study was to investigate the effects on weight of premature infants when Yakson therapy was conducted by mothers and also to measure role confidence and role satisfaction of the mothers. METHOD: A non-equivalent control group non-synchronized design was used. The data were collected from January to July, 2005. Thirty preterm infants and mothers were assigned to either an experimental (15) or a control group (15). Yakson therapy consists of three phases: laying on of hands, caressing by hands, and laying on of hands again, each phase taking 5 minutes. Yakson therapy was provided to infants in the experimental group for 15-minutes 5 times a day for 15 days. Infant weight, mothers' role confidence and satisfaction with role were measured for both groups. RESULTS: Compared to the control group, weight gain of infants in the experimental group (t=2.05, p=.049) was significantly increased after 15 days. The experimental group also had significantly higher scores in mothers' role confidence (t=1.98, p=.038). CONCLUSION: The results suggest that Yakson therapy can be used to increase weight gain in preterm infants and improve the role confidence of mothers.
Hand ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Mothers* ; Weight Gain* ; Child Health

BACKGROUND: Thoracic epidural anesthesia (TEA) combined with general anesthesia is commonly used in major upper abdominal surgery. The advantages of this method is the suppression of the perioperative stress response, the improvement in endocardial perfusion, and the reduction of myocardial oxygen consumption, postoperative morbidity and mortality. In particular, this method reduces the level of postoperative ileus and intestinal anastomosis leakage during gastrointestinal surgery. However, there is the possibility of severe cardiovascular depression using this combination method. This study evaluates the cardiovascular effects of extensive TEA combined with sevoflurane general anesthesia. METHODS: Fifty patients scheduled subtotal gastrectomy were enrolled in this study. After administering a bolus injection of 20 ml of 0.375% ropivacaine through an epidural catheter during sevoflurane general anesthesia, mean arterial pressure, heart rate, stroke volume, cardiac output, and systemic vascular resistance measured by Hemosonic (HemoSonic(TM) 100, Arrow, USA) every 5 minutes over a 30-minute period after the injection. RESULTS: All the data showed a significant decrease from 5 minutes after the epidural bolus injection except for the stroke volume, but that was not important clinically. CONCLUSIONS: A thoracic epidural injection of 20 ml of 0.375% ropivacaine can be used safely during sevoflurane anesthesia without severe cardiovascular complications during upper abdominal surgery.
Anesthesia ; Anesthesia, Epidural ; Anesthesia, General* ; Arterial Pressure ; Cardiac Output ; Catheters ; Depression ; Gastrectomy ; Heart Rate ; Humans ; Ileus ; Injections, Epidural* ; Mortality ; Oxygen Consumption ; Perfusion ; Stroke Volume ; Tea ; Vascular Resistance