BACKGROUND: Numerous disinfectants are available for disinfection and sterilization in the hospital environment but it is difficult to select an appropriate one. Biospot(R) is a chlorine-based disinfectant that consists of sodium dichloroisocyanurates. We evaluated the bactericidal effect of Biospot(R) against clinical isolates and compared it with that of other disinfectants. METHOD: Biospot(R), Wydex(R), HiCLO-S(R), Vipon(R), 70% ethanol, and 3% boric acid were evaluated. Clinical isolates were cultured from the patients in Kangnam St. Mary's hospital. There were two strains of Escherichia coli, methicillin-susceptible Staphylococcus aureus, methicillin-resistant Staphylococcus aureus, Klebsiella pneumoniae, vancomycin-resistant Enterococcus faecium, Pseudomonas aeruginosa, coagulase-negative staphylococcus, Streptococcus pneumoniae, and Bacillus subtilis. One strain of Candida albicans was included. Each strain was exposed to disinfectants for 0.5, 1, 2, 4, 8, and 15 minutes. RESULTS: All the non-spore forming bacteria were killed within 30 seconds in Biospot(R) (30 ppm of sodium dichloroisocyanurate). Wydex(R) (2% glutaraldehyde), HiCLO-S(R) (hypochlorous add 30ppm and electrolyzed oxidized water), Vipon(R) (50ppm of sodium hypochlorite), and 70% ethanol, but not in boric acid. Candida albicans were killed in 30 seconds with 100 ppm of BiOSpot(R) and all of disinfectants except boric acid. Bacillus subtilis, the spore forming bacteria, was killed in 4 minutes with 50 ppm, 2 minutes with 100 ppm of Btospot. Other disinfectants such as Vipon(R) killed Bacillus subtilis in 8 minutes. But Wydex(R), HiCLO-S(R), 70% ethanol, and boric acid could not kill the strain until 15 minutes. CONCLUSIONS: Biospot(R) was an effective and useful disinfectant against most common clinical isolates including fungus and spore forming bacteria.
Bacillus subtilis ; Bacteria ; Candida albicans ; Disinfectants ; Disinfection ; Enterococcus faecium ; Escherichia coli ; Ethanol ; Fungi ; Humans ; Klebsiella pneumoniae ; Methicillin-Resistant Staphylococcus aureus ; Pseudomonas aeruginosa ; Sodium ; Spores ; Staphylococcus ; Staphylococcus aureus ; Sterilization ; Streptococcus pneumoniae

Although pharmacological treatment constitutes the main therapeutic approach for depression, non-pharmacological treatments (self-care or psychotherapeutic approach) are usually regarded as more essential therapeutic approaches in clinical practice. However, there have been few clinical practice guidelines concerning self-care or psychotherapy in the management of depression. This study introduces the 'Evidence-Based, Non-Pharmacological Treatment Guideline for Depression in Korea.' For the first time, a guideline was developed for non-pharmacological treatments for Korean adults with mild-to-moderate depression. The guideline development process consisted of establishing several key questions related to non-pharmacologic treatments of depression, searching the literature for studies which answer these questions, assessing the evidence level of each selected study, drawing up draft recommendation, and peer review. The Scottish Intercollegiate Guidelines Network grading system was used to evaluate the quality of evidence. As a result of this process, the guideline recommends exercise therapy, bibliotherapy, cognitive behavior therapy, short-term psychodynamic supportive psychotherapy, and interpersonal psychotherapy as the non-pharmacological treatments for adult patients with mild-to-moderate depression in Korea. Hence, it is necessary to develop specific methodologies for several non-pharmacological treatment for Korean adults with depression.
Adult ; Bibliotherapy/*methods ; Clinical Protocols ; Cognitive Therapy/*methods ; Combined Modality Therapy/*methods ; Depression/*drug therapy/psychology/*therapy ; Exercise Therapy ; Humans ; Placebos/therapeutic use ; Questionnaires ; Republic of Korea

The spinal cord is a commonly affected site in human immunodeficiency virus (HIV) infection. Even though the most common disease of the spinal cord is vacuolar myelopathy, there is no case report yet in Korea. We experienced a case of suspicious vacuolar myelopathy in a 33 year-old male patient with acquired immunodeficiency syndrome. The patient presented with progressive paraparesis, gait disturbance, urinary difficulty, and the loss of sensation below thoracic spine 6~7 dermatome. Cerebrospinal fluid showed mild pleocytosis, increased protein level, and normal glucose content. The spine MRI showed extensive ill defined areas of increased signal intensity through the visualized lower cervical and thoracic spinal cord. Steroid therapy with antiretroviral drugs appeared to be ineffective to improve the symptoms of the patient.
Acquired Immunodeficiency Syndrome* ; Adult ; Cerebrospinal Fluid ; Gait ; Glucose ; HIV ; Humans ; Korea ; Leukocytosis ; Magnetic Resonance Imaging ; Male ; Paraparesis ; Sensation ; Spinal Cord ; Spinal Cord Diseases* ; Spine

BACKGROUND: Recent studies suggest that serum Cystatin C is both a sensitive marker for renal dysfunction and a predictive marker for cardiovascular diseases. We aimed to evaluate the association between Cystatin C and various biomarkers and to find out its utility in estimating risk for cardiovascular diseases in type 2 diabetic patients. METHODS: From June 2006 to March 2008, anthropometric measurements and biochemical studies including biomarkers for risk factors of cardiovascular diseases were done in 520 type 2 diabetic patients. A 10-year risk for coronary heart diseases and stroke was estimated using Framingham risk score and UKPDS risk engine. RESULTS: The independent variables showing statistically significant associations with Cystatin C were age (beta = 0.009, P < 0.0001), hemoglobin (beta = -0.038, P = 0.0006), serum creatinine (beta = 0.719, beta < 0.0001), uric acid (beta = 0.048, P = 0.0004), log hsCRP (beta = 0.035, P = 0.0021) and homocysteine (beta = 0.005, P = 0.0228). The levels of microalbuminuria, carotid intima-media thickness, fibrinogen and lipoprotein (a) also correlated with Cystatin C, although the significance was lost after multivariate adjustment. Calculated risk for coronary heart diseases increased in proportion to Cystatin C quartiles: 3.3 +/- 0.4, 6.2 +/- 0.6, 7.6 +/- 0.7, 8.4 +/- 0.7% from Framingham risk score (P < 0.0001); 13.1 +/- 0.9, 21.2 +/- 1.6, 26.1 +/- 1.7, 35.4 +/- 2.0% from UKPDS risk engine (P < 0.0001) (means +/- SE). CONCLUSIONS: Cystatin C is significantly correlated with various emerging biomarkers for cardiovascular diseases. It was also in accordance with the calculated risk for cardiovascular diseases. These findings verify Cystatin C as a valuable and useful marker for predicting future cardiovascular diseases in type 2 diabetic patients.
Biomarkers ; Cardiovascular Diseases ; Carotid Intima-Media Thickness ; Coronary Disease ; Creatinine ; Cystatin C ; Fibrinogen ; Hemoglobins ; Homocysteine ; Humans ; Lipoprotein(a) ; Risk Factors ; Stroke ; Uric Acid

BACKGROUND/AIMS: The number of hemodialysis patients and dialysis centers is increasing each year, but there are no quality standards for facilities. Thus, the Korean Society of Nephrology carried out a pilot project regarding a hemodialysis center accreditation system. This study was aimed at surveying the prevalence of anemia and abnormalities of calcium or phosphorus metabolism in hemodialysis patients in southwestern Seoul. METHODS: We investigated anemia, serum calcium, and phosphorus levels in 1,524 patients in 25 hemodialysis units. The rate of iron injections in patients with iron deficiency was also evaluated. Each item was compared between accredited (n = 12) and non-accredited centers (n = 13). RESULTS: The mean hemoglobin in subjects was 10.5 +/- 1.5 g/dL. The prevalences of anemia and iron deficiency were 27.4% and 25.2%, respectively. The rate of iron injection in patients with iron deficiency was 48.1%. The mean phosphorus level was 5.1 +/- 1.9 mg/dL and the proportion of patients with Ca x P < 55 mg2/dL2 was 70.7%. The prevalence of anemia, iron deficiency, and Ca x P were similar between accredited and non-accredited centers. The rate of iron injection in iron deficiency was higher in accredited (65.6%) than non-accredited centers (30.9%). CONCLUSIONS: Management of anemia and levels of calcium or phosphorus were acceptable in hemodialysis patients in southwestern Seoul, although some facilities should make more efforts to improve iron deficiency. The availability of data from a hemodialysis center accreditation system allowed us a unique opportunity to further explore the relationships between anemia, abnormalities of mineral metabolism, and outcomes.
Accreditation ; Anemia ; Anemia, Iron-Deficiency ; Calcium ; Dialysis ; Hemoglobins ; Humans ; Iron ; Nephrology ; Phosphorus ; Pilot Projects ; Prevalence ; Renal Dialysis

BACKGROUND/AIMS: The number of hemodialysis patients and dialysis centers is increasing each year, but there are no quality standards for facilities. Thus, the Korean Society of Nephrology carried out a pilot project regarding a hemodialysis center accreditation system. This study was aimed at surveying the prevalence of anemia and abnormalities of calcium or phosphorus metabolism in hemodialysis patients in southwestern Seoul. METHODS: We investigated anemia, serum calcium, and phosphorus levels in 1,524 patients in 25 hemodialysis units. The rate of iron injections in patients with iron deficiency was also evaluated. Each item was compared between accredited (n = 12) and non-accredited centers (n = 13). RESULTS: The mean hemoglobin in subjects was 10.5 +/- 1.5 g/dL. The prevalences of anemia and iron deficiency were 27.4% and 25.2%, respectively. The rate of iron injection in patients with iron deficiency was 48.1%. The mean phosphorus level was 5.1 +/- 1.9 mg/dL and the proportion of patients with Ca x P < 55 mg2/dL2 was 70.7%. The prevalence of anemia, iron deficiency, and Ca x P were similar between accredited and non-accredited centers. The rate of iron injection in iron deficiency was higher in accredited (65.6%) than non-accredited centers (30.9%). CONCLUSIONS: Management of anemia and levels of calcium or phosphorus were acceptable in hemodialysis patients in southwestern Seoul, although some facilities should make more efforts to improve iron deficiency. The availability of data from a hemodialysis center accreditation system allowed us a unique opportunity to further explore the relationships between anemia, abnormalities of mineral metabolism, and outcomes.
Accreditation ; Anemia ; Anemia, Iron-Deficiency ; Calcium ; Dialysis ; Hemoglobins ; Humans ; Iron ; Nephrology ; Phosphorus ; Pilot Projects ; Prevalence ; Renal Dialysis

OBJECTIVES: It is now conventional practice to use human chorionic gonadotropin (hCG) as the marker of tumor activity in gestational trophoblastic disease (GTD). The interpretation of serial serum beta-hCG regression patterns is important in monitoring the course of the disease. The purpose of this study was to establish a regression time and pattern of the serum beta-hCG in which GTD is divided into hydatidiform mole and malignant trophoblastic disease. MATERIALS & METHODS: During the period from January 1990 through December 2000, 46 patients with GTD were histopathologically diagnosed and treated at the department of Obstetrics and Gynecology in Hanyang University Hospital. For the purpose of analysis and comparison, patients were divided into 19 cases of hydatidiform mole and 27 cases of malignant trophoblastic disease which was subdivided into nonmetastatic (17) and metastatic (10). Patients were followed clinically and by weekly estimations of quantitative serum beta-hCG until negative (<3 mIU/ml). After three consecutive negative beta-hCG, serum beta-hCG were drawn monthly in all patients for one year. The level of serum beta-hCG was detected by two-site sandwich immunoassay (Chiron Diagnostics Automated Chemiluminescence System 180). The obtained data were analyzed using t test and ANOVA test by SPSS. RESULTS: The incidence of the GTD compared with delivery was one per 182.7 deliveries. The mean value of serum beta-hCG regression time in hydatidiform mole was 12.8+/-1.1 (SEM) weeks (7.0-26.0 weeks) and 17.9+/-1.4 (SEM) weeks (8.0-34.0 weeks) in malignant trophoblastic disease. The regression time was significantly shorter in hydatidiform mole than that of malignant trophoblastic disease (P<0.01). The differences of mean value of serum beta-hCG regression time between the groups with nonmetastatic (18.0 weeks) and metastatic (17.8 weeks) were not statistically significant(P =0.946). The mean values of serum beta-hCG in both hydatidiform mole and malignant trophoblastic disease declined following a log-normal distribution. CONCLUSIONS: The regression pattern of serum beta-hCG in present study was similar to that of which in Western and also similar to that of which in Korea in 1980s. The present study supports the continued use of individual patients serum beta-hCG regression curve to make treatment decision and to recognize malignant trophoblastic disease promptly.
Chorionic Gonadotropin ; Female ; Gestational Trophoblastic Disease* ; Gynecology ; Humans ; Hydatidiform Mole ; Immunoassay ; Incidence ; Korea ; Luminescence ; Obstetrics ; Pregnancy ; Trophoblasts

PURPOSE: In order to provide effective hospice care, adequate length of survival (LOS) in hospice is necessary. However the reported average LOS is much shorter. Analysis of LOS in hospice has not been reported from Korea. We evaluated the duration of LOS and the factors associated with LOS at our hospice center. MATERIALS AND METHODS: We retrospectively examined 446 patients who were admitted to our hospice unit between January 2010 and December 2012. We performed univariate and multivariate analysis for analysis of factors associated with LOS. RESULTS: The median LOS was 9.5 days (range, 1 to 186 days). The LOS of 389 patients (86.8%) was< 1 month. At the time of admission to hospice, 112 patients (25.2%) were completely bedridden, 110 patients (24.8%) had mouth care only without intake, and 134 patients (30.1%) had decreased consciousness, from confusion to coma. The median time interval between the day of the last anticancer treatment and the day of hospice admission was 75 days. By analysis of the results of multivariate analysis, decreased intake and laboratory results showing increased total white blood cell (WBC), decreased platelet count, increased serum creatinine, increased aspartate aminotransferase (AST), alanine aminotransferase (ALT), and lactate dehydrogenase (LDH) level were poor prognostic factors for survival in hospice. CONCLUSION: Before hospice admission, careful evaluation of the patient's performance, particularly the oral intake, and total WBC, platelet, creatinine, AST, ALT, and LDH level is essential, because these were strong predictors of shorter LOS. In the future, conduct of prospective controlled studies is warranted in order to confirm the relationship between potential prognostic factors and LOS in hospice.
Alanine Transaminase ; Aspartate Aminotransferases ; Blood Platelets ; Coma ; Consciousness ; Creatinine ; Hospice Care ; Hospices* ; Humans ; Korea ; L-Lactate Dehydrogenase ; Leukocytes ; Mouth ; Multivariate Analysis ; Platelet Count ; Prognosis ; Retrospective Studies ; Survival Analysis