Nosocomial infections surveillance is the basic activity of infection control programs, and many countries conduct surveillance using various methods. We convinced that each country should conduct an adequate and efficient surveillance system depending on their situations. Here we reviewed the recent nosocomial surveillance systems of other countries. As many countries have succeeded in reducing hospital infections, we expect that Korean Nosocomial Infections Surveillance System would contribute to nosocomial infection prevention and health promotion in Korea through an active surveillance at the national level.
Cross Infection* ; Health Promotion ; Infection Control ; Korea*

Diffuse alveolar hemorrhage (DAH) is associated with severe outcomes. We report a case of acute respiratory failure that required mechanical ventilation and was clinically and pathologically diagnosed as DAH related to exposure to organic dust. A 39-year-old man, who had visited a warehouse to grade beans for purchase, was referred to our hospital for impending respiratory failure. His initial radiographic examinations revealed diffuse bilateral ground-glass opacities in his lungs and bronchoalveolar lavage resulted in progressively bloodier returns, which is characteristic of DAH. He underwent bedside open lung biopsy of his right lower lobe in the intensive care unit. Biopsy results revealed DAH and organization with accumulation of hemosiderin-laden macrophages and a few fibroblastic foci. The patient was treated with empirical antibiotics and high-dose corticosteroids and successfully weaned from mechanical ventilation. DAH might be considered in the differential diagnosis of patients with acute respiratory failure after exposure to organic particles.
Adrenal Cortex Hormones ; Adult ; Anti-Bacterial Agents ; Biopsy ; Bronchoalveolar Lavage ; Diagnosis, Differential ; Dust* ; Fibroblasts ; Hemoptysis ; Hemorrhage* ; Humans ; Intensive Care Units ; Lung ; Macrophages ; Respiration, Artificial ; Respiratory Insufficiency*

Four cases of newborn with tension pneumothorax induced by a conventional ventilator were admitted to our nursery from January 1. 1992 to June 30. 1992 and they were managed by high frequency ventilator (Infrasonic Infant Star Ventilator). In contrast, four cases of newborn with tension pneumothorax who were continuously on the conventional ventilator, were included as a control group. They were admitted to our nursery from July 1. 1991 to december 31. 1991 and they were managed by conventional ventilator with conservative treatment. 1) In the control group, who were continuously managed by the conventional ventilator after thoracostomy with water seal drainage, we changed ventilator setting appropriately in control group but they had poor arterial blood gas analysis. The arterial blood gas analysis within 24hr/within 72hr in control group were pH 7.192/7.195, Paco2 72.15/82.25, PaO2 78.92/83.875, HCO3-26.975/27.925 and conventional ventilator care did not show any definite benefit for improvement of arterial blood gas analysis and tension pneumothorax as well. 2) Two cases in control group expired on the 6th day of thoracostomy without any resolution of tension pneumothorax. 3) In contrast, four cases with tension pneumothorax managed by high frequency ventilator were improved. Tension pneumothorax and arterial blood gas analysis to normalize from 6hr of high frequency ventilation and four cases of tension pneumothorax were completely reabsorbed within 4days.
Blood Gas Analysis ; Drainage ; High-Frequency Ventilation* ; Humans ; Hydrogen-Ion Concentration ; Infant ; Infant, Newborn ; Nurseries ; Pneumothorax* ; Thoracostomy ; Ventilators, Mechanical*

No abstract available.

PURPOSE: The objective of this study was to investigate the influence of hospital nurses' self-leadership, communication skill, and self-esteem on the quality of nursing service. METHODS: The participants, 230 nurses working at a general hospital in Seoul, completed a cross-sectional descriptive questionnaire survey between January 17 and 28, 2014. The collected data were analyzed using the SPSS 19.0 program for descriptive statistics, t-test, one way & two way ANOVA, correlation, and multiple regression analysis. RESULTS: Nurses' self-esteem and communication skill had significant main effects on self-leadership and the quality of nursing service, but the interaction effect of the two independent variables was not significant. Variables that significantly influenced the quality of nursing service were self-leadership, communication skill, self-esteem, and career longevity. The explanatory power of these variables for the quality of nursing service was 54.4%. CONCLUSION: Findings indicate a need for education programs for nurses which are designed to promote communication skill and enhance self-esteem and self-leadership skills which will in turn enhance the quality of nursing service.
Education ; Hospitals, General ; Longevity ; Nursing Services ; Seoul

Acute hybrid leukemia is an uncommon disease that demonstrates malignant transformation expressing lymphoid and myeloid cell lineage. We experienced a case of 25-year-old man with acute leukemia with unusual characteristics: unclassifiable morphology and undifferentiated cytochemistry by French-American-British (FAB) criteria. Microscopically, it disclosed monotonous tumor cell population in lymph node with vascular plugging and perivascular infiltration, and indian file appearance in capsule and surroun ng adipose tissue. Results of flow cytometry and immunohistochemical studies of frozen sections, cytospins, and formalin fixed lymphoid tissues disclosed hybrid form characterized by myeloid and lymphoid cell lineage. The immunophenotype analysis showed both anti-T cell, anti-B cell and anti-myeloid cell monoclonal antibody reactivity; blast cells were consistently CD7+(94.6%), CD13+(97.1%), and CD19+(85.22%). The normal hematopoietic cells were almost replaced by tumor cells in PB and bone marrow. In preparation of cytospin of peripheral blood(PB) cells separated by a Ficoll-hypaque gradients, blast cells were negative for Sudan black B, myeloperoxidase, periodic acid Schiff, and nonspecific esterase.
Male ; Humans

BACKGROUND: There are many reports showing the efficacy of polymerase chain reaction(PCR) for the diagnosis of Mycobacterium tuberculosis in sputum. but only few reports in extrapulmonary specimens. Because of the difficulty in establishing a diagnosis of tuberculosis in the extrapulmonary specimens there have been considerable interest in the development of a rapid sensitive diagnostic test that might be useful. Therefore we used PCR for detection of M. tuberculosis DNA in extrapulmonary specimens and compared the results of conventional acid-fast stain, culture methods and PCR assay. METHODS: Total of 63 clinical samples(10 cerebrospinal fluids, 12 pleural fluids, 1 pericardial fluid, 3 bone marrow aspirates, 1 ascitic fluid, 25 fine needle aspirates of lymph nodes, 7 urine, 1 stool and 3 tissue biopsies) in Ewha Womans University Tongdaemun hospital were analysed by the PCR. We performed the PCR using a species-specific M. tuberculosis DNA fragment(mtp 40 gene) as primers that was cloned and sequenced at recent and a 396-bp fragment was specifically amplified. We analyzed sensitivity and specificity of AFB culture and PCR for the diagnosis of extrapulomonary tuberculosis. RESULTS: The positivity of AFB smear, culture and PCR were 2(10%), 4(20%), 13(65%) out of total 20 cases diagnosed as clinically active extrapulmonary tuberculosis. respectively. All of 2 smear-positive samples and 2 of 4 culture-positive and smear-negative samples were PCR-positive. And 9 of 14 smear and culture negative specimens also gave detectable DNA products in PCR The specificity of PCR(95.4%) is compared with those of smear and culture(100.0%). CONCLUSIONS: This results suggest that the PCR assay is a sensitive and rapid diagnostic alternative to classical procedures for the diagnosis of extrapulmonary tuberculosis.
Ascitic Fluid ; Bone Marrow ; Cerebrospinal Fluid ; Clone Cells ; Diagnosis* ; Diagnostic Tests, Routine ; DNA ; Female ; Humans ; Lymph Nodes ; Mycobacterium tuberculosis ; Needles ; Polymerase Chain Reaction* ; Sensitivity and Specificity ; Sputum ; Tuberculosis*

Acne vulgaris is a chronic dermatologic problem with multiple factors involved in its pathogenesis. Alternative solutions to acne treatment were instigated by antibiotic resistance despite of its extensive use. Purified bee venom (PBV) has been proposed as a promising candidate for that purpose. The present study was designed to confirm the antibacterial effect of PBV and access the efficacy of cosmetics containing PBV in subjects with acne vulgaris.

PURPOSE: p53 gene mutations, one of the most common alterations found in human tumors, has also been detected in gastric carcinoma, and shown to have a crucial and early role in gastric carcinogenesis of intestinal type and mainly associated with tumor progression in the cancer of diffuse type. We tried to investigate the frequency of p53 mutations in 27 gastric carcinomas. MATERIALS AND METHODS: Fresh tumor tissue from a series of gastric carcinoma was screened for p53 mutations by polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) with silver staining and confirmed by direct-sequencing in 27 cases of gastric carcinoma. Immunohistochemical method for p53 protein accumulation was also performed in the same cases. RESULTS: Immunohistochemistry revealed 20 of 27 cases of gastric carcinoma, positive for p53. PCR-SSCP analysis of p53 exons 5-8 detected mobility shift in 4 out of 20 p53-positive tumors; three from exon 5 and the other from exon 7, respectively. DNA sequencing of exon 5 showed CGC to CAC point mutation in one of three cases; exon 7, ATC to AAC point mutation. It seemed that there was no correlation between genetic alterations of p53 gene detected by PCR-SSCP and expression of p53 protein by immunohistochemistry. CONCLUSIOAS: Our results suggest that mutations of the p53 gene are rare genetic events in carcinogenesis of gastric carcinomas. There was discrepancy between mutations screened by PCR-SSCP and overexpressions in immunohistochemical staining.
Carcinogenesis ; Exons ; Genes, p53 ; Humans ; Immunohistochemistry ; Point Mutation ; Polymerase Chain Reaction* ; Polymorphism, Single-Stranded Conformational* ; Sequence Analysis, DNA ; Silver Staining

Synovial sarcoma is a distinct and generally recognized soft tissue tumor that it’s origin still raises controversy. The synovial origin of synovial sarcoma has not been determined despite the accepted terminology implying synovium as stem cell. Three cases of primary synovial sarcoma (2 fibrous monophasic, 1 biphasic type) were studied with a panel of antibodies against different types of cytokeratin and other markers (EMA, CEA, vimentin, S-100 protein, lysozyme, 1-antichymotrypsin). Spindle shaped-cell in monophasic synovial sarcoma showed reactivity for CK7 and pancytokeratin. Epithelial cells lining of glands in biphasic synovial sarcoma reactive for CK7, pancytokeratin, EMA, and focally CEA but spindle cells only positive for vimentin. By electron microscopy, fibrous monophasic synovial sarcoma showed pseudogland formation with intercellular junctions of paired subplasmalemmal destiny and discontinuous basal lamina. These results indicate that synovial sarcoma showes epithelial differentiation. We believe that synovial sarcoma arises in pluripotential connective tissue cells that is able to be differentiated into both mesenchymal and epithelial components. So, synovial sarcoma have been considered carcinosarcoma of soft tissues depending on the type of differentiation.
Antibodies ; Basement Membrane ; Carcinosarcoma ; Connective Tissue Cells ; Epithelial Cells ; Immunohistochemistry ; Intercellular Junctions ; Keratins ; Microscopy, Electron ; Muramidase ; S100 Proteins ; Sarcoma, Synovial ; Stem Cells ; Synovial Membrane ; Vimentin