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*

BACKGROUND: Detection of causative allergens in respiratory allergy patients is important for diagnosis and selection of treatment modality. Allergen sensitization depends on the genetic susceptibility and environmental exposure to allergens. MATERIAL AND METHOD: In this study, we tried to find causative inhalant allergens in respiratory allergy patients who underwent skin prick test with common 55 inhalant allergens and RAST at Chungbuk National University Hospital in Chungbuk district. We also evaluated the changes of causative allergens because the environment here may be quite different, since the main population lives in the urban area and industrialization began later than in the other cities and districts. RESULTS: The major allergen was house dust mite, and its sensitivity rate did not change annually. Other indoor allergens such as cockroach, and animal dander including cat and dog showed similar trends. But the sensitization rate to tree and weed pollen except grass had significantly increased since 1995. Among pollens, the increase of sensntization to weed pollen was more marked. Ratio of sensitization rate to double or triple kinds of allergens also increased. CONCLUSION: Taken together, house dust mite is still the major allergen, but rate to pollen sensitization, especially to weed pollen has increased rapidly and significantly. It is suggested that causative allergens in repiratory allergy patients has begun to shift to pollen recently.
Allergens* ; Animals ; Cats ; Chungcheongbuk-do* ; Cockroaches ; Dander ; Diagnosis ; Dogs ; Environmental Exposure ; Genetic Predisposition to Disease ; Humans ; Hypersensitivity ; Poaceae ; Pollen ; Pyroglyphidae ; Skin

No abstract available.
Ileum*

After aseptic or septic meningitis, some neurologic complications such as convulsions, delirium, rigidity, cerebral infarctions and cerebral hemorrhage can be developed. The cerebral infarction after meningitis is caused by arterial or venous occlusions. Involvement of small perforating arteries leads to ganglionic infarcts while severe sapsm of major vessels may lead to massive infarctions in the distribution of middle and/or anterior cerebral arteries. Cortical venous and/or dural thrombosis (especially in the superior sagittal sinus) produces typical features, including multiple areas of white matter hemorrhagic infarction. These neurologic complications are common in bacterial meningitis and very rare in aseptic meningitis. We experienced a case of cerebral infarction in MCA/ACA territory and subdural hemorrhage in occipital lobe after aseptic meningitis in 10 month-old-boy. We report a case with a brief review of related literature.
Anterior Cerebral Artery ; Arteries ; Cerebral Hemorrhage ; Cerebral Infarction* ; Delirium ; Ganglion Cysts ; Hematoma, Subdural* ; Infarction ; Meningitis ; Meningitis, Aseptic* ; Meningitis, Bacterial ; Occipital Lobe ; Seizures ; Thrombosis

BACKGROUND: Obesity has been accepted as the rusk factor of major chronic diseases in our society. And nutritional assessment is the important issue in respect to obesity evaluation. A self-administrated semiquantitative food frequency questionnaire of which validity is recognized is used in nutritional assessment. But the relationship between nutritional assessment resulted from the questionnaire and the obesity index has not been built until now, so we studied about this relationship. METHODS: Among 324 adults who had visited health screening center from June'95 to August '96, 270 adults were evaluated except who had any chronic disease such as diabetes mellitus, pulmonary tuberculosis, thyroid disease by screening data or low calorie diet for aimed weight loss or inadequate Questionnaire. Nutritional intake was assessed by the self-administrated semiquantitative food frequency questionnaire. We evaluated the activity grade, obesity indices such as body mass index(BMI), waist to hip ratio(WHR), percent body fat using bioelectrical impedance fatness analyzer and serum total cholesterol, HDL-cholesterol, triglyceride. Then we examined the correlation between obesity Indices and nutritional variables each other. We analyzed these results using Pearson's correlation coefficient. RESULTS: We evaluated for a group of 164 men and 106 women whose mean age was 43.9 years, mean BMI was 23.2kg/m2, mean WHR was 0.85 and mean percent body fat was 21.2%. Correlation coefficient between calorie intake to recommended calorie ratio(ICRCR) and BMI was 0.13(P<0.05), WHR was 0.11(P> OR =0.05), and percent body fat was 0.07(P> OR =0.05). Fats intake to recommended fats ratio(IFRFR) and obesity indices didn't show the significant correlation between them. We could not find the significant correlation between cholesterol intake and serum total cholesterol, triglyceride but the significant negative correlation between cholesterol intake and serum HDL-cholesterol(r=-0.14) was found. CONCLUSIONS: Only BMI among obesity indices and ICRCR showed low(r=0.13) correlation coefficient although it is significant. Our results shows that obesity is the complex syndrome influenced by genetic, social, psychological, medical variables besides nutritional impacts.
Adipose Tissue ; Adult ; Caloric Restriction ; Cholesterol ; Chronic Disease ; Diabetes Mellitus ; Electric Impedance ; Fats ; Female ; Hip ; Humans ; Male ; Mass Screening ; Nutrition Assessment* ; Obesity* ; Thyroid Diseases ; Triglycerides ; Tuberculosis, Pulmonary ; Weight Loss ; Surveys and Questionnaires

BACKGROUND: During general anesthesia the adult patient's tidal volume is determined by patient's weight. Therefore patients with severe ascites, huge abdominal mass or pregnancy have considerable ventilatory change during the operation because the great change in their body weight, that might cause unwanted respiratory alkalosis or acidosis. The purpose of this study is to identify the effects of such changes in ventilation between pre-delivery and post-delivery periods during the cesarean section. METHODS: Eighteen 36weeks or older pregnant patients (ASA 1), scheduled for elective cesarean section under general anesthesia, are selected for the study. PhysioFlex was used for ventilation. Pre-induction maternal gas analysis were performed in all cases. They were randomly divided into two groups according to the ventilator setting for minute ventilation, one set by pre-pregnant weight (Group 1) and the other by pregnant (term) weight (Group 2). Blood gas analysis were performed 5 minutes after induction and 20 minutes after delivery. End-tidal CO2 and inspiratory airway pressure were also measured. RESULTS: All patients show mild hyperventilation with normal acid-base status at pre-induction period. There were no significant differences in arterial PCO2 value between two groups. Group 1 shows mild metabolic acidosis compared with group 2 (by pH at 20 minutes after delivery). CONCLUSION: Term(just prior to operation) body weight rather than pre-pregnant weight is preferable for ventilator setting in the case of cesarean section under general anesthesia.
Acidosis ; Adult ; Alkalosis, Respiratory ; Anesthesia, General* ; Ascites ; Blood Gas Analysis ; Body Weight ; Cesarean Section* ; Female ; Humans ; Hydrogen-Ion Concentration ; Hyperventilation ; Pregnancy ; Pregnancy* ; Respiration, Artificial* ; Tidal Volume ; Ventilation ; Ventilators, Mechanical

BACKGROUND AND OBJECTIVE: The outcome of asthma treatment has traditionally been assessed by measuring the conventional clinical parameters such as symptoms, expiratory flow rates and needs for medications. But none of them tells us whether the patients are actually able to function properly in their lives. Only assessment of the quality of life (QOL) can reflect the parts of patients lives affected by the disease. However, there is no measure to assess the quality of life of patients with any chronic diseases in Korea yet. We developed the QOL Questionnaire for Korean Asthmatics and evaluated its measurement properties. METHOD: The questionnaire was composed of 18 items in four domains : i.e. activity limitation (6 items), symptoms (5 items), emotional function (3 items) and environmental stimuli (4 items). At our out-patient clinic, 32 adults with moderate to severe persistent bronchial asthma were enrolled. The study design consisted of 4 week unblinded single cohort with visits at 0 and 4 weeks, and the patients were asked to answer the questionnaire by self administration method at the two separate visits. Forced expiratory volume for 1 second (FEV1) and peak expiratory flow rate (PEFR) were recorded at each visit. According to the patients and physicians global assessment, the patients were divided into two groups, i.e. stable and changed (improved). The responsiveness, reproducibility and validity of the questionnaire were evaluated. RESULTS: The total QOL scores at the second visit in the changed group were significantly higher than those at the first visit. The score differences between the two visits in the changed group were higher than in the stable group. In the stable group, the responses to the questionnaire were reproducible. The QOL scores showed good longitudinal correlation with the expiratory flow rates, whereas FEV1 did not correlate with the QOL in cross-sectional analysis. CONCLUSION: The questionnaire proved to be reproducible, responsive and valid in the subjects. It could be recommended for the outcome evaluation of Korean asthmatics.
Adult ; Asthma ; Chronic Disease ; Cohort Studies ; Cross-Sectional Studies ; Forced Expiratory Volume ; Humans ; Korea ; Outpatients ; Peak Expiratory Flow Rate ; Quality of Life* ; Self Administration ; Surveys and Questionnaires

BACKGROUND: Alexithymia refers to a specific disturbance in psychic functioning characterized by difficulties in capacity to verbalize affect and to elaborate fantasies. Although initially described in the context of psychosomatic illness, alexithymic characteristics may be observed in patients with a wide range of medical and psychiatric disorders. OBJECTIVE: The present study was to evaluate the relationship between the alexithymia and bronchial asthma, and to compare the results with finding from a group of acute infectious illness subjects. MATERIAL AND METHOD: Alexithymia was measured with on Korean translation of the TAS-20 (Toronto Alexithymic Scale-20 Korea version) and the Scored Archetypal 9 Test(SAT9). Thirty patients with bronchial asthma and thirty patients with acute infectious illness completed these tests. The SAT9 and the TAS-20K scores were compared in the both group, considering the age, gender, education level, and duration of illness. RESULT: Bronchial asthma patients had significantly higher score of on the TAS-20K and SAT9 compared with those with infectious illness(p<0.05). The two scales correlated in expected direction. Alexithymia was significantly related to education level(SAT9: r=0.335, TAS-20K: r=-0.376, p<0.01) and duration of illness(asthma group, SAT9: r=-0.383, TAS-20K: r=0.288, p<0.05). CONCLUSION: Bronchial asthma patients had significantly higher alexithymic scores. This finding suggests that psycliathic consultation may be considered for the management of asthmatic patients with alexithyria.
Affective Symptoms* ; Asthma* ; Education ; Fantasy ; Humans ; Korea ; Weights and Measures

We experienced two cases of occupational asthma induced by Elk dander in Elk-feeders and confirmed these cases by the bronchial provocation test with Elk dander. Both of them showed dual asthmatic response. They also showed positive reaction to the skin prick test with EIK dander. Now one of them has no asthmatic symptoms at all after complete avoidnce of EIK dander.
Asthma, Occupational* ; Bronchial Provocation Tests ; Dander ; Skin

BACKGROUND: Intrathecal neostigmine causes analgesia in dose-dependent pattern. This study was designed to examine postoperative analgesia with intrathecal neostigmine in a randomized, blinded trial with tetracaine as the active control in patients undergoing total knee replacement (TKR). METHODS: Eighty patients scheduled for TKR were divided into seven groups ( Control; no neostigmine, N25, 50, 75, 100, 125 and 150; subarachnoid tetracaine with neostigmine 25, 50, 75, 100, 125 and 150 g, respectively). Postoperatively, patients assessed their pain on a 10-cm visual analog scale (VAS), total analgesic requirement, time to first analgesic rescue medication and side effects were assessed. RESULTS: Increasing doses of intrathecal neostigmine showed a dose-dependent pattern of analgesia defined by the overall VAS scores, time until first administration of rescue analgesic request, and the number of rescue analgesics (p<0.05). Nausea and vomiting was also increased by increasing doses of intrathecal neostigmine (p<0.05). CONCLUSIONS: Intrathecal neostigmine with tetracaine produced definitive analgesia in patients undergoing TKR, and neostigmine 75 g resulted in a better analgesic effect with fewer side effects than other doses.
Analgesia* ; Analgesics ; Arthroplasty, Replacement, Knee* ; Humans ; Nausea ; Neostigmine* ; Tetracaine ; Visual Analog Scale ; Vomiting