BACKGROUND: With increase of antibiotics use and invasive procedures, infections caused by multi-resistant Acinetobacter baumannii (MRAB) are increasing. Recently, we experienced the outbreak of- nosocomial infections caused by MRAB resistant to imipenem and cefoperazone/sulbactam in intensive care units (ICU) and general ward. We analyzed the clinical characteristics of the infected patients and antibiotic susceptibility of the organisms. And surveillance cultures and IRS-PCR were performed to find out the transmission route. METHODS: We collected data from physical examination and clinical records. We performed surveillance cultures of environment, patients not infected with MRAB in ICU, and hands of health care workers. RESULTS: Between November 1996 and June 1997, 49 strains of MRAB were isolated from the 26 patients hospitalized in Kangnam St. Mary' s Hospital. The lower respiratory infection (13 cases) was the most common infection and sputum was the most common sources (47.1%). All strains of MRAB showed the same genotype. In disk diffusion test, all strains were resistant to piperacillin, gentamicin, amikacin, ceftazidime, cefoperazone/sulbactam, aztreonam, imipencm, ciprofloxacin. From the surveillance cultures, the genotypically identical strains were isolated from ventilator Y-piece, the floor of ICU, and hands of health care workers. It suggested that this strain was transmitted through ventilatory device or hands of health care workers. We instructed all the health care workers to wash hands, to disinfect hospital environment completely. Since July 1997, no further case has occurred. CONCLUSIONS: Since A. baumannii could be transmitted through ventilatory devices and the hands of health care workers, it is important to wash hands and to disinfect hospital environment completely.
Acinetobacter baumannii* ; Acinetobacter* ; Amikacin ; Anti-Bacterial Agents ; Aztreonam ; Ceftazidime ; Ciprofloxacin ; Cross Infection* ; Delivery of Health Care ; Diffusion ; Genotype ; Gentamicins ; Hand ; Humans ; Imipenem* ; Critical Care Units ; Patients' Rooms ; Physical Examination ; Piperacillin ; Sputum ; Ventilators, Mechanical

PURPOSE: This study was done to describe the research trend of Complementary and Alternative Medicine(CAM) in Korea and internationally. METHOD: A Systematic review of CAM related literature published from 2000 to 2005 was done. A comprehensive search by using 34 CAM modalities as search terms to identify all articles dealing with CAM was undertaken from 4 databases: PubMed, RICHIS, KoreaMed, and Riss4U. A Total of 588 abstracts and 223 original articles were reviewed by two independent reviewers using systematic analysis guidelines. Data regarding the types of study design, characteristics of subjects and researchers, and classification of CAM modalities was recorded. The outcome measures of CAM were identified. RESULTS: CAM research has been rapidly increasing worldwide in the last decade. In Korea, nursing(53.5%) followed by medicine(42.7%) occupied the majority of CAM research in comparison to medicine(42.9%) and disciplines in CAM(25.0%), like homeopathy, internationally. Prevailing research designs in Korea were experimental and quasi-experimental, however, randomized clinical trials were found. Internationally, survey research was dominant, with the exception of randomized clinical trials that were mostly an experimental design. CONCLUSION: The findings suggest that a robust research design in CAM research is needed to accumulate strong scientific evidence and to adopt nursing interventions from CAM modalities.
Biomedical Research/statistics & numerical data/*trends ; Complementary Therapies/statistics & numerical data/*trends ; Humans ; MEDLINE ; Models, Nursing ; PubMed ; Research Design

PURPOSE: Nocturia and enuresis are common voiding problems in spinal cord injured patients despite a variety of management. The purpose of this study is to determine the efficacy of desmopressin, a synthetic analogue of antidiuretic mono, as an alternative treatment in the management of spinal cord injured(SCI) patients with neurogenic bladder dysfunction unresponsive to conventional therapy. MATERIALS AND METHODS: Fourteen SCI patients with nocturia or enuresis were included in this study. The patients received 10microgram desmopressin intranasally at bedtime once every 24 hours. RESULTS: There was a significant decrease in nocturnal urinary volume, frequency of nocturia and nocturnal enuresis during nighttime after desmopressin administration. Two patients stopped desmopressin because of side effects. 8 of 12 patients improved with desmopressin and the remainder had no effect. There was no serum abnormality, although there were side effects in three cases, such as gastro-intestinal trouble, chest discomfort or nasal congestion. CONCLUSIONS: Desmopressin is safe and effective in the management of nocturia or enuresis due to neurogenic bladder dysfunction in selected SCI patients.
Deamino Arginine Vasopressin* ; Enuresis ; Estrogens, Conjugated (USP) ; Humans ; Nocturia ; Nocturnal Enuresis ; Spinal Cord Injuries ; Spinal Cord* ; Thorax ; Urinary Bladder, Neurogenic*

No abstract available.
Gastroschisis* ; Hernia, Umbilical*

PURPOSE: To investigate the difference in donor corneal cell changes after penetrating keratoplasty in various corneal diseases. METHODS: Subjects included 36 eyes from 35 people with at least 6 months of follow-up who had undergone penetrating keratoplasty between August 2000 and December 2002. The patients were classified into three groups based on the state of the corneal endothelium. Changes in cell density, polymorphisms, and polymegathism of the donor cornea were compared between groups. Results were analyzed by ANOVA. RESULTS: The overall corneal endothelial cell density after grafting was lower, but the differences in endothelial cell states between the recipient cases were not statistically significant. The change in corneal endothelial cell density showed a significantly higher difference (p=0.0013) when patients had either undergone a rejection episode during recovery or recurred herpetic uveitis. CONCLUSIONS: The preoperative state of the corneal endothelium may affect the survival of donor corneal endothelium after grafting. However, rejection of the transplant contributes more significantly to the survival of the donor corneal endothelium than other factors. We suggest close observation and keen therapy with respect to rejection after grafting.
Cell Count ; Cornea ; Corneal Diseases ; Corneal Transplantation* ; Endothelial Cells ; Endothelium, Corneal* ; Follow-Up Studies ; Humans ; Keratoplasty, Penetrating ; Tissue Donors* ; Transplants ; Uveitis

PURPOSE: To investigate the difference in donor corneal cell changes after penetrating keratoplasty in various corneal diseases. METHODS: Subjects included 36 eyes from 35 people with at least 6 months of follow-up who had undergone penetrating keratoplasty between August 2000 and December 2002. The patients were classified into three groups based on the state of the corneal endothelium. Changes in cell density, polymorphisms, and polymegathism of the donor cornea were compared between groups. Results were analyzed by ANOVA. RESULTS: The overall corneal endothelial cell density after grafting was lower, but the differences in endothelial cell states between the recipient cases were not statistically significant. The change in corneal endothelial cell density showed a significantly higher difference (p=0.0013) when patients had either undergone a rejection episode during recovery or recurred herpetic uveitis. CONCLUSIONS: The preoperative state of the corneal endothelium may affect the survival of donor corneal endothelium after grafting. However, rejection of the transplant contributes more significantly to the survival of the donor corneal endothelium than other factors. We suggest close observation and keen therapy with respect to rejection after grafting.
Cell Count ; Cornea ; Corneal Diseases ; Corneal Transplantation* ; Endothelial Cells ; Endothelium, Corneal* ; Follow-Up Studies ; Humans ; Keratoplasty, Penetrating ; Tissue Donors* ; Transplants ; Uveitis

STATEMENT OF PROBLEM: A number of studies about the nano-treated surfaces of implants have been conducting along with micro-treated surfaces of implants. PURPOSE: The purpose of this study was to get information for the clinical use of nano-treated surfaces compared with micro-treated surfaces by measuring removal torque and analyzing histological characteristics after the placement of various surface-treated implants on femurs of dogs. MATERIAL AND METHODS: Machined surface implants were used as a control group. 4 nano-treated surface implants and 3 micro-treated surface implants [resorbable blast media surface (RBM), sandblast and acid-etched surface (SAE), anodized RBM surface] were used as experimental groups. Removal torque values of implants were measured respectively and the histological analyses were conducted on both 4weeks and 8weeks after implant surgery. The surfaces of removed implants after measuring removal torque values were observed by scanning electron microscopy (SEM) at 8 weeks. RESULTS: 1. Removal torque values of the nano-treated groups were lower than those of micro-treated groups. 2. Removal torque values were similar in the anodized RBM surface groups. 3. On the histological views, there was much of bone formation at 8 weeks, but there was no difference between 4 and 8 weeks, and between the types of implant surfaces as well. CONCLUSION: It is suggested that implant topography is more effective in removal torque test than surface chemistry. To get better clinical result, further studies should be fulfilled on the combined effect of surface topography and chemistry for the implant surface treatments.
Animals ; Dogs ; Femur ; Microscopy, Electron, Scanning ; Osteogenesis ; Titanium ; Torque

PURPOSE: To evaluate morphologic characteristics of the microcalcifications on mammography that were confirmed pathologically. MATERIALS AND METHODS: Forty five cases of microcalcifications on mammography (fifteen cases of benign lesion, thirty cases of maiignancy) were retrospectively reviewed. RESULTS: The number of microcalcifications within 1 cm2 were more than 5 in 22 cases (73%) of 30 malignancy and less than 5 in 11 cases (73%) of 15 benignity. The heterogeneity of microcalcifications were seen in 26 cases of malignancy (87%) and the homogeneity of microcaicifications were 11 cases of benignity (73%). The morphologic characteristics of the microcalcifications were linear-V shape in 9 cases (30%), punctate shape in 8 cases (27%), fine stippled shape in 7 cases (23%), and round dot shape in 6 cases (20%) of malignancy and, round dot shape in 11 cases (73%), punctate shape in 2 cases (13%), and linear-V shape in 2 cases (13%) of benignity. CONCLUSION: Numerous irregular microcalcifications that are heterogenous in size and morphology were strong indicators of malignancy.
Mammography ; Population Characteristics ; Retrospective Studies

Despite its fall in incidence, gastric adenocarcinoma remains a common disease with dismal prognosis worldwide. A better understanding of its tumorigenesis and biologic properties of tumor cells related to invasion and metastasis is crucial to improving diagnosis and treatment. Conflicting results concerning the relationships between overexpression of PAI-1, c-erbB2, and p53 protein and biologic behavior of gastric carcinoma have been noted. The aim of this study was to evaluate the value of overexpression of PAI-1, c-erbB2, and p53 protein as prognostic factors in gastric adenocarcinoma. Overexpression of PAI-1, c-erbB2, and p53 protein by immunohistochemistry was correlated with variable clinicopathological parameters and patients' survival in 80 cases of gastric adenocarcinoma. Overall PAI-1 expression rate was 63.7% (51/80) and higher in advanced cancer (p=0.0003) and nodal metastasis (p=0.003) groups. Overall c-erbB2 expression rate was 43.8% (35/80) and higher in antral (p=0.03), differentiated (p=0.001), intestinal (p=0.0007), and expanding (0.03) groups. The p53 protein overexpression was 37.5% (30/80) and higher in early cancer (p=0.02), differentiated (p=0.006) and intestinal groups (p=0.009). Patients with PAI-1, c-erbB2, and p53 protein positive tumors tended to have poorer survival rates than patients with PAI-1, c-erbB2, and p53 protein negative tumors, but the difference was not statistically significant (p=0.25, 0.37, 0.52). Our data indicated that PAI-1 overexpression is one of the poor prognostic factors in gastric adenocarcinoma and c-erbB2 and p53 protein seem to be involved in the early stage of carcinogenesis of intestinal type-gastric adenocarcinoma.
Adenocarcinoma* ; Carcinogenesis ; Diagnosis ; Humans ; Immunohistochemistry ; Incidence ; Neoplasm Metastasis ; Plasminogen Activator Inhibitor 1 ; Plasminogen Activators* ; Plasminogen* ; Prognosis* ; Staphylococcal Protein A ; Stomach Neoplasms ; Survival Rate

No abstract available.
Female ; Mammaplasty*