BACKGROUND: Serratia marcescens proliferates well in a humid environment or soil and is recently considered as an important pathogen for the severe nosocomial infections. this organism is spreads easily by hand-to-hand transmission, and contaminates medical equipment used for invasive procedures, working environment, medications, and soap. METHODS: We investigated the source of an outbreak of bloodstream infections by S. marcescens isolated that occurred during the period from July to December, 2004, at a university hospital in Gyeonggi Province and attempted to intervene in the outbreak and control it. RESULTS: From July to December, 2004, S. marcescens grew from 296 blood culture from 283 patients. The medical charts of the patients were reviewed, and surveillance cultures were taken to identify the outbreak of nosocomial infections and risk factors. Only four cases of infection were identified and all remaining positive blood cultures were due to contamination. Nine isolates randomly selected from the 296 S. marcescens showed an identical pulsed-field gel electrophoresis pattern. To identify the source of infection, environmental culture and hand cultures of the related medical workers were carried out, but S. marcescens was not isolated. CONCLUSION: As the result of aggressive infection control activities, such as re-education on environmental management methods, hand washing techniques, and blood culture sampling techniques, no more S. marcescens had been grown in blood culture since January, 2005.
Cross Infection ; Electrophoresis, Gel, Pulsed-Field ; Gyeonggi-do ; Hand ; Hand Disinfection ; Humans ; Infection Control ; Risk Factors ; Serratia marcescens ; Serratia* ; Soaps ; Soil

No abstract available.
Zygapophyseal Joint*

Purpose: The purpose of this study was to identify the effects of organizational justice, organizational culture and emotional intelligence on intention to stay in reemployed nurses. Methods: Data were collected from 154 reemployed nurses working in the two university hospitals located in G Province. Data were analyzed using t-test, ANOVA, Pearson’s Correlation Coefficient and Multiple Regression Analysis with SPSS/WIN 25.0. Results: Factors influencing intention to stay in the participants were period willing to stay (β=.36, p<.001), emotional intelligence (β=.35, p<.001), career break (β=.16, p=.015), organizational justice (β=.14, p=.046). The total explanatory power was 31%. Conclusion In this study, organizational justice, emotional intelligence, career interruption, period willing to stay were found to be influential factors affecting intention to stay in reemployed nurses. A systematic intervention program for emotional intelligence is needed to increase the intention of retention in reemployed nurses. Further, human resource managers and specialists should consider organizational justice when designing the talent retention strategies.

No abstract available.
Sarcoma*

PURPOSE: We analyse the effect of the early laser treatment of rush-type ROP. METHODS: We performed a retrospective analysis of the records of 34 eyes of 17 premature infants with rush-type ROP, treated with diode indirect laser within 3 days after diagnosis and followed up for at least a year. RESULTS: Mean gestational age was 28+4 weeks, mean birth weight was 1182.9 gm and mean follow-up was 35.8 months. All patients were diagnosed with rush-type ROP at an average of 34+3 weeks and were treated with diode laser photocoagulation within an average of 1.6 days after diagnosis. The retinopathy regressed after photocoagulation in 25 eyes but regressed in 9 eyes so 8 of these eyes underwent secondary treatment. The outcome was favorable in 27 (79.4%) and unfavorable in 8 (20.6%) of the 34 treated eyes. The frequency of unfavorable outcome increased higher as acute stage at the time of treatment increased in severity. Especially in stage 3 threshold, the unfavorable outcome (33.3%) was significantly higher than that of stage 3 prethreshold (0%). CONCLUSIONS: In rush-type ROP, early treatment may be indicated regardless of the degree of EFP (extraretinal fibrovascular proliferation) because the outcome is poor by the time the stage at treatment has reached threshold.
Birth Weight ; Diagnosis ; Follow-Up Studies ; Gestational Age ; Humans ; Infant, Newborn ; Infant, Premature ; Lasers, Semiconductor ; Light Coagulation ; Retinopathy of Prematurity* ; Retrospective Studies

PURPOSE: To analyze the clinical features and the long term visual results of children with ectopia lentis after lensectomy. METHODS: Enrolled in this study were 79 eyes of 43 patients who were operated on and followed up for at least 3 years. We performed a retrospective analysis of the patient records. RESULTS: The mean age at diagnosis was 4.6 years, mean age at surgery was 5.7 years and average follow-up was 7.1 years. Of the 43 patients with bilateral ectopia lentis, 7 underwent monocular surgery. The mean age at diagnosis was higher and mean postoperative BCVA was significantly lower in the monocular surgery group than in the binocular surgery group. All eyes showed reduced hyperopia for 5 years postoperatively, but the reduction rate of the monocular operated eyes was significantly lower than that of the binocular operated eyes (P<0.05). No complication occurred during surgery and 1 eye (1.3%) with Marfan syndrome showed retinal detachment 9 years after surgery. CONCLUSIONS: Surgical treatment of ectopia lentis was safe and showed good visual outcomes after 7.1 years of follow-up. Nevertheless, consideration must be given to the possibility of amblyopia due to the difference of the degree of dislocation between the two eyes.
Amblyopia ; Child* ; Diagnosis ; Dislocations ; Ectopia Lentis* ; Follow-Up Studies ; Humans ; Hyperopia ; Marfan Syndrome ; Retinal Detachment ; Retrospective Studies ; Telescopes

PURPOSE: We performed this study to compare the TSH and free T4 levels according to gestational age and birth weight, and to reevaluate the cut-off values in the neonatal screening test for congenital hypothyroidism. METHODS: Total 2,133 neonates(1,749 healthy newborns and 384 sick neonates) were screened in Dankook University Hospital from May 2000 to January 2003. Neonates with abnormal TSH values (higher than 20 microliterU/mL) or abnormal free T4 levels(lower than 1 ng/dL) were recalled to recheck the thyroid function test. At that time, physical examinations and history-taking regarding perinatal problem, medication history, and mother's illness were undertaken. RESULTS: Serum TSH and free T4 values revealed no significant difference according to sex, delivery type, and Apgar score. The free T4 levels showed statistically significant differences, with gestational age or birth weight(P<0.01). The recall rate of neonates due to abnormal screening test was 7.48 percent. Compared with original cut-off values, the recall rate of the new cut-off values setted to TSH higher than 20 microliterU/mL or free T4 lower than 0.64 ng/dL decreased from 7.48 percent to 4.8 percent in the healthy group. But, it compromised sensitivity when applied to the sick group. CONCLUSION: In this study, neonatal free T4 levels were significantly different according to birth weight, gestational age, and the presence of compromised condition. Although the recall rate by TSH >20 microliterU/mL or free T4<1 ng/dL was relatively high, it was impossible to set up new cut-off values without compromising sensitivity. We think studies including a larger study population will be required to change the cut-off values.
Apgar Score ; Birth Weight ; Congenital Hypothyroidism* ; Gestational Age ; Humans ; Infant, Newborn ; Mass Screening ; Neonatal Screening* ; Parturition ; Physical Examination ; Thyroid Function Tests

The clinical signs of acquired hypothyroidism are usually manifested insidiously over several months to years. The incidence increases after 6 years of age and peaks at 11 to 18 years of age. The clinical symptoms and signs are fatigue, constipation, decreased growth velocity and delayed bone age, compromised intellectual performance, obesity, myxedema, hyperlipidemia, peripheral neuropathy and delayed or precocious puberty. Two children were referred to our hospital for the evaluation of severe obesity and short stature. During the evaluation we found they also had hyperlipidemia, cardiomegaly with or without pericardial effusion. Thyroid function test revealed decreased serum thyroid hormone levels with positive anti- microsome and anti-thyroglobulin antibodies consistent with long-standing acquired hypothyroidism. After the supplement of L-thyroxine, both of them showed rapid improvement of above symptoms, except for the incomplete catch-up growth. We herein report two cases of acquired hypothyroidism with severe obesity, short stature, hyperlipidemia and cardiomegaly with review of literatures.
Antibodies ; Cardiomegaly* ; Child ; Constipation ; Fatigue ; Humans ; Hyperlipidemias ; Hypothyroidism* ; Incidence ; Microsomes ; Myxedema ; Obesity ; Obesity, Morbid* ; Pericardial Effusion ; Peripheral Nervous System Diseases ; Puberty, Precocious ; Thyroid Function Tests ; Thyroid Gland ; Thyroxine

The clinical signs of acquired hypothyroidism are usually manifested insidiously over several months to years. The incidence increases after 6 years of age and peaks at 11 to 18 years of age. The clinical symptoms and signs are fatigue, constipation, decreased growth velocity and delayed bone age, compromised intellectual performance, obesity, myxedema, hyperlipidemia, peripheral neuropathy and delayed or precocious puberty. Two children were referred to our hospital for the evaluation of severe obesity and short stature. During the evaluation we found they also had hyperlipidemia, cardiomegaly with or without pericardial effusion. Thyroid function test revealed decreased serum thyroid hormone levels with positive anti- microsome and anti-thyroglobulin antibodies consistent with long-standing acquired hypothyroidism. After the supplement of L-thyroxine, both of them showed rapid improvement of above symptoms, except for the incomplete catch-up growth. We herein report two cases of acquired hypothyroidism with severe obesity, short stature, hyperlipidemia and cardiomegaly with review of literatures.
Antibodies ; Cardiomegaly* ; Child ; Constipation ; Fatigue ; Humans ; Hyperlipidemias ; Hypothyroidism* ; Incidence ; Microsomes ; Myxedema ; Obesity ; Obesity, Morbid* ; Pericardial Effusion ; Peripheral Nervous System Diseases ; Puberty, Precocious ; Thyroid Function Tests ; Thyroid Gland ; Thyroxine

BACKGROUND: Epidurally administered clonidine produces analgesia by an alpha 2-adrenergic mechanism and may provide postoperative analgesia without nausea, pruritus and respiratory depression associated with opioid administration. Many studies have shown the beneficial effects of epidural clonidine in postoperative pain management. Pre-administered epidural analgesic agent before the skin incision may prevent the nociceptive input. We provided the pre-emptive analgesia and compared the postoperative analgesic effects of epidural clonidine when used as the sole analgesic agent with epidural fentanyl and epidural bupivacaine. METHODS: Thirty-nine gynecologic patients, ASA physical status 1, 2, undergoing elective lower abdominal surgery under general anesthesia, were studied. They were not taking any premedications. Before anesthesia, an epidural catheter was inserted at the L2~3 interspace. Patients were divided into 3 groups randomly. Group 1 received 0.125% bupivacaine 20 ml through the epidural catheter, group 2 received 100 microgram fentanyl in normal saline 20 ml, and group 3 received 150 microgram clonidine in normal saline 20 ml. During the operation, we recorded the vital signs and side effects. Just before suturing peritoneum, we injected the corresponding drugs on individual groups through the epidural catheter. In the recovery room, the postoperative analgesia was assessed by VAS (visual analogue scale). Vital signs, sedation score and side effects were also checked. RESULTS: VAS and systolic blood pressure were significantly lower in group 3 than group 1 or group 2 at the recovery room. The diastolic blood pressure, heart rate and sedation score were not significantly different between three groups at the recovery room. Also the vital signs during the operation were notsignificantly different between three groups. The incidence of hypotension was 3 out of 13 in group 3 and 1 out of 13 in group 1. CONCLUSION: Epidural bolus clonidine 150 microgram produces more profound and longer postoperative analgesic effects than fentanyl 100 microgram or 0.125% bupivacaine at the lower abdominal surgery. But hypotension may occur more frequently. So, if we select the patient cautiously, epidural clonidine is a good alternative analgesic agent for the postoperative analgesia.
Analgesia ; Anesthesia ; Anesthesia, General* ; Blood Pressure ; Bupivacaine ; Catheters ; Clonidine* ; Fentanyl ; Heart Rate ; Humans ; Hypotension ; Incidence ; Nausea ; Pain, Postoperative ; Peritoneum ; Premedication ; Pruritus ; Recovery Room ; Respiratory Insufficiency ; Skin ; Vital Signs