PURPOSE: The purpose of this study was to identify vancomycin-resistant enterococcus (VRE) colonization rate in patients admitted to the intensive care unit (ICU), associated risk factors and clinical outcomes for VRE colonization. METHODS: Of the 7,703 patients admitted to the ICUs between January, 2008 and December, 2010, medical records of 554 VRE colonized and 503 uncolonized patients were reviewed retrospectively. To analyzed the impact of colonization on patients' clinical outcomes, 199 VRE colonized patients were matched with 199 uncolonized patients using a propensity score matching method. RESULTS: During the study period, 567 (7.2%) of the 7,703 patients were colonized with VRE. Multivariate analysis identified the following independent risk factors for VRE colonization: use of antibiotics (odds ratio [OR]=3.33), having bedsores (OR=2.92), having invasive devices (OR=2.29), methicillin-resistant Staphylococcus aureus co-colonization (OR=1.84), and previous hospitalization (OR=1.74). VRE colonized patients were more likely to have infectious diseases than uncolonized patients. VRE colonization was associated with prolonged hospitalization and higher mortality. CONCLUSION: Strict infection control program including preemptive isolation for high-risk group may be helpful. Further research needs to be done to investigate the effects of active surveillance program on the incidence of colonization or infection with VRE in the ICU.
Adult ; Aged ; Anti-Bacterial Agents/pharmacology ; Enterococcus/drug effects/*isolation & purification ; Female ; Hospitalization ; Hospitals, University ; Humans ; Infection Control ; Intensive Care Units ; Length of Stay ; Male ; Methicillin-Resistant Staphylococcus aureus/isolation & purification ; Middle Aged ; Retrospective Studies ; Risk Factors ; Staphylococcal Infections/*epidemiology ; Vancomycin/pharmacology ; Vancomycin Resistance/drug effects

The purpose of this study was to evaluate the influence of phenobarbital (PB) on hepatotoxic effect of carbon tetrachloride (CCI4) which induces centrilobular necrosis in liver. Rats were injected intraperitoneally CCI4 dissolved in olive oil by a dose of 0.4 mg/kg. For change related to PB pretreatment, rats were injected CCI₄ 0.4mg/kg after PB pretreatment. The liver samples were taken in 6, 12, 24, 48, 72 and 120 hours after CCI₄ and/ or PB injection. Extracted liver tissue was examined with light and electron microscopes. The results were summarized as follows: 1. Light microscopic findings: In CCI₄ group, centrilobular necrosis developed from 6 hours after injection, was the most severe in 48 hours, and recovered after 72 hours. In addition to necrosis, fatty change and pale cell change were accompanied. In PB-CCI4 group, necrosis occurred from 6 hours after CCI₄ injection and continued to 72 hours, and the degree of necrosis was more severe than that of CCI₄ group and pale cell change was decreased. 2. Electron microscopic findings: In CCI4 group, the early principal change was clumping and vesicular dilatation of endoplasmic reticulum. In PB-CCI₄ group, the degenerative change of endoplasmic reticulum was aggravated and the mitochondria also revealed severe degenerative change. According to the results, it was revealed that CCI₄ hepatotoxicity primarily began with the damage of endoplasmic reticulum, then damage of other cell organelles and cell necrosis followed, and these cytotoxic effects were aggravated by PB pretreatment.
Animals ; Carbon Tetrachloride* ; Carbon* ; Dilatation ; Endoplasmic Reticulum ; Liver ; Mitochondria ; Necrosis ; Olive Oil ; Organelles ; Phenobarbital* ; Rats*

Chondroblastoma is a benign occurrence bone tumor arising most often in the epiphyses of long bone and its occurance in skull is rare. The authors recently encountered a case of large chondroblastoma occupying middle cranial fossa. The clinical presentation, reoentgenographic appearance, gross and microscopic characteristics, surgical treatment, differential diagnosis, and the rapeutic result are presented. A 27 year old male patient was admitted to the Department of Neurosurgery, Keimyung University Hospital because of progressive diffuse swelling in right temporal area of 4 months duration. In physical examination, nontender, firm, nonmovable diffuse mass in right temporal area and bean sized polypoid mass in the anterior and superior wall of the right external auditory canal were noted. Plain skull X-rays showed lytic defect in the right temporal squama, base of middle cranial fossa, sphenoid ridge, a part of petrous bone and anterior fossa with rather sharp, but not sclerotic margin. Brain CT scan showed a lentiform nonhomogeneous slight high density mass with scattered calcification in the entire middle cranial fossa, and the tumor enhanced slightly. Selective external carotid serial angiogram revealed complete obstruction of external carotid artery just behind the origin of lingual artery without tumor staining. Right temporal craniectomy was performed with nearly total curetting of tumor mass grossly. The histological diagnosis was chondroblastoma. The patient was discharged with good result.
Adult ; Arteries ; Brain ; Carotid Artery, External ; Chondroblastoma* ; Cranial Fossa, Middle* ; Curettage ; Diagnosis ; Diagnosis, Differential ; Ear Canal ; Epiphyses ; Humans ; Male ; Neurosurgery ; Petrous Bone ; Physical Examination ; Skull ; Tomography, X-Ray Computed

No abstract available.
Dermatitis, Atopic* ; Food Hypersensitivity ; Milk Hypersensitivity* ; Milk*

PURPOSE: To report a patient with Freeman-Sheldon syndrome with blepharophimosis. METHODS: A 4-year-old girl with congenital facial abnormalities consistent with Freeman-Sheldon syndrome presented with complaints of blepharophimosis. The characteristic features of microstomia, down-slanting palpebral fissure, blepharoptosis, and telecanthus were also found. Y-V epicanthoplasty and levator aponeurosis resection were performed. RESULTS: Surgical intervention to correct ptosis and telecanthus led to initially fair cosmetic results, but one month later an unexpected decrease in interpalpebral fissure height was noted. CONCLUSIONS: Freeman-Sheldon syndrome with blepharophimosis is very rare. It was necessary to correct blepharoptosis, telecanthus, and blepharophimosis in the oculoplastic service in this case.
Blepharophimosis ; Blepharoptosis ; Child, Preschool ; Female ; Humans ; Microstomia

PURPOSE: The purpose is to correlate computed tomographic findings classified according to the degree of disease severity(grading A-E) with clinical course of acute pancreatitis. MATERIALS AND METHODS: in a retrospective review of 42 patients with acute pancreatitis, computed tomographic scans were classifed according to the degree of disease severity, and were correlatd with the clinical course. RESULTS: Pancreatic abscesses were seen in 14.3% and occured in 35.7% of grade D and E patients. Three patients with abscess died. Fatty infiltration of the liver was noted in 16.7%, pleural effusion in 21.4%.. stones and thickened wall of the gallbladder were present in 7.1% and in 9.5%, respectively. CONCLUSION: Our data indicate that phlegmonous extrapancreatic spread on initial CT scan had a high predictive value of the patients, prognosis.
Abscess ; Cellulitis ; Gallbladder ; Humans ; Liver ; Pancreatitis* ; Pleural Effusion ; Prognosis ; Retrospective Studies ; Tomography, X-Ray Computed

OBJECTIVES: The aims of this study were to assess the morale of Korean elders, to analyze the affecting factors, and to look for the ways to raise their morale. METHODS: The structured interviews and measurements of depression (Four-Item Geriatric Depression Scale and Vulnerability Factors), cognitive function (Short Portable Mental Status Questionnaire) and morale(Measurement of Morale in the Elderly Scale, MMES) were taken for the 50 Korean elders (28 females and 22 males) with age over 65 who were visiting Jong Myo during January to February in 2004. RESULTS: 1) In Korean elders, the mean scores of total MMES were 100.82+/-12.36. According to the items, mean scores of Satisfaction were 43.52+/-5.14, Equanimity 36.80+/-7.53, Will-to-live 20.00+/-4.43. 2) The total MMES scores were significantly affected by variables such as income (p<0.05), economy (p<0.005), elder abuse (p<0.01) and depression (p<0.001). While other variables including age, residence, education, number of children, sex, religion, spouse, job, illness and cognitive function were not related. CONCLUSION: To encourage morale in the Korean elders, economic support by welfarism, socio-legal prevention of elder abuse, and active involvement of geropsychiatrists into the early detection and treatment of depression must be needed.
Aged ; Child ; Depression ; Education ; Elder Abuse ; Female ; Humans ; Morale* ; Spouses

PURPOSE: There are few reports in Korean literature on the diagnostic efficacy of fine needle aspiration cytology(FNAC) for pediatric cervical lymphadenopathy. This study examined the diagnostic value of FNAC on cervical lymphadenopathy in children. METHODS: Data from 57 pediatric patients(aged 0.3 to 14 years) who underwent FNAC due to cervical lymphadenopathy between January 2001 and March 2005 was reviewed retrospectively. RESULTS: Reactive cervical lymphadenitis was the most common result of the FNAC(52.5 percent). Malignant disease were revealed in 14 percent of all cases. The sensitivity, specificity was 86 percent and 96 percent, respectively. The positive and negative predictive values for malignant disease was 75 percent and 98 percent, respectively. There were two false-positive cases on FNAC; one case of Langerhans cell histiocytosis, and another with infectious mononucleosis. A false-negative case on FNAC was found to be acute lymphocytic leukemia. In seven cases(12 percent), the final diagnosis was confirmed by an open biopsy after the FNAC. There were four FNAC cases where the specimen was not satisfactory for making a diagnosis(7 percent). There were no serious complications of the FNAC procedure. CONCLUSION: FNAC had a high diagnostic efficacy for evaluating children with cervical lymphadenopathy.
Biopsy ; Biopsy, Fine-Needle* ; Child ; Diagnosis ; Histiocytosis, Langerhans-Cell ; Humans ; Infectious Mononucleosis ; Lymphadenitis ; Lymphatic Diseases* ; Neck ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Retrospective Studies ; Sensitivity and Specificity

OBJECTIVES: Children with post-injury attention deficit disorder (ADD) exhibit deficiencies in academic functioning, social skills, and self-control, that are comparable to developmental attention-deficit hyperactivity disorder (ADHD). The similarities and differences of the two conditions have to be studied because some children with traumatic brain injury have shown premorbid ADD and seem to be less responsive to psychostimulants. METHODS: Characteristics of cognition and attention of post-injury ADD (n=12) and developmental ADHD (n=12) boys were investigated by administering KEDI-WISC and Visual and Auditory TOVA. RESULTS: No differences in KEDI-WISC subtests were found between two diagnostic groups. Post-injury ADD boys show lower commission error (lower impulsivity) in visual and auditory TOVA, and lower variability of reaction time (higher information-processing consistency) in auditory TOVA than developmental ADHD boys (p<0.05, p<0.01). CONCLUSION: Post-injury ADD and developmental ADHD are different in their attention components suggestively, which warrants further study for differential diagnosis and proper treatment.
Attention Deficit Disorder with Hyperactivity ; Brain Injuries ; Child* ; Cognition ; Diagnosis, Differential ; Humans ; Reaction Time

PURPOSE: This study was to investigate the nationwide operational status of the professional medical support staffs (PMSS) who practice the expanded roles in the hospital setting. METHODS: The data were obtained through survey from 36 hospitals with over 500 beds from 25th May to 12th July 2016. Data from 1,666 PMSS were analyzed. RESULTS: Since the job titles varied, we classified them into 5 groups according to their roles; advanced practice nurse, clinical nurse expert, PA (physician assistant), coordinator, and others. There were differences in the operation status of PMSSs depending on the region, nurse staffing grade and number of hospital beds. Qualification criteria varied from hospital to hospital, and almost half of the hospitals didn't have any qualification standards for them. There were differences in age, educational level, clinical careers, rewards, and job satisfaction in 5 groups. Especially PA group had low salary, poorer working conditions, more difficulties in performing their work, and lower job satisfaction than other groups. Most PMSS (99.5%) were using a delegated prescription authority, however only 68.3% had job description and 19.9% had documented delegated role. CONCLUSION: Adequate training curriculum, documented delegated roles, and the protocols for legal protection and efficient medical services are needed.
Curriculum ; Humans ; Job Description ; Job Satisfaction ; Nurse Clinicians ; Organization and Administration ; Physician Assistants ; Prescriptions ; Reward ; Salaries and Fringe Benefits