Remote afterloading high dose rate brachytherapy(HDRB) is a new technology and needs new biological principle for time and dose schedule. Here, authors attempt to evaluate the technique and clinical outcome in 116 patients, 590 procedures performed at Asan Medical Center for 3 years. From Sep. 1985 to Aug 1992, 471 procedures of intracavitary radiation in 55 patients of cervical cancer and 26 of nasopharyngeal cancer, 79 intraluminal radiation in 12 of esophageal cancer, 11 of endobronchial cancer and 1 Klatskin tumor and 40 interstitial brachytherapy in 4 of breast cancer, 1 sarcoma and 1 urethral cancer were performed. Median follow-up was 7 months with range 1~31 months. All procedures except interstitial were performed under the local anesthesia and they were all well tolerated and completed the planned therapy except 6 patients. 53/58 patients with cervical cancer and 22/26 patients with nasopharynx cancer achieved CR. Among 15 patients with palliative therapy, 80% achieves palliation. We will describe the details of the technique and results in the text. To evaluate biologic effects of HDRB and optimal time/dose/fractionation schedule, we need longer follow-up. But authors feel that HDRB with proper fractionation schedule may yield superior results compared to the low dose rate brachytherapy considering the advantages of HDRB in safety factor for operator, better control of radiation dose and volume and patients comfort over the low dose brachytherapy.
Anesthesia, Local ; Appointments and Schedules ; Brachytherapy* ; Breast Neoplasms ; Chungcheongnam-do ; Esophageal Neoplasms ; Follow-Up Studies ; Humans ; Klatskin's Tumor ; Nasopharyngeal Neoplasms ; Palliative Care ; Sarcoma ; Urethral Neoplasms ; Uterine Cervical Neoplasms

To provide basic information on the pathogengenesis of Vibrio vulnificus infection and for the manufacture of effective vaccine, outer membrane proteins (OMPs) were extracted from V. vulnificus ATCC 27562 strain and analysed by 12% of sodium dodecyl sulfate-polyarylamide gel(SDS-PAGE). Major 36 kDa and 48 kDa, 46 kDa, 66 kDa and 24 kDa protein bands appeared on gel by Coomassie stain and determined by densitometer. Immunogenecity of these proteins was examined by enzyme-linked immunosorbant assay(ELISA) and western blotting with rabbit anti-V. vulnificus serum. OMPs reacted with this antiserum, and the major 36 kDa protein appeared most immunogenic.
Blotting, Western ; Enzyme-Linked Immunosorbent Assay ; Membrane Proteins* ; Membranes* ; Sodium ; Vibrio vulnificus

Acinetobacter baumannii has been increasingly reported as a significant causative organism of various nosocomial infections. Here we describe an outbreak of carbapenem-resistant A. baumannii (CRAB) in the ICUs of a Korean university hospital, along with a successful outbreak control program. From October 2007 through July 2008, CRAB was isolated from 57 ICU patients. Nineteen patients were diagnosed as being truly infected with CRAB, four of whom were presumed to have died due to CRAB infection, producing a case-fatality rate of 21.1%. In surveillance of the environment and the healthcare workers (HCWs), CRAB was isolated from 24 (17.9%) of 135 environmental samples and seven (10.9%) of 65 HCWs. The pulsed field gel electrophoresis patterns showed that the isolates from patients, HCWs, and the environment were genetically related. Control of the outbreak was achieved by enforcing contact precautions, reducing environmental contamination through massive cleaning, and use of a closed-suctioning system. By August 2008 there were no new cases of CRAB in the ICUs. This study shows that the extensive spread of CRAB can happen through HCWs and the environmental contamination, and that proper strategies including strict contact precautions, massive environmental decontamination, and a closed-suctioning system can be effective for controlling CRAB outbreaks.
*Acinetobacter Infections/drug therapy/epidemiology/prevention & control ; Acinetobacter baumannii/isolation & purification/metabolism/*pathogenicity ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents/*therapeutic use ; Child ; Child, Preschool ; *Cross Infection/drug therapy/epidemiology/prevention & control ; *Drug Resistance, Multiple, Bacterial ; Hospitals, University ; Humans ; Infant ; Infection Control/*methods ; *Intensive Care Units ; Korea/epidemiology ; Male ; Middle Aged ; Young Adult

BACKGROUND: We developed a Pseudomonas aeruginosa outer membrane protein(OMP) vaccine, CFC-101, and the prophylactic efficacy of which has been demonstrated in animal models. In order to evaluate the safety and immunogenicity of the P. aeruginosa vaccine, we carried out a phase I/IIa clinical trial in healthy male volunteers. METHODS: Groups of eight volunteers, including two placebo subjects, were vaccinated intramuscularly with three doses of 0.25, 0.5 or 1.0 mg of the vaccine at one week intervals. Signs of systemic and local reactions observed after vaccination were recorded for each vaccinee for 5 days. Physical examinations were performed on days 0, 1, 7, 8, 14, 15, 21, and 42, and clinical laboratory tests were done on days 0, 3, and 21. Blood samples for assay of serum antibody levels were obtained up to 42 days after the first vaccination. RESULTS: The vaccine was generally well tolerated by all vaccinees, showing no significant side effects. In the three dosage groups, all vaccinees, except one receiving the 0.25 mg dose, showed significant elevation in serum IgG antibody titers against the vaccine proteins, indicating 100% seroconversion in 0.5 and 1.0 mg groups. The human antibodies induced by the vaccine were specific for P. aeruginosa OMPs, as confirmed by western blot analysis and immunoprecipitation assays. The capacity of the human antisera to enhance opsonophagocytic killing activity by polymorphonuclear leukocytes and to confer protection against P. aeruginosa infections indicates that the antibodies elicited by the vaccine have protective efficacy. CONCLUSION: We conclude that the P. aeruginosa OMP vaccine is safe and effective for human use and its optimal dose to be 0.5 or 1.0 mg.
Antibodies ; Blotting, Western ; Homicide ; Humans ; Immune Sera ; Immunoglobulin G ; Immunoprecipitation ; Male ; Membrane Proteins* ; Membranes* ; Models, Animal ; Neutrophils ; Physical Examination ; Pseudomonas aeruginosa* ; Pseudomonas* ; Vaccination ; Volunteers