PURPOSE: The purpose of this study was to identify the effects of structured information provided on self care knowledge, self care performance, and functional status. METHOD: The data were collected using self care knowledge and performance assessment tool, and functional status assessment tool from both group hospitalized patients at D hospital in Busan. RESULTS: There was a significant improvement(p=.032) in self care knowledge in experimental group compared to the control group. But there were not improvement in self care performance and functional status in experimental group compared to the control group. But comparing to pretest and posttest in experimental group, There were significant improvement in self care performance (p=.003) and functional status(p=.013). CONCLUSION: Structured information provided showed increased in the degree of knowledge, self care performance, and functional status. But the effect size of program which had been developed in this study was estimated small, so there is needed to modify this program and to research repeatedly.
Busan ; Humans ; Liver Cirrhosis* ; Liver* ; Self Care*

Background: A clinician reported unusually high incidence of A. xylosoxidans isolation from aspirated tissues in outpatient clinic. Methods: A. xylosoxidans isolates from January 2002 to June 2002 were investigated. The infection control nurse reviewed medical records and observed the procedures of tissue aspiration and culture at the clinical microbiology laboratory. Specimens were obtained for investigational cultures from dye, aspiration gun, slide alcohol sponge, tray, sink. water of sink, buffer solution, microscope, computer, and telephone. Results: A. xyloxosidans was isolated from twenty-four patients during 6 months. None of 24 cases had any typical signs or symptoms of infections by A. xylosoxidans. Observation of tissue aspiration and culture procedure revealed that buffer solution was used for prevention of specimen drying after tissue aspiration. Culture of the buffer solution yielded a heavy growth of A. xylosoxidans from four out of ten specimens. A. xylosoxidans was not isolated from any other investigational specimens. Conclusions: This was supposed to represent pseudoepidemic. Contaminated buffer solution was documented as the cause of this pseudoepidemic. The usage of buffer solution was stopped. During the follow-up period of 2 months, no additional A. Xylosoxidans was cultured from aspirated tissues.
Alcaligenes* ; Ambulatory Care Facilities ; Follow-Up Studies ; Humans ; Incidence ; Infection Control ; Medical Records ; Methods ; Porifera ; Telephone ; Water

No abstract available.
Herpesvirus 3, Human* ; Korea*

We experienced a female neonate with congenital nephrotic syndrome (CNS) associated with congenital diaphragmatic hernia (CDH). Because of the rare combination of two conditions, we report this case with literature review. CDH was found immediately after birth and emergency operation was done for hernia repair. But on the next day, generalized edema and oliguria(0.59 mL/kg/hour) was found and her blood chemistry showed hypoalbuminemia (1.6 g/dL), increased BUN (27.7 mg/dL) and serum creatinine( 1.8 mg/dL) along with heavy proteinuria (4+). We started albumin infusion with a bolus of intravenous furosemide. We suspected the neonate had congenital nephrotic syndrome and her 24hr urine protein was 1,816 mg/day. In spite of immunosuppressive therapy, the nephrotic syndrome and renal failure progressed. We started peritoneal dialysis on the day of life 22 but it was not satisfactory. She was complicated by intracranial hemorrhage and multi-organ failure and expired at 34 days of age. Kidney necropsy was performed which showed diffuse mesangial sclerosis (DMS). Her chromosome study revealed 46, XX and her gene study revealed a heterozygous missense mutation, Arg366His, in Wilms tumor suppressor gene (WT1). This case deserves attention on account of the 4th case of CNS with CDH revealing the Arg366His mutation in the WT1 gene andG the 1st case of early onset renal failure without male pseudohermaphroditism and Wilms tumor with CNS, CDH and the Arg366His mutation in the WT1 gene. So, this report gives support to the hypothesis that Arg366His mutation in the WT1 gene can result in CNS and CDH.
46, XY Disorders of Sex Development ; Edema ; Emergencies ; Female ; Furosemide ; Genes, Suppressor ; Hernia, Diaphragmatic ; Herniorrhaphy ; Humans ; Hypoalbuminemia ; Infant, Newborn ; Intracranial Hemorrhages ; Kidney ; Mutation, Missense ; Nephrotic Syndrome ; Parturition ; Peritoneal Dialysis ; Proteinuria ; Renal Insufficiency ; Sclerosis ; Wilms Tumor

BACKGROUND/AIMS: The treatment for steroid-refractory acute graft versus host disease (GVHD) after allogeneic stem cell transplantation (allo-SCT) needs to be standardized. We report our clinical experience with etanercept for steroid-refractory acute GVHD. METHODS: Eighteen patients who underwent allo-SCT and presented with steroid-refractory acute GVHD at Ajou University Hospital were studied retrospectively. They were given 25 mg of etanercept subcutaneously twice weekly for 4 weeks. The clinical responses were evaluated with regard to the severity of acute GVHD. RESULTS: The median patient age was 43.5 years. Using nonparametric tests, etanercept had a down-grading effect on acute GVHD (p = 0.005), although no patient experienced complete remission. Partial responses were seen in 80%, 17%, and 57% of grade II to IV patients, respectively. Skin and gut GVHD were well controlled with etanercept, whereas hepatic GVHD was not. Four patients died of fatal infections. No factors affecting the clinical outcome of etanercept were identified. CONCLUSIONS: Etanercept has a modest effect on steroid-refractory acute GVHD after allo-SCT, with tolerable side effects.
Acute Disease ; Adult ; Aged ; Allografts ; Female ; Graft vs Host Disease/etiology/*therapy ; Hematopoietic Stem Cell Transplantation/*adverse effects ; Humans ; Immunoglobulin G/adverse effects/*therapeutic use ; Immunosuppressive Agents/adverse effects/therapeutic use ; Male ; Middle Aged ; Receptors, Tumor Necrosis Factor/*therapeutic use ; Retrospective Studies ; Steroids/therapeutic use ; Young Adult

PURPOSE: We sought to evaluate the distribution and characteristics of meibomian gland dysfunction (MGD) and the treatment patterns for symptomatic MGD patients in South Korea. METHODS: One hundred ninety-six right eyes of 196 MGD patients were enrolled. For each patient, meibum expressibility in the central eight glands in both the upper and lower eyelids was examined. Each upper and lower eyelid was separately classified into one of the following three subtypes: nonobvious obstructive (low-delivery without lid margin abnormality), obvious obstructive (low-delivery with lid margin abnormality), and hypersecretory (high-delivery with lid margin abnormality). All treatment plans were also recorded. RESULTS: The mean number of expressible glands of the central eight glands in the upper eyelids (3.9 ± 2.6) was significantly higher than that in the lower eyelids (2.2 ± 2.4, p < 0.001). Obvious obstructive MGD was the most common subtype, followed by the hypersecretory and nonobvious obstructive subtypes in both the upper and lower eyelids. Of the 196 subjects, 38 (19.4%) had upper and lower eyelids that were assigned to different categories. Eyelid hygiene was the most prescribed treatment (74.5%), followed by lubricant eye drop usage (71.5%). Physicians tended to determine treatment plans based on the subtype of the upper eyelid rather than that of the lower eyelid. CONCLUSIONS: The majority of subjects were classified as having the obvious obstructive subtype of MGD, and 19.4% had upper and lower eyelids that were different subtypes. Eyelid hygiene was the most prescribed treatment for MGD patients, and treatment patterns were mostly determined based on the subtype of the upper eyelids.
Classification ; Diagnosis ; Eyelids ; Humans ; Hygiene ; Korea ; Meibomian Glands

Non-typhoidal Salmonella species are important foodborne pathogens that can cause gastroenteritis, bacteremia, and subsequent focal infections. Non-typhoidal salmonellosis is problematic, particularly in immunocompromised hosts. Any anatomical site can be affected by this pathogen via hematogenous seeding and may develop local infections. However, cervical lymphadenitis caused by non-typhoidal Salmonella species is rarely reported. Herein, we have reported a case of cervical lymphadenitis caused by group D non-typhoidal Salmonella associated with lymphoma.
Bacteremia ; Focal Infection ; Gastroenteritis ; Immunocompromised Host ; Lymphadenitis ; Lymphoma ; Salmonella ; Salmonella Infections ; Seeds

Angiotensin converting enzyme gene insertion/ deletion polymorphism has been shown to be associated with cardiovascular disease including cardiomyopathy, myocardial infarction, essential hypertension, progression of IgA nephropathy and diabetic nephropathy. Since glomerulosclerosis has similarities to atherosclerosis, angiotensin converting enzyme gene polymorphism may be associated with glomerulsclerosis. Therefore, we tested whether genotype distribution of the insertion/deletion polymorphism in angiotensin converting enzyme gene is different in patients with minimal change nephrotic syndrome and focal segmental glomerulosclerosis. In genotype distribution of the angiotensin converting enzyme gene I/D polymorphism, control subjects were II type 44.3%, ID type 40.9%, DD type 14.8% and patients with minimal change nephrotic syndrome were II type 38.2%, ID type 45.5%, DD type 16.3% and patients with focal segmental glomerulosclerosis were II type 13.3%, ID type 46.7%, DD type 40.0%. This result suggests that DD genotype was more frequent in patients with focal segmental glomerulosclerosis than minimal change nephrotic syndrome and control subjects. We also examined the association between ACE genotype and clinical characteristics in the patients with minimal change nephrotic syndrome and focal segmental glomerulosclerosis. There were no significant association between I/D polymorphism distribution and hypertension, chronic renal failure, response to steroid in patients with minimal change nephrotic syndrome. The incidence of chronic renal failure in patients with focal segmental glomerulosclerosis DD genotype was higher than that of other genotypes. The response rate to steroid in patients with focal segmental glomerulosclerosis DD genotype was lower than that of other genotypes.
Angiotensins* ; Atherosclerosis ; Cardiomyopathies ; Cardiovascular Diseases ; Diabetic Nephropathies ; Genotype ; Glomerulonephritis, IGA ; Glomerulosclerosis, Focal Segmental* ; Humans ; Hypertension ; Incidence ; Kidney Failure, Chronic ; Myocardial Infarction ; Nephrosis, Lipoid* ; Nephrotic Syndrome ; Peptidyl-Dipeptidase A*

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is one of the major pathogens of nosocomial infections. Especially in intensive care units (ICUs) and nasal carriage of Staphylococcus aureus has been known as a major risk factor of staphylococcal infections. In Korea, MRSA is the most common pathogen of nosocomial infections in ICUs. We performed this study to investigate the effects of conventional control measures and the additional effect of intranasal fusidic acid in prevention of MRSA nasal carriage and infection in ICUs of one educational hospital in Korea. METHOD: All patients admitted to medical ICU and surgical ICU in Samsung medical center from April to September 1999 were studied prospectively. Surveillance culture was done in all patients and health care workers by nasal swab culture. We tried to control MRSA infection by conventional methods in the first period April-June 1999) and by additional intranasal fusidic acid application in the second period (July-September 1999) RESULTS: Comparing the first with second periods, new nasal MRSA colonization rate among patients was significantly decreased from 14.8% to 1.8% in surgical ICU (P=0.016). Although there was no statistical difference between the first and second periods in medical ICU (14.6% vs 5.9%, P=0.192), the new nasal colonization of the first period was significantly decreased than that of the previous study which was performed in 1996 (14.6% vs 36.2%, P=0.015). And new MRSA infection rate was much more decreased than the previous study, but there was no statistical significance (11.7% vs 2.0%, P=0.066). CONCLUSION: Conventional methods for MRSA control decreased new MRSA nasal colonization of patients in ICUs. Application of intranasal fusidic acid was considered as an additional control measure for reducing MRSA nasal colonization. For evaluating effect of intranasal fusidic acid for preventing of MRSA infection in ICUs, further study with larger scale of study population is warranted.
Colon ; Cross Infection ; Delivery of Health Care ; Furosemide* ; Fusidic Acid* ; Humans ; Intensive Care Units ; Korea ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Prospective Studies ; Risk Factors ; Staphylococcal Infections ; Staphylococcus aureus

Small bowel tumors have been difficult to diagnose because of low incidence and absence of specific symptoms. There are no efficient and accurate tests available for diagnosis. Capsule endoscopy is an efficient diagnostic tool for small bowel disease and obscure gastrointestinal bleeding. We diagnosed two cases of small bowel gastrointestinal stromal tumor (GIST) diagnosed by capsule endoscopy that were treated by surgery. A 68 year old male presented with abdominal pain. The capsule endoscopy showed fungating ulcer mass at the jejunum. A 55 year female presented with melena. The capsule endoscopy showed an intraluminal protruding mass with a superficial ulcer at the jejunum. Two cases were diagnosed with GIST after surgery. We report these two case diagnosed by capsule endoscopy and review the medical literature.
Abdominal Pain ; Aged ; Capsule Endoscopes* ; Capsule Endoscopy ; Diagnosis ; Female ; Gastrointestinal Stromal Tumors* ; Hemorrhage ; Humans ; Incidence ; Jejunum ; Male ; Melena ; Ulcer