A clinical observation was performed on 2,122 cases of premature infants who were admitted to Ilsin Christian during the past 5 years from Jan. 1986 to Dec. 1990. The results were as follows; 1) The incidence of prematurity was 5.7%, overall mortality rate was 15.8%, and the sex ratio of male to female was 1.5:1. 2) Concomitant maternal diseases were premature rupture of membrane 457 cases (21.5%), preeclampsia & eclampsia 424 cases (19.9%), multiple pregnancy 250 cases (11.7%) etc, in the order of frequency. 3) Prematurity was most prevalent among multipara over 3. 4) Incidence of prematurity according to maternal age was frequent in woman more than 35 years old. 5) Mortality of prematurity was higher inversely propotional to birth weight & gestational age. 6) Main causes of death were IRDS 45 cases (43%), congenital anomaly 72 cases (21.6%), sepsis 31 cases (9.3%), and unknown 84 cases (25.0%). 7) Clinical problems were hyperbilirubinemia 38.9%, hypoglycemia 28.6%, IRDS 18%, sepsis & other infections 8.1% etc, in the order of frequency. 8) Most deaths were seen within first 24hr (74.5%).
Adult ; Birth Weight ; Cause of Death ; Eclampsia ; Female ; Gestational Age ; Humans ; Hyperbilirubinemia ; Hypoglycemia ; Incidence ; Infant, Newborn ; Infant, Premature ; Male ; Maternal Age ; Membranes ; Mortality ; Pre-Eclampsia ; Pregnancy ; Pregnancy, Multiple ; Rupture ; Sepsis ; Sex Ratio

No abstract available.

PURPOSE: Our purpose was to examine the relationship between the intrauterine infection and the concentration of cord blood interleukin 6 in preterm infants. METHODS: Patients delivering preterm infants because of spontaneous preterm labor were evaluated for clinical signs of chorioamnionitis, which was defined as a temperature of >or=37.8 degrees C along with >or=2 of the followings : Significant maternal tachycardia (>or= 100/min), fetal tachycardia (>or=160/min), purulent discharge, uterine tenderness, and leukocytosis (WBC >or=15,000c ells/mm3). Their placentas were examined for histologic chorioamnionitis. Cord blood was assayed for Interleukin 6 and CRP. And Interleukin 6 and CRP were sequentially determined at 12-24hour and at 36-48 hour. An elevated interleukin 6 was determined to be 20 pg/mL. Infants were evaluated for the evidences of early and late neonatal sepsis, respiratory distress syndrome, necrotizing enterocolitis, intraventricular hemorrhage, neonatal pneumonia, and bronchopulmonary dysplasia. RESULTS: Umbilical cord blood interleukin 6 was significantly higher in the presence of intrauterine infection than in the absence of intrauterine infection (208.4+/-426.3 pg/mL VS 13.3+/-20.6 pg/mL P=0.018). And the frequencies of histologic chorioamnionitis, early neonatal sepsis, neonatal pneumonia, and morbidity were significantly higher in the presence of intrauterine infection than in the absence of intrauterine infection (P=0.003, P=0.000, P=0.042, and P=0.000, respectively). There was significant difference in gestational age, but no significant differences in maternal age, parity, birth weight, method of delivery, respiratory destress syndrome, necrotizing enterocolitis, intraventricular hemorrhage, and bronchopulmonary dysplasia. Using receiver operator characteristic curves, the best cutoff for interleukin 6 was found to be 20 pg/mL. CONCLUSION: Cord blood interleukin 6 was significantly elevated in the intrauterine infection in the preterm infant.
Birth Weight ; Bronchopulmonary Dysplasia ; Chorioamnionitis ; Enterocolitis, Necrotizing ; Female ; Fetal Blood* ; Gestational Age ; Hemorrhage ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Interleukin-6* ; Interleukins* ; Leukocytosis ; Maternal Age ; Obstetric Labor, Premature ; Parity ; Placenta ; Pneumonia ; Pregnancy ; Sepsis ; Tachycardia

The antiarrhythmic efficacy if low dose amiodarone treatment was studied in 30 cases of ventricular premature beats(VPBs). Amiodarone was administered 600mg daily in three divided doses for for initial 7-10 days as loadihg dosage,then 100-200mg once daily as maintenance. The results obtained were as follow : 1) The complete control of VPBs was achieved by amiodarone treatment in 90%, 27cases of 30 cases(all 11 cases with simple VPBs and 16 cases of the remainders with complex VPBs). 2) The QT interval and QTc were significantly prolonged, whereas heart rate was reduced significantly after amiodarone treatment. 3) In 27 cases of responder, the frequency of VPBs began to decrease overtly 2-3 days after amiodarone administration, then relatively stablized in 6 days, and complete cnotrol of VPBs was achieved in all cases about 10 days after treatment. 4) No significant side-reaction was observed except the decrease of serm T3 level after treatment.
Amiodarone* ; Arrhythmias, Cardiac* ; Heart Rate ; Selective Estrogen Receptor Modulators

BACKGROUND: The usage of appropriate disinfectants is essential for infection control in a hospital. Inadequate use of disinfectants is the cause of human or environmental toxicity and is a waste of cost. The objective of this study was to describe the status of the usage of disinfectants in Korean hospitals. METHOD: One hundred and eighty three hospitals of over 300 beds were investigated by a questionnaire distributed by mall. Data collection was done on November 1999. The questionnaire was made by the Association of Infection Control Nurses in Korea, based on references and protocols of the Korean Society of Nosocomial Infection Control. Numerical and percentage data were analyzed by SPSS. RESULTS: The collection rate of the questionnaire was 43.7% (80/300). Thirty five hospitals (46.7%) had an official process in selecting disinfectants in their hospitals. Regarding skin antiseptics, 10% povidone iodine and 70% alcohol were commonly used in skin preparation for intravenous catheterization or pre-operative skin disinfection, For disinfection of mucosal membranes such as mouth and periurethral area, 3% boric acid solution or 3% H202 were used. Most of the hospitals decontaminated contaminated medical instruments manually with dodecyl diamino ethyl glycine (20.8%). glutaraldehyde (15.6%). quaternary ammonium compounds (13.8%), virkon (12.3%) and sodium hypochlorites (11.7%). Glutaraldehyde and virkon were frequently used for disinfection of endoscopes. Sodium hypochlorites (48.9%) and quaternary ammonium compounds (19.8%) were the most commonly used environmental disinfectants. Some noticeable problems in disinfectants were as follows. First, for mouth care, many hospitals (41.7%) over-used boric acid, which has cumulative toxicity for humans. Second, many hospitals had an incorrect protocol of disinfecting endoscopes. Third, for environmental decontamination and instrument cleaning, some hospitals used high level disinfectants such as glutaraldehyde, which is too costly and provides unnecessary safety problems. Fourth, after patient discharge, many hospitals did not use disinfectants at all. Considering the specific Korean medical environment of high incidence of multi-drug resistant microorganisms, use of disinfectants for discharged environments may be warranted. CONCLUSION: This study included only hospitals of over 300 beds, which has a limitation in representing the status of disinfectants usage in a country. However, significant problems from misunderstanding the basic principles of disinfectants and misusages of disinfectants were observed in this investigation. These observations will provide useful information for designing a guideline for the appropriate uses and for efficient education of disinfectants, and also for planning a national control program for proper disinfectants usage in this country.
Anti-Infective Agents, Local ; Catheterization ; Catheters ; Cross Infection ; Data Collection ; Decontamination ; Disinfectants* ; Disinfection ; Education ; Endoscopes ; Glutaral ; Glycine ; Humans ; Incidence ; Infection Control ; Korea* ; Membranes ; Mouth ; Patient Discharge ; Povidone-Iodine ; Quaternary Ammonium Compounds ; Skin ; Sodium ; Surveys and Questionnaires

Erythropoietic protoporphyria (EPP) is an autosomal dominant condition due to decreased activity of ferrochelatase. The disease is characterized by a wide range of photocutaneous changes and occasionally by liver disease. The level of protoporphyin is raised in erythkocytes and it may also be increased in the feces. We report herein a case of EPP present in a family which was diagnosed by a high free erythrocyte protoporphyrin (FEP) count.
Erythrocytes ; Feces ; Ferrochelatase ; Humans ; Liver Diseases ; Protoporphyria, Erythropoietic*

Erythropoietic protoporphyria (EPP) is an autosomal dominant condition due to decreased activity of ferrochelatase. The disease is characterized by a wide range of photocutaneous changes and occasionally by liver disease. The level of protoporphyin is raised in erythkocytes and it may also be increased in the feces. We report herein a case of EPP present in a family which was diagnosed by a high free erythrocyte protoporphyrin (FEP) count.
Erythrocytes ; Feces ; Ferrochelatase ; Humans ; Liver Diseases ; Protoporphyria, Erythropoietic*

A 70-year-old man with a long history of diabetes mellitus presented to our hospital (Department of Ophthalmology, Sahm Yook Medical Center, Seoul, Korea) complaining of severe ocular pain and visual disturbance in his left eye that had started three days prior to admission. A round 3.7 x 5.0 mm dense central stromal infiltrate with an overlying epithelial defect was noted on slit-lamp examination. Following corneal scrapings and culture, topical 0.5% moxifloxacin and 0.5% tobramycin were administered hourly. A few days later, Stenotrophomonas maltophilia was isolated in a bacterial culture from a corneal specimen. According to the results of susceptibility tests, topical 0.5% moxifloxacin was given every hour and 0.5% tobramycin was stopped. The patient's clinical features improved steadily with treatment. The corneal epithelium healed rapidly, and the infiltrate resolved within four weeks of the initiation of treatment. The patient's best corrected visual acuity improved from hand motion to 20 / 25.
Aged ; Anti-Infective Agents/administration & dosage ; Aza Compounds/*administration & dosage ; Cornea/*microbiology/pathology ; Diagnosis, Differential ; Eye Infections, Bacterial/diagnosis/*drug therapy/microbiology ; Follow-Up Studies ; Gram-Negative Bacterial Infections/diagnosis/*drug therapy/microbiology ; Humans ; Keratitis/diagnosis/*drug therapy/microbiology ; Male ; Ophthalmic Solutions ; Quinolines/*administration & dosage ; Stenotrophomonas maltophilia/*isolation & purification ; Visual Acuity

A 70-year-old man with a long history of diabetes mellitus presented to our hospital (Department of Ophthalmology, Sahm Yook Medical Center, Seoul, Korea) complaining of severe ocular pain and visual disturbance in his left eye that had started three days prior to admission. A round 3.7 x 5.0 mm dense central stromal infiltrate with an overlying epithelial defect was noted on slit-lamp examination. Following corneal scrapings and culture, topical 0.5% moxifloxacin and 0.5% tobramycin were administered hourly. A few days later, Stenotrophomonas maltophilia was isolated in a bacterial culture from a corneal specimen. According to the results of susceptibility tests, topical 0.5% moxifloxacin was given every hour and 0.5% tobramycin was stopped. The patient's clinical features improved steadily with treatment. The corneal epithelium healed rapidly, and the infiltrate resolved within four weeks of the initiation of treatment. The patient's best corrected visual acuity improved from hand motion to 20 / 25.
Aged ; Anti-Infective Agents/administration & dosage ; Aza Compounds/*administration & dosage ; Cornea/*microbiology/pathology ; Diagnosis, Differential ; Eye Infections, Bacterial/diagnosis/*drug therapy/microbiology ; Follow-Up Studies ; Gram-Negative Bacterial Infections/diagnosis/*drug therapy/microbiology ; Humans ; Keratitis/diagnosis/*drug therapy/microbiology ; Male ; Ophthalmic Solutions ; Quinolines/*administration & dosage ; Stenotrophomonas maltophilia/*isolation & purification ; Visual Acuity

PURPOSE: The respiratory tract infections including pneumonia have been the major contributing factor for bronchial asthma, and are frequently involved in hospitalization due to asthma attack. We studied clinical characteristics of hospitalized cases due to asthma attack with and without pneumonic infiltrates. METHODS: Over 5 years between January 1993 and December 1997, 628 patients were hospitalized due to asthma attack. 315 of them had pneumonic infiltrates on chest X-ray (defined as pneumonia group) and 197 patients had no pneumonic infiltrates (uncomplicated group). The clinical characteristics of both groups were reviewed retrospectively. RESULTS: The age on admission and first attack in pneumonia group were significantly younger than those of uncomplicated group (P<0.05). The incidence of male was higher than that of female in both groups. The interval from attack to admission and duration of hospitalization were much longer in pneumonia group (P<0.05). The bronchial asthma attack was most frequently occurred between September and November. The atopy-perennial type was predominant in the both groups, and the incidence of non-atopy type was higher in the pneumonia group. The mild asthma attack was predominant in the pneumonia group and moderate one was predominant in the uncomplicated group. The incidence of fever and inflammatory reaction (peripheral blood WBC count, serum CRP level) were higher in the pneumonia group (P<0.05). There was no significant difference in the serum IgE level between two groups. CONCLUSION: Frequency and duration of hospitalization due to asthma attack might be lessened by prevention against respiratory tract infection.
Asthma* ; Female ; Fever ; Hospitalization ; Humans ; Immunoglobulin E ; Incidence ; Male ; Pneumonia ; Respiratory Tract Infections ; Retrospective Studies ; Thorax