BACKGROUND: Urinary tract infections (UTIs) are the most frequent nosocomial infections and are frequently associated with indwelling urinary catheters. It is known that adherence to standard infection control measures for urinary catheters can reduce UTIs in hospitals. This study was performed to evaluate the effect of education in reducing catheter-related UTIs (CR-UTIs) in intensive care units (ICUs) of a university hospital. METHODS: CR-UTIs were prospectively monitored for all patients with indwelling urinary catheters in ICUs from July 2006 through December 2007. Recommendations based on previously known guidelines for catheter insertion, catheter management, and specimen collection to prevent CR-UTIs were formulated and educated in March 2007. Knowledge and adherence level were evaluated before and after educating healthcare workers about the recommendations using questionnaire. Changes in knowledge and adherence level before and after education were compared by Chi-square test. Changes in the rate of CR-UTIs and urinary catheter utilization ratios were also analyzed by Fisher's exact test. RESULTS: After education, knowledge level of and adherence level to most of the recommendations were improved significantly. The rate of CR-UTIs significantly decreased by 48% from 7.43/1,000 catheter-days before intervention to 3.87/1,000 catheter-days after intervention (P=0.02). CONCLUSION: Surveillance for nosocomial infections and education for standard infection control measures are very important in preventing CR-UTIs in ICUs.
Catheters ; Cross Infection ; Delivery of Health Care ; Humans ; Infection Control ; Critical Care ; Intensive Care Units ; Prospective Studies ; Specimen Handling ; Urinary Catheterization ; Urinary Catheters ; Urinary Tract ; Urinary Tract Infections ; Surveys and Questionnaires

A 73-year-old woman with chronic hepatitis C was hospitalized with proximal muscle weakness and generalized muscle pain. The patient was diagnosed as rhabdomyolysis with myoglobinuric acute renal failure. But there was no history of muscle compression, ingestion of drugs which can cause rhabdomyolysis, or alcohol abuse. The initial clinical features and laboratory findings showed no evidence of infectious myopathy or electrolyte abnormality. The electromyography and muscle biopsy was performed and polymyositis was diagnosed. Polymyositis, an idiopathic inflammatory myopathy, can cause rhabdomyolysis, but myoglobinuric acute renal failure due to polymyositis is very rare. We report a case of myoglobinuric acute renal failure caused by polymyositis with review of the literatures.
Acute Kidney Injury* ; Aged ; Alcoholism ; Biopsy ; Eating ; Electromyography ; Female ; Hepatitis C ; Hepatitis C, Chronic* ; Hepatitis, Chronic* ; Humans ; Muscle Weakness ; Muscular Diseases ; Myalgia ; Myoglobinuria ; Myositis ; Polymyositis* ; Rhabdomyolysis

PURPOSE: The purpose of this study was to describe the use pattern of alternative therapies in middle aged women. METHOD: The subjects of this study were 530 women from 40 to 64 years of age. The data of this study was patients' records. The data was gathered from April 1st, 2004 to June 30th, 2004. Data was analyzed statistically by using the SPSS/WIN 10.0 program. RESULT: It was shown that 63.5% of the subjects have utilized one or more types of alternative therapy. The most common type of alternative therapy was dietary and nutritional therapy 38.3%, and the place of use was the home 64.1%. The most common reason was a recommendation by friends. The degree of satisfaction after the use of alternative therapy was 95.2%. Among users of alternative therapies, the most frequent responses to each question were as follows; Motive of Use- "for health maintenance and promotion." (62.7%) In the relation ship between general characteristics and utilization of alternative therapy, religion (x2=12.33, p=.02), exercise (x2=8.21, p=004), and health status (x2=14.95, p=.005) showed a significant statistical difference. CONCLUSION: We found that middle aged women used alternative therapies more frequently than other populations. Therefore, it is suggested that medical doctors or nurses verify the true effects or side-effects from the most therapies or nurses verify the true effects or side-effects from the most common complementary or alternative therapies through experiments.
Complementary Therapies ; Female ; Friends ; Humans ; Middle Aged ; Ships

PURPOSE: Variation in the morphology of gingival papilla may be determined by the shape and position of anatomic crown as well as contact area and embrasure form of individual teeth. However, periodontal biotype classification is regarded to be subjective because of the lack of definite criteria. In this study, we defined the objective parameters which constitute the periodontal biotype and measured their relationship. MATERIALS AND METHODS: 109 of dental casts were prepared using three dimensional scanner and specialized reconstruction software, then acquiredvirtual models were sent to the 20 professional dentists to define the specific periodontal biotypes. Several parameters around periodontal structures were measured from the virtual models; facial surface area of the anterior tooth (AT), anterior papillary area (AP), proportion of the dento-papillary complex, clinical papillary length (PL), and clinical papillary angle (PA). Statistical analysis was performed to confirm the relationship among parameters. RESULTS: Coincidence rate of periodontal biotype within observers was 63.77+/-16.05%. Coincidence rate between observers was 76.15+/-16.43%. Among the parameters measured, PL showed the most positive correlations and PA presented the most negative correlations. The parameter of the AP and PL of six maxillary anterior teeth showed significant correlation coefficient. CONCLUSION: Anterior papillary area and clinical papillary length would be objective parameters for determining the consistent periodontal biotypes.
Crowns ; Dentists ; Humans ; Tooth

The purpose of this study was to analyze the minimum two year clinical and radiological results of revision total hip arthroplasties using allogenic chip bone graft and cement in acetabular bone deficiencies. Thirty six revision total hip arthroplasties that had been performed in thirty four patients between Sep. 1992 and May. 1994 at Seoul Paik Hospital and had followed more than two years were included in this study. The clinical result was evaluated by Harris hip score. The mean Harris hip score was 48 points preoperatively, 88 points at final follow-up, a mean of 3 years after revision. In radiological evaluation, osseous union between grafted bone and host bone was seen within 4 months in thirty two hips (89%), a complete grafted bone-cement radiolucent line of two millimeter or more in at least one zone was seen in seven hips (19%) and acetabular component migration was seen in six hips (17%) at postoperative 3 year follow-up radiograph. At the time of follow-up, five hips (14%) had been revised a second time: three for aseptic acetabular loosening, two for infection. In conclusion, we recommend the technique using allogenic chip bone graft and cement to reconstruct the acetabular bone deficiencies in revision total hip arthroplasties, though other technique will be recommend in severe segmental acetabular deficiencies or previous infection.
Acetabulum* ; Arthroplasty ; Arthroplasty, Replacement, Hip* ; Follow-Up Studies ; Hip ; Humans ; Seoul ; Transplants*

Bronchial foreign body aspirations are uncommon in adults and usually have various underlying conditions, otherwise accidentally occurred in dental procedure, medical, surgical procedure. The most commonly aspirated objects were food materials, with peanuts leading the list. When bronchial foreign body was aspirated, no definite respiratory symptoms or foreign body is may not seen, then diagnosis is delayed. Therefore late complications was developed. The tendency to use fiberoptic bronchoscope for removal of foreign bodies in adults is increased. We report a rare case of bronchial pneumonia due to occult aspiration of a twig before 1 year with a review of the literatures.
Adult ; Arachis ; Aspirations (Psychology) ; Bronchopneumonia ; Bronchoscopes ; Diagnosis ; Foreign Bodies ; Humans ; Pneumonia*

BACKGROUND AND OBJECTIVE: There has been little clinical data on the treatment outcome of patients with acute asthma attack in Korea. We designed a management protocol of acute asthma, and analyzed clinical p arameters obtained from this protocol. METHOD: A total of 32 cases with acute asthma were treated with oxygen, beta2 agonist, and methylprednisolone. Ipratropium was added in cases of severe attack. After 90 minutes, intravenous aminophylline was given to the patients with poor response. RESULT: Beta2 agonist and methylprednisolone were sufficient for symptom control in 17 cases. Ipratropium and aminophylline were added in 6 and 9 cases, respectively. There was no difference in improvement of PEF, heart rate, respiratory rate, PaO2, PaCO2, and SaO2 at 90 minutes and 8 hours between beta2 agonist inhalation and subcutaneous group. Serum potassium concentration levels significantly decreased in patients treated with ipratropium of aminophylline(n=15, 4.17+/-0.45 vs. 3.99+/-0.35mM/L, p<0.05), compared with patients using only beta2 agonist and methylprednisolone(n=17, 3.89+/-0.30 vs. 4.14+/-0.45mM/L, p>0.05). CONCLUSION: Subcutaneous beta2 agonist may be an alternative to inhalant beta2 agonist for the emergency treatment of acute asthma, and we think a consensus regarding use of aminophylline in the emergency room should be made.
Aminophylline ; Asthma* ; Consensus ; Emergency Service, Hospital ; Emergency Treatment ; Heart Rate ; Humans ; Inhalation ; Ipratropium ; Korea ; Methylprednisolone ; Oxygen ; Potassium ; Respiratory Rate ; Treatment Outcome*

Tetrasomy for the short arm of chromosome 12 (Pallister-Killian syndrome) is an uncommon mosaic aneuploidy, which may present in the prenatal period with an ultrasonographically detected fetal abnormalities or following karyotyping for maternal age and other causes. In this syndrome the chromosome abnormalities, isochromosome is present in amniocyte with a much greater percentage than fetal lymphocyte. The most consistent reported prenatal ultrasound findings for tetrasomy 12p include polyhydramnios with short femurs and a diaphragmatic hernia. We report a case identified by prenatal karyotyping diagnosis.
Aneuploidy ; Arm ; Chromosome Aberrations ; Chromosomes, Human, Pair 12 ; Diagnosis ; Femur ; Hernia, Diaphragmatic ; Isochromosomes ; Karyotyping ; Lymphocytes ; Maternal Age ; Mosaicism ; Polyhydramnios ; Tetrasomy* ; Ultrasonography

Benign solitary schwannoma of the chest wall is a rare disease of nerve sheath origin A 43-year-old female patient was admitted to our hospital for right upper quandrant pain Chest X-ray shows nonspecific finding, ultrasonography & CT scan revealed a solid tumor on the right lateral chest wall. On aspiration needle biopsy, this mass was turned out to be a schwannoma of the right lateral chest wall. This mass was excised surgically in an encapsulated state by right lateral thoracotomy. Histological section revealed a typical schwannoma, which is characterized by Antoni A and Antoni B tissues of high & low cellularity.
Adult ; Biopsy, Needle ; Female ; Humans ; Neurilemmoma* ; Rare Diseases ; Thoracic Wall* ; Thoracotomy ; Thorax* ; Tomography, X-Ray Computed ; Ultrasonography

BACKGROUND: The control of multidrug-resistant microorganisms (MDROs) is important in preventing healthcare-associated infections. We performed a survey to evaluate the current system for control of MDROs in general hospitals in Korea. METHODS: A questionnaire consisted of queries about infection control systems, personnel, antibiotic use monitoring systems, isolation and barrier precautions, and obstacles to and opinions about MDROs. The questionnaire was mailed to 145 hospitals with more than 300 beds in November 2005. RESULTS: One hundred and two of the 145 (70.3%) hospitals responded; 65.3% of the responded hospitals had antibiotics control programs and 96.0% of those had control programs for MDROs. Surveillance cultures for vancomycin-resistant enterococcus (VRE) and methicillin-resistant Staphylococcus aureus (MRSA) were taken in 21.6% and 16.7% of the hospitals, respectively. Over 90% of the hospitals had guidelines with respect to wearing gloves, collecting infectious wastes, and cleaning the environment for MRSA and VRE, but less than a half of the hospitals had the same standard for extended-spectrum beta-lactamase-producing gram-negative bacteria and carbapenem-resistant gram-negative bacteria. Most hospitals recommended gowning when contamination or invasive procedures were anticipated, but for VRE patients, gowns were used more strictly whenever there was contact with MDROs. Major obstacles related to isolation of patients infected or colonized with MDROs were the cost for isolation rooms (37.3%), and proposed solutions were reimbursement from the medical insurance company (86.3%), construction of a nationwide management system (61.8%), and effort by individual hospitals (58.8%) for MDROs infection control. CONCLUSION: Most of the hospitals have adopted control programs, but more needs to be done. Further efforts, including periodic reporting of antibiotic resistance, sufficient cost reimbursement, and providing education and increased awareness are urgently needed.
Anti-Bacterial Agents ; Colon ; Drug Resistance, Microbial ; Education ; Enterococcus ; Gram-Negative Bacteria ; Hospitals, General* ; Humans ; Infection Control* ; Insurance ; Korea* ; Methicillin-Resistant Staphylococcus aureus ; Postal Service ; Surveys and Questionnaires