BACKGROUND: Serratia marcescens proliferates well in a humid environment or soil and is recently considered as an important pathogen for the severe nosocomial infections. this organism is spreads easily by hand-to-hand transmission, and contaminates medical equipment used for invasive procedures, working environment, medications, and soap. METHODS: We investigated the source of an outbreak of bloodstream infections by S. marcescens isolated that occurred during the period from July to December, 2004, at a university hospital in Gyeonggi Province and attempted to intervene in the outbreak and control it. RESULTS: From July to December, 2004, S. marcescens grew from 296 blood culture from 283 patients. The medical charts of the patients were reviewed, and surveillance cultures were taken to identify the outbreak of nosocomial infections and risk factors. Only four cases of infection were identified and all remaining positive blood cultures were due to contamination. Nine isolates randomly selected from the 296 S. marcescens showed an identical pulsed-field gel electrophoresis pattern. To identify the source of infection, environmental culture and hand cultures of the related medical workers were carried out, but S. marcescens was not isolated. CONCLUSION: As the result of aggressive infection control activities, such as re-education on environmental management methods, hand washing techniques, and blood culture sampling techniques, no more S. marcescens had been grown in blood culture since January, 2005.
Cross Infection ; Electrophoresis, Gel, Pulsed-Field ; Gyeonggi-do ; Hand ; Hand Disinfection ; Humans ; Infection Control ; Risk Factors ; Serratia marcescens ; Serratia* ; Soaps ; Soil

No abstract available.
Ambulatory Care Facilities* ; Humans ; Outpatients*

BACKGROUND: The influenza is a contagious respiratory illness caused by influenza viruses. The primary target groups recommended for annual vaccination are healthcare workers and households which have frequent contact with persons at high risk and can transmit influenza to those persons at high risk. Members of these groups should be vaccinated against the flu so that they can avoid getting infected with continuously mutating influenza viruses. We assessed healthcare workers' knowledge and attitudes regarding influenza vaccination in order to help promote the vaccination rate. METHODS: This survey was carried out in two hospitals affiliated with the Catholic University School of Medicine, from December 2004 to January 2005. Of the 3,023 questionnaires distributed, 2,023 could be evaluated. RESULTS: The most frequently cited reason for receiving influenza vaccine was self-protection against influenza (55.4%). The most common reasons for not receiving influenza vaccine are personal health problems such as concurrent flu, pregnancy or breast-feeding (29.2%). There is no significant difference in the frequency of side effect between two groups receiving and not receiving vaccine. The most frequent side effect of influenza vaccination is flu-like syndrome; People receiving vaccine have more significant knowledge than those people not receiving vaccine about efficacy of flu vaccination, risk of influenza infection of healthcare workers and their need of flu vaccination. CONCLUSION: In order to promote the vaccination rate, education targeting people at high risk need to keep continuous and facilitate access to vaccination.
Delivery of Health Care* ; Education ; Family Characteristics ; Humans ; Influenza Vaccines ; Influenza, Human* ; Orthomyxoviridae ; Pregnancy ; Vaccination* ; Surveys and Questionnaires

BACKGROUND: Meicillin-resistant Staphylococcus aureus(MRSA) is a common cause of nosocomial infections worldwide. Identification of strains by molecular typing facilitates epidemiological studies and improves disease control This study was performed to determine the usefulness of mecA-associated hypervariable region(HVR) polymerase chain reaction (PCR) and random amplified polymorphic DNA(RAPD) analysis in the investigation of a nosocomial MRSA infections. METHODS: Methicillin-resistance was identified by NCCLS disk diffusion method using the oxacillin disk. And PCR was done for detection of mecA gene. Antimicrobial susceptibility test, HVR-PCR and RAPD using 3 primers were performed for epidemiological analysis on isolates of MRSA. RESULTS: During the period from 1997 Dec. to 1998 May, 120 strains of S. aureus were isolated from clinical specimens. Among them, 78 strains were MRSA, and 72 strains were mecA positive. The strains of mecA positive MRSA were classified into four types by antibiogram, six genotypes by HVR-PCR, and 29 groups by RAPD using three primers. The combination of HVR genotypes and RAPD analysis showed 43 different types in 72 mecA positive MRSA isolates The five strains which were repeatedly isolated from the same patients showed the same HVR genotypes and RAPD analysis. CONCLUSIONS: Antibiogram, HVR-PCR, and RAPD could classify MRSA isolates into only 4-6 types, respectively, but combination of these methods could improve the typability. And combination of results of RAPD analysis using three primers were better than that using one primer in epidemiological studies of MRSA because of same reasons. It can be concluded that molecular typing of MRSA using HVR-PCR and RAPD assay is useful in epidemiolgical investigation of nosocomial infections caused by MRSA, because of its simplicity and reproducibility.
Cross Infection ; Diffusion ; Epidemiologic Studies ; Genotype ; Humans ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Microbial Sensitivity Tests ; Molecular Typing ; Oxacillin ; Polymerase Chain Reaction ; Staphylococcus

PURPOSE: The purpose of this study was to study complementary and alternative medicines (CAM) used among cancer patients in Korea. METHOD: This study was a descriptive survey. Study participants were 1,150 cancer patients selected from 28 representative hospitals in Korea. Data were collected between December 1, 2004 and March 30, 2005. RESULTS: Their diagnosis were as follows : 20.0% for breast cancer, 15.6% for stomach cancer, 14.4% for liver cancer, 10.8% for lung cancer, 10.0% for colon cancer, and 10.0% for uterine cancer. 75.0% of cancer patients had used CAM. The most popular categories of CAM use were diet with 153.2%, non-prescription of oriental medical doctor 47.9% and mind-body control 20.3%. CAM use gender, age, cancer type, cancer treatment method, and current treatment type was significantly different in. CONCLUSION: CAM use among cancer patients in Korea was very popular (75.0%) and so systemic guidelines of CAM use are needed.
Breast Neoplasms ; Colonic Neoplasms ; Complementary Therapies* ; Diagnosis ; Diet ; Humans ; Korea* ; Liver Neoplasms ; Lung Neoplasms ; Stomach Neoplasms ; Uterine Neoplasms

A healthy 18-year-old woman presented with an asymptomatic tiny papular eruption on the hands, forearms, legs and trunk. A skin biopsy from the left forearm revealed a typical lichen nitidus lesion associated with an adjacent transepidermal perforating lesion. We report a case of perforating lichen nitidus, and briefly review the relevant literature of perforating lichen nitidus.
Adolescent ; Biopsy ; Female ; Forearm ; Hand ; Humans ; Leg ; Lichen Nitidus* ; Lichens* ; Skin

PURPOSE: To evaluate the major radiologic features of chronic focal pancreatitis in various imaging studies, with special emphasis on CT and ERCP findings. MATERIALS AND METHODS: From 1991 to 1995, twelve patients were pathologically proved to be suffering from focal chronic pancreatitis after pancreatico-duodenectomy ; for retrospective evaluation, imaging studies were available for eight(seven men, one woman ; mean age 58.9+/-6.6, range 47 to 67). Clinical, surgical, and radiological findings, including CT(n=8), ultrasound(n=7), ERCP(n=8) andUGI(n=3) were analysed. RESULTS: Seven male patients had suffered from chronic alcoholism for between 20 and 50years. Serum bilirubin levels were normal in eight patients and alkaline phosphatase levels were normal in seven patients. Serum CA 19-9 levels were normal in all five patients who had undergone preoperative evaluation. Seven patients(87.5%) showed focal enlargement without definable margin on CT, and five of the six lesions detectable on ultrasound(83.3%) were ill defined hypoechoic nodules. Dilated side branches within lesions were seen in five ofeight patients(83.3%) on CT and ERCP. Double duct signs were observed in siven(87.5%) patients, and dilated intrahepatic ducts in six(75%), with diameters ranging from 5 to 8mm(average : 5.42+/-1.96mm). The average ratio ofpancreatic duct caliber to gland width was 0.33+/-0.19. None of the patients had calcification within the lesionand one case showed intraductal calcification. None showed perivascular fat obliteration around the superiormesenteric artery or celiac axis. The average biductal distance between abnormal common bile duct and theimmediately adjacent pancreatic duct was 4.0+/-1.15mm. One of three cases who under went a UGI examination showed severe luminal narrowing and mucosal thickening in the second portion of the duodenum, another showed double contour, and the other merely showed widening of the C-loop of the duodenum. CONCLUSION: Chronic focalpancreatitis mostly demonstrated ill defined focal enlargement and double ductal dilatation. Dilated side brancheswithin the lesion, no vascular encasement, a mild degree of intrahepatic ductal dilatation, a ratio of pancreatic duct to parenchymal width of less than 0.5, and clinical findings including chronic alcoholism and normal CA 19-9serum level may be reliable indicators for differentiating chronic focal pancreatitis from pancreatic cancer.
Alcoholism ; Alkaline Phosphatase ; Arteries ; Axis, Cervical Vertebra ; Bilirubin ; Cholangiopancreatography, Endoscopic Retrograde* ; Common Bile Duct ; Dilatation ; Duodenum ; Female ; Humans ; Male ; Pancreatic Ducts ; Pancreatic Neoplasms ; Pancreatitis* ; Pancreatitis, Chronic ; Phenobarbital

Expander procedure is a newly developed extraocular muscle weakening technique which has several advantages such as good control of resection margin, easy reoperation, rare postoperative muscular paresis. For the study of usability of Gore-Tex(R) as a muscle expander, fifteen rabbits received expander procedure with Gore-Tex(R) in right eye and silicone retinal band in left eye. At postoperative 1, 3, 5, 7, 12 weeks, histopathologic examination was performed. There was no significant difference in inflammatory reaction in both groups. Inflammatory reaction decreased with time in both groups. In Gore-Tex(R) expander group, muscle regeneration from cut end was observed at the 3rd postoperative week and fibroblast ingrowth into the expander was observed at the 5th postoperative week. These findings were more prominent with time. Adhesion of expander to underlying sclera was not observed in both groups. It is concluded that expander procedure using Gore-Tex(R) will be a new and useful surgical method for the extraocular muscle weakening procedure.
Fibroblasts ; Paresis ; Rabbits ; Regeneration ; Reoperation ; Retinaldehyde ; Sclera ; Silicones

No abstract available.
Compliance* ; Early Detection of Cancer* ; Family Practice* ; Humans

BACKGROUND: In order to reduce the diagnostic window period between the time of human immunodeficiency virus (HIV) infection and serological diagnosis, new fourth generation screening assays which detect HIV p24 antigen and specific antibody simultaneously have been developed. In this study, we evaluated the performance of a new fourth generation assay. METHODS: We compared a new fourth generation assay, Architect HIV Ag/Ab combo, with another fourth generation assay AxSYM HIV Ag/Ab combo and a third generation assay, AxSYM HIV 1/2 gO for their performance. The assays were evaluated using 3 HIV seroconversion panels, 305 sera of healthy subjects and 100 sera of patients with HBsAg or anti-HCV antibodies. Within-run and total coefficient variations of the three screening assays were analyzed for the evaluation of precision. RESULTS: Architect HIV Ag/Ab combo shortened the window period by 8.7+/-2.1 days relative to AxSYM HIV 1/2 gO and 2.0+/-2.0 days relative to AxSYM HIV Ag/Ab combo in seroconversion panels. Architect HIV Ag/Ab combo presented the best performance in precision among the three reagents; total CV for positive control was 3.6%, 9.6% and 4.6% for Architect HIV Ag/Ab combo, AxSYM HIV Ag/Ab combo and AxSYM HIV 1/2 gO, respectively. Specificities of three assays were not different in this study. CONCLUSIONS: HIV Ag/Ab combined assays reduced the diagnostic window as compared to the third generation screening assays, enabling an earlier diagnosis of HIV infection. A new fourth generation assay, Architect HIV Ag/Ab combo presents a better performance than AxSYM HIV Ag/Ab combo, showing improved seroconversion sensitivity and precision.
Diagnosis ; Hepatitis B Surface Antigens ; Hepatitis C Antibodies ; HIV Core Protein p24 ; HIV Infections ; HIV Seropositivity ; HIV* ; Humans ; Indicators and Reagents ; Mass Screening