BACKGROUND: Currently, many laboratories have selected several different methods for the detection of M. tuberculosis in the sputum. To select efficient method for clinical laboratories among the various methods, we compared the results of several methods. METHODS: Total 72 sputums were examined by the six combinations of stain methods. The samples were constructed as follows on the result of direct smear ZN stain; negatives (26), traces (3), 1+(9), 2+(12), 3+(12) and 4+(10). The true positives were determined after close evaluation of the clinical, radiological and other laboratory findings. RESULTS: The sensitivities and specificities of each methods were as follows; direct smear ZN stain were 83.6% and 100%, direct smear Auramine stain were 90.9% and 100%, centrifugation ZN stain were 94.6% and 100%, centrifugation Auramine stain were 98.2% and 94.1%, cytocentrifugation ZN stain were 96.4% and 100%, cytocentrifugation Auramine stain were 100% and 64.7%, nested PCR were 80% and 94.1% and culture were 67.3% and 100% respectively. CONCLUSIONS: Concentration method by centrifugation is suitable for routine laboratory if enough centrifugal force were engaged. Auramine stain is more suitable staining method than ZN stain in direct smear but not in concentrated smear because it has the potency of false positivity. The PCR assay is thought to be not only a fast, sensitive method but also a specific method for the direct detection of M. tuberculosis in the sputum. The culture method using Ogawa media is specific but not sensitive.
Benzophenoneidum ; Centrifugation ; Mycobacterium tuberculosis* ; Mycobacterium* ; Polymerase Chain Reaction* ; Sputum* ; Tuberculosis

No abstract available.

BACKGROUND: Pseudomonas aeruginosa is a major cause of nosocomial infections. During recent three years, the isolation rate was high in Wonkwang University Hospital, especially in intensive care unit(ICU) and wards of neurosurgery. We performed this study to investigate the isolation rate and mode of transmission of P. aeruginosa, and usefulness of antibiotic resistance, colonial characteristics and PFGE patterns in the epidemiologic survey. METHOD: From Aug. 1996 to Oct. 1998, 1,682 strains of P. aeruginosa were isolated. For the isolation of P. aeruginosa, environment and 18 nurses's hands were cultured. Antibiotic resistance were tested by NCCLS disk diffusion method for 298 selected strains. Among them 98 strains were evaluated for colonial characteristics(color and margin) on the blood agar and PFGE patterns restricted by Spe I, were evaluated. RESULTS: Overall isolation rate was 12% and was high in medical ICU (23%) and neurosurgical ICU(12%). The majority of specimens where P. aeruginosa was isolated were sputum 47%, urine 24% and wound 21% in decreasing order. The wards where isolation rate was high, had more resistant strains. Ninty eight strains could be classified into 39 different groups by PFGE patterns. But 29 strains belonged to five major patterns (P1-5) and were suspected as epidemic or cross-infected strains. Majority of these strains revealed resistant to two or more antibiotics and colonial phenotype of G2R, GIR(P1), G1I, G3I(P2), Wm(P3), G3I, G3R(P4) and G3I(P5) types. Forty four strains isolated from specimens(sputum, urine, wound, and stool) of 7 patients during hospitalization, revealed single or two PFGE patterns per patient. Conclusion: Transmission mode of P. aeruginosa was suspected to be patient's own GI-tract and cross contamination, especially via health care persons. Combined phenotypes of antibiotic resistance and colonial characteristics correlated well with PFGE patterns. So, in the early period of outbreak of P. aeruginosa, careful examination of colonial characteristics and antibiotic resistance patterns gave meaningful information.
Agar ; Anti-Bacterial Agents ; Cross Infection ; Delivery of Health Care ; Diffusion ; Drug Resistance, Microbial* ; Electrophoresis, Gel, Pulsed-Field ; Epidemiologic Studies* ; Hand ; Hospitalization ; Humans ; Critical Care ; Neurosurgery ; Phenotype ; Pseudomonas aeruginosa* ; Pseudomonas* ; Sputum ; Wounds and Injuries ; Surveys and Questionnaires

Background: Periprosthetic joint infection (PJI) is the most serious complication after total joint arthroplasty. The incidence and burden of PJI in North America have been reported.There might be potential differences according to ethnics and regional practices between western countries and East Asia. Nevertheless, its incidence in East Asia remains unknown.We aimed to evaluate the incidence and economic burden of PJI in Korea and to project the future burden. Methods: We identified numbers of total hip arthroplasties, total knee arthroplasties and PJIs in Korea from 2010 to 2018 using medical claim data of Korean Health Insurance and Review and Assessment. Annual incidence and medical cost of PJI were calculated. We projected future burden of PJI through 2030 using Quasi-poisson regression model. Results: The annual incidence of PJI ranged from 2.3% to 2.8% and the average cost per each PJI patient ranged from $4,361 to $6,016. Total annual cost of PJI increased from $8.0 million in 2010 to $18.0 million in 2018 and was projected to exceed $57.0 million by 2030. Conclusion The incidence of PJI in Korea is comparable with reported PJI incidence of 2.0%–2.7% in the United States. Our findings would be used for worldwide comparison of PJI epidemiology and establishment of healthcare policies for PJI in East Asia.

No abstract available.
Skull Fracture, Depressed*

BACKGROUND: The incidence of hip fractures has been reported to vary geographically, and its trend has also varied widely. However, the trend in the age-adjusted incidence of hip fractures has not been well studied in Korea. After we identified eligible studies presenting multiple age-adjusted incidences of hip fractures in the Korean population in PubMed, we evaluated changes in the absolute number of occurrence and calculated the annual percentage change (APC) of age-adjusted incidences of hip fractures. METHODS: We have searched PubMed for the original and English-language literature on the incidence of hip fractures in the Korean population published since 2000. The studies presenting multiple age-adjusted incidences of hip fractures were selected. We evaluated the change in the absolute number of hip fractures and calculated the APC of age-adjusted incidences of hip fractures for each study. RESULTS: Three eligible articles were identified. The absolute number of hip fractures for both genders increased over time in all three studies although the operational definition of hip fracture differed from one another. The APC of the age-adjusted incidence of hip fractures was positive for women and negative for men. However, the change was not statistically significant in both genders during each study period (2001–2004, 2005–2008, and 2006–2010, respectively). CONCLUSIONS: The age-adjusted incidence of hip fractures was stable among men and women, while the absolute number of hip fractures increased for both genders in Korea. Further studies with longer study periods on age-adjusted incidences are required to better determine the trend in the incidence of hip fractures in Korea.
Female ; Hip Fractures* ; Hip* ; Humans ; Incidence* ; Korea* ; Male

BACKGROUND: Osteoporosis after menopause is known as a disease that needs preventive measures before medical treatment. Many patients, however, do not undergo hormone therapy to prevent it. This paper investigates some obstacles to hormone replacement therapy (HRT). METHOD: A total of 85 menopausal women who under went bone-mineralodensitometry (BMD) examination at Chuncheon Sungshim Hospital Health Care Clinic from May, 1995 to April, 1997 were the subjects of our study. We interviewed them by telephone, examined their medical records including their BMD results. We also examined what the obstacles were for them to receive HRT for osteoporosis. RESULTS: The average age of the subjects was 55.8years. Only 40 women (47%) replied that they knew beforehand the purpose of the BMD examination. The rest of the subjects replied that they simply went through the examination because it was inclusive to health items. Those who had heard of HRT for osteoporosis were only 43 people because(50.1%), and those who did not currently receive HRT amounted to 32 (74.4%). The reasons why they do not undergo the therapy were fear of cancer, no symptoms related to osteoporosis, financial difficulty, and weight gain. Among the 32 subjects, only 1 person replied that she would not receive the HRT even if the above obstacles were removed. Therefore, it seems that most of our subjects would receive HRT if such obstacles removed. Those who were currently receiving HRT were 11 people(12.9%). According to the open questionnaire, many of them replied that they do not feel any inconvenience while receiving the HRT, but some of them complained of epigastric pain, dysmenorrhea, or mastalgia. They replied that after the HRT they felt no arthralgia and felt far better in body and mind than before treatment. All the 11 people replied that they will continue to receive the HRT. CONCLUSION: The main reason why so few people received HRT for osteoporosis proved to be the lack of knowledge of the therapy. Even those who had heard of HRT complained about the negative aspects, which in fact can be overcome, and as a result a considerable number of them do not receive HRT. Therefore we conclude that in order to increase the number of patients who will undergo HRT for osteoporosis after menopause we need to strengthen education about the merits of this therapy rather than just performing BMD examination.
Arthralgia ; Delivery of Health Care ; Dysmenorrhea ; Education ; Female ; Gangwon-do ; Hormone Replacement Therapy* ; Humans ; Mastodynia ; Medical Records ; Menopause ; Osteoporosis ; Osteoporosis, Postmenopausal* ; Telephone ; Weight Gain ; Surveys and Questionnaires

BACKGROUND: Leptin has been found to be involved in the regulation of hematopoiesis processes and angiogenesis. Therefore, we investigated the effect of leptin in the proliferation and angiogenesis of peripheral blood (PB)-derived endothelial progenitor cells (EPCs). METHODS: Mononuclear cells were isolated from PB of healthy male volunteers and were cultured in endothelial cell growth medium-2 (EGM-2). After 6 days of culture, cells were treated with 50 ng/mL vascular endothelial growth factor (VEGF) and/or with various concentrations of leptin (10 ng/mL, 100 ng/mL, 1microgram/mL, and 10 microgram/mL) and were further cultured for one week. Proliferation of EPCs was examined by an assay measuring the uptake of 1,1'-dioctadecyl-3,3,3',3'-tetramethylindocarbo cyanine-labeled acetylated LDL (Dil-ac-LDL) and tubule formation on a matrigel. The control group of cells was not treated with VEGF and/or leptin. RESULTS: The number of Dil-ac-LDL labeled-EPCs, tubule formation on matrigel and the number of cells present along tubules were significantly increased in the leptin-treated groups of cells as compared to the control group or VEGF treated group of cells (P<.05). The effect was synergistically increased in the group of cells co-treated with leptin and VEGF. The number of EPCs was increased in a leptin dose-dependent manner that was maximal at a concentration of 1microgram/mL leptin. CONCLUSION: This study shows that leptin increased in vitro proliferation and angiogenesis of EPCs derived from peripheral blood.
Endothelial Cells ; Hematopoiesis ; Humans ; Leptin* ; Male ; Stem Cells* ; Vascular Endothelial Growth Factor A ; Volunteers

Sarcopenia-related falls and fractures are increasing worldwide due to the aging population. The purpose of this study was to 1) evaluate anthropometric characteristics related to hip fracture in Korean patients, 2) investigate sarcopenia prevalence in hip fracture (HF) and non-hip fracture (NF) groups, and 3) investigate the correlation between sarcopenia and osteoporosis. This case-control study examined 359 HF and 1,614 NF normal populations using Korea National Health and Nutrition Examination Survey data. We performed whole-body dual energy X-ray absorptiometry to analyze body composition using the skeletal muscle mass index (SMI: lean mass/height2) and bone mineral density (BMD). In the HF group, using the AWGS definition, the prevalence of sarcopenia in women and men was 44.3% and 68.2%, respectively; in the NF group, it was 7.1% and 16.1%, respectively. Lower appendicular SMI (P < 0.001), leg muscle mass (P < 0.001), and higher prevalence of sarcopenia (P < 0.001) were observed in the HF group after adjustment for age and gender. In multivariate analysis, sarcopenia (OR = 6.52; 95% CI = 4.67-9.09), age (OR = 1.15; 95% CI = 1.13-1.17), and osteoporosis (OR = 1.87; 95% CI = 1.35-2.58) were associated with the occurrence of a hip fracture. This study showed a higher prevalence of sarcopenia in patients with hip fractures compared with a normal population, and higher prevalence of sarcopenia in men.
Absorptiometry, Photon ; Accidental Falls ; Aging ; Body Composition ; Bone Density ; Case-Control Studies* ; Female ; Hip Fractures ; Hip* ; Humans ; Korea ; Leg ; Male ; Multivariate Analysis ; Muscle, Skeletal ; Nutrition Surveys ; Osteoporosis ; Prevalence* ; Sarcopenia*

OBJECTIVES: Many medication errors can occur when ordering and dispensing medicine in hospitals. The clinical decision support system (CDSS) is widely used in an effort to reduce medication errors. This study focused on the evaluation of user satisfaction with the CDSS for medication at a university hospital. Specifically, this study aimed to identify the factors influencing user satisfaction and to examine user requirements in order to further improve user satisfaction and drug safety. METHODS: The study was based on survey data from 218 users (103 doctors, 103 nurses, and 15 pharmacists) at a university hospital that uses the CDSS. In order to identify the factors influencing user satisfaction with the CDSS, a multiple linear regression was performed. In order to compare the satisfaction level among the professional groups, an analysis of variance (ANOVA) was performed. RESULTS: The reliability of information, decision supporting capability, and departmental support were significant factors in influencing user satisfaction. In addition, nurses were the most satisfied group, followed by pharmacists and doctors according to the ANOVA. Areas for further improvement in enhancing drug safety were real time information searching and decision supporting capabilities to prevent adverse drug events (ADE) in a timely manner. CONCLUSIONS: We found that the CDSS users were generally satisfied with the system and that it complements the nationwide drug utilization review (DUR) system in reducing ADE. Further CDSS evaluation in other hospitals is needed to improve user satisfaction and drug safety.
Complement System Proteins ; Decision Support Systems, Clinical ; Drug Toxicity ; Drug Utilization Review ; Humans ; Linear Models ; Medication Errors ; Pharmacists