To elucidate the role of plasmid-mediated AmpC-type B-lactamases in clinical practice, cefoxitin-resistant isolates of E. coli (19 strains) and K. pneumoniae (7 strains) from three hospitals in Korea were studied. All of the 26 isolates produced at least one j3-lactamase and 16 (62%) isolates produced AmpC-type B-lactamases poorly inhibited by clavulanic acid. In 16 such isolates, 4 kinds of AmpC enzymes were detected; the pI 8.0 AmpC enzyme in 11 isolates, the pI 8.9 in 3 isolates of E. coli, the pI 8.5 in 1 isolate of E. coli, and the pI 7.8 in 1 isolate of K pneumoniae. The pI 8.0 and 7.8 AmpC enzymes had an apparent molecular mass of 38 kDa and the pI 8.5 and 8.9 AmpC enzymes had a molecular mass of 35 kDa. Cefoxitin resistance was transmissible in six E. coli and three K pneumoniae strains due to a common AmpC-type B-lactamase with a pl of 8.0. This enzyme was confirmed to be CMY-1 B-lactamase by Southern blotting and PCR analysis. Four E. coli isolates produced large amounts of AmpC-type j3-1actamase. They were chromosomal AmpC hyperproducers carrying some alterations in the promoter and attenuator regions of the ampC chromosomal gene. The pI 7.8 AmpC enzyme is currently under study. In conclusion, this study showed that the CMY-1 plasmid-mediated cephamycinase play an important role in cephamycin resistance of K. pneumoniae and E. coli clinical isolates in Korea.
beta-Lactamases* ; Blotting, Southern ; Cefoxitin ; Clavulanic Acid ; Korea ; Pneumonia* ; Polymerase Chain Reaction

PURPOSE: This study was to identify adolescents' smoking behavior and the status and need of smoking prevention education for adolescents. METHOD: The subjects were 375 students selected through convenient sampling from three middle schools and three high schools in Jeonbuk. Data were collected through a questionnaire survey and analyzed using SPSS 10.1. RESULT: The smoking rate was 20.8% and 83.7% the students experienced smoking prevention education. Students were educated by a special instructor (39.8%) or a health teacher (26.8%). Among the teaching methods, lecture was 69.4%, but some students (30.7%) wanted anti-smoking school. Among the students, 85.0% answered they want smoking prevention education and 46.7% said that it should be covered in regular curriculum. CONCLUSION: High interest and continuity are emphasized for the success of smoking prevention education. In addition, various teaching methods need to be developed including anti-smoking school, lectures, counselling and long term education program. Moreover, smoking prevention education programs need to be covered in regular curriculum.
Adolescent* ; Curriculum ; Education* ; Humans ; Jeollabuk-do ; Lectures ; Smoke* ; Smoking* ; Teaching ; Surveys and Questionnaires

The purpose of this study was to find educational needs of toddler's mother in child-caring experience. The subject of the study was toddler's mother who visited one health care center in J city for immunization and had a child or children between twelve and thirty six months old. The subjects were 37 mothers. The instrument used for this study was a semi-structured questionnaire developed by researcher and based on Objective Content Test of Garretson(1967). The Collected data were analized by two researchers using the method of content Analysis. The results of this study are summarized as follows ; 1) Of the large categories, the need of the highest frequency was 'prevention and management of disease and injury', that of the lowest 'growth and development'. 2) In 'physical care' category, 'care of sleeping' was the highest. In 'nutrition and eating-habitual management' category, 'weaning management' was the highest. In 'prevention and management of disease and injury' category, 'disease management' was the highest. In 'discipline and teaching' category, 'discipline' was the highest. 3) In comparison with preceding references, the educational needs of child-caring which had not been shown in preceding references but had been shown in this study were hair-caring, kind of weaning diet, method of cure and nursing, management of deformity, and so on. In conclusion, educational needs of toddler's mother in child-caring experience were matter-of-fact and inclusive. Needs in management of special situation such as disease were higher than usual parenting procedure or method. In addition, there were higher needs in questions happened through child-caring experience or confirmation of procedures practicing now. Then, it is suggested that parent education program should be developed on the basis of educational needs found in this study to be more effective in preparing mothers's child-caring.
Child ; Congenital Abnormalities ; Delivery of Health Care ; Diet ; Education ; Humans ; Immunization ; Mothers* ; Nursing ; Parenting ; Parents ; Weaning ; Child Health ; Surveys and Questionnaires

The study conducted from May to September in 1994 to investigate applicability of the Hearing Handicap Inventory for the Elderly-Screening version(HHIE-S) in parallel with the puretone audiometer to the initial screening test of noise-induced hearing loss(NIHL) in some noise-exposed workers. Subjects were selected by systemic sampling that took every fifth person from 6,700 workers taking the annual occupational health examination by the department of Health Maintenance of Dongsan Hospital Keimyung University in Taegu. The authors administered the pure-tone audiometric test and self-reported questionnaire of HHIE-S including items of sociodemographic and job-related variables concurrently. The final subjects analysed were 1,019(488 males and 531 females) excluding fourteen persons who had many missing values in their questionnaires. The reliability coefficients of HHIE-S scale by Cronbach's alpha were 0.84. In the univariate analysis of hearing handicap measured by the HHIE-S, work duration, military service and the hearing threshold loss at 1kHz and 4kHz was the only selected variable explaining the hearing handicap in males and hearing threshold loss at 1kHz and 4kHz, age, and work duration were selected in females. In ROC curves for HHIE-S scores against NIHL as gold standard which was defined by the follow-up audiogram as more than 30dB of the average of 0.5/1/2kHz and 50dB at 4kHz, the optimal cutoff for the parallel HHIE-S appeared to be 8. The results suggest that HHIE-S appeared to have some reliability and validity in this data and might be used in screening NIHL in parallel with pure-tone audiometer in noise-exposed workers.
Daegu ; Female ; Follow-Up Studies ; Hearing ; Hearing Loss, Noise-Induced* ; Humans ; Male ; Mass Screening* ; Military Personnel ; Occupational Health ; Surveys and Questionnaires ; Reproducibility of Results ; ROC Curve

PURPOSE: This exploratory study was done to categorize medical personnel's perceptions of burnout and analyzed the characteristics. METHODS: Q methodology was applied using a 45 Q-sample categorized on an 11-point scale which was completed by nurses and doctors working at a university hospital in Seoul, Korea. Collected data were analyzed using the PC-QUANL program. RESULTS: Medical personnel's perceptions of burnout were categorized into three types; 33.83% of the total variance was explained. The first type was 'functionally deteriorating pressure' the second type was 'daily powerlessness' and the third was 'achievement-oriented re-energization'. CONCLUSION: There is a need to establish and apply intervention strategies for each type to alleviate medical personnel burnout and increase work efficiency to qualitatively improve medical services.
Korea ; Seoul

BACKGROUND: As anti-retroviral therapy has improved and the life expectancy of patients' with HIV in Korea has increased, an increased number of surgical procedures have been performed in this population. Therefore, in the current study, we investigated the trend in surgery conducted on patients with HIV in our hospital over the last 5 years. METHODS: We retrospectively reviewed the medical records of HIV-infected patients who underwent surgery under general or local anesthesia at our hospital between 2005 and 2010. RESULTS: The total number of surgeries performed in HIV-infected patients in the 5-year period was 95. Of these, 23 (24%) were performed under general anesthesia and 72 (76%) under spinal anesthesia. Anorectal surgery was the most commonly performed surgery (71 cases, 76%). The postoperative complication rate was 5.3% (3 cases of pneumonia and 2 of wound infection), with general anesthesia and time to discharge being identified as contributory factors. Preoperative CD4+ T cell count was not significantly associated with complications. CONCLUSION: This study was the first to analyze the trends in surgical procedures performed in HIV-infected patients in Korea. Our study may be beneficial as a reference for clinicians who manage patients with HIV.
Acquired Immunodeficiency Syndrome ; Anesthesia, General ; Anesthesia, Local ; Anesthesia, Spinal ; Cell Count ; HIV ; Humans ; Korea ; Life Expectancy ; Medical Records ; Pneumonia ; Postoperative Complications ; Retrospective Studies ; Wounds and Injuries

No abstract available.

Anaphylaxis during anesthesia is rare, but often fatal. Rocuronium is a neuromuscular relaxant used for induction of anesthesia. We experienced a case of anaphylaxis after rocuronium administration during induction of anesthesia. A 64-year-old female patient was scheduled for bilateral radius fracture fixation. The history of patient showed no specific findings other than hypersensitivity to mackerel. She had no previous experience of anesthesia. Anesthesia was induced by intravenous injection of propofol 100 mg and continuous infusion was begun with remifentanil 0.25 µg/kg/min, followed by rocuronium 40 mg. Immediately after intravenous administration of rocuronium, the manual ventilation became difficult, and the patient developed erythema and severe hypotension. The patient was diagnosed with anaphylaxis based on clinical features and started treatment. First, we performed endotracheal intubation promptly. Then, immediate intravenous administration of epinephrine and fluid followed. Despite adequate treatment, hypotension was not corrected and intravenous epinephrine was administered. However, ventricular tachycardia occurred which was successfully treated with a defibrillator. Later, the patient uneventfully recovered in the intensive care unit. The patient was not tested for skin prick test, but rocuronium was the most likely cause of anaphylaxis at that time. The authors unexpectedly experienced drug-induced anaphylaxis, which is life-threatening to the patient. Clinicians should be aware of the diagnosis, treatment, and prevention as anaphylaxis can be hazardous to the patient.
Administration, Intravenous ; Anaphylaxis* ; Anesthesia* ; Defibrillators ; Diagnosis ; Epinephrine ; Erythema ; Female ; Humans ; Hypersensitivity ; Hypotension ; Injections, Intravenous ; Intensive Care Units ; Intubation, Intratracheal ; Middle Aged ; Perciformes ; Propofol ; Radius Fractures ; Skin ; Tachycardia, Ventricular ; Ventilation

We present a case of mucous gland adenoma arising from the main bronchus of the lower lobe of the left lung in terms of clinicopathologic, immunohistochemical, and ultrastructural aspects as well as review of related literatures. The patient, a 31-year-old female, was admitted to Catholic University Medical College Hospital with complaints of coughing and purulent sputum for about seven years. The chest CT showed a severely calcified tumor in the left lower lobe of the lung. Grossly, the calcified tumor arising from the main bronchus protruded into the lumen and showed bronchiectasis of the lower lobe and atelectasis of the upper lobe of the lung. The tumor was pale brown-gray and sharply circumscribed and showed some small cystic spaces filled with mucoid material. Microscopically, most of the tumor showed dystrophic calcification. The growth pattern of the tumor is composed of cysts, tubules, and glands lined by cytologically bland columnar, cuboidal, or flattened mucus secreting cells. Electron micrograph of tumor cells showed some round or oval mucous granules measuring 0.5-1.8 micrometer.
Adenoma* ; Adult ; Bronchi* ; Bronchiectasis ; Cough ; Female ; Humans ; Lung ; Mucus ; Pulmonary Atelectasis ; Sputum ; Tomography, X-Ray Computed

No abstract available.
Child* ; Dehydration* ; Humans