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

No abstract available.
Anemia, Refractory* ; Cyclosporine*

PURPOSE: The aim of this study was to examine the sensitivity and specificity of the influenza rapid antigen test, in comparison with reverse transcription polymerase chain reaction (RT-PCR), according to the time of the test from symptom onset and the clinical manifestations in the patients tested for suspected infection of the influenza A (H1N1) at a second hospital. METHODS: A total of 529 pediatric patients, aged between 6 and 12 years old, who visited the emergency department from October 1, 2009 to December 31, 2009, received the influenza rapid antigen test and RT-PCR. We examined the sensitivity and specificity of the influenza rapid antigen test in comparison with RT-PCR according to the time of the test from symptom onset (<24 hours, 24 to 48 hours, 48 to 72 hours, >72 hours) and clinical manifestations (fever, cough, rhinorrhea.nasal obstruction, sore throat, gastrointestinal symptoms, and general symptoms) in a retrospective study based on hospital charts. RESULTS: The sensitivity of the influenza rapid antigen test at elapsed times of less than 24 hours, 24 to 48 hours, and 48 to 72 hours after the onset of the symptoms was 53.9%, 61.4%, and 62.1% respectively. When the elapse time was greater than 72 hours, the sensitivity was 31.6%; thus, the sensitivity of the influenza rapid antigen test tended to decrease with elapsed time. The sensitivity of the test was 79% in patients presenting with gastrointestinal symptoms, which was the highest, but there was no statistical difference according to the clinical manifestations of the patients. CONCLUSION: Our study suggests that more accurate results might be gained when the influenza rapid antigen test is performed within 72 hours after symptom onset.
Aged ; Child ; Cough ; Emergencies ; Humans ; Influenza, Human ; Pharyngitis ; Polymerase Chain Reaction ; Retrospective Studies ; Reverse Transcription ; Sensitivity and Specificity

No abstract available.
Cell Proliferation* ; Interleukin-1* ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive*

Systemic lupus erythematosus (SLE) has been a well-known systemic autoimmune disease with hematologic abnormalities such as anemia, leukopenia, and thrombocytopenia. Myelodysplastic syndrome (MDS) is defined as a clonal expansion of BM derived pluripotent stem cells. Although SLE and MDS are independent disease entities, there have been several reports regarding rheumatic manifestations of MDS, which suggest that there might be a relationship between these two diseases in the pathogenetic sequence. We reviewed our cases of MDS and SLE and encountered four patients with both MDS and SLE, both of which developed concurrently. They were all women from 15 to 50 years old. They had anemia or pancytopenia. Bone marrow findings were disclosed as MDS, RA or hypoplastic MDS, RA. They had positive ANA at a titer above 1:160 of homogeneous, speckled, or dense cytoplasmic pattern. Double-stranded DNA levels increased in all cases, whereas serum complement and immunoglobulin levels were decreased except in case 1.
Anemia ; Autoimmune Diseases ; Bone Marrow ; Complement System Proteins ; Cytoplasm ; DNA ; Female ; Humans ; Immunoglobulins ; Leukopenia ; Lupus Erythematosus, Systemic* ; Middle Aged ; Myelodysplastic Syndromes* ; Pancytopenia ; Pluripotent Stem Cells ; Stem Cells ; Thrombocytopenia

No abstract available.
Humans* ; Leukemia*

Purpose of this study is to evaluate the temperature lowering effects of the local cold air application on the skin surface and the muscle of different depth, and to observe whether the rebound rise of the temperature occurs after the cold air application. Subjects were prepared in a relaxed prone position. Cold air of CRAis(Kyung-won Century, Korea) was applied to the gluteal area of 20 healthy subjects for 5 minutes. The skin and intramuscular temperatures were measured by a thermogram(Infrared system, Sweden) and digital thermometers(Barnant company, USA). The temperatures were measured before and 30 seconds after the cold air application, and then every 5 minutes for the next 110 minutes. The few variables were considered that might affect the temperature changes. The thermometer-probes were inserted into the outer quadrant of the gluteal muscle below 5 cm from the iliac crest with the depth of 2 cm, 4 cm, and 6 cm respectively. ANOVA was used for the analysis of the data. The resting temperature of the skin surface was 32.6+/-1.2oC, and the lowest temperature was 12.9+/-3.3oC after 5 minutes of cold air application. The resting intramuscular temperatures with 2 cm, 4 cm, and 6 cm depth were 36.5+/-0.2oC, 36.9+/-0.2oC, and 37.1+/-0.2oC respectively (p<0.05). The lowest temperature in 2 cm, 4 cm, and 6 cm depth was 35.1+/-0.7oC, 36.2+/-0.4oC, and 36.9+/-0.3oC respectively(p<0.05). The mean duration to reach the lowest temperature was 20, 25, and 45 minutes respectively. The temperatures in the skin and the muscle with the depth of 2 cm, 4 cm, and 6 cm after 2 hours on cold air application were 32.2+/-1.1oC, 36.2+/-0.5oC, 36.6+/-0.3oC, and 36.9+/-0.3oC(p<0.05) respectively. The temperatures in the skin and the muscle were significantly lower after 2 hours than before the cold air application(p<0.05). The change of skin surface temperature was more rapid than that of the muscle and the deeper the muscle was the lesser the temperature change. In conclusion, the effect of cold air application for 5 minutes lasts up to 2 hours and the rebound rise of the temperature due to reactive vasodilatation seems not to occur in the gluteal muscle.
Cryotherapy ; Prone Position ; Skin Temperature ; Skin* ; Vasodilation

Seborrheic dermatitis is a chronic recurrent inflammatory disorder presumed to be caused by increased sebaceous gland secretion, metabolic changes in the cutaneous microflora, and changes in the host immune function. Stellate ganglion block (SGB) is known to increase the blood flow rate without altering the blood pressure, heart rate, or cardiac output, to stabilize hypertonic conditions of the sympathetic nerves, and to affect the endocrine and immune systems. It is used in the differential diagnosis and treatment of autonomic nervous system disorders of the head, neck, and upper limbs. The authors report the first case of successful treatment of a patient with seborrheic dermatitis through repeated SGB trials.
Autonomic Nervous System Diseases ; Blood Pressure ; Cardiac Output ; Dermatitis, Seborrheic* ; Diagnosis, Differential ; Head ; Heart Rate ; Humans ; Immune System ; Neck ; Nerve Block ; Sebaceous Glands ; Stellate Ganglion* ; Upper Extremity

The purpose of this study is to characterize the recurrence and to investigate the risk factors for the recurrence in the 989 patients who had hypertensive intracerebral hemorrhage between 1989-1995. Fifty-three patients(5.4%) had two episodes of hemorrhage with median interval of 22.3+16.3 months(range, 1.7-71.9 months). The probable risk of recurrent hemorrhage was the highest within two years of the first hemorrhage, being 3.6 % in the first year and 3.5 % in the second year. The sites of the recurrent hemorrhage were different from the initial site in all patients. The common patterns of recurrence were "ganglionic(putamen/caudate nucleus)-thalamic" in 26.8% and "ganglionic-ganglionic in 21.4%. The "lobar-lobar" pattern was noted in only 2 patients, The overall mortality was 28.3%. In patients who had ganglionic-ganglionic pattern, the mortality was significantly inc reased (p<0.005). No recurrent hemorrhage occurred during the regular treatment for hypertension. The only significant tactor for recurrent hemorrhage was the antihypertensive therapy of less than 3 months after the initial attack(p<0.005). Considering lifelong treatment for hypertension, long-term regular control for hypertension will be required to prevent the recurrent hemorrhage.
Hemorrhage ; Humans ; Hypertension ; Intracranial Hemorrhage, Hypertensive ; Mortality ; Recurrence ; Risk Factors

BACKGROUND AND OBJECTIVES: Benign recurrent vertigo has been defined as recurrent spells of vertigo lasting minutes to hours without cochlear and neurologic signs. The etiology is still unclear, but viral and vasospastic etiology as migraine equivalent has been suggested. We attempt to analyze the symptoms and vestibular function test of Benign recurrent vertigo that has clinically diagnosed. MATERIALS AND METHODS: We analyzed retrospectively the clinical characteristics and vestibular function test including ocular-motor test, rotation test and computerized dynamic posturography from 100 patients with a Benign recurrent vertigo diagnosis. RESULTS: Eight two percent of the patients were female, mean age was 52 years, and mean duration of prevalence was 47.3 months. In the characteristics of vertigo, 91% of patients have spinning sensation during attack. The vertigo attacks most commonly lasts several hours (57%), and frequency of attack is three to twelve time per year in 47%. A high incidence (40%) of headache was detected, but incidence of other associated symptoms including fluctuating hearing loss (3%), tinnitus (27%), aural fullness (9%) was relatively low. The incidence of spontaneous nystagmus and positional nystagmus was 18% and 10% each. Saccadic undershoot was observed in 21% of patients, but it was not associated with other ocular-motor test abnormalities. In rotation test, low gain, phase lead and asymmetry was observed in 18%, 3% and 9%, respectively. There were no abnormal findings in posturography. CONCLUSIONS: Although benign recurrent vertigo did not show any characteristic clinical findings or vestibular function test, it deserves to be considered for differential diagnosis of episodic vertigo.
Diagnosis, Differential ; Female ; Headache ; Hearing Loss ; Humans ; Incidence ; Migraine Disorders ; Neurologic Manifestations ; Nystagmus, Physiologic ; Prevalence ; Retrospective Studies ; Tinnitus ; Vertigo ; Vestibular Function Tests