PURPOSE: This study was done to identify the intensive care unit nurses' knowledge of and compliance with the standard precautions (universal precaution) as stated in infection control guidelines. METHOD: From September 14 to September 28, 2006, data were collected via a questionnaire survey from 189 Intensive Care Unit nurses working at three university branch hospitals and one general hospital in Gyeonggi province. RESULTS: The mean knowledge score was 18.8/20.0 (93.9%). The mean compliance score was 3.4/4.0 (85.8%). Two factors influencing compliance were perception of the standard precautions and experience of needle stick injuries over the past year (p<.05). Two factors influencing knowledge were support of co-workers in the use of protective devices and the availability of hand-washing device or waterless alcohol gel (p<.05). CONCLUSION: In order to improve knowledge and compliance with standard precautions, all factors of importance for knowledge and compliance must be taken into consideration in the clinical work place and in education.
Compliance ; Hospitals, General ; Hospitals, Satellite ; Hypogonadism ; Infection Control ; Critical Care ; Intensive Care Units ; Mitochondrial Diseases ; Needlestick Injuries ; Ophthalmoplegia ; Protective Devices ; Surveys and Questionnaires ; Universal Precautions ; Workplace

BACKGROUND: There has been no general agreement in classifying basal cell carcinoma (BCC), and little is known about the immunohistochemical profiles in each subtypes of BCC. BCC is a locally-invasive tumor, but its aggressive forms tend to recur and metastasize. OBJECTIVE: In this study, we have compared the histolopathological subtypes of BCC by immunohistochemical study. We also focused on identifying representative markers of growth in the aggressive forms of BCC by assessing VEGF, p53 and alpha-SMA expression. METHODS: A total of 87 BCC specimens were collected at the 7 branch hospitals of The Catholic University of Korea from July 1997 to June 2003. For multiple immunohistochemical staining, a tissue microarray technique was used. The 87 samples were divided into 6 subtypes: 18 nodular, 19 nodular infiltrative, 12 micronodular, 14 infiltrative, 11 morphea and 13 basosquamous. Overall, 18 samples were classified as non-aggressive and the remaining 69 as aggressive. RESULTS: The following results were obtained after immunohistochemical staining with antibodies alpha-SMA, VEGF and p53. A significant increase of alpha-SMA expression was observed in aggressive forms of BCC, whereas the expression of p53, VEGF, the number of mast cells remained the same. The representative markers of tumor growth such as alpha-SMA were most highly expressed in the basosquamous type, and least expressed in the micronodular type compared to the nodular type. CONCLUSION: alpha-SMA was considered as an appropriate immunohistochemical marker in BCC to represent aggressiveness.
Antibodies ; Carcinoma, Basal Cell* ; Hospitals, Satellite ; Immunohistochemistry ; Korea ; Mast Cells ; Scleroderma, Localized ; Vascular Endothelial Growth Factor A

BACKGROUND: Laboratory studies as diagnostic tools of scrub typhus have shown PCR to be sensitive and specific, but there have been few clinical studies. The aims of this study were to determine the diagnostic accuracy and clinical usefulness of the nested PCR through a prospective comparison of the nested PCR and indirect immunofluorescence assay (IFA). MATERIALS AND METHODS: We conducted a multicenter prospective study of patients with possible scrub typhus. Adult patients who have had fever together with eschar or a maculopapular skin rash and more or equal to two of the following symptoms: headache, malaise, myalgia, coughing, nausea, and abdominal discomfort were enrolled. Each patient was admitted between September, 2004 and December, 2004 to Chosun University Hospital and one of its three community branch hospitals (Haenam General Hospital, Jangheung Hospital, Muan Hospital), which are all located in the southwest of Korea. Whole blood samples were collected for PCR testing and sera were obtained for serology evaluation using the IFA and passive hemagglutination assay (PHA). RESULTS: We enrolled 135 possible scrub typhus patients, and 118 scrub typhus patients were confirmed on the basis of either a single indirect immunofluorescent specific IgM titer against O. tsutsugamushi of > or =1:10 or 4-fold or greater rise in IFA follow up titer. One hundred eighteen patients were confirmed as scrub typhus, 7 patients were undetermined and 10 patients were confirmed as the other diseases. The result of nested PCR assay demonstrated a sensitivity of 82.2% (95% confidence interval 0.74-0.88), a specificity of 100% (95% confidence interval 0.66-1), positive predictive value of 1 (95% confidence interval 0.95-1) and negative predictive value of 0.32 (95% confidence interval 0.17-0.51). 96 patients out of 118 patients were positive for IgM on the admission day. Of 22 patients with negative for IgM antibody at admission, 19 had positive results for nested PCR using buffy coat. CONCLUSION: The nested PCR assay of buffy coat is useful for rapid and reliable test for confirmation of the diagnosis of scrub typhus.
Adult ; Cough ; Diagnosis* ; Exanthema ; Fever ; Fluorescent Antibody Technique, Indirect ; Follow-Up Studies ; Headache ; Hemagglutination ; Hospitals, General ; Hospitals, Satellite ; Humans ; Immunoglobulin M ; Korea ; Myalgia ; Nausea ; Orientia tsutsugamushi ; Polymerase Chain Reaction* ; Prospective Studies* ; Scrub Typhus* ; Sensitivity and Specificity

BACKGROUND: Laboratory studies as diagnostic tools of scrub typhus have shown PCR to be sensitive and specific, but there have been few clinical studies. The aims of this study were to determine the diagnostic accuracy and clinical usefulness of the nested PCR through a prospective comparison of the nested PCR and indirect immunofluorescence assay (IFA). MATERIALS AND METHODS: We conducted a multicenter prospective study of patients with possible scrub typhus. Adult patients who have had fever together with eschar or a maculopapular skin rash and more or equal to two of the following symptoms: headache, malaise, myalgia, coughing, nausea, and abdominal discomfort were enrolled. Each patient was admitted between September, 2004 and December, 2004 to Chosun University Hospital and one of its three community branch hospitals (Haenam General Hospital, Jangheung Hospital, Muan Hospital), which are all located in the southwest of Korea. Whole blood samples were collected for PCR testing and sera were obtained for serology evaluation using the IFA and passive hemagglutination assay (PHA). RESULTS: We enrolled 135 possible scrub typhus patients, and 118 scrub typhus patients were confirmed on the basis of either a single indirect immunofluorescent specific IgM titer against O. tsutsugamushi of > or =1:10 or 4-fold or greater rise in IFA follow up titer. One hundred eighteen patients were confirmed as scrub typhus, 7 patients were undetermined and 10 patients were confirmed as the other diseases. The result of nested PCR assay demonstrated a sensitivity of 82.2% (95% confidence interval 0.74-0.88), a specificity of 100% (95% confidence interval 0.66-1), positive predictive value of 1 (95% confidence interval 0.95-1) and negative predictive value of 0.32 (95% confidence interval 0.17-0.51). 96 patients out of 118 patients were positive for IgM on the admission day. Of 22 patients with negative for IgM antibody at admission, 19 had positive results for nested PCR using buffy coat. CONCLUSION: The nested PCR assay of buffy coat is useful for rapid and reliable test for confirmation of the diagnosis of scrub typhus.
Adult ; Cough ; Diagnosis* ; Exanthema ; Fever ; Fluorescent Antibody Technique, Indirect ; Follow-Up Studies ; Headache ; Hemagglutination ; Hospitals, General ; Hospitals, Satellite ; Humans ; Immunoglobulin M ; Korea ; Myalgia ; Nausea ; Orientia tsutsugamushi ; Polymerase Chain Reaction* ; Prospective Studies* ; Scrub Typhus* ; Sensitivity and Specificity

BACKGROUND: There has been no general agreement on classifying basal cell carcinoma (BCC), and little is known about the squamous cell differentiations of each subtype of BCC. BCC is a locally-invasive tumor, but its aggressive forms tend to recur and metastasize. OBJECTIVE: We have compared the histolopathological subtypes of BCC by squamous differentiation, with special emphasis on basosquamous carcinoma and the difference between the non- aggressive and aggressive forms of BCC. MATERIALS AND METHOD: A total of 87 BCC specimens were collected from the 7 branch hospitals of The Catholic University of Korea from July 1997 to June 2003. RESULTS: 1. The 87 samples were divided into 6 subtypes: 18 nodular, 19 nodular infiltrative, 12 micronodular, 14 infiltrative, 11 morpheaform, 13 basosquamous. Overall, 18 samples were classified as non- aggressive and the remaining 69 as aggressive. 2.In nodular-infiltrative BCC and basosquamous carcinoma, squamous cell differentiation was significantly more prominent than in the nodular BCC. CONCLUSION: Squamous cell differentiation should be considered as one of the aggressive markers, especially in nodule-forming BCC.
Carcinoma, Basal Cell* ; Carcinoma, Basosquamous ; Cell Differentiation* ; Hospitals, Satellite ; Korea

OBJECTIVE: To study intrauterine or extrauterine misplacement of intrauterine devices in respect to their usage in diagnosis and therapy via retrospective analysis. METHODS: Data from 1993 to 2000 on a total of 32 patients from seven Catholic University branch hospitals who had been admitted to treat IUDs which had misplaced to intrauterine or extrauterine locations were analyzed for usage in a retrospective study. RESULTS: The data for intrauterine and extrauterine misplacement revealed no significant difference between from the statistical average in relation to age, parity and duration of insertion. In terms of removal method, all 15 patients with extrauterine misplacement underwent surgical extraction by open or laparascopic method under general anesthesia, but those patients with intrauterine misplacement had their device removed after cervical dilatation with a laminaria using local anesthesia. Concerning diagnosis, 81.2% of extrauterine misplacement were diagnosed using x-ray while 58% of intrauterine misplacement were diagnosed using vaginal US. The result of the Fisher's exact test showed a significant difference (p=0.043) in the rate of diagnosis for intrauterine and extrauterine misplacement of IUDs. Also, the results of multi-variable analysis performed for logistical regression analysis showed that intrauterine misplacement occurred 1.23 times more frequently than extrauterine misplacement. CONCLUSION: Further studies are required on a broader patient population, on more types of IUDs and with time variables taken into account. Despite more research, prevention of complications such as misplacement remains the most appealing situation, being influenced by such factors as technical skill of the physician inserting the IUD, appropriate duration of insertion and proper patient education.
Anesthesia, General ; Anesthesia, Local ; Diagnosis ; Female ; Hospitals, Satellite ; Humans ; Intrauterine Devices ; Labor Stage, First ; Laminaria ; Parity ; Patient Education as Topic ; Pregnancy ; Retrospective Studies

Hai Phong currently has 20 hospitals with 3,500 beds, 9 professional centers of medical colleges, 1 secondary medical school and 2 companies with 5,711 health cadres in which medical doctors: 974, professor: 4 phylosophy doctor: 6; masters of science: 9, 1st grade medical doctor: 329 and 2nd grade medical doctor: 133. The long term stratery of Hai Phong health branch aims at redution of the morbidity and mortality rate of the microbial and parasitological infections, gradual improvement the nutritional condition, assure of the standards of the food safety and hygience and enhancement of the health care services
Health ; Hospitals, Satellite

OBJECTIVES: The purpose of study was to define the clinical and epidemiological factors of HNP and to provide the meaningful sources for establishing a prognosis and a rationale for clinical management of occupational low back problem. METHODS: This study was performed at eight branch hospitals of Catholic University of Korea and several governmental hospitals f or occupational disorders around the Kyunggi province of Korea since Jan. 1985. We analyzed the several factors about lumbar HNP through comparative study of the hospital admission series of each 200 patients in both occupation- and nonoccupation related, subjected to epidemiologic and clinical investigation, respectively. RESULTS: 1. Mean age of occupational HNP was younger(30.9+/-8.8) than non-occupational HNP(35.2+/-10.5) (p<0.05). 2. The duration of clinical symptom before admission was longer in non-occupational HNP(19.9+/-22.8 Mo.) than in occupational HNP(6.9+/-12.4 Mo.) (p<0.05). 3. The symptomatic attack before admission was more frequent in non-occupational HNP(3.7+1.9) than in occupational HNP(2.5+/-0.9) (p<0.05). 4. There were no significant differences in physical findings between two groups, except for low rate(63%) of straight leg raising test(SLR) limitation in occupational HNP compared to non-occupational HNP(83%) (p<0.05). 5. Even though The main reason for operative intervention was a failure of conservative treatment in both groups(p<0.05), extruded subligamentous type was predominant(50%) in occupational HNP(p<0.05), whereas extruded transligamentous type occupied major portion(67.8%) in non-occupational HNP(p<0.05). CONCLUSION: The clinical results were poor in occupational HNP in both conservative and operative management groups, compared to non-occupational HNP(p<0.05) and mean durations admission and re-admission rate was higher in occupational HNP, compared to non-occupational HNP (p<0.05).
Gyeonggi-do ; Hospitals, Satellite ; Humans ; Korea ; Leg ; Occupations ; Prognosis ; Spine*

We developed the Tele-PACS of radiology, which uses the communication network as asymmetric satellite data communication system. The asymmetric satellite data communication system uses receive-only satellite links for data delivery and PSTN(Public Switched Telephone Network) modem or N-ISDN(Narrow-band Integrate Services Digital Network) for communication. The satellite communication linking we implemented showed the very high-speed performance compared to the terrestrial linking such as 28.8 kbps modem linking or 56Kbps linking. The satellite linking was 5-10 times faster than the terrestrial linking on the average. We developed the down-link system of satellite and the medical collaborative tools and the Web-based Image-viewer. We concluded that 1) Satellite networking is currently the cheapest and fastest solution for internet access. 2) Web-based Image-Viewer enables small size hospitals in rural area to connect to the central PACS easily and to retrieve the image data reliably. 3) The suggested teleradiology system using satellite networking could be adequate to the fast telemedicine and telecare for rural hospitals especially located in geographically isolated areas such as islands.
Hospitals, Rural ; Internet ; Islands ; Modems ; Satellite Communications ; Telemedicine ; Telephone ; Teleradiology

We developed the Tele-PACS of radiology, which uses the communication network as asymmetric satellite data communication system. The asymmetric satellite data communication system uses receive-only satellite links for data delivery and PSTN(Public Switched Telephone Network) modem or N-ISDN(Narrow-band Integrate Services Digital Network) for communication. The satellite communication linking we implemented showed the very high-speed performance compared to the terrestrial linking such as 28.8 kbps modem linking or 56Kbps linking. The satellite linking was 5-10 times faster than the terrestrial linking on the average. We developed the down-link system of satellite and the medical collaborative tools and the Web-based Image-viewer. We concluded that 1) Satellite networking is currently the cheapest and fastest solution for internet access. 2) Web-based Image-Viewer enables small size hospitals in rural area to connect to the central PACS easily and to retrieve the image data reliably. 3) The suggested teleradiology system using satellite networking could be adequate to the fast telemedicine and telecare for rural hospitals especially located in geographically isolated areas such as islands.
Hospitals, Rural ; Internet ; Islands ; Modems ; Satellite Communications ; Telemedicine ; Telephone ; Teleradiology