BACKGROUND: Neurosurgical site infection may have serious sequelae, especially that occurring after craniotomy. A nationwide prospective multicenter study was performed in Korea to determine the incidence and risk factors for surgical site infections (SSI) after craniotomy. Methods: We collected demographic data, clinical and operative risk factors for SSI, and information regarding the antibiotics administered for the patients who underwent craniotomy in 17 hospitals between July and December of 2008. All the data were collected using a real-time web-based reporting system. RESULTS: Of the 1,020 patients who underwent craniotomy, 31 (3%) developed SSI, including 4 with superficial incisional SSI, 2 with deep incisional SSI, and 25 with organ/space SSI. The SSI rate was predicted on the basis of the National Nosocomial Infections Surveillance (NNIS) risk index. The SSI rate of 3.1%, 3.3%, and 1.8% were ascribed NNIS scores of 0, 1, and 2, respectively. The independent risk factors for SSI identified were postoperative cerebrospinal fluid leakage (odds ratio, 12.13; 95% confidence interval, 4.54-32.42) and preoperative Glasgow coma scales score < or =8 (odds ratio, 2.35; 95% confidence interval, 1.07-5.18). Third generation cephalosporins were the most frequently (in 65.6% of the cases) used for prophylaxis. CONCLUSION: A multicenter SSI surveillance system for craniotomy was first established in Korea. The NNIS risk index was not effective in identifying the patients at risk. We required to further analyze a large number of SSI cases to correctly identify the risk factors for SSI after craniotomy.
Anti-Bacterial Agents ; Antibiotic Prophylaxis ; Cephalosporins ; Coma ; Craniotomy ; Cross Infection ; Humans ; Incidence ; Korea ; Prospective Studies ; Risk Factors ; Weights and Measures

OBJECTIVE: To evaluate the clinical outcome and characteristics of laparoscopy assisted vaginal hysterectomy (LAVH) in gynecologic patients. METHODS: From September, 2001 to February, 2004, total 570 cases of patients were performed LAVH at Gacheon medical school Ghil Hospital. We reviewed medical records and analyzed these cases about age, parity, weight, previous surgery history, operation indication, operation outcome, duration of hospitalization and complication. RESULTS: The results of this study summarized as follows. The mean age of patients was 46.4 +/- 7.2 years old. Average parity of patients was 2.4 +/- 1.4. Average weight of patients was 63.4 +/- 8.2 kg. Previous operation history was 195 cases (34.2%). Most common operation indication was uterine leiomyoma, followed by adenomyosis, combination of leiomyoma and adenomyosis and endometriosis. The mean operation time was 72 +/- 20.6 minutes. The mean duration of hospitalization was 4.5 +/- 0.6 days. The major complication of operation was trocar site bleeding, followed by bladder injury, bowel injury, and ureteral injury. CONCLUSION: LAVH is safe and useful. So it is recommendable to gynecologic patients.
Adenomyosis ; Endometriosis ; Female ; Hemorrhage ; Hospitalization ; Humans ; Hysterectomy, Vaginal* ; Laparoscopy* ; Leiomyoma ; Medical Records ; Parity ; Schools, Medical ; Surgical Instruments ; Ureter ; Urinary Bladder

PURPOSE: This study was done to investigate sleep patterns and utilization of the charcoal eyepatch in high school students through a survey research. METHOD: The participants in this study were 80 students in a high school in Seoul. The period of data collection was from July 1, 2002 to 15, 2002. The research instruments used in this study were the measures of sleep and SPSSWIN 10.0 Program was used for data analysis. RESULT: The students went to bed after 12 p.m., but many of them easily fell asleep within 5 minutes. They woke up quite early at around 4 to 6 o'clock in the morning but remained in bed 1 hour. Satisfaction with their sleep was the response for 38.8% of the students. While 77% napped, they generally did so in the afternoon and 38.8% napped for half an hour. As for quality of sleep, 2.5% of the students could not sleep deeply, and 21.7% woke frequently during sleep. Their sleep environments were calm and comfortable, and they turned off the light when sleeping. The utilization of the charcoal eyepatch was effective for sleep, fatigue and powerlessness in high school students. CONCLUSION: Utilization of the charcoal eyepatch was effective for sleep in high school students and while the utilization of charcoal is recommended in life, the effect of charcoal must be testified through research.
Charcoal* ; Data Collection ; Fatigue ; Humans ; Seoul ; Statistics as Topic

OBJECTIVE: Fragile X syndrome is the most common form of familial mental retardation, attributable to (CGG)n expansion in the FMR1 gene. This study was undertaken to ascertain the distribution of FMR1 CGG repeat in the general Korean women and to identify ethnic difference in FMR1 CGG repeat number. Material and METHOD: Between January 1999 and December 1999, we evaluated 1,000 low risk women who visited Gachon Medical School Hospital. DNA samples were extracted from the venous bloods by routine methods, and G-C specific Polymerase Chain Reaction (PCR)s were performed to evaluate FMR1 CGG repeat number. RESULTS: Mean FMR1 CGG repeat number was 26.9 (6-50), single PCR bands were detected in 776 cases (77.7%). There were two more bands in 22.3% of the cases. Most of the cases are located between 21 and 35 repeats, especially 21-25 repeats. The pattern of distribution of CGG repeat is dispersed. In 13 cases, we could not obtain the PCR results. CONCLUSION: Low risk of transmission rate of the FRX in Korea can be expected.
Alleles* ; Blotting, Southern ; DNA ; Female ; Fragile X Syndrome ; Humans ; Intellectual Disability ; Korea ; Polymerase Chain Reaction ; Schools, Medical

PURPOSE: Anti-insulin antibodies develop within several months of initiation of insulin therapy in most of diabetic patients. The purpose of this study is to observe the relationship between the clinical factors and development of anti-insulin antibody METHODS: Serum was collected from 116 diabetic patients and 47 nondiabetic children for the measurement of anti-insulin antibody titer by radioimmunoassay (RIA). Retrospective analysis of the medical records of clinical factors were evaluated. RESULTS: There was no relationship of anti-insulin antibody titer with age, duration, HbA1c, insulin dose, and BMI in diabetic children. There was no difference in anti-insulin antibody titer according to the sex, the presence of family history, the presence of DKA, the presence of complications, the presence of puberty, species of insulin, duration of disease in diabetic children. The titers of anti-insulin antibody were significantly higher in type 1 diabetic children(30.3+/-17.9% in type 1 and 16.5+/-7.0% in type 2, P<0.05), in which the daily insulin doses were significantly higher than in type 2 DM patients. Additionally, anti-insulin antibody titers were significantly lower in well-controlled DM patients (HbA1c<7%), in which daily insulin doses also were significantly lower than in DM patients whose HbA1c>7%. The positive rates of anti-insulin antibody were higher in male patients with diabetes(73.2% in male and 53.3% in female, P<0.05). The positive rates of anti-insulin antibody were significantly higher in DM patients without diabetic ketoacidosis at DM onset than in DM patients with diabetic ketoacidosis at DM onset & also were higher in poorly-controlled group(HbA1c>7%). CONCLUSION: The results suggests that anti-insulin antibody developed more likely in type 1 DM and less likely in DM patients whose control had been good and who used less insulin doses, which remains to be studied further with more patients for longer duation.
Adolescent ; Antibodies ; Child* ; Diabetic Ketoacidosis ; Female ; Humans ; Insulin ; Male ; Medical Records ; Puberty ; Radioimmunoassay ; Retrospective Studies

BACKGROUND: Onychomycosis, especially toenail onychomycosis has become one of the common fungal infection and has historically been regarded as a cosmetic rather than medical problem by many patients, even by physicians. Recently, however, there are several reports that this is a refractory disease which may cause a deleterious effect on patients' quality of life (QOL). OBJECTIVE: The purpose of this study was to investigate the impact of toenail onychomycosis on QOL in Korea and to assess the changes of QOL after treatment. METHODS: Total 1004 patients with toenail onychomycosis which was confirmed by clinical findings and KOH preparation were enrolled at 47 dermatologic centers in Korea, and interviewed with standardized QOL questionnaire before and after systemic antifungal treatment. Responses to the questionnaire were scored by f-point scale (0~4) and averaged, and were analyzed for 5 dimensions of emotional impact, social impact, symptom and functional impact, patients' views concerning treatment, and relationship with doctor. RESULTS: 1. Before and after treatment, the most serious impact was emotional dimension showing 1.90 and 1.30 in average score (AS), and social (AS: 1.14 and 0.83) and symptom and functional impact (AS: 1.05 and 0.92) was also affected. 2. In female rather than male, statistically more significant impact on patients' QOL was observed in all dimensions. 3. After treatment, 3 of 5 dimensions were improved significantly - emotional dimension (AS: from 1.90 to 1.30), social dimension (AS: from 1.14 to 0.83), patients' view concerning treatment(AS: from 1.34 to 1.02) 4. The degree of patients' satisfaction at the therapeutic effect was very high - 62.4% (immediately after. treatment) and 65.8% (9 months after initiation of treatment) of patients answered excellent or good. CONCLUSION: This study confirms that toenail onychomycosis has significant Impact on the overall QOL of patients. Also the effect of antifungal therapy on patients' QOL were satisfactory. Therefore, both doctor and patient should pay more attention to the treatment of onychomycosis.
Female ; Humans ; Korea* ; Male ; Nails* ; Onychomycosis* ; Quality of Life* ; Social Change ; Surveys and Questionnaires

BACKGROUND: The cases of Methicillin-Resistant Staphylococcus aureus(MRSA) infection after middle ear surgery, most of which are thought to be hospital acquired infection, are increasing recently in our hospital. MRSA infection is apt to be long lasting and to bring many complications because MRSA is resistant to aminoglycosides and cephalosporin as well as methicillin. There are many reports that medical personnel have a role to transmit that organisms to other patients. OBJECTIVES: To find and eradicate infection source and transmission route are both essential because medical personnel who contact MRSA infected patients can be a continuing transmission route. MATERIALS AND METHODS: Bacterial cultures from the noses and hands of medical personnel working in the department of Otolaryngology of Korea University Hospital were done and ribotyping through Southern blot technique was used to compare and prove an identical strain of MRSA organism between medical personnel and patients. RESULTS: As a result of ribotyping with EcoRI and HindIII, one distinct subtype(type I) was identified to be shared between medical personnel and patients. Among 30 medical personnel, 10 were carriers of MRSA. Seven MRSA isolates from these 10 medical carriers and 18 from 30 isolates of otorrhea shared the same type I ribotype. CONCLUSION: This finding reveals that MRSA transmission could occur between medical personnel and patients. Medical personnel should be aware of their possible role as a relay-stay of transmission of pathogenic organisms and should give efforts to prevent it.
Aminoglycosides ; Blotting, Southern ; Ear, Middle* ; Hand ; Humans ; Korea ; Methicillin ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Nose ; Otolaryngology ; Ribotyping ; Staphylococcus

PURPOSE: To improve treatment modality and results by analysis of clinical characteristics. local control, survival and resurrence rate in limited stage small cell lung cancer. METHODS AND MATERIALS : 26 patients with limited stage small cell lung cancer were treated with combined radiation and chemotherapy from Feb. 1986 to Dec. 1992 at the National Medical Center. We followed up on 21 patients (81%) , who were mostly irradiated with 4,000-5,000cGy (75% of all patients) in the results by the analysis retrospectively. Survival rate was evaluated by the Kaplan-Meier method. RESULTS: Mean survival of irradiated patients with limited small cell lung cancer was 12 months. 1-year and 2-year survival rate were 65.3% and 15.4%. Tumor response rate and median survival after combined chemotherapy and irradiation were the following ; 50% and 15 months of complete response, and 23% and 11 months of partial response respectively. Response rates by radiation dose were 66% for below 4,000cGy. 69% for between 4,000-5,000cGy and 86% for above 5,000cGy. 21 of all patients showed treatment failure(81%), which as appeared 9 of local failure.9 of distant failure and 3 of local and distant failure. CONCLUSION: Local response rate after induction chemotherapy alone in limited stage of small cell lung cancer was 54%. Furthermore it was increased to 73% after adding of radiation. We have to increase radiation dose above 5,000cGy and need to try new effective chemotherapy agents for the improvement of local control and survival rate and also will try concurrent chemoradiotherapy in near time.
Chemoradiotherapy ; Drug Therapy ; Humans ; Induction Chemotherapy ; Retrospective Studies ; Small Cell Lung Carcinoma* ; Survival Rate*

The retrospective analysis was performed on 37 patients with stage III non small cell lung cancer who received the radiotherapy from Feb. 1986 to Dec. 1990 at the Dept. of Radiation Oncology, National Medical Center. This analysis, with 29 patients (78.4%) having been followed from 10 to 60 months, was done to know the survival rate and significant prognostic factor. The actuarial 2, 5-year survival rates were 20.6%, 6.9% in our all patients and Median survival time was 10 months. Of patients with KPS(Karnofsky performance status) greater than 80%, the 2, 5 year survival rate and median survival time were 29.2%, 9.7% and 13 months, respectively. The 2-year survival rate and median survival time of patients with KPS less than 80% were 13.7% and 7 months, respectively. The survival difference according to performance status was statistically significant(29.2% vs. 13.7%)(p<0.05). In stage IIIa, the 2, 5-year survival rate and median survival rate and median survival time were 29.2%, 9.7% and 12 months, respectively. The 2-year survival rate and metian survival time of stage IIIb were 8.6% and 10 months, respectively. The survival difference between stage IIIa and IIIb did not show statistical significance(p>0.1). Of the prognostic factors, the difference of survival rate by initial performance status was statistically significant (p<0.05). But the difference of survival rates by pathologic cell type, stage, total radiation dose, radiotherapy response, and combination with chemotherapy were not statistically significant.
Carcinoma, Non-Small-Cell Lung* ; Drug Therapy ; Humans ; Radiation Oncology ; Radiotherapy ; Retrospective Studies ; Small Cell Lung Carcinoma ; Survival Rate

Carcinosarcoma is a rare malignant neoplasm consisting of both epithelial and nonepithelial components, that is, carcinoma and sarcoma in the same tumor. Since Queckenstedt reported the case of carcinosarcoma of the stomach in 1904, only 30 cases have been reported. We present a case of carcinosarcoma and adenocarcinoma of the stomach in 63-year-old man with the review of the literature.
Adenocarcinoma* ; Carcinosarcoma* ; Humans ; Middle Aged ; Sarcoma ; Stomach*