• Tuberculosis and Respiratory Diseases
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• v.76 no.2
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• pp.80-83
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• 2014

Patients with acquired immunodeficiency syndrome (AIDS) are at higher risks of bacterial pneumonia than the general population, and the pathogen is the most commonly involved Streptococcus pneumoniae. We hereby report a case of pneumococcal pneumonia associated with leptomeningitis, osteomyelitis and epidural abscess in a patient with AIDS. He is being successfully treated with ampicillin/sulbactam and clindamycin. And because the pneumococcal infection is usually associated with morbidity and mortality rates in the setting of AIDS, we should consider for pneumococcal vaccinations among the AIDS populations.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.6
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• pp.540-544
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• 2004

The oral lesion of acquired syphilis - primary, secondary, and tertiary - is comparatively rare. Most of the time secondary syphilis manifests itself as a systemic disease with maculopapular eruptions of the skin, generalized lymphadenopathy, fever, and occasional eruptions on the mucous membranes. The lesions of the tertiary stage may occur anywhere in the body, including the oral cavity. Necrotizing faciitis of the head and neck is an uncommon, rapidly spreading soft tissue infection of polymicrobial origin characterized by extensive necrosis and gas formation in the subcutaneous tissue and superficial fascia. This is characterized by its fulminating, devastating, and rapid-progressing course. The mortality rate is high if it is not treated promptly and vigorously. Patients with an impaired immune system and those with small-vessel disease such as diabetes mellitus are more prone to develop this infection.

• Journal of Korean Society for Atmospheric Environment
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• v.12 no.3
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• pp.315-322
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• 1996

Recently, hospital acquired infections have an increase interest as a public problems, which are caused of indoor pollutants in hospital. Microorganisms, ethylene oxide, formaldehyde, and anesthetic gases are main hazardous pollutants in hospital. The possible pathways of the infection are a respiratory channel as well as a blood channel. The blood channel is concerned since these pollutants might be dissolved into the Ringer's solution. The objective of this research was to evaluate the removal efficiencies of adsorption trap for formaldehyde and microorganisms as indoor pollutants which permeated into the Ringer's solution. Dissolved formaldehyde in the solution was increased with the injection dose time. The amount of dissolved formaldehyde was 67.5 $\pm$ 9.5% in Ringer's solution when injection dose time was controlled about 7hrs. An adsorption trap was designed for preventing formaldehyde and microorganisms to be permeated into Ringer's solution. The adsorption trap was packed with 0.4g of active carbon (60/80 mesh) in a sterilized plastic tube (7.79 cm length, 0.46 cm i.d.) and both ends were packed with glass wool. Devised infusion set equipped with the adsorption trap showed 99.9% of removal efficiency for formaldehyde. Microorganism numbers detected on sterilized water for injection and 5% dextrose infusion used in the hospital were 2,695 $\times 10^3$ cells/l and 4,190 $\times 10^3$ cells/l, respectively. Removal efficiency by the adsorption trap was 92.3 $\pm$ 8.5% as for microorgnisms.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.19 no.2
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• pp.96-103
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• 2016

Helicobacter pylori infection is acquired mainly during childhood and causes various diseases such as gastritis, peptic ulcer disease, mucosa-associated lymphoid tissue (MALT) lymphoma, and iron deficiency anemia. Although H. pylori infection in children differs from adults in many ways, this is often overlooked in clinical practice. Unlike adults, nodular gastritis may be a pathognomonic endoscopic finding of childhood H. pylori infection. Histopathological findings of gastric tissues are also different in children due to predominance of lymphocytes and plasma cells and the formation of gastric MALT. Although endoscopy is recommended for the initial diagnosis of H. pylori infection, several non-invasive diagnostic tests such as the urea breath test (UBT) and the H. pylori stool antigen test (HpSA) are available and well validated even in children. According to recent data, both the $^{13}C$-UBT and HpSA using enzyme-linked immunosorbent assay are reliable non-invasive tests to determine H. pylori status after eradication therapy, although children younger than 6 years are known to have high false positives. When invasive or noninvasive tests are applied to children to detect H. pylori infection, it should be noted that there are differences between children and adults in diagnosing H. pylori infection.

• Tuberculosis and Respiratory Diseases
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• v.69 no.6
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• pp.450-455
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• 2010

Background: High cortisol levels are frequently observed in patients with severe infections are of prognostic value in sepsis. The aim of this study was to evaluate the clinical usefulness of serum cortisol in assessment for the severity of community-acquired pneumonia (CAP). Methods: This study analyzed the results of 52 CAP subjects admitted in Changwon Fatima Hospital between July 2008 to May 2010. Total serum cortisol, infection markers such as C-reactive protein (CRP), procalcitonin (PCT) and CURB (Confusion, Uremia, Respiratory rate, Blood pressure)-65 were examined retrospectively. Results: In clinically unstable subjects on admission day 4, baseline serum cortisol, CURB-65, and CRP were elevated significantly compared to those of stable subjects. Area under curve (AUC) of cortisol, CRP, and CURB-65 from ROC curves were 0.847, 0.783, and 0.724 respectively. In the subjects with serum cortisol ${\geq}22.82{\mu}g/dL$, CRP, PCT, CURB-65 score, and mortality were significantly elevated. Conclusion: These findings suggest that measurement of serum cortisol in early stage may provide helpful information in the assessment of CAP severity.

• The Journal of Korean Academic Society of Nursing Education
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• v.23 no.4
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• pp.378-388
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• 2017

Purpose: The aim of this study was to identify the status of performance on standard precautions among nursing students and to examine the mediating effects of internal health locus of control on the relationship between awareness and performance on standard precautions of hospital-acquired infection control. Methods: The participants in this study were 134 nursing students. The measurements included a standard precautions awareness and performance scale, and a multidimensional health locus of control scale. Data were analyzed using independent t-test, one-way ANOVA, $Scheff{\acute{e}}$ test, Pearson correlation coefficient, and simple and multiple regression techniques. Mediation analysis was performed by the Baron and Kenny's method and Sobel test. Results: The mean score of standard awareness, standard performance, and internal health locus of control about standard precaution were $174.30{\pm}9.08$; $169.48{\pm}12.04$; and $20.43{\pm}2.82$; respectively. There was a positive correlation between standard awareness and performance (r=.414, p<.001). Also, standard awareness was significantly correlated with internal health locus of control (r=.413, p=.014). Internal health locus of control showed partial mediating effects in the relationship between awareness and performance. Conclusion: The results indicate a need to improve the internal health locus of control of nursing students. Therefore, an internal health locus of control improvement program should improve performance on standard precautions for patients and themselves.

• Quality Improvement in Health Care
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• v.21 no.1
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• pp.36-49
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• 2015

In Intensive Care Units (ICUs), where severely ill patients are treated, importance of reducing Hospital Acquired Infection (HAI) cannot be overstated. One of the simplest and most effective actions against HAI is proper hand hygiene (HH) behavior of Health Care Workers (HCWs). However, compliance varies across different cultures and different job types of HCWs (physicians, residents and nurses). This study aims to understand determinants of HH behavior by HCWs' job types in Korea. Qualitative analysis was performed based on Reasoned Action Approach style interviews with staff physicians, residents and nurses across 7 teaching hospitals. We found that all HCWs strongly believe HH is important in reducing HAI. There were, however, job type-specific HH behavior modifying factors; staff physicians stated feeling pressure to be HH behavior role model. Residents identified Quality Improvement team that measured compliance as a facilitator; a notable barrier for residents was senior physicians not washing their hands, because they were afraid of appearing impudent to their seniors. Nurses designated their chief nurse as a key referent. All participants mentioned heavy workload and lack of access to alcohol-based sanitizer as situational barriers, and sore and dry hand as deterrents to HH compliance.

• Childhood Kidney Diseases
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• v.23 no.1
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• pp.43-47
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• 2019

Atypical hemolytic uremic syndrome (aHUS), a rare form of thrombotic microangiopathy, is distinguished from the typical form by the absence of a preceding verotoxin-producing Escherichia coli infection. Notably, aHUS occurs in association with genetic or acquired disorders causing dysregulation of the alternative complement pathway. Patients with aHUS may show the presence of anti-complement factor H (CFH) autoantibodies. This acquired form of aHUS (antiCFH-aHUS) primarily affects children aged 9-13 years. We report a case of a 13-year-old Lao girl with clinical features of aHUS (most likely anti-CFH-aHUS). The initial presentation of the patient met the classical clinical triad of thrombotic microangiopathy (microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury) without preceding diarrheal illness. Low serum levels of complement 3 and normal levels of complement 4 indicated abnormal activation of the alternative complement pathway. Plasma infusion and high-dose corticosteroid therapy resulted in improvement of the renal function and hematological profile, although the patient subsequently died of infectious complications. This is the first case report that describes aHUS (possibly anti-CFH-aHUS) in Laos.

• Tuberculosis and Respiratory Diseases
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• v.55 no.6
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• pp.579-588
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• 2003

Background : The hospital-acquired pneumonia is the most common nosocomial infection. Recently, the Acinetobacter baummannii infections are rapidly increasing, especially the frequency of Multi-drug resistant A. baumannii. Therefore we assessed clinical features and prognosis of patients in the ICU with Multi-drug resistant A. baumannii from the sputum culture using the Clinical Pulmonary Infection Score(CPIS). Method : The medical records of 43 patients with Multi-drug resistant A. baumannii from sputum culture who were suspected had clinically pneumonia and admitted to the ICU from January 2000 to July 2002 were retrospectively analyzed. Results : 19 patients were CPIS greater than 6 and 24 patients were CPIS less than or equal to 6. Mean age for the former was $71{\pm}11$ years old, and the latter was $61{\pm}19$ years old. The mean APACHE II score on admission and on sputum study was not different between two groups($17.4{\pm}5.7$ vs $18.5{\pm}6.1$, p=0.553, $20{\pm}6$ vs $17{\pm}8$, p=0.078). But the mortality rate was 73.7% for the former, and 16.7% for the latter(p<0.001). Conclusion : In ICU patients who had clinically suspected pneumonia with sputum culture positive for Multi-drug resistant A. baumannii, the mortality was significantly higher if CPIS was greater than 6.

• Journal of Microbiology and Biotechnology
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• v.23 no.2
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• pp.267-273
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• 2013

Multiplex RT-PCR was used to detect respiratory viruses in 5,318 clinical samples referred to the laboratory of a tertiary teaching hospital from December 2006 to November 2010. The acquired data were analyzed with respect to types, ratio, and co-infection trends of infected respiratory viruses. Trends in respiratory viral infection according to sex, age, and period of infection were also analyzed. Of the 5,318 submitted clinical samples, 3,350 (63.0%) specimens were positive for at least one respiratory virus. The infection rates were 15.8% for human rhinovirus, 14.4% for human respiratory syncytial virus A, 9.7% for human respiratory syncytial virus B, 10.1% for human adenovirus, 5.4% for influenza A virus, 1.7% for influenza B virus, 4.7% for human metapneumovirus, 2.3% for human coronavirus OC43, 1.9% for human coronavirus 229E/NL63, 3.7% for human parainfluenza virus (HPIV)-1, 1.1% for HPIV-2, and 5.3% for HPIV-3. The co-infection analysis showed 17.1% of double infections, 1.8% of triple infections. The median age of virus-positive patients was 1.3 years old, and the 91.5% of virus-positive patients were under 10 years old. Human respiratory syncytial virus was the most common virus in children < 5 years of age and the influenza A virus was most prevalent virus in children over 5 years of age. These results help in elucidating the tendency of respiratory viral infections.