• Title/Summary/Keyword: hospital infection

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'Clinical Observation for the 226 Cases of CVA' (뇌졸중환자(腦卒中患者) 226예(例)에 대(對)한 임상적(臨床的) 고찰(考察))

  • Lee, Seong-Hun;Jun, Chan-Yong;Park, Chong-Hyeong
    • The Journal of Korean Medicine
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    • v.18 no.1
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    • pp.5-24
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    • 1997
  • Clinical observation was made on 226 cases of CVA that were confirmed through brain CT, MRI scan and clinical observation. They were hospitalized in the oriental medical hospital of Kyung-Won University from January to December in 1995. 1. The CVA cases were classified into the following kinds: cerebral infarction, cerebral hemorrhage, subarachnoid hemorrhage(SAH), transient ischemic attack, and the greatest in number among them were the cases of cerebral infarction. 2. The frequency of strokes was much the same between male and female cases and most cases were over 50 of age. 3. In the case of cerebral infarction the place of the most frequent occurrences was in the MCA territory, and as for cerebral hemorrhage, in the basal ganglia area. 4. The most ordinary preceding disease was hypertension. The next was diabetes mellitus. 5. Generally it is thought that CVA occurs frequently in winter. But on the contrary this study of observation confirmed that it occurs mostly in spring and summer. 6. The predisposing factors of cerebral infarction were usually initiated during the time of resting and sleeping and those of cerebral hemorrhage chiefly during the time of exercising. 7. As concerns the course of hospitalization, most patients passed through vestern medical hospitals or oriental medical hospitals. 8. For the patients the condition of whose consciousness was bad at the time of admission. the prognosis in most cases was bad. 9. The common symptoms were motor disability and verbal disturbance. 10. With regard to cerebral infarction, the average time to start physical theraphy was 6.4 days and with cerebral hemorrhage 9.7 days after stroke. 11. The duration of hospitalization was in most cases more than one month. 12. The main complication was urinary tract infection. 13. At the time of admission to hospital, the blood pressure in most cases was high, but it well controlled at the time of discharge. 14. Most cases were given simultaneous treatment in both ways of western and oriental medicine.

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Clinical Investigation of Women with Asthma Worsened During Pregnancy (임신 중 천식의 악화로 내원한 환자의 임상적 고찰)

  • Kwon, Young-Hwan;Kim, Kyung-Kyu;Jung, Hye-Cheol;Lee, Sung-Yong;Kim, Je-Hyeong;Lee, So-Ra;Lee, Sang-Yeub;Lee, Sin-Hyeong;Cho, Jae-Yun;Shim, Jae-Jeong;Kang, Kyung-Ho;Yoo, Se-Hwa;In, Kwang-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.4
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    • pp.548-554
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    • 1999
  • Background : Asthma is the most common respiratory crisis encountered in clinical practice, occurring in up to 4% of all pregnancies. Pregnancy often appears to alter the course of asthma. But the mechanisms responsible for variable changes in the asthma course during pregnancy remain unknown. Poor control and exacerbations of asthma during pregnancy may result in serious maternal and fetal complications. To investigate the course of asthma during pregnancy in korean women, we did a retrograde study of 27 pregnant women who had been admitted to Korea University Hospital for asthma worsened. Method: Twenty seven pregnant women who had been visited to Korea University Hospital for asthma worsened were enrolled in our retrospective study. We reviewed medical recordings and interviewed patients with asthma. Results: Twenty seven pregnant women with asthma were evaluated, and 25 patients were enrolled to our study. Two patients experienced abortions at 6 weeks and 25 weeks gestation, respectively. The period of asthma worsened was commonly during weeks 20 to 28 of gestation. And all patients wosened were improved during the last 4 weeks of pregnancy. Twenty(80%) of 25 women whose asthma worsened during pregnancy reverted toward their prepregnancy status after delivery(p<0.002). The causes of asthma worsened during pregnancy are reduction or even complete cessaton of medication due to fears about its safety(40%), worsening after upper respiratory infection (28%), and unknown(32%). There were no adverse perinatal outcomes in 25 pregnant asthma subjects. Conclusions: A major problem of therapy for asthma during pregnancy is reduction or even complete cessation of medication due to fears of fetal effects. Therefore, maternal education and optimal clinical and pharmacologic management is necessary to mitigate maternal and fetal complications.

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Management of Tuberculosis Outbreak in a Small Military Unit Following the Korean National Guideline (국내 결핵관리지침에 따른 군내 결핵 집단발병 관리 사례 보고)

  • Ji, Sang Hoon;Kim, Hee Jin;Choi, Chang Min
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.1
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    • pp.5-10
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    • 2007
  • Background: Korean national guidelines for examining contacts with active pulmonary tuberculosis (TB) are a tuberculin skin test (TST) and chest radiographs. The treatment of a latent TB infection as performed only in those younger than six years of age who test positive for TST. Although there is a high incidence of active TB in young Korean soldiers, the current national guidelines for controlling contacts with active TB in soldiers are insufficient. This study highlights the problems with the Korean guidelines for controlling a TB outbreak in a small military unit. Material and Methods: In December of 2005, there was a tuberculosis outbreak in a military unit with a total of 464 soldiers in Kyung Gi province. The chest radiographs were taken of all the soldiers, and TST were carried out on 408 candidates. Results: In the first screening of the chest radiographs, two active TB patients were detected. By August of 2006, four additional cases were detected, making a total of six cases after the outbreak. All the patients showed active pulmonary TB or TB pleuritis. When the results of TST in the close contacts and non-close contacts were compared, there was a significant difference in the absolute size of the induration($9.70{\pm}7.50mm$ vs. $6.26{\pm}7.02mm$, p<0.001) as well as the ratio of patients showing an induration > 10mm (50.0% vs. 32.0%, p<0.001) and 15mm (33.2% vs. 20.9%, p= 0.005). Conclusion: Although the national guidelines for managing a TB outbreak in a military unit were followed, there were continuous instances of new active TB cases. This highlights the need for new guidelines to prevent the spread of TB.

A Survey of the Basic Protection Manners of Dental Personnels Against Hepatitis B in and around Seoul (수도권 치과의료 종사자들의 B형 간염에 대한 기초방호실태 및 수행에 관한 조사)

  • Yoon, Mi-Sook;Park, Mi-Young
    • Journal of dental hygiene science
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    • v.1 no.1
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    • pp.46-52
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    • 2001
  • The purpose of this study was to examine dental personnels' concern for health, their personal protection manner, and whether or not they were inoculated against hepatitis B and made an inquiry of patients about that. It's ultimately meant to serve as a basis for the preparation of an anti-infection guide for the protection of dental personnels against all sorts of infectious diseases. After a survey was conducted from March 29 through May 9, 2001, the following findings were obtained: (1) The dental personnel group that had worked for 5 to less than 7 years took health examination the most, with 71.4%, before joining the hospital, and 61.5% of those who had served for 9 years or more, the greatest percentage, took medical checkup after joining the hospital(P<0.05). (2) The largest percentage of being inoculated against the anti-B type hepatitis after employment was 71.4% of the dental personnels over 35, and 57.7% of those with 9-year or more working experiences. Therefore, their age and service term made a significant difference(P<0.05). (3) There was no significant gap in personal protection practices between the dental hygienists and nurse aids(P>0.05). But the use of safety goggles for treatment was not properly done, with just 1.48 on the basis of 3 points, whereas the use of mask was scored 2.40 and the use of gloves was scored 1.96. (4) After a narcotic was used once, the leftovers were wasted by 89.7% of the dental hygienists and 70.0% of the nurse aids. More dental hygienists wasted them(P<0.05). (5) For hand washing, antibiotic liquid soap was used by 19.3% of the dental hygienists and 10.0% of the nurse aids, which were both very low percentage. And just 37.2% of the dental hygienists utilized a disposable paper towel to dry their hands, and only 36.0% of the nurse aids used the same(P<0.05).

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Effect of Synagis (palivizumab) prophylaxis on readmission due to respiratory syncytial virus in very low birth weight infants (극소 저체중 출생아에서 Synagis (palivizumab) 접종이 respiratory syncytial virus 감염으로 인한 재입원에 미치는 영향)

  • Park, Soo Kyoung;Jung, Yu Jin;Yoo, Hye Soo;Ahn, So Yoon;Seo, Hyun Joo;Choi, Seo Hui;Kim, Myo Jing;Jeon, Ga Won;Koo, Soo Hyun;Lee, Kyung-Hoon;Chang, Yun Sil;Park, Won Soon
    • Clinical and Experimental Pediatrics
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    • v.53 no.3
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    • pp.358-364
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    • 2010
  • Purpose : The aim of this study was to determine the efficacy of $Synagis^{(R)}$ (palivizumab) in reducing the respiratory syncytial virus (RSV) readmission rate in very low birth weight infants (VLBWI ) and the subgroup that showed the most effective vaccination. Methods : We enrolled 350 VLBWI who had been discharged alive from the neonatal intensive care unit of Samsung Medical Center from January 2005 to December 2007 and were followed up for at least one year. A retrospective study based on medical records was performed for a period of one year after discharge. RSV readmission rate was investigated according to BPD (bronchopulmonary dysplasia, requiring oxygen at postnatal day 28) and $Synagis^{(R)}$ prophylaxis. We categorized the subgroups by the severity of BPD gestational age, and birth weight and compared the RSV readmission rates between subgroups. Results : Eleven VLBWI were readmitted. $Synagis^{(R)}$ prophylaxis resulted in a 86% reduction in the rate of readmission due to RSV infection (prophylaxis group, 0.7% and no prophylaxis group, 5.0%; P =0.02). Readmission rate in BPD patients was also reduced in the prophylaxis group (0.7% in the prophylaxis group vs. 5.2% in the no prophylaxis group, P =0.03). The readmission rate in patients without BPD was reduced in the prophylaxis group (0% in the prophylaxis group vs. 4.9% in the no prophylaxis group, P =1.00), but this was not statistically significant.Conclusion : $Synagis^{(R)}$ prophylaxis was effective at reducing RSV readmission in VLBWI. Its efficacy was verified irrespective of BPD, gestational age, or birth weight.

Clinical Characteristics of Asthmatic Patients Who Visited Emergency Room (응급실로 내원한 천식환자들의 임상적 특성)

  • Suh, Jung-Kyung;Lee, So-Ra;Lee, Sang-Youb;Lee, Sang-Hwa;Cho, Jae-Youn;Shim, Jae-Jeong;In, Kwang-Ho;Kang, Kyung-Ho;Yoo, Se-Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.2
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    • pp.290-297
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    • 1997
  • Background : Despite remarkable progress of understanding the pathophysiology and therapy of bronchial asthma, asthma morbidity and mortality are on the rise. Also hospitalization and attending rates of emergency department for asthma have been increasing gradually. We analyzed clinical characteristics and prognosis of patients who visited emergency room due to asthma attack in order to define clinical characteristics of these group of patients. Method : We reviewed 105 adult asthmatic patients who attended emergency department of Korea University Hospital between August 1995 and July 1996, retrospectively. Results : 103 patients(56 female, 47 males, mean age : 48.6 years) attended-68 self referral, 18 practitioner referral and 17 OPD transfer- and 86 patients(83.5%) were admitted. Attending emergncy department was clearly more frequent in December(13.6%) and May(12.6%). Time lag between onset of asthmatic attack and arrival at the hospital was $14.2{\pm}15.5$ hour and initial peak expiratory flow rate was $166.7{\pm}68.3L/min$.(43.3% predicted) The commonest cause for visiting emergency room was aggravation of asthma due to upper respiratory tract infection in mild asthmatics. About half of them had history of previous ER visits. Their prognosis was not bad, but after discharge, about half of patients escaped from OPD follow-up. Conclusion : As a group they merit detailed attention and follow up arrangement. Clinician need to monitor and review the treatment plans, the medications, the patient's management technique, and the level of asthma control. For this group, plans for longer term treatment, including asthma education program and adjustment of overall treatment plan should be made.

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Susceptibility tests of oral antibiotics including cefixime against Escherichia coli, isolated from pediatric patients with community acquired urinary tract infections (소아 원외 요로감염 환아에서 분리된 E. coli에 대한 cefixime을 포함한 경구 항생제의 감수성 연구)

  • Lee, Soo Young;Lee, Jung Hyun;Kim, Jong Hyun;Hur, Jae Kyun;Kim, Sun Mi;Ma, Sang Hyuk;Kang, Jin Han
    • Clinical and Experimental Pediatrics
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    • v.49 no.7
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    • pp.777-783
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    • 2006
  • Purpose : Urinary tract infection(UTI) is one of the most frequent infections in children. E. coli is the most frequent etiological micropathogen in pediatric community UTI, and E. coli has developed resistance to many antibiotics, highlighting the need for regular surveys of this organism resistant patterns in the community. The aim of this study was to determine the oral antibiotic susceptibility patterns of E. coli, isolated from pediatric patients with uncomplicated community acquired UTI. Methods : E. coli isolates, obtained from pediatric patients with uncomplicated community acquired UTI between October in 2004 to September in 2005. And minimal inhibitory concentrations(MICs) of oral aminopenicillins and beta-lactamase inhibnitors(ampicillin, amoxacillin, ampicillin-sulbactam), oral cephalosporins(cefaclor, cefixime) and sulfa drug(trimethoprime-sulfamethoxazole) were performed according to the National Committee for Clinical Laboratory Standards(NCCLS) guide line. Results : Total 211 organisms were isolated from pediatric out-patients with community UTI. E. coli was the most common organism(89 percent), followed by E. fecalis, Proteus species, S. aureus, M. morganii, and P. aeruginosa. The resistant rates of aminopenicillins and beta-lactamase inhibitors, cefaclor and sulfa drug to E. coli were very high. But, the resistant rate of cefixime was markedly low, and ESBL strains were isolated with small rates. Conclusion : Our study results suggest that aminopenicillins, cefaclor and sulfa drug may not be useful as first line empirical antibiotics to treat pediatric patients with community UTI in Korea. But, 3rd generation cephalosporin such as cefixime can be used as effective second line antibiotics after primary treatment failure, also may be useful as an empirical first line antibiotic. Finally, we conclude that a continuous surveillance study to monitor susceptibility patterns of E. coli in community UTI will be needed for the standard guide lines of empirical oral antibiotic treatment.

Usability of Urinary Reagent Strips in Diagnosis of Meningitis (뇌수막염의 진단에서 뇨검사 시험지를 이용한 뇌척수액 검사의 유용성)

  • Jeong, Jin Yeong;Park, Sang Kyu
    • Pediatric Infection and Vaccine
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    • v.4 no.2
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    • pp.265-270
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    • 1997
  • Purpose: Rapid diagnosis and prompt treatment remain the cornerstone of management of patients with meningitis. Examination of cerebrospinal fluid(CSF) for glucose, protein, cells, and organisms is necessary for accurate diagnosis, but in many parts of the world facilities do not exist to do so. We tested CSF samples from 69 children with suspected meningitis with urinary reagent strips and analyzed the results to know the usability of urinary reagent strips in diagnosis of meningitis. Methods: 69 CSF samples obtained from children with suspected meningitis were analysed. Each sample was divided into two; one was sent to the laboratory for routine diagnostic evaluation, and the other was tested with the reagent strip(Combur10 Test M). Laboratory values of CSF glucose, protein, and leucocytes for each CSF sample were plotted against the corresponding reagent-strip category. Results: There was good agreement between the dipstick and laboratory values for CSF protein and cell count but not for glucose. Conclusion: Rapid diagnosis of meningitis could be made with three component of the Combur10 test strip. It is easy to do and would be of particular value to those working in parts of the world where no laboratory facilities exist.

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Frequency of Candida Strains Isolated from Candidiasis Patients at A Tertiary Hospital over the Last 10 Years (최근 10년 동안 일개 상급종합병원의 칸디다혈증 환자에서 분리된 칸디다 균종의 빈도)

  • Hwang, Yu-Yean;Kang, On-Kyun;Park, Chang-Eun;Hong, Sung-No;Kim, Young-Kwon;Huh, Hee-Jae;Lee, Nam-Yong
    • Korean Journal of Clinical Laboratory Science
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    • v.54 no.2
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    • pp.110-118
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    • 2022
  • Candidemia is a major cause of nosocomial infections resulting in increased morbidity and mortality. It remains a serious risk in inpatients and increases medical treatment costs. From 2009 to 2018, Candida strains (3,533) isolated from blood culture tests at the S Hospital were analyzed according to the period, year, sex, age, ward, etc. During the entire period, 54,739 of 717,996 blood culture tests showed a positive rate (7.6%) and the Candida isolation rate was 3,533 (6.4%) out of 1,036 patients. Among the Candida isolates, C. albicans was most common (33.8%), followed by C. tropicalis (28.6%), C. glabrata (19.8%), C. parapsilosis (7.8%), and C. krusei (4.0%). In early (2009~2013)/late (2014~2018) isolation, C. tropicalis decreased by 3.8% and C. glabrata increased by 3.4%. After 50 years of age, the higher the separation frequency. C. parapsilosis (31.3%) in 1~10s, C. tropicalis (30.3%) and C. glabrata (27.6%) in 41~50s, and C. tropicalis (28.6%) in 80s are relatively frequent. has been separated C. krusei was isolated in a relatively high proportion from females (60.9%). Therefore, a systematic and continuous nosocomial infection control system should be established for appropriate treatment as per antifungal treatment guidelines. The system should continuously monitor the distribution of Candida species and provide rapid identification results.

Study on the Safety of Firefly Luciferase in Human as a Transient Reporter Gene of Oncolytic Virotherapy (항암 바이러스 치료제의 보고유전자로써 반딧불이 루시퍼레이즈의 인체 내 안전성에 대한 연구)

  • Hong, Young Mi;Yoon, Woong Hee;Lee, You Ra;Kim, Soo Ji;Ngabire, Daniel;Narayanasamy, Badrinath;Ornella, Mefotse Saha Cyrelle;Kim, Myunghee;Cho, Euna;Lee, Bora;Hwang, Tae-Ho
    • Journal of Life Science
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    • v.31 no.11
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    • pp.1028-1036
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    • 2021
  • Firefly luciferase (FLuc) can function as an efficient marker in the gene and viral therapies. Nonetheless, its clinical translation has been unaccomplished with the concerns on its exogenous nature and the similarity with human fatty acyl-CoA synthetase. In this study, we aimed to show safety of FLuc by conducting a set of preclinical experiments and a human use. Initially, FLuc permeability across the plasma membrane was investigated by delivering the FLuc-carrying viral vector, OTS-412, or the FLuc recombinant protein. After in vitro infection of OTS-412 into different cancer cell lines, FLuc activity was detected only in the cell lysates, but not in culture media. In addition, recombinant FLuc protein further showed the impermeability against the plasma membrane. Similar result was also observed in the in vivo experiment. After being injected into the VX2 tumor-bearing rabbit, the FLuc exclusively resided within the tumor tissue without being detected in the blood plasma or other organs. Human cancer cell lines originated from various organs were lysed and treated to the FLuc, and none of the human substrates was reactive against the FLuc. As a final step, FLuc recombinant protein was intravenously injected into a human. The luciferase was degraded with the half-life of 20 to 30 minutes in blood, and was untraceable from 1.5 hr after the injection. In addition, the blood plasma was nonresponsive against the fatty acids. Hematological analysis was also comparable between the pre- and post-injection. Altogether, our study collectively demonstrates the safety of the firefly luciferase.