Nosocomial Infection Surveillance in a Rehabilitation Hospital Affiliated University Hospital / 병원감염관리

BACKGROUND: A rehabilitation hospital has the characteristics of longer hospital stay, a variety of medical and paramedical personnels involved in treatment, and more probability of the primary care giver being a nonmedical person. The purpose of this study is to describe the characteristics of nosocomial infection in a rehabilitation hospitals METHODS: Surveillance was done in a rehabilitation hospital affiliated university hospital from June to August 1996, May to June 1997, and July to September 1999. Nosocomial infection was investigated by an infection control practitioner (JCP) according to the Center for Disease Control and Prevention (CDC)'s definitions visiting the rehabilitation wards regularly. RESULTS: The overall NI rates were 3.83 in 1996, 4.42 in 1997 and 1.91 in 1999 per 1,000 patient days, and the urinary tract infection (UTI) rates were 2.82 in 1996, 2.87 in 1997 and 1.07 in 1999 per 1,000 patient days. Both of overall NI rate and UTI rate in 1999 decreased significantly compared with that in 1996 and 1997 (P<0.001). Comparing the ward specific NI rate, the average NI rate of the spinal cord injury ward was the highest (5.67 per 1,000 patient days) and that of the pediatric rehabilitation ward was the lowest (0.83 per 1,000 patient days). UTI constituted of the largest proportion of NIs. The distribution of UTI showed a decreasing tendency from 73.47% in 1996 to 56.00% in 1999, but the distribution of gastrointestinal infection showed an increasing tendency from 4.08% and 5.40% in 1997 and 1996 to 24.00% in 1999. The commonly isolated organisms were E. coli (33.63%), Enterococcus spp. (12.73%) and C. difficile (7.27%). It reflected that the main infection was UTI. CONCLUSION: The main NI in rehabilitation hospital was the UTI. It means that the infection control program of rehabilitation hospital should be focused on the control of UTI. Surveillance in the rehabilitation hospital enabled us to describe the characteristics of nosocomial infection in the rehabilitation hospital. NI rate was decreased through continuous communications and educations with factual datum and involvement of various medical and paramedical personnels. These results show that NI surveillance is crucial for an efficient infection control program.

Reference Value of Cadmium in Myocardium in Korean / 대한산업의학회지

Cadmium(Cd) is an ubiquitous, toxic and non-essential metal which is controversial about the association with a cardiovascular disease. In this study, we investigated the reference level of Cd in myocardium in Korean general population. The level of Cd and zinc(Zn) concentration in myocardium of 252 cases of "sudden and unexpected death" autopsies(male 172, female 60) aged 0 to 87 years was analyzed. The concentration of Cd and Zn was determined with atomic absorption spectrophotometer(Perkin-Elmer Model 5100) by flameless and flame method, respectively. The content of Cd and Zn in myocardium showed the log-normal distribution rather than normal distribution. Geometric mean concentration of Cd was 0.19 microgram/g wet weight in myocardium. The level of Cd in myocardium was not significantly different between male(0. 18 microgram/g wet weight) and female(0.22 microgram/g wet weight). Geometric mean concentration of Zn in myocardium was 25.25 microgram/g wet weight. The level of Zn between male(25.13 microgram/g wet weight) and female(25.57 microgram/g wet weight) was not different. The deposit of Cd in myocardium was age-dependent of biphasic pattern, but the Zn level by age was not significantly different. The level of Cd in myocardium was increased to the fifties of age, thereafter a leveling-off was shown. The regression model of Cd deposit in myocardium by age was predicted as the following equation Log Heart-Cd = -1.2726 + 0.0234 Age - 0.0002 Age2. The maximum Cd deposit in myocardium was estimated to be 0.26 microgram/g wet weight at the age of 58.5 in Korean general population. In addition, the total Cd burden in heart by age was predicted as a following equation Total Cd burden in Heart = -10.165 + 2.891 Age - 0.0258 Age2. The maximum heart burden of Cd was estimated to be 70.7 microgram at age of 55.4. The positive correlation between Cd and Zn was observed in myocardium. The linear regression equation was Log Heart-Zn = 1.4195 +/- 0.0262- Log Heart-Cd.

The Influence of Smoking, Alcohol Ingestion, and Physical Activity on Copper, Zinc and Ceruloplasmin in Blood of Male Adults / 대한산업의학회지

Objective : To investigate the influence of smoking, alcohol ingestion, and physical activity on copper and zinc in RBC and serum and serum ceruloplasmin, this study was performed in a cross-sectional study in 113 healthy men aged 20 to 40 years who had no symptomatic liver, heart, gastrointestinal, and other chronic diseases. METHODS: At the men's entry into the study, blood samples were drawn from each subject and immediately centrifuged for analysis of copper, zinc, iron, ceruloplasmin, total cholesterol, and hematocrit. Each man completed a questionnaire that provided information on smoking, amount of alcohol intake, and physical activity. Partial regres sion analysis was performed on confounding variables such as age, body mass index, hematocrit, serum cholesterol, and serum iron. RESULTS: In general linear models, adjustment for confounding variables did not show statistical differences, and there was only an increasing tendency in serum copper in heavy smoker (P=0.0678). There was no difference between high physical activity with mild smokers and lower physical activfty with, heavy smokers. CONCLUSIONS: This study suggested that copper, zinc and eeruloplasmin were not good biomarker for early effect by smoking, alcohol intake and physical activity in young adult. However, selection bias should be considered in evaluation of this result, and a large prospective study will be needed in advance on usefulness of copper, zinc and ceruloplasmin as a marker for risk factors and early change of atherosclerosis.

A Study on Urinary Cadmium Concentration and Renal Indices of Inhabitant in an Abandoned Mine Area / 예방의학회지

Urinary cadmium is used as a sensitive indicator for internal Cd dose, and increased excretion of N-acetyl-beta-D-glucosaminidase(NAG), beta(2)microglobulin(MG) and total protein are useful indices for renal dysfunction by chronic exposure to Cd. The target group was 184 inhabitant(82 men and 102 women) in an abandoned mine area known as exposure to low level Cd. The control group was took 160 individuals(64 men and 96 women) in Cd not-exposed area. Urinary Cd concentration was significantly higher in the target group than the control. The geometric mean of urinary Cd for male was 2.56ng/l, 2.80ng/g creatinine and 2.50ng/S.G. in the target group and 1.19ng/l, 1.36ng/g creatinine and 1.17ng/S.G. in the control. For female 2.69ng/l, 3.94ng/g creatinine and 2.63ng/S.G. in the target group and 1.27ng/l, 1.97ng/g creatinine and 1.25ng/S.G. in the control, respectively. In addition, urinary Cd of the target group had affected by the period of residence and dietary habit for the rice and the vegetables from the target area. These findings suggest the chronic exposure to Cd of the target population. Mean excretion of urinary NAG, beta(2)MG and total protein were not significant between two groups. In the target group, urinary NAG activity and total protein were significantly correlated with urinary Cd, but beta(2)MG was not related. Urinary excretion of NAG, beta(2)MG and total protein were significantly increased in 10 than in <2 of urinary Cd level. In 2~10 group of urinary Cd level, the excretion of NAG significantly increased while not showed for beta(2)MG. In present study, urinary excretion of NAG was relatively sensitive than beta(2)MG in chronic exposure population to low level Cd.

Species Differences in Effect of Ethanol to Urinary Metabolites Excretion of Trichloroethylene in Mice and Rats / 예방의학회지

This study was conducted to examine the species differences in the urinary excretion of trichloroethanol(TCE-OH) and trichloroacetic acid(TCA) of trichloroethylene(TCE) metabolites and the effect of ethanol on these metabolites in mice and rats. TCE administered to Male Sprague Dawley rats and ICR mice as a single oral dose(100, 200, 500, 1,000 or 2,000 mg/kg body weight) and ethanol(3.0 g/kg body weight) was taken orally 12 hours before TCE administration. The metabolites in urine were measured 0, 12, 24, 36 and 48 hours after TCE administration. The results of metabolite excretion were as follows; Total trichlorocompounds(TTC) in urine increased with TCE dose in mice while increased only below dose of 1,000 mg/kg TCE in rats. The net excretion of TCE metabolites was significantly greater in mice than rats, although the proportion of TCE-OH to TCA was not different between mice and rats. These findings indicate that mice were internally exposed to significantly higher concentration of TCE metabolites than rats and this trend appeared to be more prominent with the increase of TCE dose. Ethanol increased significantly TCE-OH in urine of rats while the increase of TCE-OH induced by ethanol was not significant in mice, and didn't increase TCA of urine in both of rats and mice. This result suggests that the effect of ethanol on TCE metabolism may be due to the increase of TCE-OH.