BACKGROUND: Rapid and accurate identification of methicillin-resistant Staphylococcus (MRSA) is very important for patients because they are one of the most common etiologic agents of hospital infection. Conventional identification methods for MRSA are influenced by various factors such as pH, concentration of salt, conditions of media. METHODS: 53 methicillin resistant staphylococcus strains identified by ATB plus system (Biomerieux, France) were preformed the polymerase chain reaction (PCR), Southern blot hybridization fort the detection of mec A gene, and subcultured in Meuller-Hinton media containing 4 microgram/mL oxacillin for the comparison. RESULTS: The correlation of detection rate of mec A gene PCR and ATB plus systems was 81.6%. The correlation of mec A gene PCR and MRSA on Mueller-Hinton media containing 4 microgram/mL oxacillin was 80%. We confirmed by Southern blot hybridization the amplified mer A gene originated from chromosome of MRSA. As the results of oxacillin sensitivity test, minimal inhibitory concentrations of MRSA were distributed between 40 microgram/mL and 320 microgram/mL. When compared with executing time, ATB plus system took 24 hours, but PCR took 5 hours for identification. CONCLUSION: We concluded that mec A gone PCR techniques were simple and rapid for detection of MRSA comparative to conventional methods.
Blotting, Southern ; Cross Infection ; Genes, vif ; Humans ; Hydrogen-Ion Concentration ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Oxacillin ; Polymerase Chain Reaction* ; Staphylococcus

No abstract available.

No abstract available.
Female ; Pregnancy ; Pregnancy, Abdominal* ; Ultrasonics*

Gitelman's syndrome is a rare autosomal recessive, inherited renal tubular disorder, first described by Gitelman et al. in 1966, and it is characterized by hypokalemic metabolic alkalosis, hypomagnesemia, salt wasting, normal to low blood pressure and rather low urinary calcium excretion rates with elevated plasma renin activity. This syndrome is caused by inactivating mutation in the SLC12A3 gene coding for the thiazide-sensitive sodium chloride cotransporter in the distal convoluted tubule. In most of the patients with Gitelman's syndrome, the disease manifests with transient episodes of muscular weakness and tetany in the adulthood. Herein, we report a case of Gitelman's syndrome atypically presented with chest pain and syncope.
Alkalosis ; Calcium ; Chest Pain* ; Clinical Coding ; Gitelman Syndrome* ; Humans ; Hypotension ; Muscle Weakness ; Plasma ; Renin ; Sodium Chloride Symporters ; Syncope* ; Tetany ; Thorax*

No abstract available.
Humans ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis*

Hallux valgus has been defined as a static subluxation of the first metatarsophalangeal joint with lateral deviation of the proximal phalanx on the first metatarsal head from the longitudinal axis of the first metatarsal with medial deviation of the first metatarsal. And first-second metatarsal angle is increased as well as bursal hypertrophy over the medial eminence of the first metatarsal head. Many procedures have been reported for the treatment of the hallux valgus ranging from resection arthroplasty to distal first metatarsal or basal first metatarsal osteotomy. Of these, Johnson and Corless have required sufficiently good results in the modifying Mitchell osteotomy into Chevron osteotomy. The Chevron procedure is an osteotomy involving the distal portion of the first metatarsal, lateral displacement of the metatarsal head with exostosectomy, and tightening of the medial capsular structures. Authors studied 17 cases in 10 patients with the hallux valgus deformity treated by Chevron osteotomy at the Department of Orthopedic Surgery, Capital Armed Forced General Hospital from September 1987 to September 1989. The results were as follows; 1. Seven patients (12 cases) were male and three patients (5 cases) were female. All patients had bilateral hallux valgus deformity. 2. The average first-second intermetatarsal angle was 11 degrees and average valgus angle was 32 degrees, preoperatively. They were corrected to 9 degrees and 14 degrees respectively. 3. The metatarsalgia of the great toe was subsided in all cases and they were satisfied with the result of their operations in respect to cosmetically and functionally. Avascular necrosis of capital fragment, nonunion, and dorsal angulation were not developed in any case. But, one case had marginal skin necrosis, presumably due to excessive compressive dressing. 4. Chevron osteotomy is a technically easy procedure and it can be obtained early bone healing with less complication.
Arm ; Arthroplasty ; Bandages ; Congenital Abnormalities ; Female ; Hallux Valgus ; Hallux ; Head ; Hospitals, General ; Humans ; Hypertrophy ; Male ; Median Eminence ; Metatarsal Bones ; Metatarsalgia ; Metatarsophalangeal Joint ; Necrosis ; Orthopedics ; Osteotomy ; Skin ; Toes

Achilles tendon injuries are one of the most common tendon injuries in the lower extremities, but spontaneous bilateral achilles tendon rupture without any external force is extremely rare. We present a case of a patient who had spontaneous bilateral achilles tendon rupture related to multiple steroid injections for carpal tunnel syndrome in diabetes. According to this case, we suggest that we should take special precaution to use steroid to the diabetes though it is not applied to the achilles tendon directly.
Achilles Tendon ; Carpal Tunnel Syndrome ; Diabetes Mellitus ; Humans ; Lower Extremity ; Rupture ; Tendon Injuries

BACKGROUND: Intrathecal or epidural neostigmine has a postoperative analgesic effect. In this study we evaluated the effects of epidural neostigmine on postoperative analgesia and stress responses after gastrectomy. METHODS: Eighty, ASA physical status 1 or 2, patients scheduled for gastrectomy were randomly assigned to one (n = 20) of four groups. Patients received 5 ml of 0.25% bupivacaine with either saline (N0 group), neostigmine 5microgram/kg (N5 group), neostigmine 10microgram/kg (N10 group), neostigmine 15microgram/kg (N15 group) epidurally 30 minutes before operation. All patients received identical general anesthesia. Patient-controlled epidural analgesia (PCEA) was provided by bupivacaine (0.05%) and fentanyl (4 microgram/ml) for postoperative analgesia. RESULTS: The N10 and N15 groups showed reduced 24-h PCEA consumptions compared with the N0 and N5 groups (P < 0.05). No differences in visual analog pain scores at rest or during movement were observed between the groups. The concentrations of plasma cortisol, epinephrine, norepinephrine and glucose did not differ among the four groups, and their incidences of postoperative adverse effects were similar. CONCLUSIONS: Epidural neostigmine 10 and 15microgram/kg in bupivacaine produced a postoperative analgesic effect, but did not suppress stress responses after gastrectomy
Analgesia* ; Analgesia, Epidural ; Anesthesia, General ; Bupivacaine ; Epinephrine ; Fentanyl ; Gastrectomy* ; Glucose ; Humans ; Hydrocortisone ; Incidence ; Neostigmine* ; Norepinephrine ; Plasma

Fractures of C1 are not uncommon, constituting only 10% of all cervical spine injuries. There is a high prevalence of concomitant fractures of the second and first cervical vertebral complex. Surgical treatment is controversal. Mainstay of treatment is various combination of traction and cervical orthosis according to degree of displacement and location of fracture. We experienced unusual type of fracture, anterior arch fracture of C1 who had a history of total laminectomy of C1,2 due to cervical cord tumor(neurilemmoma arising from C2 root). We performed C1,2 lateral mass screw fixation with posterior fusion with good postoperative outcome.
Laminectomy ; Orthotic Devices ; Prevalence ; Spine ; Traction

No abstract available.
Survival Rate* ; Uterine Cervical Neoplasms*