Reviewing the results of the blood cultures performed at Yeungnam University Hospital during 4-year-period through January, 1, 1984 to December 31, 1987, the following results were obtained. 1) Out of 8083 blood specimens cultured microorganisms grew in 582 specimens with positivity rate of 7.20%. Polymicrobial bacteremia was found in 16 patients. 2) Among 582 positive specimens, Gram-positive cocci grew in 189 specimens, and Gram-negative bacilli, in 393 specimens. Clinically significant microorganisms consisted of 82 Staphylococcus aureus, and 20 Streptococcus species in Gram-positive cocci group, 80 Salmonella typhi, 72 Escherichia coli, 72 Salmonella paratyphi A in Enterobacteriaceae, and 46 Pseudomonas cepacia, and 16 Pseudomonas aeruginosa in glucose non-fermenting microorganisms. 3) Increasing incidence of Serratia, Acinetobacter and Pseudomonas species as major nosocomial infection source is noteworthy. They showed increased tendency from 6.3% of 1984 to 17.7% of 1987 of total positive blood cultures. 4) High isolation rate of Pseudomonas species and Aeromonas hydrophila was noted in summer, while Salmonella typhi showed high prevalence from May to September and in January. 5) In susceptibility tests of isolated organisms, staphylococcus aureus was sensitive to basic antimicrobial agents except for ampicillin. The glucose non-fermenting microorganisms showed high resistance to basic antimicrobial agents in 32.2%. In conclusion, considering the relatively higher incidence of growth of Staphylococcus epidermidis than ideal level indicates that sampling technique should be improved. Secondly, all the hospital staffs in cooperation with Hospital Infection Committee are desirable to pay efforts to decrease the nosocomial infection.
Acinetobacter ; Aeromonas hydrophila ; Ampicillin ; Anti-Infective Agents ; Bacteremia ; Burkholderia cepacia ; Cross Infection ; Enterobacteriaceae ; Escherichia coli ; Glucose ; Gram-Positive Cocci ; Humans ; Incidence ; Prevalence ; Pseudomonas ; Pseudomonas aeruginosa ; Salmonella paratyphi A ; Salmonella typhi ; Serratia ; Staphylococcus aureus ; Staphylococcus epidermidis ; Streptococcus

It is now generally accepted that most, if not all, colon cancers originate within previously benign adenomas. Endoscopic polyp resection and regular follow up endoscopic examination are essential for prevention of carcinoma fro benign adenoma. However, small colorectal polyps are difficult to recognize during follow up endoscopic examinations because of the lack of reliable endoscopic landmarkers. Endoscopic Indiaink marking of the colon was first described by Ponsky and King in l975. The method has subsequently been advocated by expert as the best available means to mark the site of a colonic lesion. We prospectively studied the effectiveness of India ink as a long term colonic mucosal marker. Twelve patients who were diagnosed as colorectal polyp had a India ink marking with standard sclerotherapy needle. All patients who were followed at 6 months interval (mean duration 13 months) continue to display intensely stained mucosa at the original sites. No side effects or complications were encountered. India ink appears to be a safe and effective long term marker for colonic mucosal lesions.
Adenoma ; Colon* ; Colonic Neoplasms ; Follow-Up Studies ; Humans ; India* ; Ink* ; Mucous Membrane* ; Needles ; Polyps ; Prospective Studies ; Sclerotherapy

BACKGROUND: Do-Not-Resuscitate(DNR) order has been used without specific legislation commonly in hospitals of Korea. We designed this study to assess the current use of DNR order in the emergency department and to make a database for establishing a policy for DNR order, especially in ER. METHODS: We retrospectively reviewed medical records of 164 patients who expired in the emergency department of Severance hospital from Sep. 1996 to Aug. 1997. We evaluated age, sex, diagnosis, specific department involved, whether written orders were made and medical care after decision of DNR. The patients were divided into 2 groups : DNR vs CPR. To determine factors influencing DNR decision, we searched for presence of malignancy, irreversible shock, unconsciousness and chronic illness. The logistic regression analysis was used for statistical significance. RESULTS: We found that 102(62.2%) out of 164 expired patients had a DNR order. But only in 59% of cases, were written DNR order on the chart. Factors which had the most influence on decision of DNR were malignancy and age. The sex, chronic illness, irreversible shock, and unconsciousness were not significant factors. CONCLUSION: We found malignancy and old age as an important factor when DNR order had been made. But further evaluation of other factors may be necessary to establish definitely a policy for DNR order.
Cardiopulmonary Resuscitation ; Chronic Disease ; Diagnosis ; Emergency Service, Hospital ; Humans ; Korea ; Logistic Models ; Medical Records ; Retrospective Studies* ; Shock ; Unconsciousness

BACKGROUND: The purpose of this study was to determine the tibial fixation strength provided by different intraosseous soft tissue graft lengths within the tibial tunnel. METHODS: Porcine tibial bones and digital flexor tendons were used for testing. Bone mineral densities of proximal tibial medial condyles were measured, and two-strand tendon bundles of 8 mm diameter were used. An intraosseous graft length of 2 cm was used in group 1 (n = 10), and a graft length of 4 cm was used in group 2 (n = 10). Tunnels were 4 cm in length and 8 mm in diameter. Tibial fixation was performed using a suture tied around a screw post with a washer and an additionally inserted 7 x 20 mm bioabsorbable screw. After applying preconditioning loading of 10 cycles, 1,000 cycles between 70-220 N were applied at a frequency of 1 Hz. Graft slippage and total graft movement were recorded. Ultimate tensile strength was measured by pull-out testing at an Instron crosshead speed of 1,000 mm/min. RESULTS: No significant intergroup difference was found for total graft movement after cyclic loading (slippage in group 1, 1.2 mm and group 2, 1.2 mm, respectively, p = 0.917; and total graft movement in group 1, 3.3 mm and group 2, 2.7 mm, respectively, p = 0.199). However, mean ultimate tensile strength in group 2 was significantly higher than that in group 1 (group 1, 649.9 N; group 2, 938 N; p = 0.008). CONCLUSIONS: In a porcine model, ultimate tensile strength was greater for a 4 cm long intraosseous flexor tendon in the tibial tunnel. However, no intergroup difference in graft slippage or total graft movement was observed. The results show that a 2 cm intraosseous graft length in the tibial tunnel is safe and has sufficient strength (> 450 N) for adequate rehabilitation after anterior cruciate ligament reconstruction.
Animals ; Anterior Cruciate Ligament/injuries/*physiopathology/surgery ; *Anterior Cruciate Ligament Reconstruction ; Biomechanical Phenomena ; Bone Density ; Models, Animal ; Swine ; Tendons/*transplantation ; Tensile Strength ; Tibia/*surgery

Pure red cell aplasia in uncommon disorder characterized by finding of anemia, absence of nucleated red blood cell in the marrow, absence of reticulocytes in the peripheral blood and normal peripheral platelet and leukocytes counts. We experienced one case of pure red cell aplasia associated with hemolytic anemia characterized by hemoglobinuria, reticulocytopenia, and erythroid hypoplasia of the bone marrow. The cause of the illness was not definitely identified, but we concluded that this patient had simultaneous occurrence of PRCA and hemolytic anemia following administration of diphenylhydantoin after craniotomy rather than virus or bacteria induced. The simultaneous occurrence of PRCA and hemolytic anemia in uncommon and the mechanism for diphenylhydantoin induced PRCA and hemolytic anemia is unclear.
Anemia ; Anemia, Hemolytic ; Bacteria ; Blood Platelets ; Bone Marrow ; Craniotomy ; Erythrocytes ; Hemoglobinuria ; Humans ; Leukocytes ; Phenytoin ; Red-Cell Aplasia, Pure* ; Reticulocytes

PURPOSE: Free radicals are defined as any species capable of independent existence that contains one or more unpaired electrons and they have the effects on carcinogenesis and tumor progression by causing mutations on genetic structure or suppressing repair of mutated DNA. This study was aimed to identify changes of antioxidant capacity in carcinogenesis and tumor progression of colorectal cancer (CRC). METHODS: We studied the level of serum antioxidant capacity using ABTS technique for 34 CRC patients who were operated between July 1997 and January 1998 at department of surgery, Taegu Catholic Medical Center and compared with 38 persons who had normal value of liver function during the same period. RESULTS: CRC patients showed decreased serum antioxidant capacity level compared to that of control group (CRC male 1.23 0.15 mmol/L, CRC female 1.11 0.13 mmol/L, control male 1.40 0.15, control female 1.35 0.11 mmol/L). Changes of antioxidant capacity levels were not correlated with stages, even though the marginal difference between T-stages (T1/2 1.23 0.10 mmol/L, T3/4 1.16 0.15 mmol/L). CONCLUSIONS: Free radicals may be the causative agent of colorectal carcinogenesis and can be associated with early phase of carcinogenesis rather than tumor progression.
Carcinogenesis ; Colorectal Neoplasms* ; Daegu ; DNA ; Female ; Free Radicals ; Genetic Structures ; Humans ; Liver ; Male ; Reference Values

OBJECTIVE: Intracavitary injection of beta-emitting radiation source for control of cystic tumors has been tried with a benefit of localized internal radiation. The authors treated cystic brain tumor patients with Holmium-166-chitosan complex (Ho-166-chico), composed of a beta-emitting radionuclide Holmium-166 and biodegradable chit polymer, and evaluated the safety and effective measurement for response. METHODS: Twenty-two patients with recurrent cystic brain tumor and/or located in a deep or eloquent area were enrolled in this pilot study. The cyst volume and wall thickness were determined on CT or MRI to assess radiological response. The activity of Ho-166-chico injected via Ommaya reservoir was prescribed to be 10-25 Gy to the cyst wall in a depth of 4 mm. RESULTS: There was neither complications related to systemic absorption nor leakage of Ho-166-chico in all 22 patients. But, two cases of oculomotor paresis were observed in patients with recurrent craniopharyngioma. Radiological response was seen in 14 of 20 available follow-up images (70%). Seven patients of 'evident' radiological response experienced more than 25% decrease of both cyst volume and wall thickness. Another 7 patients with 'suggestive' response showed decrease of cyst volume without definitive change of the wall thickness or vice versa. All patients with benign tumors or low grade gliomas experienced symptomatic improvement. CONCLUSION: Ho-166-chico intracavitary radiation therapy for cystic tumor is a safe method of palliation without serious complications. The determination of both minimal effective dosage and time interval of repeated injection through phase 1 trial could improve the results in the future.
Absorption ; Brain Neoplasms* ; Brain* ; Chitosan ; Craniopharyngioma ; Follow-Up Studies ; Glioma ; Holmium ; Humans ; Paresis ; Pilot Projects* ; Polymers

Fecal incontinence is a disabling condition with devastating psychosocial impact due to diverse etiology. This study was performed to assess various causes of fecal incontinence, clinical evaluation, and adequate surgical treatment. METHODS: Eighty patients presenting fecal incontinence during July 1989 and June 1997 were included. They were evaluated by clinical parameters and physiologic tests including the defecography, electromyography, transanal ultrasonography, and anorectal manometry. Surgery was performed in 31 patients based on those evaluation. Pre- and post-operative comparison of manometric findings, clinical assessment, incontinence score, and the outcome of surgery were assessed. Mean postoperative follow-up was 22 (2~84) months. RESULTS: Inappropriate anal surgery was the most common cause, and then injuries during delivery, trauma, rectal prolapse, and hysterectomy in descending order. Defecography was performed in 21 patients and mean values of anorectal angles were 115+/-15degrees at rest, 98+/-18degrees during squeezing, and 136+/-10degrees during push. Electromyography was performed in 8 patients showing pudendal neuropathy in 2, bilateral lumbosacral polyradiculopathy in 4, and normal finding in 2 patients, respectively. Transanal ultrasonography was performed in 33 patients and 22 among them showed finding of an injury of the anal sphincters. Surgery was performed in 31 patients due to anal sphincter damage, rectovaginal fistula, and anal stricture in descending order. Type of surgery was determined by respective cause: plication, triple repair (sphincteroplasty, anoplasty, perineorrhaphy), and posterior rectopexy in descending order. Nerve preserving graciloplasty was performed in a 12 year-old girl who had severe defect of the anal sphincters by traffic accident, showing sound recovery with a good functional outcome. Although there was no significant difference of manometric variables between pre- and post-operative periods, sphincter length, and maximum resting and squeezing pressure, revealed an increasing tendency postoperatively. According to the clinical assessment between pre- and post-operative periods, urgency to evacuate, soiling, sensation on defecation, and quality discrimination were significantly improved postoperatively (P<0.01). Incontinence score was markedly decreased from 10.6+/-6.1 during preoperative period to 2.9+/-4.7 during postoperative period (P<0.01). Eighty one percent of the patients undergone surgery experienced a significant symptomatic improvement. CONCLUSIONS: According to the analysis of the causes of fecal incontinence, inappropriate anal surgery, injuries during delivery, and trauma were main causes. Adequate application of physiologic tests, such as, defecography, electromyography, transanal ultrasonography, and anorectal manometry, were helpful in determining treatment modality and types of surgery. We got satisfactory results with adequate surgery based on the physiologic tests.
Accidents, Traffic ; Anal Canal ; Child ; Constriction, Pathologic ; Defecation ; Defecography ; Discrimination (Psychology) ; Electromyography ; Fecal Incontinence* ; Feces ; Female ; Follow-Up Studies ; Humans ; Hysterectomy ; Manometry ; Polyradiculopathy ; Postoperative Period ; Preoperative Period ; Pudendal Neuralgia ; Rectal Prolapse ; Rectovaginal Fistula ; Sensation ; Soil ; Ultrasonography

No abstract available.
Bronchoalveolar Lavage Fluid* ; Bronchoalveolar Lavage* ; Humans ; Lung*

No abstract available.
Adenosine Deaminase* ; Adenosine* ; Bronchoalveolar Lavage Fluid* ; Bronchoalveolar Lavage* ; Humans ; Tuberculosis, Pulmonary*