BACKGROUND: An intensive and ongoing surveillance program is effective for preventing the hospital infections. but it is time-consuming to detect all cases of hospital infections. So, labratory-based surveillance was performed with the aid of personal computer. The software 'MICRO' that coded and used privately was written in FoxPro 2.0 code. METHODS: All results of the microbiologic culture were stocked in the software and hospital infections were detected by review d an positive microbiology reports and daily ward rounds with examination of patient progress notes. If there was any suggestion or evidence of outbreak of hospital infections the data were analyzed by the 'MICRO' and reported to hospital infections control committee. RESULTS: We detected the outbreak of nosoccmial pneumonia due to a putative single species of methicillin-resistant Staphylococcus aureus in the neurosurgical ward at May, 1996. The suggestive outbreak of wound infections in the 7th ward at April, 1966 was denied by the 'MICRO'. The possible outbreak of 10th ward at May, 1996 was detected. CONCLUSIONS: We describe a surveillance method that identifies excessive rates of positive culture on patient location culture site, and organism indentification using the 'MICRO'. We were able to monitor patient-to-patient cross-infections and possible breakdowns in proper technique, and expect suggestive outbreak of infections early. These results demonstrate that computer analysis of positive culture rates by 'MICRO' is a sensitive and time-efficient method for detecting potentially preventable hospital infections.
Cross Infection* ; Humans ; Methicillin-Resistant Staphylococcus aureus ; Microcomputers* ; Pneumonia ; Wound Infection

20-40% of cases of acute transverse myelitis are attributed to viral infections, although the specific viral etiology is only rarely identified. We have studied one patient with transverse myelitis in association with acute hepatitis B virus infection. Hepatitis virus should be considered as rare cause of transverse myelitis.
Hepatitis B virus* ; Hepatitis B* ; Hepatitis Viruses ; Hepatitis* ; Humans ; Myelitis, Transverse*

One hundred cases of anterior communicating artery aneurysms, operated upon during a 10-year period from 1977 to 1987, were analysed to study the microsurgical anatomy of the aneurysms. All of the cases were operated by direct intracranial approach using a operating microscope. Findings of preoperative four-vessel angiogram, operative microphotographs, operative microvideo tapes, and operator's drawings with narratives were investigated on in order to provide the detaild microsurgical anatomy of the aneurysms to obtain the classification according to it. The results were as follows; 1) The anatomical variations of the anterior portion of circle of Willis were as follows;right A1 hypoplasia in 23 cases, left A1 hypoplasia in 9 cases, left A1 aplasia in 3 cases, duplication of anterior communicating artery in 3 cases, and fenestration of anterior communicating artery in 1 case. 2) The diameter of the aneurysm was as follows;5-10mm in 73% below 5mm in 16%, and over 10mm in 11%. 3) Classification of the anterior communicating artery aneurysms according to its direction were as follows;anterior directions in 65%, posterior directions in 16%, superior directions in 10%, inferior direction in 9%. 4) The frequency of hemorrhage were as follows;One bleeding in 65%, Two bleedings in 25%, more than three bleedings in 10%. 5) The vasospasm was observed in 26%, the hydrocephalus in 44%. 6) The posteriorly directing aneurysms showed worse preoperative state than anteriorly directing ones, and the diameter and the direction of anterior communicating artery aneurysm has no relationship with hydrocephalus, vasospasm, and rebleeding. 7) Overall mortality was 5%. Psychotic disturbance, one of the significant complications of rupture of the anterior communicating artery aneurysms, was observed in 13% and among these 6% were observed after operation. Frontal lobe syndrome, organic brain syndrome, depression, confusion, mutism, memory disturbance were manifestations of psychotic disfurbances.
Aneurysm ; Arteries ; Brain ; Circle of Willis ; Classification* ; Depression ; Frontal Lobe ; Hemorrhage ; Hydrocephalus ; Intracranial Aneurysm* ; Memory ; Mortality ; Mutism ; Rupture

No abstract available.
Occupational Diseases*

PURPOSE: This study was intended to evaluate the positional relationship between the hyoid bone and the mandible in patients with mandibular protrusion after mandibular set-back surgery by means of 3D-CT. MATERIALS AND METHODS: Preoperative(3 weeks before) and postoperative (6 weeks after) 3D-CT and cephalogram were taken on 32 patients(12 male, 20 female, mean age of 23.2) treated by bilateral sagittal split osteotomy with rigid fixation. The angular measurement on 3D-CT basilar view were deviation of Me and H, long axis angle of left and right cornu majus. The lineal measurement on 3D-CT basilar view were composed of intercondylar line and coordinates(x,y) of Me and H. The angular and lineal measurement of lateral cephalogram were composed of mandibular plane angle, SNA, SNB, ANB, FH-NA and FH-NB, and coordinates(x,y) of B, Pog, Me and H, PAS, Lpw, MPH and IAS. On the frontal cephalogram, deviation of Me were evaluated. RESULTS: The mean mandibular set-back was 8.0mm horizontally and mandibular plane angle was slightly increased. The hyoid bone was displaced postero-inferiorly, the distance between MP(mandibular plane) and H(hyoid bone) was increased and the posterior airway space values (PAS, Lpw, IAS) were decreased. The coordinates Me(x,y), H(x,y) and deviation angle Me' and H'were revealed the strong positive correlation. CONCLUSION: The results revealed that the horizontal, vertical and transverse relationship of the mandibular and the hyoid bone movements were significantly correlated in patients performed mandibular set-back surgery.
Axis, Cervical Vertebra ; Female ; Humans ; Hyoid Bone* ; Male ; Mandible* ; Orthognathic Surgery* ; Osteotomy

No abstract available.

Heterotopic partial liver transplantation(HLT) in the rat is relatively simple method to orthotopic liver transplantation. Addition of mesocaval shunt which diverts almost intestinal blood to systemic circulation provides only splenopancreaticoduodenal blood for the graft. The usefulness of our novel model is first, evaluating the pure effect of pancreaticoduodenal blood to liver regeneration, second, evaluating the contribution of splanchnic viscera to liver reperfusion injury. In the first group (conventional HLT, C-HLT), the thirty percent graft liver was transplanted just below the host liver with whole portal blood input. In the second group(mesocaval shunt added HLT, M-HLT), the superior mesenteric vein was diverted to systemic circulation and portal blood from the spleen-pancreas-duodenum supplied the graft. The graft weight at 2 posttransplant weeks was significantly increased in the C-HLT group compared with the M-HLT group, which suggests pancreatic blood alone is not sufficient to regenerate the partial liver grafts. There was no significant difference in the graft survival between two groups, which implies the influence of intestine to postreperfusion injury is negligible.
Animals ; Graft Survival ; Intestines ; Liver Regeneration ; Liver Transplantation* ; Liver* ; Mesenteric Veins ; Models, Animal* ; Rats* ; Reperfusion Injury ; Transplants ; Viscera

A 41-year-old female was admitted to our hospital for self-audible wheezing sound and dyspnea. On past history, she has been suffered from chest discomfort, and treated recurrently by other hospitals. But, there was no symptomatic improvement. A stridor and mixed wheezing sound was auscultated on whole lung field. PFT revealed fixed type or variable intra- & extra-thoracic air way obstructive pattern. By bronchoscopy & bronchogram, we found web-like structure on the distal trachea. A bronchoplasty was performed and the post-operative PFT showed slight improvement & she had no more complaints.
Adult ; Bronchoscopy ; Dyspnea ; Female ; Hemoptysis* ; Humans ; Lung ; Respiratory Sounds ; Thorax ; Trachea

Background: We hypothesized that intravenous lidocaine mixed with propofol may have an influence on anesthesia induction and hemodynamic responses to propofol induction and endotracheal intubation as well as propofol-induced pain on injection. Methods: Seventy-five patients were allocated to group L1 (2% lidocaine 1.5 mg/kg, n=25), group L2 (2% lidocaine 2 mg/kg, n=25) or group C (normal saline 0.05 mL/kg, n=25) according to the lidocaine dosage mixed with propofol 2 mg/kg. The pain on injection was scored as none, mild, moderate, and severe. The site of pain and recall of pain were also recorded. Loss of verbal response was observed during induction. Mean arterial blood pressure (MAP) and heart rate (HR) were recorded before anesthetic induction (baseline value), immediately before and after endotracheal intubation, and every min until 5 min thereafter. Results: Ninety-two percent of patients reported pain upon injection in group C, whereas 8% of the patients in group L1 and no patient in group L2. Loss of verbal response before injection of total dose of propofol was observed in 44% in group L2, 36% in group L1 and 28% in group C. Lowered MAP caused by propofol increased significantly after endotracheal intubation in all three groups (p<0.05). HR increased immediately and 1 min after endotracheal intubation in all three groups (p<0.05). Conclusions: Our results indicate that intravenous lidocaine 1.5 mg/kg or 2 mg/kg mixed with propofol 2 mg/kg significantly reduces the incidence and the degree of pain, but does not affect anesthesia induction and hemodynamic responses to propofol and tracheal intubation.
Anesthesia ; Arterial Pressure ; Heart Rate ; Hemodynamics* ; Humans ; Incidence ; Intubation* ; Intubation, Intratracheal ; Lidocaine* ; Propofol*

The right hemisphere lesion may cause motor impersistence. Thirty-nine patients were selected for this study, 13 with right hemisphere lesion, 13 with left hemisphere lesion and age matched 13 normal controls. The neuropsychological test was done between seven days and two months after onset of stroke. Total impersistence scores of left hemisphere lesion are 395.31 and those of right hemisphere lesion and controls were 277.34, 422.82, respectively. In right hemisphere lesion, the impersistence scores of frontal lobe, parietal lobe and other sites were 303.60, 251.00 and 323.00, respectively. In conclusion, it is suggested that motor impersistence is more affected in right hemisphere lesion than left hemisphere lesion. And especially, the right frontal lobe lesion is correlated with motor impersistence.
Frontal Lobe ; Humans ; Neuropsychological Tests ; Parietal Lobe ; Stroke