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

No Abstract Available.
Amblyopia*

BACKGROUND: The purpose of this clinical study was to evaluate the Incentive Spirometry (IS) and Deep Breathing Exercises (DBE) to prevent postoperative pulmonary complications after abdominal surgery in patients over 60 years of age. METHODS: We prospectively randomized 90 patients into 1 of 3 groups: the control group (30 patients) received no respiratory treatment, the IS group (30 patients) was treated with incentive spirometry 4 times daily and DBE group (30 patients) carried out deep breathing exercises under supervision for 15 min 4 times daily. ABGA was taken at ward, PR (preop.room), RR (recovery room), POD1 day and POD2 day. Roentgenographic changes observed at 24 h. and 48 h. after surgery. Pulmonary complications were defined as the development of 3 or more of 6 new findings: cough, sputum, dyspnea, chest discomfort, temperature greater than 38oC, pulse rate more than 100 beats/min. RESULTS: PaO2 in the DBE group and IS group at PR were significantly increased than the values at ward, and the values of the PaO2 in the DBE group at RR and POD1 day, and those of IS group at PR and POD2 day were significant higher than those of the control group (p<0.05). The frequency of development of pulmonary complications (43.3% in the control group, 20% in the DBE group, 20% in the IS group) and roentgenographic changes were comparable in the 3 groups (26.7%, 16.7%, 20% respectively). The DBE group showed the different incidence of postoperative pulmonary complications between upper and lower abdominal surgery (upper: lower= 35.7: 6.3%). CONCLUSIONS: We concluded that DBE and IS were effective in preventing postoperative pulmonary complications after abdominal surgery and lower abdominal surgery causes lesser postoperative pulmonary complications than upper abdominal surgery.
Breathing Exercises ; Cough ; Dyspnea ; Heart Rate ; Humans ; Incidence ; Motivation* ; Organization and Administration ; Prospective Studies ; Respiration* ; Spirometry* ; Sputum ; Thorax

The present report describes a case of VATER syndrome with situs inversus viscerum totalis in a newborn Korean male infant who died immediately after his birth. The disposition of all the organs in thoracic and abdominal cavities formed a complete mirror picture of normal disposition. In addition, the following abnormalities were also present : 1) Unsegmented bar of the 12th thoracic vertebra fused with 11th thoracic vertebra at left side and 1st lumbar vertebra at right side, 2) Imperforated anus (Type 3 of Ladd and Grorss classification), 3) Tracheoesophageal fistula with upper esophageal atresia, 4) Patent ductus arteriosus connected to the descending aorta, 5) Atrial septal defect, septum primum type, 6) Slightly enlarged ureter, 7) Translocation of cecum with appendix beneath the liver, 8) Coiled appendix, 9) Incomplete oblique fissure of the right lung.
Abdominal Cavity ; Anal Canal ; Aorta, Thoracic ; Appendix ; Cecum ; Ductus Arteriosus, Patent ; Esophageal Atresia ; Heart Septal Defects, Atrial ; Humans ; Infant* ; Infant, Newborn* ; Liver ; Lung ; Male* ; Parturition ; Situs Inversus* ; Spine ; Tracheoesophageal Fistula ; Ureter

PURPOSE: The purpose of this study was to determine whether Fas-L expression is associated with increased apoptotic induction of tumor-infiltrating lymphocytes (TIL) in human gastric carcinomas. MATERIALS AND METHODS: The author analysed 38 cases of early gastric carcinoma (EGC) and 61 cases of advanced gastric carcinoma (AGC) who received gastric resection, in whom the number of diffuse type was 38 cases and the number of intestinal type was 61 cases. The author used immunohistochemical staining for Fas, Fas-L and CD45, and TUNEL in situ apoptosis detection kit. TIL were detected by CD45 and apoptosis of TIL were detected by CD45 expression and TUNEL positivity on serial histologic sections. RESULTS: Fas-L was localized to neoplastic cells in 61% (23/38) of EGC group and 66% (40/61) of AGC group. The extent of Fas-L expression was variable, with both Fas-L positive and negative neoplastic region occuring within tumors. TIL adjacent to Fas-L expressing tumor region were decreased in number and TIL adjacent to FasL-negative tumor region were increased in number; apoptotic induction of TIL showed just the opposite pattern (p<0.05). Fas expression was found essentially homogeneously throughout the tumor mass independent of tumor stage. Fas expression showed 64% (39/61) of intestinal type and 68% (26/38) of diffuse type. Labeling indices for tumoral apoptosis in EGC and AGC were 6.72% and 7.13%, respectively and this difference was statistically insignificant. Co-expression of Fas-L and Fas, which occurred over large areas of the tumors, did not result in an enhanced rate of tumor cell apoptosis. In addition, factors such as tumor stage and other prognostic factors were not concerned in Fas and Fas-L expression, number of TIL and apoptotic induction. CONCLUSION: These findings suggest Fas-mediated apoptotic depletion of TIL in response to Fas-L expression by stomach cancers, and provide the evidence to support the Fas counterattack as a mechanism of immune escape in gastric cancer. In addition, gastric carcinoma cells of the intestinal and diffuse type did not differ in their expression of the apoptotic receptor Fas.
Apoptosis* ; Humans ; In Situ Nick-End Labeling ; Lymphocytes, Tumor-Infiltrating ; Stomach Neoplasms ; United Nations

Optic ataxia is characterized by an impaired visual control of the direction of arm reaching to a visual target, accompanied by defective hand orientation and grip formation. In humans, optic ataxia is associated with lesions of the superior parietal lobule, which also affect visually guided saccades and other forms of eye-hand coordination. A 67-year-old woman presented with sudden, unilateral, direct optic ataxia in the right homonymous half field and saccadic abnormalities which consisted of prolonged latency, undershoot dysmetria, and decreased velocity. Brain MRI showed a left parieto-occipital watershed infarction. It is suggested that lesions of the superior parietal lobule and the adjacent parietal eye field are responsible for optic ataxia and saccadic abnormalities, respectively.
Aged ; Arm ; Ataxia* ; Brain ; Cerebellar Ataxia ; Female ; Hand ; Hand Strength ; Humans ; Infarction* ; Magnetic Resonance Imaging ; Rabeprazole ; Saccades

No abstract available.
Autoradiography* ; Brain* ; Rats, Wistar* ; Receptors, Muscarinic*

No abstract available.
Glucose* ; Humans ; Infant, Newborn* ; Metabolism*

Two cases of Dandy-Walker syndrome are reported with emphasis on CT findings. The Dandy-Walker syndrome is known to be a developmental anomaly, which is a congenital cystic dilatation of the fourth ventricle due to atresia of foramen Magendie and possibly also foramen Luschka, associated with some form of vermian dysgenesis. The CT findings of one case reveal huge cystic mass in midline of the posterior cranial fossa with small compressed cerebellar hemisphere in the lateral portion, associated with hydrocephalus. The other shows semilunar-shaped cystic mass in posterior cranial fossa with anteriorly displaced cerebellum, which communicates with apparent fourth ventricle through the vallecula. Both cases show no inferior.
Cerebellum ; Cranial Fossa, Posterior ; Dandy-Walker Syndrome ; Dilatation ; Fourth Ventricle ; Hydrocephalus

PURPOSE: The aim of this study is to analyse the clinical characteristics and results of treatment of knee dislocation. MATERIALS AND METHODS: The 18 cases of the traumatic dislocation of knee were treated at Yeung-nam university hospital from 1991 Jan. to 1997 Apr. and those were followed more than one year after injury. Result: Anterior and posterior cruciate ligament were ruptured in all cases and the two thirds of the ruptured site of cruciate ligament was femoral attachment, Medial collateral ligament injury(13 cases) were more than lateral collateral injury(8 cases) and more than half cases of collateral ligament injury were rup- tured at tibial and fibular attachment. The functional result by Lysholm knee scoring revealed fair(81 score) in average and excellent in 3 cases, good in 5 cases, fair in 10 cases. Complications were limitation of motion in 6 cases, pain in 2 cases and nerve paraiysis in 1 case. CONCLUSION: Applying classification system according to direction of displacement is sometimes difficult because the dislocation of knee could be transferred after reduction. It was thought that another subclassifica- tion system in terms of ligaments involved should be used. Functional results by Lysholm knee scoring revealed fair(81 score) in average. Early range of motion should be started after surgical repair and minimal immobilization to avoid limitation of knee motion.
Classification ; Collateral Ligaments ; Dislocations* ; Immobilization ; Knee Dislocation ; Knee* ; Ligaments ; Posterior Cruciate Ligament ; Range of Motion, Articular