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

BACKGROUND: To assess the clinical utility of new DNA extraction method, the authors attempted PCR using mycobacterial DNA extracted by Chelex 100 ion exchange resin method for 63 clinical samples in patients with pulmonary tuberculosis and compared with proteinase K method, simultaneously. METHODS: We used Chelex 100 ion exchange resin for preparation of DNA. Decontaminated sputums were mixed with resin and incubated at 56degrees C and 100degrees C without opening tube. After centrifugation, supernatants were used directly as template for PCR. 245 bps in primary PCR and 188 bps in nested PCR were amplified and analysed by agarose gel electrophoresis EtBr staining. RESULTS: Chelex 100 ion exchange resin method is more simple, rapid and reliable than proteinase K method, and during sample preparation, carry-over contamination loss of amplificated DNA, influence of organic solvents and cross-contamination are diminished. The results of PCR products are interpreted more distinctively in Chelex 100 ion exchange resin method than proteinase K method. CONCLUSIONS: In the basis of the results, it could be suggested that extraction of mycobacterial DNA by Chelex 100 ion exchange resin is more simple, rapid reliable method than that of conventional method for detection of mycobacterial DNA in patients with tuberculosis by polymerase chain reaction.
Centrifugation ; Diagnosis* ; DNA* ; Electrophoresis, Agar Gel ; Endopeptidase K ; Humans ; Ion Exchange ; Polymerase Chain Reaction* ; Solvents ; Sputum ; Tuberculosis* ; Tuberculosis, Pulmonary

Cancer-related facial pain refractory to pharmacologic management or nondestructive means is a major indication for destructive pain surgery. Stereotactic mesencephalotomy can be a valuable procedure in the management of cancer pain involving the upper extremities or the face, with the assistance of magnetic resonance imaging (MRI) and electrophysiologic mapping. A 72-year-old man presented with a 3-year history of intractable left-sided facial pain. When pharmacologic and nondestructive measures failed to provide pain alleviation, he was reexamined and diagnosed with inoperable hard palate cancer with intracranial extension. During the concurrent chemoradiation treatment, his cancer-related facial pain was aggravated and became medically intractable. After careful consideration, MRI-based stereotactic mesencephalotomy was performed at a point 5 mm behind the posterior commissure, 6 mm lateral to and 5 mm below the intercommissural plane using a 2-mm electrode, with the temperature of the electrode raised to 80degrees C for 60 seconds. Up until now, the pain has been relatively well-controlled by intermittent intraventricular morphine injection and oral opioids, with the pain level remaining at visual analogue scale 4 or 5. Stereotactic mesencephalotomy with the use of high-resolution MRI and electrophysiologic localization is a valuable procedure in patients with cancer-related facial pain.
Aged ; Analgesics, Opioid ; Electrodes ; Facial Pain* ; Humans ; Magnetic Resonance Imaging ; Morphine ; Palate, Hard ; Upper Extremity

Heterotopic pregnancy is named when an extrauterine (ectopic) pregnancy coexists with an intrauterine pregnancy simultaneously by many causes such as PID (pelvic inflammatory disease), endometriosis, IUD (intrauterine device), previous pelvic surgery and others. This is very rare in general population, with a range of occurrence estimated between 1:7963 and 1:30000. But recently the incidence has increased as the uses of ARTs (assisted reproductive technologies) including ovulation induction, IVF-ET (in-vitro fertilization and embryo transfer) and GIFT (gamete intrafallopian transfer) increase. Because this has high maternal morbidity, mortality and fetal loss, early diagnosis and proper management is very important. We report a case of heterotopic pregnancy following IVF-ET with a brief review.
Early Diagnosis ; Embryonic Structures ; Endometriosis ; Female ; Fertilization ; Incidence ; Mortality ; Ovulation Induction ; Pregnancy ; Pregnancy, Heterotopic*

No abstract available.
Blood Glucose* ; Humans ; Infant, Newborn ; Infant, Premature*

No abstract available.
Brain Abscess* ; Brain*

No abstract available.
Brain Abscess* ; Brain*

No abstract available.
Psychosurgery*

Acute infarcts of the anterior inferior cerebellar artery (AICA) territory are unusual. Furthermore incomplete AICA infarcts are perplexing because of its variations of vascular anatomy and inconsistent clinical features. We present a case with clinical features of AICA infarction, which consist of ipsilateral peripheral-type facial palsy, vertigo, and contralateral facial and upper limb sensory changes without motor weakness. The patient had hypertension and was a current smoker. The high signal intensity on inferior pontine tegmental area was found on MRI and the R2 interneuronal dysfunction was note on Blink reflex. The angiographic findings didn't show any focal vascular lesions, which is contrary to the pathogenesis of AICA infarction published previously. On the clinical ground, the present case reserves to attention in that patients with peripheral-type facial palsy should be properly evaluated and with thorough neurological examination and we could differentiate between the incomplete AICA infarcts such as Gasperini syndrome and Bell's palsy.
Arteries ; Bell Palsy ; Blinking ; Facial Paralysis* ; Humans ; Hypertension ; Infarction ; Interneurons ; Magnetic Resonance Imaging ; Neurologic Examination ; Upper Extremity ; Vertigo

BACKGROUND: The Amplified Mycobacterium tuberculosis Direct Test (AMTDT) has been developed for the direct detection of M. tuberculosis complex in respiratory specimens. Traditional methods for diagnosis of extrapulmonary tuberculosis such as the acid-fast bacilli (AFB) stain have their well-known limitations. We investigated the usefulness of the AMTDT for a wide range of non-respiratory specimens to establish early diagnosis of extrapulmonary tuberculosis. METHODS: 346 specimens (219 urine, 117 pleural fluid, 6 ascitic fluid, 2 lymph node, 1 gastric aspirate, and 1 pus specimens) from 340 patients referred from November 1997 to September 1998 were tested by the AMTDT. The AMTDT results were evaluated by comparing with clinical diagnosis and smear results. RESULTS: The overall sensitivity, specificity, and positive and negative predictive values of the AMTDT were 82.9%, 93.8%, 64.2%, and 97.6%, respectively. There were no difference in sensitivity and specificity between pleural fluid and urine specimens. In 31 specimens from tuberculosis patients concurrently tested with AMTDT and stain, 15 were only AMTDT positive and 4 were only stain positive. Among the results considered to be false positive, 47.2% of cases were shown as being less than 150,000 relative light units (RLU). In 30 specimens from tuberculosis patients during or after treatment, all six of the patients with reactivation or aggravation were AMTDT positive, and one case was considered to be false positive. CONCLUSIONS: Our study demonstrates the efficacy of the AMTDT in diagnosing extrapulmonary tuberculosis. Prudent interpretation of the AMTDT's results is recommended in case of that being less than 150,000 RLU.
Ascitic Fluid ; Diagnosis ; Early Diagnosis ; Humans ; Lymph Nodes ; Mycobacterium tuberculosis* ; Mycobacterium* ; Polymerase Chain Reaction ; Sensitivity and Specificity ; Suppuration ; Tuberculosis