BACKGROUND: To access the accuracy and clinical usefulness of microplate identification (ID) system for the identification of Enterobacteriaceae, we compared microplate ID system with API 20E(bioMerieux, Etoile, France). METHODS: Ninety-two cultures of Enterobacteriaceae and one isolate of Aeromonas species were simultaneously identified by microplate ID system and the API 20E. Twenty biochemical tests used in microplate ID system were lactose, sucrose, and H2S in Kligler's iron agar media; indole, sucrose, raffinose, arabinose, trehalose, adonitol, dulcitol, sorbitol, cellibiose, methy-red, phenylalanine deaminase, ornithine decarboxylase, lysine decarboxylase, arginine dihydrolase, urease, and citrate in microplate; and oxidase test. The identification was obtained by considering percent likelihood(% ID), modal frequency and ID score method. RESULTS: Among the 92 cultures of Enterobacteriaceae and one isolate of Aeromonas species, agreement rate of identification according to the % ID between microplate ID system and API 20E were 90.3% to the species level and 97.8% to the genus level. CONCLUSIONS: For the identification of clinical Enterobacteriaceae isolates, the microplate ID system compares favorably with API 20E in identification accuracy and have the advantage of costsaving and easy to use.
Aeromonas ; Agar ; Arabinose ; Arginine ; Citric Acid ; Enterobacteriaceae* ; Galactitol ; Iron ; Lactose ; Lysine ; Ornithine Decarboxylase ; Oxidoreductases ; Phenylalanine ; Raffinose ; Ribitol ; Sorbitol ; Sucrose ; Trehalose ; Urease

Since its introduction into clinical practice in the 1980s, endoscopic ultrasound (EUS) has been described as a good imaging modality for the diagnosis of pancreatobiliary diseases. However, differential diagnosis of certain lesions based only on B-mode ultrasound images can be challenging. Clinical use of ultrasound contrast agents has expanded the utility of EUS from that of detection to characterization of pancreatobiliary lesions based on the enhancement features of contrast-enhanced EUS (CE-EUS). Current low mechanical index techniques for CE-EUS using second-generation contrast agents have a number of distinct advantages over conventional diagnostic modalities in evaluating pancreatobiliary lesions, including real-time assessment of perfusion pattern, availability, and the absence of exposure to radiation. This article describes the technical aspects of CE-EUS and reviews the expanding indications in pancreatobiliary diseases and further development of this technique.
Biliary Tract Diseases/diagnosis/*ultrasonography ; *Contrast Media ; Diagnosis, Differential ; Endosonography/*methods ; Humans ; Medical Illustration ; Pancreatic Diseases/diagnosis/*ultrasonography

Surgical treatment is recommended in tricuspid valve endocarditis not responding to antibiotics or presenting severe heart failure. However, risk of early prosthetic valve endocarditis especially in drug addictors is principal concern in the treatment. A 37 year-old man with tricuspid valve endocarditis underwent staged operation of primary tricuspid valvulectomy and secondary bioprosthetic valve implantation successfully. We report it with references of literature.
Adult ; Anti-Bacterial Agents ; Endocarditis* ; Heart Failure ; Humans ; Tricuspid Valve

OBJECTIVE: The purpose of this study was to review the clinicopathologic features, recurrent rate, survival rate and controversable issues in the treatment of the ovarian malignant germ cell tumors. PATIENTS AND METHODS: From August, 1991 to November, 1998 thirty-one patients with malignant germ cell tumors of the ovary treated in the department of obstetrics and gynecology, Kosin University Medical college, were eligible and assessable. Demographic characteristics, symptoms, signs, stage, tumor grade, mode of therapy and results of follow up were reviewed retrospectively. RESULTS: The patients with malignant germ cell tumor constituted 6.37% of all ovarian malignancies during this period. Histologic subtypes were 8 dysgerminoma(25.8%), 7 endodermal sinus tumor(22.6%), 10 immature teratoma(32.3%), 3 mixed germ cell tumor(9.7%), 3 choriocarcinoma(9.7%). The age of the patients ranged from 10 to 40 years (mean +/-S.D.; 24.26 +/- 7.51). The most common symptom was abdominal pain(38.7%). Most had stageI(18 cases, 58.0%) or stageIII(5 cases, 16.2%) diseases. All patients underwent surgery as the initial treatment, and nine patients received more than one operation. Postoperative adjuvant chemotherapeutic regimens were VAC, VBP, EP, BEP, EMA, and EMA CO. The mean follow up duration was 26.0(+/- S.D.; +/- 20.3) months. The 2-year and 5-year survival rate were 91.97%(+/- S.E.; +/- 0.05) and 86.86%(+/- S.E.; +/- 0.07).
Endoderm ; Female ; Follow-Up Studies ; Germ Cells* ; Gynecology ; Humans ; Neoplasms, Germ Cell and Embryonal* ; Obstetrics ; Ovary ; Retrospective Studies ; Survival Rate

PURPOSE: The purpose of this study was to retrospectively analyze the etiologic transition of the predisposing factors and organisms for septic arthritis of the knee. MATERIALS AND METHODS: Between January 1995 and December 2006, 122 cases of septic arthritis of the knee were retrospectively evaluated for the etiologic transition and causative organism with using the patients' medical records. We researched the incidence and causative factor of septic arthritis of the knee, which was diagnosed via the patients' symptoms, physical examinations, hematologic exams, culture studies & cytology of the joint fluid. We assessed the correlation of disease with age, the year the disease happened, the causative factors and the incidence. RESULTS: Septic arthritis of the knee was increased after 40 years old, and it also increased after 1998. The most common predisposing factor was intra-articular injection of the knee joint. Even though there were no detected organisms in 79 cases (64.8%), the most common causative organism was S. aureus (20.5%). CONCLUSION: The most common etiologic factor of septic arthritis of the knee was an intra-articular injection. We should be prudent for using good aseptic technique and the correct procedure to reduce the secondary infection that's recently due to increased invasive treatment of the knee joint.
Arthritis, Infectious ; Coinfection ; Incidence ; Injections, Intra-Articular ; Joints ; Knee ; Knee Joint ; Medical Records ; Physical Examination ; Retrospective Studies

Linear array echoendoscopes were developed in the early 1990s and they have facilitated performing EUS-guided interventional procedures. The introduction of linear array echoendoscopes allows performing fine needle aspiration because the device enables tracing the path of the tip of the needle during puncture procedure. In addition to being very useful for diagnostic purpose, this device enabled us to develop various therapeutic endoscopic procedures. Therapeutic drainage procedures, including EUS-guided bile duct drainage, pancreatic pseudocyst drainage and pancreatic duct drainage, have all been more frequently performed in the last decade. In addition to the acquisition of tissue or fluid, various substances can be delivered into the target areas with EUS, with an example being an EUS-guided celiac plexus neurolysis/block. In this review, we describe the present place and role of interventional EUS in clinical practice.
Bile Ducts ; Biopsy, Fine-Needle ; Celiac Plexus ; Drainage ; Hypogonadism ; Mitochondrial Diseases ; Needles ; Ophthalmoplegia ; Pancreatic Ducts ; Pancreatic Pseudocyst ; Punctures

BACKGROUND: Some bacteria have typical antibiogram profiles which can be used to verify antimicrobial susceptibility tests and organisms identification. So, we developed interpretative reporting and quality control software program using antibiogram of disk susceptibility test for more accurate results and helping physician's decision making in antibiotic therapy. METHODS: A computer program was developed with knowledge base rules based on antimicrobial disks tested, bacterial classification, bacteria's resistance mechanism and phenotypic probability to antibiogram results. And comment contents according to detection code of antibiogram were coded. All comment code were displayed to computer's screen, and interpreted results were printed to the final report after the validation and correction of the disk susceptibility test results. RESULTS: Detection code for evaluating aminoglycoside susceptibility pattern of gram-negative bacilli were detected, in order of decreasing frequency, Stenotrophomonas maltophilia (9.1%), Citrobacter freundii (9.1%), Enterobacter species (8.3%), Klebsiella pneumoniae (7.6%), Escherichia coli (3.6%), and Acinetobacter species (3.3%). More than 5% of C. freundii, Enterobacter species, E. cloacae, E. aerogenes, and Morganella morganii were detected by detection code for evaluating natural resistance. CONCLUSIONS: It is considered that this program is useful in quality control of antimicrobial susceptibility test and decision making in antimicrobial therapy of patients. And detection rate of rule check codes on natural resistances of gram-negative bacilli in this study were higher than those previously reported. Finally, it is concluded that further studies on natural resistance of antimicrobials about gram-negative bacilli, and the addition and reformation of codes for rule check and comment contents are needed.
Acinetobacter ; Bacteria ; Citrobacter freundii ; Classification ; Cloaca ; Decision Making ; Enterobacter ; Escherichia coli ; Humans ; Immunity, Innate ; Klebsiella pneumoniae ; Knowledge Bases ; Microbial Sensitivity Tests* ; Morganella morganii ; Quality Control* ; Stenotrophomonas maltophilia

No abstract available.
Thoracic Surgery*

BACKGROUND: The differentiation between hemorrhagic(HS) and norhemorrhagic(NHS) stroke is the most important first step in the management of acute stroke because clinical management of the two disorders differs substantially. Neuroimaging studies are useful in diagnosing and distinctioning between HS and NHS. The use of clinical variables, such as Siriraj stroke scores(SSS), has led to good sensitivity, specificity and predictive values. The aim of our study was to evaluate the use of the SSS in the Korean population and assess whether it could aid to expedite treatment decisions. METHODS: We reviewed 111 cases of stroke patients admitted to our hospital via the emergency department over a 6 months period from July to December 1998. Levels of consciousness, vomiting, headache, and atheroma markers used in the SSS were applied to these patients who met the criteria for a stroke. RESULTS: Of the 111 patients, the SSS classified 83 with sensitivities of 81.1%(NHS) and 73.3%(HS) and positive predictive values of 84.3% and 68.8%, respectively. The overall accuracy rate was 78.3%. CONCLUSION: Our results suggest that the SSS is not reliable in distinguishing stroke types in the Korean population. Definite neuroimaging studies are needed prior to thrombolytic therapy.
Consciousness ; Emergency Service, Hospital ; Headache ; Humans ; Neuroimaging ; Plaque, Atherosclerotic ; Sensitivity and Specificity ; Stroke* ; Thrombolytic Therapy ; Vomiting

BACKGROUND: Incidence of traumatic hip dislocation have ween increased with development of transportation. Traumatic hip dislocation demands early recognition as an emergency and prompt reduction. So we designed this study to determine what kinds of factors affect the prognosis of the patient. METHODS: Eighty five patients who admitted emergency department of our hospital with the traumatic hip dislocation were enrolled in this study. Cause of injury, type of dislocation, method of reduction, the time from dislocation to reduction, age, gender and associated patellar injury were evaluated by retrospective chart reviews. RESULTS: Average age of excellent and good group(E&G) is 28+/-17.8 and fair and poor group(F&P) is 39+/-18.6, so the older the age the more poor prognosis(P<0.05). The time to take reduction of E&G group is 18+/-8.2 hours and F&P group is 25+/-12.6 hours, so the faster the better prognosis(P<0.05). We classify the type of hip dislocation by Thompson and Epstein method, type I to type V. The prognosis of type I is better than type V(P<0.05). Fifty five case were associated with patellar injury and they had poor prognosis than the other cases that were not associated with knee joint injury. CONCLUSION: In traumatic dislocated hip patients, the prognosis was poor in old age, delay in reduction, higher type of dislocation and associated with knee joint injury.
Dislocations ; Emergencies ; Emergency Service, Hospital ; Hip Dislocation* ; Hip* ; Humans ; Incidence ; Knee Joint ; Prognosis* ; Retrospective Studies ; Transportation