No abstract available.
Antibodies* ; Coxiella burnetii* ; Coxiella* ; Prevalence*

No abstract available.
Hemorrhage* ; Kidney Transplantation*

Sixty-eight clinical isolates of Stenotrophomonas maltophilia from inpatients of 2 university hospitals in Taegu were epidemiologically analyzed by using the minimum inhibitory concentrations of 25 antimicrobial drugs, biochemical reaction, pulsed-field gel elctropgoresis (PFGE), and PCR with enterobacterial repetitive intergenic consensus sequences as primer (ERIC-PCR). 1. All the strains were susceptible to minocycline. More than 57% were susceptible to sulfisomidine (Su), ciprofloxacin (Ci), Ofloploxacin (Of), nalidixic acid (Na), and chloramphenicol (Cm), and 19apprx35% to ceftazidime (Cd), trimethoprim (Tp), Ticacillin-clavulanic acid, and cefoperazone-sulbactam. Most isolates were resistant to beta-lactam antibiotics such as ampicillin (Ap), carbenicillin (Cb), cefotaxim (Ct), cefoxitin (Cx), and aminoglycosides including gentamicin (Gm), tobramycin (Tb), amikacin (Ak). 2. All the isolates were multiply resistant of 5 to 17 drugs and showed 40 different resistance pattern types. 3. All the strains showed very similar biochemical reactions except beta-galactosidase and nitrate reduction test. Fourteen strains selected randomly were classified 10 different pattern type by PFGE and ERIC-PCR. These two methods showed identical result. Four strains isolated from wound in 1994 showed similar MIC pattern and identical API 20NE profile, PFGE, and ERIC-PCR pattern indicating episodes of cross-infection among patients. These results indicate that PFGE or ERIC-PCR profile has comparable discriminatory power for epidemiological typing of S. maltophilia.
Amikacin ; Aminoglycosides ; Ampicillin ; Anti-Bacterial Agents ; beta-Galactosidase ; Carbenicillin ; Cefotaxime ; Cefoxitin ; Ceftazidime ; Chloramphenicol ; Ciprofloxacin ; Consensus Sequence ; Daegu ; Gentamicins ; Hospitals, University ; Humans ; Inpatients ; Microbial Sensitivity Tests ; Minocycline ; Nalidixic Acid ; Polymerase Chain Reaction ; Stenotrophomonas maltophilia* ; Stenotrophomonas* ; Sulfisomidine ; Tobramycin ; Trimethoprim ; Wounds and Injuries

No abstract available.
Meningioma* ; Sclerosis*

Surgical clip migration and subsequent stone formation in the common bile duct is a rare, but well-established complication after laparoscopic cholecystectomy. There are some suggestions about the mechanisms of the migration process, but the details are still unclear. We report here on a case in which common bile duct stones were formed around surgical clips, and other clips were found to have penetrated into the common hepatic duct, which we believe were in the process of migration after laparoscopic cholecystectomy. The patient required a laparotomy to retrieve the bile duct stones due to the distal bile duct stricture, and another laparotomy was necessary to remove the penetrating clips, which were deeply embedded in the bile duct wall. Although a variety of endoscopic and percutaneous interventional procedures are available in this era of modern medical technology, it is sometimes impractical to apply these procedures in such cases as ours, and exploratory laparotomy is sometimes required to correctly treat the patient. This case shows that the metallic surgical clips can penetrate into the intact bile duct wall through serial maceration, and we believe that careful application of clips may be the only way to prevent their migration after laparoscopic cholecystectomy.
Bile Ducts ; Cholecystectomy, Laparoscopic* ; Common Bile Duct ; Constriction, Pathologic ; Hepatic Duct, Common* ; Humans ; Laparotomy ; Surgical Instruments*

PURPOSE: This study was aimed at comparing the rate of decrease in preoperative serum bilirubin after biliary drainage and the postoperative complication rate in patients with distal common bile duct (CBD) cancer. METHODS: Forty six patients who had undergone pancreaticoduodenectomy due to distal CBD cancer were included in this study. The patients were divided into the complicated and uncomplicated groups. For the patients who underwent preoperative biliary drainage, the preoperative bilirubin level and the rate of decrease in serum bilirubin were measured and compared between the two groups. RESULTS: The postoperative complication and mortality rates were 43.4% (20/46) and 6.5% (3/46), respectively. The complication rates were not different between the drainage and non-drainage groups (p=0.48). The preoperative serum bilirubin levels were also not different between the complicated and uncomplicated groups (p=0.214). In the uncomplicated group, the rate of decrease in the serum total bilirubin level tended to be higher than in the complicated group, but this was not statistically significant (mean: 0.82 vs 0.27 mg/dl/day, respectively, p=0.117). Patients with a higher preoperative bilirubin decrease rate showed a larger bilirubin decrease in the immediate postoperative period (from POD 1 to POD 7, r=0.371, p=0.05). CONCLUSION: The preoperative biliary drainage and the serum bilirubin level were not correlated with the postoperative complication rate. Patients with higher preoperative bilirubin decrease rates showed a larger bilirubin decrease in the immediate postoperative period, which can be interpreted as having a faster recovery of their liver function. Further study with a larger number of cases is required to see if the preoperative bilirubin decrease rate could be used as a prognostic indicator after pancreaticoduodenectomy.
Bilirubin* ; Common Bile Duct* ; Drainage* ; Humans ; Liver ; Mortality ; Pancreaticoduodenectomy ; Postoperative Complications* ; Postoperative Period

BACKGROUND: Pathologic diagnosis of central nervous system (CNS) neoplasms is made by comparing light microscopic, immunohistochemical, and molecular cytogenetic findings with clinicoradiologic observations. Intraoperative frozen cytology smears can improve the diagnostic accuracy for CNS neoplasms. Here, we evaluate the diagnostic value of cytology in frozen diagnoses of CNS neoplasms. METHODS: Cases were selected from patients undergoing both frozen cytology and frozen sections. Diagnostic accuracy was evaluated. RESULTS: Four hundred and fifty-four cases were included in this retrospective single-center review study covering a span of 10 years. Five discrepant cases (1.1%) were found after excluding 53 deferred cases (31 cases of tentative diagnosis, 22 cases of inadequate frozen sampling). A total of 346 cases of complete concordance and 50 cases of partial concordance were classified as not discordant cases in the present study. Diagnostic accuracy of intraoperative frozen diagnosis was 87.2%, and the accuracy was 98.8% after excluding deferred cases. Discrepancies between frozen and permanent diagnoses (n = 5, 1.1%) were found in cases of nonrepresentative sampling (n = 2) and misinterpretation (n = 3). High concordance was observed more frequently in meningeal tumors (97/98, 99%), metastatic brain tumors (51/52, 98.1%), pituitary adenomas (86/89, 96.6%), schwannomas (45/47, 95.8%), high-grade astrocytic tumors (47/58, 81%), low grade astrocytic tumors (10/13, 76.9%), non-neoplastic lesions (23/36, 63.9%), in decreasing frequency. CONCLUSIONS: Using intraoperative cytology and frozen sections of CNS tumors is a highly accurate diagnostic ancillary method, providing subtyping of CNS neoplasms, especially in frequently encountered entities.
Brain Neoplasms ; Central Nervous System Neoplasms ; Central Nervous System ; Cytogenetics ; Diagnosis ; Frozen Sections ; Humans ; Meningeal Neoplasms ; Methods ; Neurilemmoma ; Pituitary Neoplasms ; Retrospective Studies