Nosocomial infections surveillance is the basic activity of infection control programs, and many countries conduct surveillance using various methods. We convinced that each country should conduct an adequate and efficient surveillance system depending on their situations. Here we reviewed the recent nosocomial surveillance systems of other countries. As many countries have succeeded in reducing hospital infections, we expect that Korean Nosocomial Infections Surveillance System would contribute to nosocomial infection prevention and health promotion in Korea through an active surveillance at the national level.
Cross Infection* ; Health Promotion ; Infection Control ; Korea*

Management of patients with unstable fracture or fracture-dislocation of thoraco-lumbar spine continues to be controversial. One area of disagreement involves spinal fusion with internal fixation for prevention of later spinal instability. Intemal fixation of the spine without fusion has been advocated in the treatment of the unstable thoraco-lumbar fracture or dislocation. During the period of January 1981 to March 1984, thirty-two patients underwent fixation by Harrington distraction rod without fusion for the treatment of thoraco-lumbar fractures. Eight cases among them had second operation for the removal of the Harrington rods in 13.4months after Harrington rod fixation and were followed up clinically and radiolagically for 1 year at the Department of Orthopaedic Surgery, St. Mary's Hospital, Catholic Medical College and Center. The rationales for this procedure were to minimize the number of permanently stabilized segments and to provide more spinal mobility. We have expected that spontaneous fusion of vertebral body occur by the prolonged immobilization with Hamngton distraction rods. After the Harrington rods, the average conection rate of kyphotic angle was 41.8% and average correction rate of height of collapsed vertebral body or displacement of vertebral body was 42.3% at one year follow up. Instrumentations in eight patient were removed at 13.4 months after the initial surgery and the patients were followed up for one year. At the time of removal of instrumentation, unilateral partial facetectomy was done for histologic examination of the facet joint which is above the lower Harrington hook in four patients. The average correction rate of kyphotic angle was 37.5% and the average correction rate of height of collapsed or displaced vertebral body was 40.6% at one year after the removal of H-rods. The range of spine motions were incresed gradually. But histologic findings of the immobilized facet joint revealed fibrillation, fissures, thinning of the normal cartilagenous surface, decreased cartilagenous cellularity, and vascular tidemark invasion which are characteristics of osteoarthritis. Through this study, we obtained following conclusions: 1. Immediate Harrington distraction rodding was effective for the anatomic reduction of the collapsed vertebral body. And it provided immediate spinal stability, and spontaneous fusion of vertebral body. 2. Prolonged immobilization of the spine by Harrington rods is believed to have deleterious effect on articular cartilage of the immobilized facet joint as the degenerative changes of the cartilage of the facet joint was consistently found in this study. And it was regarded as a predisposing factors in the development of symptomatic arthritis of the spine. 3. If a fractured and collapsed vertebral body can be reduced by Harrington distraction rods, a spontaneous fusion of vertebral body occur. Harrington rodding without fusion could be one of the useful surgeries for management of the fractures and fracture-dislocation of the spine.
Arthritis ; Cartilage ; Cartilage, Articular ; Causality ; Dislocations ; Follow-Up Studies ; Humans ; Immobilization ; Osteoarthritis ; Spinal Fusion ; Spine ; Zygapophyseal Joint

No abstract available.
Acyclovir ; Chickenpox* ; Child* ; Herpesvirus 3, Human* ; Humans

Interleukin-6(IL-6) is a multifunctional cytokine, and deregulated IL-6 gene expression has been implicated as being involved in the pathogenesis of a number of diseaaes. So we measured the serum level of IL-6 to find a relationahip between uterine cervical cancer and serum IL-6 level. The serum levels of IL-6 were meesured m 54 patients adrnitted to the Severance hospital, from August, 1992 to February, 1993, of whom 27 patients were diagnosed as invasive cancer of cervix, 17 as CIN, and also utilizing 10 patiente diagnosed as uterine myoma as a control group for matched age and parity. The average serum level of IL-6 in invasive cancer, CIN, and uterine myoma were respectively 30.33pg/ml, 37.27pg/ml, and 12.45pg Jml. In 22% af cervical cancer patients (6 of 27), and 27% of CIN patients (4 of 17) studied blood levels of II-6 were detected whereas only 10% of uterine myoma (1 of 10) shorved the same result. However, the difference does not seem to be statistically significant, There was no statistically significant difference among any of the groups, and age and stage did not show any significant cmrelation, and the results need furt,ber investigations.
Cervix Uteri* ; Female ; Gene Expression ; Humans ; Interleukin-6* ; Leiomyoma ; Parity ; Uterine Cervical Neoplasms

No abstract available.

BACKGROUND/PURPOSE: Phospholipase A (PLAq) is an rate-limiting enzyme hydrolyzing arachidonic acid from the sn-2 position of membrane phospholipids. In vitro studies demonstrated that the enzyme could be secreted into extracellular mileu by pro-inflammatory cytokines and endotoxin which were reported to have important roles in chronic liver diseases. This study was performed to know whether the enzyme is involved in the pathophysiology of the diseases. METHODS: The subjects were composed of 24 patients with chronic hepatitis B, 26 patients with liver cirrhosis and 14 healthy individuals. The PLAp activities wem measured in the sera of the subjects by detecting radioactivity of "C-fatty acid hydrolyzed from "C-labeled phosphotadylethanolamine by the enzyme. RESULTS: The activities of PLA were increased in the patients with chronic liver diseases, especially in the chronic hepatitis B patients with acute exacerbation and in the decompensated cirrhosis patients. Furthermore, their activities were closely related with the levels of transaminase in hepatitis group and with the levels of serum albumin in cirrhosis group, respectively. CONCLUSIONS: These results suggest that extracellular PLA might be involved in the exacerbution and progression of the chronic liver diseases.
Arachidonic Acid ; Cytokines ; Fibrosis ; Hepatitis ; Hepatitis B, Chronic ; Humans ; Liver Cirrhosis ; Liver Diseases* ; Liver* ; Membranes ; Phospholipases A2* ; Phospholipases* ; Phospholipids ; Radioactivity ; Serum Albumin

No abstract available.
Nipples*

A total of 162 patients with invasive cervical cancer was investigated retrospectively with a view to elucidate the efficacy of pretreatment staging procedures of application with intravenous pyelography, cystoscopy, rectosigmoidoscopy. All 72 intravenous pyelograms, 155 sigmoidoscopies, 158 cystoscopies were normal. Of 111 patients with stage Ib who had paraaortic lymph node biopsies, two patients had a positive node(0.02%). Of 51 patients with stage II who had paraaortic lymph node biopsies, five patients had positive paraaortic lymph node(10%). And the accuracy of computed tomography and magnetic resonance imaging in the evaluation of invasive cervical cancer was assessed. In evaluating stage of cervical cancer, clinical staging had an accuracy of 78.9%, compared with 65.7% for CT and 58.9% for MRI. And for detection of parametrial invasion, clincal staging had an accuracy of 85.9%, compared with 85.1% for CT and 78.9% for MRI. Both modalities were comparable in evaluating lymph node metastasis ( 76.1% for CT, 74.4% for MRI ). IVP, cystoscopy and sigmoidoscopy for staging procedure evaluated in this study are unnecessary and should no longer be performed in patients with early stage cervical cancer. In addition, paraaortic lymph node biopsies in the absence of clinically suspicious nodes are not warranted. Compared with CT and MRI, pelvic examination offered improved evaluation of cervical cancer staging, parametrial invasion, but CT and MRI was useful in detecting the pelvic lymph node metastasis which was nearly impossible by clinical evaluation.
Biopsy ; Cystoscopy ; Gynecological Examination ; Humans ; Lymph Nodes ; Magnetic Resonance Imaging* ; Neoplasm Metastasis ; Retrospective Studies ; Sigmoidoscopy ; Urography ; Uterine Cervical Neoplasms

No abstract available.
Osteochondroma*

In 1985, Stein et al, indentified an anaplastic large-cell malignant lymphoma that was distinctive because of the diffuse dermal infiltration of pleomorphic large lymphocytes, sinus growth pattern, and reactivity with the monoclonal antibody Ki-1(CD30). The clinical feature; distinguishing anaplastic large-cell Ki-1 lymphoma include a young median age, frequent peripheral adenopathy with sparing of the mediastinum, and extranodal disease with skin the most common sitc of involvement. We report a case of Ki-1 postive large-cell lymphoma in a 74-year-old male patient who presented with multiple ulcerated nodules on the right shin area.
Aged ; Humans ; Lymphocytes ; Lymphoma* ; Lymphoma, Large-Cell, Anaplastic ; Male ; Mediastinum ; Skin ; Ulcer