Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most prevalent nosocomial pathogens in Korea. The prevalence of MRSA is nearly 70% of clinical isolates of S. aureus, and the importance of infection control has increased. Many DNA-based molecular techniques have been introduced to type MRSA strains, but no single method of molecular techniques is universally applicable. This review summarizes the molecular techniques in epidemiological analyses of MRSA, describing some practical applicatiais of these techniques.
Epidemiologic Methods* ; Infection Control ; Korea ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Prevalence

BACKGROUND: Rapid and accurate detection of Mycobacterium tuberculosis is important for patients with tuberculous meningitis because early diagnosis and prompt initiation of treatment improve the outcome of the disease. PCR techniques have been applied but are not yet well established for the diagnosis of tuberculous meningitis. The Amplicor(TM) M. tuberculosis test (Roche Diagnostic Systems, Inc. ) can be used fur the detection of M. tuberculosis by PCR technique, but its use has not been recommended currently for extrapulmonary samples. We evaluated the Amplicor(TM) M. tuberculosis test for the direct detection of M. tuberculosis from cerebrospinal fluid (CSF) specimens of patients suspicious of having tuberculous meningitis. METHODS: We examined a total of 103 CSF samples from 76 patients. Tuberculous meningitis was diagnosed by clinical history, chest X-ray, CSF chemistry, bacteriology, computed tomography and response to antituberculous treatment. Twenty-six samples were obtained from 13 patients with tuberculous meningitis. For the Amplicor(TM) M. tuberculosis test, 0.3 - 2.0 mL of CSF was centrifuged at 15,000 rpm for 15 min and its pellet was treated as the instructions of the kit. RESULTS: Of the 103 CSF samples, none were smear-positive by Ziehl-Neelsen acid-fast stain, seven were culture-positive and twelve were PCR-positive. Of the 26 samples from 13 patients with tuberculous meningitis, seven from six patients were culture-positive and eleven from six patients were PCR-positive. The sensitivity, specificity, positive and negative predictive values of the Amplicor(TM) M. tuberculosis test for the patients compared to the clinical diagnosis were 46.2, 98.4, 85.7, and 89.9%, respectively, while the culture yielded 46.2, 100.0, 100.0, and 90.0%, respectively. CONCLUSIONS: The Amplicor(TM) M. tuberculosis test using CSF specimen for the diagnosis of tuberculous meningitis is specific and is as sensitive as culture. The assay will provide rapid and valuable information for the diagnosis and control of tuberculous meningitis.
Bacteriology ; Cerebrospinal Fluid ; Chemistry ; Diagnosis* ; Early Diagnosis ; Humans ; Mycobacterium tuberculosis ; Polymerase Chain Reaction* ; Sensitivity and Specificity ; Thorax ; Tuberculosis* ; Tuberculosis, Meningeal*

BACKGROUND: Rapid and accurate detection of Mycobacterium tuberculosis is important for patients with tuberculous meningitis because early diagnosis and prompt initiation of treatment improve the outcome of the disease. PCR techniques have been applied but are not yet well established for the diagnosis of tuberculous meningitis. The Amplicor(TM) M. tuberculosis test (Roche Diagnostic Systems, Inc. ) can be used fur the detection of M. tuberculosis by PCR technique, but its use has not been recommended currently for extrapulmonary samples. We evaluated the Amplicor(TM) M. tuberculosis test for the direct detection of M. tuberculosis from cerebrospinal fluid (CSF) specimens of patients suspicious of having tuberculous meningitis. METHODS: We examined a total of 103 CSF samples from 76 patients. Tuberculous meningitis was diagnosed by clinical history, chest X-ray, CSF chemistry, bacteriology, computed tomography and response to antituberculous treatment. Twenty-six samples were obtained from 13 patients with tuberculous meningitis. For the Amplicor(TM) M. tuberculosis test, 0.3 - 2.0 mL of CSF was centrifuged at 15,000 rpm for 15 min and its pellet was treated as the instructions of the kit. RESULTS: Of the 103 CSF samples, none were smear-positive by Ziehl-Neelsen acid-fast stain, seven were culture-positive and twelve were PCR-positive. Of the 26 samples from 13 patients with tuberculous meningitis, seven from six patients were culture-positive and eleven from six patients were PCR-positive. The sensitivity, specificity, positive and negative predictive values of the Amplicor(TM) M. tuberculosis test for the patients compared to the clinical diagnosis were 46.2, 98.4, 85.7, and 89.9%, respectively, while the culture yielded 46.2, 100.0, 100.0, and 90.0%, respectively. CONCLUSIONS: The Amplicor(TM) M. tuberculosis test using CSF specimen for the diagnosis of tuberculous meningitis is specific and is as sensitive as culture. The assay will provide rapid and valuable information for the diagnosis and control of tuberculous meningitis.
Bacteriology ; Cerebrospinal Fluid ; Chemistry ; Diagnosis* ; Early Diagnosis ; Humans ; Mycobacterium tuberculosis ; Polymerase Chain Reaction* ; Sensitivity and Specificity ; Thorax ; Tuberculosis* ; Tuberculosis, Meningeal*

No abstract available.

No abstract available.

No abstract available.
Knee* ; Menisci, Tibial*

No abstract available.
Arthroscopy* ; Hip*

BACKGROUND: Intravenous urography(IVU) has long been accepted as the primary radiologic study for the diagnosis of renal colic. But the IVU does pose disks of contrast material reactions and exposure to radiation. Recently, IVU has been challenged as a first line modality and ultrasonography proposed as a replacement. We, therefore, felt obliged to re-evaluate the IVU, KUB and ultrasonography as diagnostic tools. METHODS: We evaluate the sensitivity and specificity of ultrasound, IVU and KUB in detecting urinary calculi in suspected acute renal colic, a prospective study of 69 patients, both sides of kidney and ureter, who visited urban university hospital emergency center from September 1997 to January 1998. Our sonographic criteria far a positive examination consisted of visualization of urinary tract calculus and/or hydronephrosis and/or urinoma. RESULTS: In Ultrasonography, the accuracy, sensitivity and specificity were 94, 94 and 94%. In IVU and KUB, they were 90, 81, 98% and 71, 43, 96%. CONCLUSION: Ultrasonography is very useful diagnostic tool in initial evaluation of acute renal colic.
Calculi ; Diagnosis ; Emergencies ; Humans ; Hydronephrosis ; Kidney ; Prospective Studies ; Renal Colic* ; Sensitivity and Specificity ; Ultrasonography* ; Ureter ; Urinary Calculi ; Urinary Tract ; Urinoma

Polyethylene glycol (PEG)-3350 is the most frequently used lavage solution for bowel cleansing prior to colonoscopy or elective surgery because its large molecular weight means that it is poorly absorbed. However, if it leaks into the peritoneal cavity, complications may arise. Few published studies have assessed the absorption, distribution, metabolism and excretion of PEG. Moreover, no published clinical data regarding complications due to the intra-peritoneal leakage of PEG-3350 could be found. We report on an elderly patient who developed the poisoning caused by leaking of PEG-3350 during bowel preparation. It resulted in severe metabolic acidosis, hypernatremia, hyperosmolality and a high anion gap, but it was effectively treated with early continuous renal replacement therapy after surgery.
Absorption ; Acid-Base Equilibrium ; Acidosis ; Aged* ; Colonoscopy ; Humans ; Hypernatremia ; Metabolism ; Molecular Weight ; Peritoneal Cavity ; Poisoning* ; Polyethylene Glycols* ; Renal Replacement Therapy ; Therapeutic Irrigation

PURPOSE: Although most researchers agree that platelet-rich plasma (PRP) is a good source of autogenous growth factors, its effect on bone regeneration is still controversial. The purpose of this study was to evaluate whether increasing angiogenic factors in the human PRP to enhance new bone formation through rapid angiogenesis. MATERIAL AND METHODS: In vitro, the human platelets were activated with application of shear stress, 20 microgram/ml collagen, 2 mM CaCl2 and 10U thrombin/1 x 109 platelets. Level of vascular endothelial growth factor (VEGF) and platelet microparticle (PMP) in the activated platelets were checked. In the animal study, human angiogenic factors-enriched PRP was tested in 28 athymic rat's cranial critical bone defects with beta-TCP. Angiogenesis and osteogenesis were evaluated by laser Doppler perfusion imaging, histology, dual energy X-ray densinometry, and micro-computed tomography. RESULTS: In vitro, this human angiogenic factors-enriched PRP resulted in better cellular proliferation and osteogenic differentiation. In vivo, increasing angiogenic potential of the PRP showed significantly higher blood perfusion around the defect and enhanced new bone formation around acellular bone graft material. CONCLUSION: Angiogenic factor-enriched PRP leads to faster and more extensive new bone formation in the critical size bone defect. The results implicate that rapid angiogenesis in the initial healing period by PRP could be supposed as a way to overcome short term effect of the rapid angiogenesis.
Angiogenesis Inducing Agents ; Animals ; Blood Platelets ; Bone Regeneration ; Calcium Phosphates ; Cell Proliferation ; Collagen ; Durapatite ; Humans ; Intercellular Signaling Peptides and Proteins ; Osteogenesis ; Perfusion ; Perfusion Imaging ; Platelet-Rich Plasma ; Rats, Nude ; Transplants ; Vascular Endothelial Growth Factor A