We examined the incidence of nasel MRSA carriers who were admitted to the ICU during about 6 months. The nasal organisms of 25 medical staffs were also examined during this period. Of 83 patients, 8 (9.6%) had MRSA. Of 25 medical staffs, 1 (4%) had MRSA. Patients who had MRSA were isolated to the single room and their nasal cavities were wiped with 10% popidon iodine solution.
The routine inspection of nasal organisms in critically-ill patients on admission to the ICU and in staffs was useful to determine MRSA carrier and to prevent the prevalence of MRSA infections.
Three adult patients received intravenous infusion of 0.5g vancomycin for 90 minutes twice a day. This prescription was sufficient to maintain the minimum inhibitory concentration of vancomycin for adult patients without impairing renal function.

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Several investigators have proposed criteria to predict the need for postoperative mechanical ventilation in patients with myasthenia gravis. Kimura et al. recently described the Shinshu University scoring system which is applied to Japanese patients. They identified eight risk factors-myasthenia and/or cholinergic crisis, respiratory disease, bulbar palsy, thymoma, operability, other complications, pyridostigmine dosage, and % vital capacity.
We tested the value of this scoring system retrospectively in 74 patients with myasthenia gravis who recieved thymectomy. Sixty-four patients out of 74 (86.5%) were predicted accurately by the scoring system. However, six patients, predicted not to need controlled ventilation, needed prolonged postoperative ventilatory support. Of these 6 patients, two had seriously reduced % vital capacity of less than 59%, one had a progressive exacerbation of myasthenic symptoms before surgery, and one encountered bulbar weakness with menstruation.
This study aimed to propose new criteria and a modified scoring system. We applied the statistical technique of multivariate discriminant analysis to select the most useful preoperative variables for identifying with myasthenia gravis patients who need mechanical ventilation. Using this new scoring system, a prediction of the postoperative need for ventilatory support was accurately achieved in 94.6%, and false negative could be reduced in only two cases.

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