This study was carried out in order to find out the valuable measure to kill the parasite eggs in night soil. The fresh eggs of Ascaris put into human stool were irradiated with Cobalt 60 of 200,000 to 1,000,000 rad and cultured in test tubes at 25-30 C, washing with 2 percent formalin solution every 24 hours. The continuous development of those eggs were observed under microscope and the proprotions of developed eggs were compared with those of control groups. The major result can be summarized as follows: In general, The eggs in stool developed poorly than the eggs in saline. If the eggs were irradiated with the larger dose of Cobalt 60, the proportion of developed eggs were reduced subsequently. The eggs irradiated with the dose of 1,000,000 rad in saline developed in the proportion of 15.5 percent, whereas irradiated with 200,000 rad 94 percent developed in 4 weeks. The 44.5 percent of eggs in stool irradiated with 200,000 rad developed after 4 weeks, 30.5 percent with 300,000 rad, 25 percent with 500,000 rad and 3.5 percent with 1,000,000 rad respectively. The effective minimum dose of Cobalt 60 irradiation to kill the Ascaris eggs in stool was estimated 1,000,000 rad. Further examination will be required to observe the infectivity of irradiated Ascaris eggs to animals and to evaluate the effect from the standpoint of sanitary engineerings.
parasitology-nematode-Ascaris lumbricoides ; Cobalt 60 ; radiology ; prevention ; egg ; infectivity

The computed tomographic (CT) and clinical findings in 9 patients with serologically confirmed Japanese encephalitis were reviewed. In 6 patients with prominent pyramidal and extrapyramidal symptoms and signs, the main CT finding was low density areas in the thalamus, internal capsule, basal ganglia, and midbrain. Low density areas were compatible with the anatomical distribution of pathologic lesions in Japanese encephalitis. Diffuse low density in the periventricular white matter was evident in 5 of 6 cases, with ventricular compression in 2 cases, between the 1st and 7th day of illness. There was enlargement of the third and lateral ventricles and cortical sulci dilatation in 3 cases on or after the 21st day of illness. In once CT scan obtained on the 10th day of illness, diffuse low density in the periventricular white matter was observed with enlargement of lateral ventricles and cortical sulci dilatation. Gyral enhancement was noted in 3 of 4 cases within 4 days after the onset of symptoms. There was a limited correlation between the clinical and CT findings.
Asian Continental Ancestry Group* ; Basal Ganglia ; Dilatation ; Encephalitis, Japanese* ; Humans ; Internal Capsule ; Lateral Ventricles ; Mesencephalon ; Thalamus ; Tomography, X-Ray Computed

Behcet's disease (BD) is a multisystem disorder presenting recurrent oral and genital ulcerations as well as ocular lesions, involving the nervous system in a subgroup of patients. BD develops at a young age and is frequently presented with an acute or subacute brainstem syndrome or hemiparesis, as well as with other various neurological manifestations, the syndrome is often included in the differential diagnosis of multiple sclerosis, stroke of the young adult, and other neurological disorders. Transverse myelitis (TM) is a clinical syndrome in which an immune-mediated process causes neural injury to the spinal cord, resulting in varying degrees of weakness, sensory alterations and autonomic dysfunction. Spinal Neuro-behcet's disease is rare case. We reported a 33-year old man who had been treated for BD for 3 years.
Brain Stem ; Diagnosis, Differential ; Humans ; Multiple Sclerosis ; Myelitis, Transverse ; Nervous System ; Nervous System Diseases ; Neurologic Manifestations ; Paresis ; Spinal Cord ; Stroke ; Ulcer ; Young Adult

One of the reasons for insertion of endotracheal tube is to provide a patent airway. Unfortunately, the tube itself may become the cause of airway obstruction. Especially, armored tube is known to be most effective in maintenance of airway patency. However, airway obstruction has been reported by a varity of causes even though armored tube was used. We experienced airway obstruction with armored tracheostomy tube by swelling of inner layer near the cuff. The tube was reused one and had been disinfected with ethylene oxide. Therefore, to prevent complication such as airway obstruction by use of armored tubes, it is desirable to avoid reusal of armored tube and to examine the lumen as well as cuff before intubation when reused.
Airway Obstruction* ; Ethylene Oxide ; Intubation ; Tracheostomy*

PURPOSE: Dexamethasone is a well-known treatment for preterm infants with bronchopulmonary dysplasia. However, serious side effects have been identified, including hypertension, and cardiac hypertrophy. This study was undertaken to examine whether dexamethasone induced cardiac hypertrophy in preterm infants with bronchopulmonary dysplasia. METHODS: We retrospectively reviewed 12 infants with bronchopulmonary dysplasia treated with dexamethasone at Korea University Hospital from August 1995 to February 1999. Serial two-dimensional and M-mode echocardiographic measurements were taken before treatment and at 1,2,3,4,5 weeks after the start of dexamethasone therapy. RESULTS: Patients receiving dexamethasone had a significantly increase in interventricular septal thickness and left ventricular posterior wall thickness. These effects were transient, reached their maximal degree by the third week of treatment, and approached pretreatment conditions by the fifth week of treatment. Heart rate was increased but statistically not significant. The fractional shortening, systolic and diastolic arterial pressure were transiently increased during dexamethasone therapy. CONCLUSION: We conclude that a transient myocardial hypertrophy is associated with dexamethasone therapy in infants with bronchopulmonary dysplasia. Follow up of careful echocardiac monitoring should be considered in infants with dexamethasone therapy.
Arterial Pressure ; Bronchopulmonary Dysplasia ; Cardiomegaly* ; Cardiomyopathy, Hypertrophic* ; Dexamethasone* ; Echocardiography ; Follow-Up Studies ; Heart Rate ; Humans ; Hypertension ; Hypertrophy* ; Infant ; Infant, Newborn ; Infant, Premature* ; Korea ; Retrospective Studies

Anti-Müllerian hormone (AMH) is now accepted as an important clinical marker of ovarian reserve and is increasingly measured as an initial evaluation at infertility clinics. The aim of this study was to establish reference values for the revised second generation (Gen II) assay using population-based data. In this population-based cohort study, AMH data from unselected infertile women aged 25–45 years from June 2013 to June 2014 (n = 15,801) were collected. The AMH values were measured using the revised Gen II assay. We established and validated 5 AMH-age regression models. Based on the optimal AMH-age model, reference values and centile charts were obtained. The quadratic model (log AMH = 0.410 × age − 0.008 × age²− 3.791) was the most appropriate for describing the age-dependent decrease in AMH measured using the revised Gen II assay. This is the largest population-based study to establish age-specific reference values of AMH using the revised Gen II assay. These reference values may provide more specific information regarding the ovarian reserve estimation of infertile women.
Biomarkers ; Cohort Studies ; Female ; Humans ; Infertility ; Ovarian Reserve ; Reference Values*

A bronchial blocker (BB) is preferred for lung separation in patients with difficult airways. However, BBs, unlike double-lumen tubes, must be placed in the bronchus of the lung being operated on, hence can be damaged by surgical manipulation. Intubation was unexpectedly difficult in this male patient, so a Coopdech BB was placed in the right mainstem bronchus through a single-lumen tracheoscopic ventilation tube for a thoracoscopic right upper lobectomy. During the bronchial resection, however, the distal tip of the BB was transected and pinched in the staple line, so the staple line was partially opened, and the BB was withdrawn into the trachea. The opened bronchial stump was sutured manually under apnea without conversion to an open thoracotomy, and there was no significant air leakage through the suture line. This case underlines the importance of frequently evaluating the position of a BB during lung surgery.
Airway Management ; Apnea ; Bronchi ; Humans ; Intubation ; Lung ; Male ; One-Lung Ventilation ; Sutures ; Thoracoscopy ; Thoracotomy ; Trachea ; Ventilation

BACKGROUND: Ketamine hydrochloride, NMDA receptor antagonist is a potent analgesic and anesthetic. Other analgesics, like opioid, have been shown to effectively relieve postoperative pain when infused into epidural space, but effects of ketamine hydrochloride infused into epidrual space for postoperative pain control is still controversial, and therefore the present study was undertaken. METHODS: Ninety adult patients (ASA I or II) scheduled for upper abdominal and chest surgery were randomized into ketamine and fentanyl groups. For all patients, informed consent was obtained preoperatively. Anesthesia was induced with thiopental sodium/succinylcholine and maintained with nitrous oxide/oxygen/enflurane. Skeletal muscle relaxation was maintained with vecuronium. Epidural catheterization was done after operation. Ketamine group received epidural bolus of 0.1% bupivacaine 10 ml followed by continuous epidural infusion of 0.1% bupivacaine 100 ml containing ketamine 200 mg. Fentanyl group received epidural bolus of 0.1% bupivacaine 10 ml containing fentanyl 100 microgram followed by continuous epidural infusion of 0.1% bupivacaine 100 ml containing fentanyl 600 microgram. Continuous infusion rate was 2 ml/hr in both groups. Analgesic effects were assessed using VAS (visual analogue score), PHS (Prince Henry score) and PRS (pain relief score). Side effects and number of patients using additional analgesics were evaluated. RESULTS: Analgesic effects were significant in both group after drug administration. But fentanyl group had greater analgesic effects than ketamine group. Fentanyl group experienced side effects such as pruritus (27 cases), nausea and vomiting (9 cases). Ketamine group had side effects such as nausea and vomiting (13 cases). Number of patients using additional analgesics were seven and twenty-four in the fentanyl and ketamine groups, respectively. CONCLUSIONS: We conclued continuous epidural infusion of ketamine had fewer analgesics effect at early state of postoperative pain than fentanyl.
Adult ; Analgesics ; Anesthesia ; Bupivacaine ; Catheterization ; Catheters ; Epidural Space ; Fentanyl ; Humans ; Hydrogen-Ion Concentration ; Informed Consent ; Ketamine* ; Muscle, Skeletal ; N-Methylaspartate ; Nausea ; Pain, Postoperative* ; Pruritus ; Relaxation ; Thiopental ; Thorax ; Vecuronium Bromide ; Vomiting

While it is generally considered that tuberculous meningitis (TBM) causes various vascular complications, there have been few reports of moyamoya syndrome following TBM. A 23-year-old female was diagnosed as TBM. Preliminary brain MRA yielded normal findings. Follow-up MRA and cerebral angiography conducted 1.5 years later yielded findings that were consistent with moyamoya disease. They showed no interval change after 2 years, and the patient had no neurological deficits. This patient with TBM subsequently developed moyamoya syndrome during the course of antituberculosis medication.
Brain ; Cerebral Angiography ; Female ; Follow-Up Studies ; Humans ; Moyamoya Disease ; Tuberculosis, Meningeal ; Young Adult

OBJECTIVE: To identify differences in the expression of the genes for peroxisome proliferator-activated receptor (PPAR)-γ, cyclooxygenase (COX)-2, and the proinflammatory cytokines interleukin (IL)-6 and tumor necrosis factor (TNF)-α in granulosa cells (GCs) from polycystic ovary syndrome (PCOS) patients and controls undergoing controlled ovarian stimulation. METHODS: Nine patients with PCOS and six controls were enrolled in this study. On the day of oocyte retrieval, GCs were collected from pooled follicular fluid. Total mRNA was extracted from GCs. Reverse transcription was performed and gene expression levels were quantified by realtime quantitative polymerase chain reaction. RESULTS: There were no significant differences in age, body mass index, and total gonadotropin dose, except for the ratio of luteinizing hormone to follicle-stimulating hormone between the PCOS and control groups. PPAR-γ and COX-2 mRNA was significantly downregulated in the GCs of PCOS women compared with controls (p=0.034 and p=0.018, respectively), but the expression of IL-6 and TNF-α mRNA did not show significant differences. No significant correlation was detected between the expression of these mRNA sequences and clinical characteristics, including the number of retrieved oocytes, oocyte maturity, cleavage, or the good embryo rate. Positive correlations were found among the PPAR-γ, COX-2, IL-6, and TNF-α mRNA levels. CONCLUSION: Our data may provide novel clues regarding ovarian GC dysfunction in PCOS, and indirectly provide evidence that the effect of PPAR-γ agonists in PCOS might result from alterations in the ovarian follicular environment. Further studies with a larger sample size are required to confirm these proposals.
Body Mass Index ; Cyclooxygenase 2* ; Cytokines* ; Embryonic Structures ; Female ; Follicle Stimulating Hormone ; Follicular Fluid ; Gene Expression ; Gonadotropins ; Granulosa Cells* ; Humans ; Interleukin-6 ; Interleukins ; Luteinizing Hormone ; Oocyte Retrieval ; Oocytes ; Ovulation Induction ; Peroxisomes* ; Polycystic Ovary Syndrome* ; Polymerase Chain Reaction ; PPAR gamma ; Prostaglandin-Endoperoxide Synthases ; Reverse Transcription ; RNA, Messenger ; Sample Size ; Tumor Necrosis Factor-alpha