BACKGROUND: This study was performed to evaluate the results of intervention activities on the management of steam sterilizers and sterile items in out-patient clinics and clinical laboratories. METHODS: A checklist was developed and used to monitor and evaluate the adequacy of sterilizers and sterilized items at out-patient clinics and clinical laboratories in a tertiary-care hospital. The checklist consisted of 7 items: condition of the material used for packaging sterile items, maintenance of shelf-life records, sterilizer cleanliness, maintenance of expiry date details of sterilized items, sterilization conditions, use of chemical indicators, and the results of biological indicators. Monitoring and additional intervention activities were carried out once every week for 53 weeks from August 2007 to July 2008. The study period was divided into 2 terms, early and late intervention; the duration of each term was 6 months, and we compared the ratio of adequacy of management of sterilizer and sterilized items between the 2 terms. RESULTS: There were a total of 795 observations from 15 departments in 1 year. Sterility of the materials used for packaging increased from 87.4% in the first 6-month term to 97.9% in the second 6-month term. Records for shelf-life increased from 89.6% to 98.5% in the same period, while the figures for maintaining expiry date details of sterilized items and for steam sterilizer cleanliness increased from 92.6% to 99.2%, and from 91.9% to 98.5 (P<0.05), respectively. CONCLUSION: Our intensive checklist-based intervention was effective in improving the management of steam sterilizers and sterile items in out-patient clinics and clinical laboratories.
Ambulatory Care Facilities ; Checklist ; Humans ; Infertility ; Organothiophosphorus Compounds ; Outpatients ; Product Packaging ; Steam ; Sterilization

OBJECTIVE: In order to confirm the local production of total and specific IgE antibodies in the nasal polyp tissues. MATERIAL AND METHOD: We measured total IgE and house dust mite(Dermatophagoides pteronpssinus .' DP)-specific IgE antibody using enzyme-linked immunosorbent assay(ELISA) in the supernatant of nasal polyp homogenates from 72 subjects undergoing nasal polypectomy. The subjects were divided into three groups according to skin reactivity to DP: 20 strongly atopic subjects to group I(mean wheal diameter) 3mm), 19 weakly atopic subjects to group II (mean wheal diameter 1-3mm) and 33 negative skin responders to group III. RESULT: Group I showed significantly higher levels of total and DP-specific IgE levels in the nasa
Antibodies ; Dust* ; Immunoglobulin E* ; Nasal Polyps* ; Pyroglyphidae* ; Skin ; United States National Aeronautics and Space Administration

OBJECTIVES AND METHODS: To confirm the local production of IgE antibody from the nasal polyp tissue, and to evaluate the difference between atopics and non-atopics, nasal polyp tissues were taken from both 10 atopic and 10 non-atopic subjects. The tissue total IgE (tlgE) level was measured by enzyme-linked immunosorbent assay (ELISA) and serum tlgE level by radio-immunoassay. The tissue albumin level was measured by nephelometry, and serum albumin level by Bromocresol green method. RESULTS: The polyp tissue tlgE/albumin as well as serum tlgE/albumin ratio were significantly higher in atopics than in non-atopics (p < 0.05), with no difference in the albumin level between the two groups (p > 0.05). Three non-atopic subjects had high polyp tissue tlgE/albumin (> 10). A significant correlation was noted between serum tlgE/albumin and polyp tlgE/albumin (r = 0.46, p = 0.04). The ratio of polyp tlgE/albumin to serum tlgE/albumin was greater than 1 in all of the non-atopic subjects and 7 of 10 atopic subjects. CONCLUSION: These findings support the hypothesis that IgE antibody could be locally produced from the nasal polyp tissue of non-atopic subjects as well as atopic subjects. The possibility of an isolated local production of IgE antibody was suggested.
Albumins/analysis ; Antibodies, Anti-Idiotypic/analysis* ; Biopsy, Needle ; Comparative Study ; Enzyme-Linked Immunosorbent Assay ; Female ; Human ; Hypersensitivity, Immediate/immunology* ; IgE/biosynthesis* ; IgE/analysis ; Male ; Nasal Polyps/pathology ; Nasal Polyps/immunology* ; Radioimmunoassay ; Reference Values ; Tissue Culture ; Substances: IgE ; Substances: Antibodies, Anti-Idiotypic ; Substances: Albumins

BACKGROUND AND OBJECTIVE: IgG subclass deficiency has been reported in patients with bronchial asthma and is associated with recurrent respiratory tract infections. This study was done to identify prevalence of IgG subclass deficiency and to evaluate the possible difference between atopic and non-atopic asthmatics. Subjects and METHODS: We measured serum levels of IgG and IgG subclass in 35 asthmatic patients and 50 healthy controls using nephelometry. Reference values of each IgG subclass was defined as cumulative percentile between 2.5% to 97.5% of controls. RESULTS: Total IgG, IgG1 and IgG2 of asthmatics were significantly lower than for those of controls(p<0.05, respectively). In atopic asthmatics, compared with non-atopic asthmatics, IgG4 level was significantly higher (p<0.05). The frequency of IgG subclass levels below the reference value was eight (22.9%) of 35 asthmatics. CONCLUSION: IgG, IgG1 and IgG2 were significantly lower in asthmatic patients. Some patients had IgG subclass levels below reference value. Further studies will be needed to evaluate their clinical significance.
Asthma* ; Humans ; Immunoglobulin G* ; Nephelometry and Turbidimetry ; Prevalence ; Reference Values ; Respiratory Tract Infections

PURPOSE: To evaluate the clinical results of arthroscopic inside-out repair leaving posterior horn tear. MATERIALS AND METHODS: Among the patients taken arthroscopic meniscal repair due to meniscus longitudinal tear from Jan. 1999 to Dec. 2004, total 32 patients were evaluated, and followed at minimum of two years(mean 32 months). Meniscal repair was done as maximum 3mm interval. The length of unrepaired posterior horn was mean 7.5mm. RESULTS: Preoperative Lysholm score was mean 62.5 and postoperative improved to 91.0. Twenty eight cases(87.5%) showed excellent or good results by Tapper and Hoover criteria. In 4 cases, symptoms recurred at 4 to 12 months after repair and 2 cases were combined with ACL deficiency. Second look arthroscopy was performed in 10 cases, 4 cases for recurred symptom and 6 cases for determining whether healing of untreated posterior horn occurred or not. We observed complete healing of 4 cases and incomplete healing of 2 cases on the acquisition of stability. CONCLUSION: It was suggested that meniscal repair leaving posterior horn tear may be healed if both stabilities of the torn area and the knee joint were maintained.
Animals ; Arthroscopy ; Horns* ; Humans ; Knee Joint

Non-acetylated salicylates have been recommended for use as alternatives to nonsteroidal anti-inflammatory drugs (NSAIDs) in aspirin and/or tartrazine-sensitive patients. We experienced a case of an aspirin-sensitive asthmatic patient who developed a broncho-obstructive reaction after taking 100 mg of sodium salicylate. The result of this study suggests that sodium salicylate may cross-react with aspirin in aspirin-and tartrazine-sensitive patients.
Aspirin/*adverse effects/immunology ; Asthma/*complications/diagnosis/etiology ; Bronchial Provocation Tests ; Cross Reactions ; Drug Hypersensitivity/*complications/diagnosis/etiology ; Female ; Humans ; Middle Aged ; Sodium Salicylate/*adverse effects/immunology ; Tartrazine/adverse effects

STUDY DESIGN: A comparative retrospective study between those who have and have not undergone donor site reconstruction after thoracolumbar spinal anterior interbody fusion using an auto-iliac bone graft. OBJECTIVES: To determine the efficacy of iliac reconstruction in reducing iliac donor site morbidity. SUMMARY OF LITERATURE REVIEW: An autogenous bone graft harvested from the iliac crest is still the gold standard for spinal anterior interbody fusion. However, defects of a significant size often remain in the donor site, which may cause pain, pelvic instability and cosmetic deformity etc. Iliac donor site reconstruction with bone cement is one of the methods for reducing the donor site morbidity, with a relatively easy technique. MATERIALS AND METHODS: A review of patients who underwent iliac bone graft harvesting, with or without reconstruction, by a single orthopaedic surgeon was conducted. The iliac donor site morbidity, at least one after remote surgery was compared in those who had and had not undergone iliac reconstruction. All patients were evaluated by an independent observer. During a two and half year period, 61 patients met the inclusion criteria. Twenty-three patients underwent iliac donor site reconstruction with bone cement and 9 with auto rib bone reconstruction, while the remaining 29 had no donor site reconstruction. Patients were asked to assess the duration and severity of their donor site pain, using a visual analogue scale (VAS), and other morbidity, such as cosmetic deformity. RESULTS: The severity of chronic donor site pain was significantly reduced in the donor site reconstruction group; however, there were no statistically significant differences, other than chronic pain, in the morbidities. CONCLUSIONS: Iliac donor site reconstruction, with bone cement or auto-rib bone, is a relatively easy technique to perform after anterior spinal fusion. Better results can be expected, especially in reducing postoperative donor site pain.
Chronic Pain ; Congenital Abnormalities ; Humans ; Pelvic Pain ; Retrospective Studies ; Ribs ; Spinal Fusion* ; Tissue Donors* ; Transplants*

Urinary tract infection (UTI) is one of the most common complications after radical cystectomy and orthotopic neobladder reconstruction. This study investigated the incidence and implicated pathogen of febrile UTI after ileal neobladder reconstruction and identify clinical and urodynamic parameters associated with febrile UTI. From January 2001 to May 2015, 236 patients who underwent radical cystectomy and ileal neobladder were included in this study. Fifty-five episodes of febrile UTI were identified in 46 patients (19.4%). The probability of febrile UTI was 17.6% and 19.8% at 6 months and 24 months after surgery, respectively. While, Escherichia coli was the most common implicated pathogen (22/55, 40.0%), Enterococcus spp. were the most common pathogen during the first month after surgery (18/33, 54.5%). In multivariate logistic regression analysis, ureteral stricture was an independent risk factor associated with febrile UTI (OR 5.93, P = 0.023). However, ureteral stricture accounted for only 6 episodes (10.9%, 6/55) of febrile UTI. Most episodes of febrile UTI occurred within 6 months after surgery. Thus, to identify risk factors associated with febrile UTI in the initial postoperative period, we assessed videourodynamics within 6 months after surgery in 38 patients. On videourodyamic examination, vesicoureteral reflux (VUR) was identified in 16 patients (42.1%). The rate of VUR presence in patients who had febrile UTI was not significantly different from those in patients without febrile UTI (50% vs. 39.3%, P = 0.556). Patients with febrile UTI had significantly larger residual urine volume (212.0 ± 193.7 vs. 90.5 ± 148.2, P = 0.048) than those without. E. coli and Enterococcus spp. are common pathogens and ureteral stricture and residual urine are risk factors for UTI after ileal neobladder reconstruction.
Aged ; Anti-Bacterial Agents/therapeutic use ; Cystectomy/adverse effects ; Enterococcus/isolation & purification ; Escherichia coli/isolation & purification ; Female ; Humans ; Ileum/*surgery ; Incidence ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Postoperative Complications ; Reconstructive Surgical Procedures ; Retrospective Studies ; Risk Factors ; Urinary Bladder Neoplasms/*surgery ; Urinary Tract Infections/drug therapy/*epidemiology/etiology/microbiology ; Urodynamics

To confirm local production of IgE, and evaluate role of immunoglobulins on eosinophil activation in nasal polyp (NP) tissue, we measured IgG, IgA, secretory IgA(sIgA), total (tIgE) and specific IgE (sIgE) to Dermatophagoides pteronyssinus(DP) by ELISA in NP tissue homogenates from 51 subjects. They were classified according to skin reactivity to DP: group I, 15 highly atopic subjects; group II, 18 weakly atopic subjects; and group III, 18 non-atopic subjects. Eosinophil cationic protein (ECP) level was measured by CAP system. Highest level of DP-sIgE was noted in group I, followed by group II and III (p<0.05). Nine (60%) of group I and 4 (22%) of group II subjects had detectable level of DP-sIgE with no significant differences in IgA, sIgA, and IgG. All of NP tissue had eosinophilic infiltration with no significant difference in activated eosinophil count or ECP level among 3 groups. A significant correlation was noted between EG2+ cell count and tIgE (r=0.55, p<0.05), and DP-sIgE level (r=0.60, p<0.05). A significant correlation was also noted between ECP and IgG (r=0.51, p<0.05) and DP-sIgE level (r=0.47, p<0.05) with no significant correlation with IgA or sIgA. These results suggest that DP-sIgE was detectable in NP tissue from weakly atopic subjects as well as highly atopic subjects. IgG and sIgE may have potential roles in eosinophil degranulation in NP tissue.
Blood Proteins/analysis ; Cell Degranulation/immunology ; Dermatophagoides pteronyssinus/immunology ; Eosinophil Granule Proteins ; Eosinophils/immunology ; Humans ; Immunoglobulin A/analysis/immunology ; Immunoglobulin E/analysis/immunology ; Immunoglobulin G/analysis/immunology ; Immunoglobulins/analysis/*immunology ; Nasal Polyps/*immunology/pathology ; *Ribonucleases

PURPOSE: To evaluate the results of arthroscopic contouring surgery and posterolateral meniscal repair for pediatrics with snapping discoid lateral meniscus without tear. MATERIALS AND METHODS: Nine children below 10 years, with snapping discoid lateral meniscus without tear were evaluated in this study. 3 cases had a morphologic deformity of lateral meniscus in MRI and arthroscopic findings, but there was no meniscal tear. Only contouring surgery was performed in 6 cases, and in 3 cases, because of the instability of meniscus over 5mm in traction due to the relaxation of the menisco-capsular junction after contouring surgery, posterolateral repair was performed. The average duration of follow up was 39 months(range, 25 to 72 months). RESULTS: Additional posterolateral repair was done due to remaining snapping, in three cases of six contouring surgery cases. In all cases, snapping was disappeared. The average Lysholm score was improved from 71 in preoperative status to 97 in postoperative status(p=0.008) CONCLUSION: In case of the increased instability of the posterolateral corner of lateral meniscus after contouring surgery in the treatment of snapping discoid lateral meniscus, posterolateral repair is effective to improve the snapping symptom from meniscal subluxation.
Child ; Congenital Abnormalities ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Menisci, Tibial* ; Pediatrics* ; Relaxation ; Traction