In order to prevent cross-infection, the sterilization of used and/or contaminated anesthetic- apparatus is still a difficult problem in clinical practice, particularly, following anesthesia for known advanced pulmonary tuberculosis cases. Therefore the antibacterisl activities of, an amphoteric detergent, Dodecyl diaminoethyl glycin hydrochloride (Hygien 51) were tested in vitro as a disinfectant against mycobacteria (M. tuberculosis H37 Rv, M. bovis, M. avium, M. tuberculosis H37 Ra, M. phlei, B.C.G.) The antimycobacterial activity tests were performed according to the modified Kolmer method. The testing organisms were cultured in Dubos broth at 37 degrees C, and the detergent, Hygien 51, was: diluted with sterile distilled water to 1,3,5 and 10%. One half milliliter of culture was pipetted into each tube containing 4.5 ml of diluted detergent, and at intervals of 3, 15, 30, 60, 120, 180 and 240 minutes, a 4mm loopful of the material was removed from each tube, and transferred to Ogawa media. The tests were carried out at two different temperatures, 20 degrees C and 50 degrees C. The subcultures were incubated at 37 degrees C for more than 8 weeks. The results were obtained as follows: 1) At room temperature (20 degrees C), all mycobateria, except M. bovis, were destroyed by treatment- with 10% solution of the detergent for more than 60 minutes. M. bovis was relatively sensitive to the detergent, and was killed by 5% solution for 30 min. and 10% for 15 min., but M. avium. was very resistant, and was not killed by 10% solution for 240 min. 2) By treatment with the detergent at 50 degrees C, the antimycobacterial activities of the detergent were highly increased. All mycobacteria were destroyed by 1% solution for 180 min, and by 10% for less than 30 min at 50 degrees C. In the comparison of the antibacterial activities against mycobacteria and other bacteria, it shows that mycobacteria are generally more resistant to the detergent, Hygien 51.
Anesthesia ; Bacteria ; Detergents ; Sterilization ; Tuberculosis ; Tuberculosis, Pulmonary ; Water

As 8 year old boy with a tracheal cannula because of tracheal stenosia was admitted for tracheal raconstruction. The tracheal stenosis site was 2cm below the tracheal soma and 4cm above the carina. The stenotic area was 5mm in diameter and 1.5cm in length. After proper premedication, anesthesia was induced with intramuscular ketamine and maintained mainly with 0.1% ketamine intravenous drip infusion and supplemented by small amounts of muscle relaxants and N2O EKG, direct arterial pressure and arterial blood gas tensions were monitored during anesthesia. Tracheal segmental resection and reconstruction were performed without serious hypoxia and hypercarbia. Anesthetic management for possible risk during operation was discussed and the literature reviewed.
Anesthesia* ; Anoxia ; Arterial Pressure ; Carisoprodol ; Catheterization* ; Catheters ; Child* ; Electrocardiography ; Humans ; Infusions, Intravenous ; Ketamine ; Male ; Premedication ; Tracheal Stenosis*

No abstract available.
Pyelonephritis*

Recently, the emergency of Middle East Respiratory Syndrome in Korea raised public concern regarding emerging infectious disease (EID) and affected the strategy for blood safety. Although some cases of EID such as West Nile virus in the United States and hepatitis E virus in Japan emerged in a restricted area, the emergence can rapidly affect the situation in other countries in a globalized society with advancements in transportation and international exchange. Because the risk of transfusion-mediated infection may occur by the agent of EID which can be transmitted through blood, the strategy for safety must be considered for agents that were not tested in the stage of blood donor screening. We reviewed the characteristics of transfusion-transmissible EIDs raising concerns worldwide and the strategies which had been adopted.
Blood Donors ; Blood Safety ; Communicable Diseases, Emerging* ; Emergencies ; Hepatitis E virus ; Humans ; Japan ; Korea ; Mass Screening ; Middle East ; Transportation ; United States ; West Nile virus

BACKGROUND: To evaluate the safety of double plateletpheresis which has already become established among developed countries and to set the guidelines for the donor selection and the deferral period between blood donations for Korean blood donors METHODS: From October to November, 2003, double plateletphereses were done in 28 voluntary donors whose platelet counts were more than 200,000/microliter at the KRC Cenral, Nambu, and Dongbu blood centers. During the collection the citrate reaction and the collection time were recorded and regular cell counts were done after the collection to assess the recovery. The platelet count, pH test, and blood culture were done in all the collected platelets. RESULTS: The mean total processing volume was 4,312mL and the mean volume of the anticoagulant infused to donor was 373 mL. The average collection time was 97 minutes. Most donors complained 'slight' citrate reaction during procedures and felt the procedures 'a little boring' because of the long collection time. The platelet count counted immediately after procedures was decreased by 35.9% on the average and it took 14 days for 95% of donors to recover the 95% level of the original platelet count. The mean product volume was 501 mL and the mean platelet yield of products was 6.4 x 10 11 platelets. The pH measured at fifth day after collection was 7.3 and no aerobic bacteria was found in the culture. CONCLUSION: No significant adverse reaction was found in double plateletpheresis for Korean blood donors as compared with the existing one dose plateletpheresis. The guidelines for donor selection should include the minimum platelet count requirement with more than 200,000/microliter and the deferral period between donations should be or more 14 days.
Bacteria, Aerobic ; Blood Donors* ; Blood Platelets ; Cell Count ; Citric Acid ; Developed Countries ; Donor Selection ; Humans ; Hydrogen-Ion Concentration ; Platelet Count ; Plateletpheresis* ; Tissue Donors

Purpose: Long-term oncologic differences in outcome between groups of patients with Lynch syndrome (LS) colorectal cancer (CRC) and sporadic CRC with microsatellite instability-high (MSI-H) are the focus of investigation in the current study. Methods: Patients registered in the Korean Hereditary Tumor Registry and 2 tertiary referral hospitals treated for stage I– III CRC between 2005 and 2015 were retrospectively analyzed. Detection for both groups was performed using pedigree, microsatellite instability, and mismatch repair (MMR) gene testing. Multivariate analyses for overall survival (OS) and disease-free survival (DFS) were conducted. Results: Cases of LS (n = 77) and sporadic CRC with MSI-H (n = 96) were identified. LS CRC patients were younger in age and displayed tumor sidedness, typically involving left-sided colon and rectum, compared to patients with sporadic CRC with MSI-H. OS and DFS were lower for LS CRC relative to CRC with MSI-H (OS, 72.7% vs. 93.8%, P = 0.001; DFS, 71.4% vs. 88.5%, P = 0.001). In multivariate analyses, tumor sidedness, stage, and chemotherapy were independent factors for OS and DFS. LS CRC was a prognostic factor for poorer OS (hazard ratio, 2.740; 95% confidence interval, 1.003–7.487; P = 0.049), but not DFS. Conclusion Our findings indicate that LS CRC is associated with poorer outcomes compared to sporadic CRC with MSI-H, presenting distinct clinical features. In view of the current lack of knowledge on genetic and molecular mechanisms, appropriate management taking into consideration the difficulty of identification of CRC with hypermutable tumors harboring heterogeneity is essential.

Purpose: Long-term oncologic differences in outcome between groups of patients with Lynch syndrome (LS) colorectal cancer (CRC) and sporadic CRC with microsatellite instability-high (MSI-H) are the focus of investigation in the current study. Methods: Patients registered in the Korean Hereditary Tumor Registry and 2 tertiary referral hospitals treated for stage I– III CRC between 2005 and 2015 were retrospectively analyzed. Detection for both groups was performed using pedigree, microsatellite instability, and mismatch repair (MMR) gene testing. Multivariate analyses for overall survival (OS) and disease-free survival (DFS) were conducted. Results: Cases of LS (n = 77) and sporadic CRC with MSI-H (n = 96) were identified. LS CRC patients were younger in age and displayed tumor sidedness, typically involving left-sided colon and rectum, compared to patients with sporadic CRC with MSI-H. OS and DFS were lower for LS CRC relative to CRC with MSI-H (OS, 72.7% vs. 93.8%, P = 0.001; DFS, 71.4% vs. 88.5%, P = 0.001). In multivariate analyses, tumor sidedness, stage, and chemotherapy were independent factors for OS and DFS. LS CRC was a prognostic factor for poorer OS (hazard ratio, 2.740; 95% confidence interval, 1.003–7.487; P = 0.049), but not DFS. Conclusion Our findings indicate that LS CRC is associated with poorer outcomes compared to sporadic CRC with MSI-H, presenting distinct clinical features. In view of the current lack of knowledge on genetic and molecular mechanisms, appropriate management taking into consideration the difficulty of identification of CRC with hypermutable tumors harboring heterogeneity is essential.

PURPOSE: The Korean Hereditary Tumor Registry, the first and one of the largest registries of hereditary tumors in Korea, has registered about 500 families with hereditary cancer syndromes. This study evaluates the temporal changes in clinicopathologic features and surgical patterns of Lynch syndrome (LS) patients. MATERIALS AND METHODS: Data on 182 unrelated LS patients were collected retrospectively. The patients were divided into the period 1 group (registered in 1990-2004) and 2 (registered in 2005-2014). The clinical characteristics of the two groups were compared to identify changes over time. RESULTS: The period 1 group included 76 patients; the period 2 group, 106 patients. The mean ages at diagnosis were 45.1 years (range, 13 to 85 years) for group 1 and 49.7 years (range, 20 to 84 years) for group 2 (p=0.015). The TNM stage at diagnosis did not differ significantly-period 1 group: stage 0-I (n=18, 23.7%), II (n=37, 48.7%), III (n=19, 25.0%), and IV (n=2, 2.6%); period 2 group: stage 0-I (n=30, 28.3%), II (n=35, 33.0%), III (n=37, 34.9%), and IV (n=4, 3.8%). Extended resection was more frequently performed (55/76, 72.4%) in the period 1 group than period 2 (49/106, 46.2%) (p=0.001). CONCLUSION: Colorectal cancer in patients with LS registered at the Korean Hereditary Tumor Registry is still diagnosed at an advanced stage, more than two decades after registry's establishment. Segmental resection was more frequently performed in the past decade. A prompt nationwide effort to raise public awareness of hereditary colorectal cancer and to support hereditary cancer registries is required in Korea.
Colorectal Neoplasms ; Colorectal Neoplasms, Hereditary Nonpolyposis* ; Diagnosis ; Humans ; Korea ; Neoplastic Syndromes, Hereditary ; Registries ; Retrospective Studies

Purpose: This study was performed to compare the oncologic outcomes between nonradical management and total mesorectal excision in good responders after chemoradiotherapy. Methods: We analyzed 75 patients, who underwent 14 watch-and-wait, 30 local excision, and 31 total mesorectal excision, in ycT0–1N0M0 based on magnetic resonance imaging after chemoradiotherapy for advanced mid-to-low rectal cancer in 3 referral hospitals. The nonradical management group underwent surveillance with additional sigmoidoscopy and rectal magnetic resonance imaging every 3–6 months within the first 2 years. Results: Nonradical management group had more low-lying tumors (P < 0.001) and less lymph node metastasis based on magnetic resonance imaging (P = 0.004). However, cT stage, ycT, and ycN stage were not different between the 2 groups. With a median follow-up period of 64.7 months, the 5-year locoregional failure rate was higher in the nonradical management group than in the total mesorectal excision group (16.7% vs. 0%, P = 0.013). However, the 5-year overall survival and disease-free survival rates of the nonradical management and total mesorectal excision groups were not different (95.2% vs. 93.5%, P = 0.467; 76.4% vs. 83.6%, P = 0.665; respectively). Conclusion This study shows that nonradical management for ycT0–1N0 mid-to-low rectal cancer may be an alternative treatment to total mesorectal excision under proper surveillance and management for oncologic events.

Purpose: This study was performed to compare the oncologic outcomes between nonradical management and total mesorectal excision in good responders after chemoradiotherapy. Methods: We analyzed 75 patients, who underwent 14 watch-and-wait, 30 local excision, and 31 total mesorectal excision, in ycT0–1N0M0 based on magnetic resonance imaging after chemoradiotherapy for advanced mid-to-low rectal cancer in 3 referral hospitals. The nonradical management group underwent surveillance with additional sigmoidoscopy and rectal magnetic resonance imaging every 3–6 months within the first 2 years. Results: Nonradical management group had more low-lying tumors (P < 0.001) and less lymph node metastasis based on magnetic resonance imaging (P = 0.004). However, cT stage, ycT, and ycN stage were not different between the 2 groups. With a median follow-up period of 64.7 months, the 5-year locoregional failure rate was higher in the nonradical management group than in the total mesorectal excision group (16.7% vs. 0%, P = 0.013). However, the 5-year overall survival and disease-free survival rates of the nonradical management and total mesorectal excision groups were not different (95.2% vs. 93.5%, P = 0.467; 76.4% vs. 83.6%, P = 0.665; respectively). Conclusion This study shows that nonradical management for ycT0–1N0 mid-to-low rectal cancer may be an alternative treatment to total mesorectal excision under proper surveillance and management for oncologic events.