No abstract available.

PURPOSE: To assess blood loss and transfusion between Navigation assisted minimally invasive total knee arthroplasty (TKA) performed with immediate release of drain and 1-hour - delayed release of drain. MATERIALS AND METHODS: We carried out a prospective randomised study to evaluate the blood loss in 100 knees having a Navigation-assisted minimally invasive TKA by dividing into two groups, one having a immediate release of drain (group A) and the other having a 1 hour-delayed release of drain(group B). All patients had a unilateral primary TKA using cemented type. RESULTS: The mean drainage of blood was 464.9 ml in a immediate release of drain group and 409.1ml in 1 hour-delayed release of drain group. This difference was not statistically significant (p=0.117). The pre- and postoperative hemoglobin were mean 13.36g/dl and 10.77 g/dl in group A, mean 12.8 g/dl and 10.37 g/dl in group B. All patients were not transfused in intra- and post operation. CONCLUSION: There was no significant difference in total blood loss of drain and pre- and postoperative hemoglobin between the two groups by the Navigation-assisted minimally invasive TKA. All patients were not transfused in intra- and post operation.
Arthroplasty* ; Drainage ; Humans ; Knee* ; Prospective Studies

Background: The current conventional drug susceptibility test (DST) for Mycobacterium tuberculosis (Mtb) takes several weeks of incubation to obtain results. As a rapid method, molecular DST requires only a few days to get the results but does not fully cover the phenotypic resistance. A new rapid method based on the ability of viable Mtb bacilli to hydrolyze fluorescein diacetate to free fluorescein with detection of fluorescent mycobacteria by flow cytometric analysis, was recently developed. Methods: To evaluate this cytometric method, we tested 39 clinical isolates which were susceptible or resistant to isoniazid (INH) or rifampin (RIF), or ethambutol (EMB) by phenotypic or molecular DST methods and compared the results. Results: The susceptibility was determined by measuring the viability rate of Mtb and all the isolates which were tested with INH, RIF, and EMB showed susceptibility results concordant with those by the phenotypic solid and liquid media methods. The isolates having no mutations in the molecular DST but resistance in the conventional phenotypic DST were also resistant in this cytometric method. These results suggest that the flow cytometric DST method is faster than conventional agar phenotypic DST and may complement the results of molecular DST. Conclusion In conclusion, the cytometric method could provide quick and more accurate information that would help clinicians to choose more effective drugs.

PURPOSE: To evaluate the diagnostic utility and predictors for determinate results of an enzyme-linked immunospot assay using induced sputum cells (IS ELISPOT) for a rapid diagnosis of pulmonary tuberculosis (TB). MATERIALS AND METHODS: Subjects suspected of pulmonary TB who had either sputum acid fast bacilli smear-negative or not producing sputum spontaneously were prospectively enrolled. ELISPOT assay was performed using cells from induced sputum. RESULTS: A total of 43 subjects, including 25 with TB (TB group) and 18 with non-TB disease (non-TB group) were enrolled. Results of IS ELISPOT were determinate in only 17/43 (39%) subjects, but all of determinate results were consistent with the final diagnosis. Of the 43 sputum samples, 11 (26%) were inadequate to perform IS ELISPOT. Of 32 adequate sputum samples, the proportion of determinate results was significantly higher in the TB group (75%, 15/20) than in the non-TB group (17%, 2/12) (p=0.002). The status of active TB was a unique predictor but smear positivity was not a significant predictor for determinate results. In addition, sensitivity of IS ELISPOT (75%, 9/12) in smear negative TB was higher than that of TB-polymerase chain reaction (25%, 3/12). CONCLUSION: IS ELISPOT showed relatively high diagnostic value and accuracy in the TB group, independent of smear positivity. IS ELISPOT may provide additional diagnostic yield for microbiological tools in the rapid diagnosis of smear-negative TB.
Adult ; Aged ; *Enzyme-Linked Immunospot Assay ; Female ; Humans ; Immunologic Tests/*methods ; Male ; Middle Aged ; Mycobacterium tuberculosis/*isolation & purification ; Predictive Value of Tests ; Prospective Studies ; Reproducibility of Results ; Risk Factors ; Sensitivity and Specificity ; Sputum/*microbiology ; Tuberculosis, Pulmonary/*diagnosis/microbiology

Mercury is one of the heavy metals that cause intoxications. Mercury can cause muscular tremor, psychic irritability, renal toxicity and so on. Mercury intoxications usually occur chrough chronic respiratory ingestion. We describe a case in that a woman had applicated inorganic mercury to her whole body and developed mercury intoxications which can be characterized by the whole body skin rash, fever, acute renal failure and the hepatotoxicity appeared. We managed the patient with diuretics, antibiotics and continuous veno-venous hemodiafiltration. On the 6th hospital day, serum creatinine was normalized. Since then, the skin rash and hepatotoxicity were gradually alleviated.
Acute Kidney Injury* ; Anti-Bacterial Agents ; Creatinine ; Diuretics ; Eating ; Exanthema ; Female ; Fever ; Hemodiafiltration ; Humans ; Metals, Heavy ; Skin* ; Tremor

Pregnancy related stroke is rare and poorly understood. A 28-year-old pregnant woman at 20 weeks of gestation presented with sudden headache and left homonymous hemianopsia. MRI revealed acute right posterior cerebral artery territory infarction. Laboratory data revealed combined protein C and S deficiencies. Coagulation profiles returned to normal 6 months after the delivery. Although stroke can occur either with protein C or S deficiency, acute cerebral infarction associated with combined protein C and S deficiencies during gestation is very rare.
Adult ; Cerebral Infarction ; Female ; Headache ; Hemianopsia ; Humans ; Infarction ; Magnetic Resonance Imaging ; Posterior Cerebral Artery ; Pregnancy* ; Pregnant Women ; Protein C* ; Protein S ; Stroke*

OBJECTIVE: Assisted reproductive technology has been associated with an increase in multiple pregnancies. The most effective strategy for reducing multiple pregnancies is single embryo transfer. Beginning in October 2015, the National Supporting Program for Infertility in South Korea has limited the number of embryos that can be transferred per in vitro fertilization (IVF) cycle depending on the patient's age. However, little is known regarding the effect of age and number of transferred embryos on the clinical outcomes of Korean patients. Thus, this study was performed to evaluate the effect of the number of transferred blastocysts on clinical outcomes. METHODS: This study was carried out in the Fertility Center of CHA Gangnam Medical Center from January 2013 to December 2014. The clinical outcomes of 514 women who underwent the transfer of one or two blastocysts on day 5 after IVF and of 721 women who underwent the transfer of one or two vitrified-warmed blastocysts were analyzed retrospectively. RESULTS: For both fresh and vitrified-warmed cycles, the clinical pregnancy rate and live birth or ongoing pregnancy rate were not significantly different between patients who underwent elective single blastocyst transfer (eSBT) and patients who underwent double blastocyst transfer (DBT), regardless of age. However, the multiple pregnancy rate was significantly lower in the eSBT group than in the DBT group. CONCLUSION: The clinical outcomes of eSBT and DBT were equivalent, but eSBT had a lower risk of multiple pregnancy and is, therefore, the best option.
Blastocyst* ; Embryo Transfer* ; Embryonic Structures ; Female ; Fertility ; Fertilization in Vitro ; Humans ; Infertility ; Korea ; Live Birth ; Pregnancy ; Pregnancy Rate ; Pregnancy, Multiple ; Reproductive Techniques, Assisted ; Retrospective Studies ; Single Embryo Transfer

Mental health is influenced by the gut-brain axis; for example, gut dysbiosis has been observed in patients with major depressive disorder (MDD).Gut microbial changes by fecal microbiota transplantation or probiotics treatment reportedly modulates depressive symptoms. However, it remains unclear how gut dysbiosis contributes to mental dysfunction, and how correction of the gut microbiota alleviates neuropsychiatric disorders. Our previous study showed that chronic consumption of Lactobacillus reuteri ATG-F4 (F4) induced neurometabolic alterations in healthy mice. Here, we investigated whether F4 exerted therapeutic effects on depressive-like behavior by influencing the central nervous system. Using chronic unpredictable stress (CUS) to induce anhedonia, a key symptom of MDD, we found that chronic F4 consumption alleviated CUS-induced anhedonic behaviors, accompanied by biochemical changes in the gut, serum, and brain. Serum and brain metabolite concentrations involved in tryptophan metabolism were regulated by CUS and F4. F4 consumption reduced the elevated levels of serotonin (5-HT) in the brain observed in the CUS group. Additionally, the increased expression of Htr1a, a subtype of the 5-HT receptor, in the medial prefrontal cortex (mPFC) of stressed mice was restored to levels observed in stress-naïve mice following F4 supplementation. We further demonstrated the role of Htr1a using AAV-shRNA to downregulate Htr1a in the mPFC of CUS mice, effectively reversing CUS-induced anhedonic behavior. Together, our findings suggest F4 as a potential therapeutic approach for relieving some depressive symptoms and highlight the involvement of the tryptophan metabolism in mitigating CUS-induced depressive-like behaviors through the action of this bacterium.

A 69-year-old male admitted to the psychological department due to delusion. One week later, he developed pneumonia and deep drowsy mental status. Despite improvement of pneumonia, his mental status got worse and he was referred to neurological department. The complete blood count tests showed repeated hypereosinophilia. The serologic tests revealed toxocariasis. He was treated with steroid and albendazole and his mental state rapidly improved. Toxocariasis is a common cause of reactive hypereosinophilia, which may be an underestimated etiology of reversible encephalopathy.
Aged ; Albendazole ; Blood Cell Count ; Delusions ; Humans ; Male ; Pneumonia ; Serologic Tests ; Toxocariasis*