Background: There have been many reports on microbial contamination of antiseptics and disinfectant used in the hospitals. Mid to low level disinfectants such as chlorhexidine gluconate, quaternary ammonium, phenols and benzalkonium are reported to be the one with high risk of microbial contamination. We investigated microbial contamination of 0.05% chlorhexidine gluconate solution used in our hospital. Methods: 0,05% chlorhexidine gluconate solution and 0.05% chlorhexidine gluconate cotton balls used in the general ward and intensive care unit were randomly collected for microbial culture. Also, sterile water, 20% chlorhexidine gluconate and staining solution, which is mixed in the preparation room to make 0,05% chlorhexidine gluconate solutions, were collected for bacterial culture to evaluate the focus of microbial contamination. Results: Total of 31 chlorhexidine gluconate samples was randomly collected from general wards. intensive care unit and preparation room for microbial culture. Seven of thirteen 0.05% chlorhexidine gluconate solution and 5 of twelve 0.05% chlorhexidine soaked cotton balls kept in a canister were contaminated by Burkholderia cepacia. Sterile water used for dilution of 20% chlorhexidine gluconate to make 0.05% chlorhexidine and originally purchased 20% chlorhexidine gluconate were not contaminated by microorganism. But staining solution that is used as an additive to differentiate from other diluted disinfectants was contaminated by Bukholderia cepacia. 0.05% chlorhexidine gluconate solutions that were mixed in the preparation room were also contaminated by same organism. Source of contamination was thought to be staining solution. All the previously made chlorhexidine. solutions and staining solution were discarded. Staining solution was not used afterward. Several processes in the handling of chlorthexidine solution were corrected and no microbial contamination was found afterward. Conclusion: Diluted chlorthexidine gluconate solutions are always under a risk of microbial contamination if any of the process in the handling is overlooked. Staining solution as an additive to disinfectants should be used carefully.
Ammonium Compounds ; Anti-Infective Agents, Local ; Benzalkonium Compounds ; Burkholderia cepacia ; Chlorhexidine* ; Disinfectants ; Intensive Care Units ; Patients' Rooms ; Phenol ; Phenols ; Water

We report two cases showing typical clinical features of subcutaneous granuloma annulare. Clinically, rapidly growing non-tender subcutaneous nodules developed on the scalp of healthy children without histories of trauma or infection. Histopathologically, collagen degeneration surrounded by histiocytes and lymphocytes in a palisading arrangement were seen in the deep dermis and subcutaneous layer. The foci of degeneration contained pale and edematous basophilic mucinous deposits. The skin lesions resolved spontaneously without specific treatment. Subcutaneous granuloma annulare should be considered in the differential diagnosis of children presenting with soft tissue masses.
Basophils ; Child ; Collagen ; Dermis ; Diagnosis, Differential ; Granuloma Annulare* ; Granuloma* ; Histiocytes ; Humans ; Lymphocytes ; Mucins ; Scalp ; Skin

Lipid cell tumors of the ovary are among the rarest of the functional ovarian neoplasms. Recently, authors experienced a case of lipid cell tumor of the left ovary in a 19 year old female, who presented with amenorrhea and hirsutism for 4 years. Grossly, the ovary was well encapsulated, and measured 6.5x6x4.5 cm. Cut surface show homogenous yellowish bulging neoplastic tissue and peritheral displaced normal ovarian tissue. Microscopically, neoplastic cells were composed of rounded and polyhedral cells, arranged in nests seperated by rich vascular networks. On the basis of the author's findings and the evidence available in the literature, we determined this case as ovarian lipid cell tumor.
Female ; Humans

A 55 year old male complain right shoulder pain and right upper quadrant pain about three months. He was a heavy alcoholism. Highly selective angiography, CT scan and operation findings suggest primary malignant neoplasm of the liver. Right hepatic lobectomy and partial diaphragmectomy was done under impression of heaptocellular carcinoma. The specimen measured 15x11x9 cm and disclose relatively hard and nodular mass devoid of cirrhotic changes. Cut surface show unilobar large mass measuring 11x8x6 cm and bearing brightly yellow discoloration and multifocal hemorrhagic necrosis. Histological characteristics were diffuse proliferation of large neoplastic cells with ample cytoplasm, containing granular materials, erythrophagocytosis, neutrophagocytosis and hemosiderin pigments. Atypical and bizarre mitosis and multinucleated giant cells bearing abundant erythro and neutrophagocytosis were frequently seen. The large or vesicular nuclei were irregular, with occasional deep indentations and revealed sharply defined nuclear membrane, coarse chromatin and conspicious nucleoli. Ultrastructurally the cytoplasm of neoplasltic cells had lysosomal granule, phagolysosome, phagocytized material and residual bodies. Immunohistochemical stains for alpha 1-antitrypsin, alpha 1-antichymotrypsin, vimentin and lysozyme showed positive reactions, but, alpha fetoprotein, cytokeratin, S-100 protein, factor VIII, complement 3 receptor and carcinoembryonic antigen were negative. Alpha-naphtyl acetate esterase activity in paraffin embedded tissue ribbon showed negative reaction. These findings show compatible with primary malignant lymphoma, true histiocytic type, (histiocytic sarcoma, Kupffer cell carcinoma) of the liver.
Male ; Humans

BACKGROUND: Elderly patients often have postoperative psychiatric disorders compared with young patients. METHODS: This study was undertaken to compare the effects of general or regional anesthesia on postoperative psychiatric disorders in 31 elderly patients with elective orthopedic and urological surgery. Mini Mental States Examinations(MMSE) was done to find out postoperative delirium at preoperative, postoperative 6hours, 1st, 3rd, and 7th days. RESULTS: Mean changes in MMSE score after general anesthesia were significantly decreased compared with preoperative score and with in regional anesthesia at postoperative 6 hours and 1st day. Postoperative MMSE scores were decreased below 17 points in 17 patients among 22 patients in general anesthesia and 3 patients among 26 patients in regional anesthesia. Hospital admission duration were significantly prolonged in general anesthesia compare with regional anesthesia. CONCLUSIONS: The incidence of postoperative delirium is more common after general aneshtesia than after regional anesthesia. Therefore regional anesthesia is recommeded in elderly patients to decrease postoperative delirium.
Aged* ; Anesthesia, Conduction* ; Anesthesia, General* ; Delirium* ; Humans ; Incidence ; Orthopedics

BACKGROUND: A retrospective study was performed to evaluate postoperative mortality within 30 days following surgery. METHODS: The records of 31,806 patients who received operation under general anesthesia were reviewed. RESULTS: 1) Postoperative deaths were 184 cases, the ratio of which was comprising 0.57% of all surgical operative cases. 2) The highest ratio of the mortality in age group was 51~60 years group which was 24.5%, and in physical status it was ASA class III which was 36.4%. The highest ratio to the mortality rate in postoperative days was 8~30 days which was 45.1%. 3) The most common causes of death was low cardiac output due to heart failure on operating theater, and hypovolemic shock within postoperative 2 days, and intracranial problem within postoperative 7 days, and pulmonary complication within postoperative 30 days. CONCLUSION: We conclude that fatality rate could be decreased by intensive and multidisciplinary care for postoperaive complications as respiratory and renal failure.
Anesthesia, General ; Cardiac Output, Low ; Cause of Death ; Heart Failure ; Humans ; Mortality ; Renal Insufficiency ; Retrospective Studies ; Shock

To evaluate the technique to provide rapid onset of anesthesia and postoperative pain control for cesarean section, we have used spinal anesthesia and epidural analgesia with a 26-gauge, long spinal needle through a 18-gauge Tuohy needle(Espocan) for elective cesarean section in twenty cases, 0.5% heavy bupivacaine 8-12mg was injected through spinal needle for anesthesia during operation, and then spinal needle was removed and epidural catheter was inserted into the epidural space for postoperative pain control. Ten milliliters of bupivacaine 0.125% with 0.45 mg buprenorphine was injected into epidural space through epidural catheter at the time of pain recognition in postoperative period. The results were as follows; 1) There were 5 cases(25%) of hypotension after spinal anesthesia. 2) There were 4 cases(20%) of complaint of pain during operation. 3) The time from injection of 0.5% heavy bupivacaine to onset of anethesia to T4 level is 3.8+/-1.5 minutes and the time from induction of spinal anesthesia to deliverly of infant is 10.1+/-2.9 minutes. 4) Two cases of postoperative headache were noted, but they were mild and relieved spontaneously. 5) Other analgesics were needed in two cases at postoperative periods. The technique is recommended for the anesthesia of cesarean section because it allows rapid onset of anesthesia with spinal anesthesia and gives advantages of postoperative pain control with epidural catheter.
Analgesia, Epidural* ; Analgesics ; Anesthesia ; Anesthesia, Spinal* ; Bupivacaine ; Buprenorphine ; Catheters ; Cesarean Section* ; Epidural Space ; Female ; Headache ; Humans ; Hypotension ; Infant ; Needles ; Pain, Postoperative ; Postoperative Period ; Pregnancy

No abstract available.
Actinomycosis* ; Hemoptysis*

No abstract available.
Diagnosis* ; Humans ; Hydrocephalus* ; Infant* ; Infant, Newborn*

Some species of traditional herbal medicine has a history of use, most traditional natural herbs have been used for various diseases such as diabetes, hypertension, and obesity. Among them, Passiflora incarnata L. is a traditional natural medicine, flowers as well as berries, roots, and leaves have been used as a medicine. It has been used as a natural medicine for the treatment of insomnia and anxiety for a longtime in Europe, and it has been used primarily for sedation tea in North America. Moreover, Passiflora incarnata L. is widely used anti-asthmatic, analgesic and sedation in Brazil. In other words, Passiflora incarnata L. has been used to treat a sedative, dysmenorrhea, insomnia, cancer, etc. in many countries. Present review of the plants showed a wide range of pharmacological activity in anxiolytic relax the clinical disease, such as anti-inflammatory, anxiety and antioxidant. In addition, Passiflora incarnata L. affects menopause symptoms such as vasomotor symptoms, insomnia, and depression. This review aims to provide the latest information on specific functional components of Passiflora incarnata L. especially the results of clinical trials will provide new insights into opportunities for the future development of natural medicines and doors will be used for purposes of analysis.
Anxiety ; Brazil ; Depression ; Dysmenorrhea ; Europe ; Female ; Flowers ; Fruit ; Herbal Medicine ; Hypertension ; Menopause ; North America ; Obesity ; Passiflora* ; Plant Extracts ; Sleep Initiation and Maintenance Disorders ; Tea