BACKGROUND: Glutaraldehyde is used most commonly as a high-level disinfectant for semicritical patient-care equipments. However, its potential toxicity to healthcare workers and a long exposure time needed to kill mycobacteria can be problematic. Recently, Perasafe(R) (Antec International, UK) has been introduced in the market as a safe and very effective disinfectant. This study was to evaluate the efficacy of Perasafe(R) against not only bacteria and yeast but also mycobacteria and bacterial spores and compare it with glutaraldehyde. MATERIAL AND METHOD: Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Candida albicans, Mycobacterium tuberculosis, and Bacillus subtilis were used for the test. Perasafe(R) and Cidex(R) were used at the final concentration of 1.62% and 2.25%, respectively; the disinfectants were neutralized by Tween 80 (0.5%) in the mycobacterial test and by lecithin (0.75%) in all other tests. Bacterial suspensions were made in phosphate buffer with or without fetal bovine serum (1%) to simulate dirty or clean conditions, respectively. The disinfectants were tested at 0, 24 and 48 hr of preparation to check stability. An effective disinfectant activity was defined as a 5 log10 reduction in viable counts. RESULTS: E. coli, S. aureus, P. aeruginosa and C albicans were effectively disinfected in less than 5 min by both Perasafe(R) and Cidex(R) and the both disinfectants remained equally effective under the dirty conditions or at 48 hr of preparation. Perasafe(R) was effective in 1 min against B. subtilis spores compared to Cidex(R) which took 30 min for the same activity. M. tuberculosis was effectively disinfected in 10 min by Perasafe(R) and 20 min by Cidex(R). CONCLUSIONS: Perasafe(R) showed greater tuberculocidal and sporicidal activities than Cidex(R), although both disinfectants were equally effective against common bacterial and yeast pathogens. Perasafe(R) may be an outstanding high-level disinfectant for endoscopes and other semicritical medical equipment.
Bacillus subtilis ; Bacteria* ; Candida albicans ; Delivery of Health Care ; Disinfectants ; Endoscopes ; Escherichia coli ; Glutaral ; Lecithins ; Mycobacterium tuberculosis ; Polysorbates ; Pseudomonas aeruginosa ; Spores ; Spores, Bacterial* ; Staphylococcus aureus ; Suspensions ; Tuberculosis ; Yeasts*

PURPOSE: To report a case of iridocorneal endothelial syndrome, which overlapped with some of the features of posterior polymorphous corneal dystrophy. CASE SUMMARY: A 61-year-old female presented with tearing pain and blurred vision in her left eye, which was aggravated in the morning. The symptom started approximately 1 year prior to her visit. At the initial visit, the visual acuities were 1.0 in both eyes and the intraocular pressures were normal. On slit-lamp examination, a single pair of horizontal parallel lines was observed at the central corneal endothelial layer in the right eye. In contrast, multiple pairs of oblique parallel lines were observed in the left eye. The lines of the lesions were more prominent and wavier in the left eye than those of the right eye. The overlying cornea was clear, and the corneal thicknesses were in the normal range in both eyes. Using a gonioscopic examination, localized peripheral anterior synechiae were observed only in the left eye. The pupil and iris were normal in both eyes. On specular microscopic examination, the corneal endothelial cell size in the right eye increased and the corneal endothelial density decreased to 668 cells/mm². In the left eye, multiple abnormal endothelial cells with dark-light reversal were observed. In conclusion, the patient was subsequently diagnosed with iridocorneal syndrome, rather than posterior polymorphous corneal dystrophy. CONCLUSIONS: Posterior polymorphous corneal dystrophy and iridocorneal endothelial syndrome may present with many similarities. Therefore, in cases of uncertain diagnosis, an understanding of the clinical features is important for proper diagnosis.
Cornea ; Diagnosis ; Endothelial Cells ; Female ; Humans ; Intraocular Pressure ; Iridocorneal Endothelial Syndrome ; Iris ; Middle Aged ; Pupil ; Reference Values ; Tears ; Visual Acuity

Purpose: This descriptive study investigated the effects of nurses’ knowledge of withdrawalof life-sustaining treatment, death anxiety, and perceptions of hospice care on their attitudes toward withdrawal of life-sustaining treatment. Methods: Data were collected from 262 nurses at tertiary hospitals, general hospitals, or primary hospitals in Busan, Korea, and statistically analyzed using the t-test, analysis of variance, the Scheffé test, Pearson correlation coefficients, and hierarchical regression analysis. Results: The participants’ scores were 3.68±0.45 (out of 5) for attitudes toward withdrawal of life-sustaining treatment, 0.65± 0.15 (out of 1) for knowledge of withdrawal of life-sustaining treatment, 2.61±0.26 (out of 4) for death anxiety, and 4.06±0.43 (out of 5) for perceptions of hospice care. Furthermore, knowledge of withdrawal of life-sustaining treatment and perceptions of hospice care showed positive correlations with attitudes toward withdrawal of life-sustaining treatment, while death anxiety showed a negative correlation. The most significant factors influencing attitudes toward withdrawal of life-sustaining treatment were perceptions of hospice care, followed by having experienced caring for patients who withdrew life-sustaining treatment, death anxiety, having a spouse, and ethical values, and the overall explanatory power was 43.0%. Conclusion This study showed that perceptions of hospice were an important fac-tor influencing nurses’ attitudes toward withdrawal of life-sustaining treatment. Therefore,it is necessary to develop and validate educational intervention programs that can improve perceptions of hospice care.

Bronchopulmonary sequestration (BPS) is a rare congenital abnormality of the lower airway, generally characterized by blood supply received from the systemic circulation. We present a rare case of a 19-year-old man with incidentally detected BPS supplied by a branch of a pulmonary artery, rather than a systemic artery. Computed tomography showed a sequestered segment supplied by a branch of the left pulmonary artery and containing an ectopic bronchus. As chest computed tomography revealed necrosis in the sequestered tissue, infection was presumed, and the tissue was surgically removed. This may represent a very unusual occurrence, as such cases have yet to be reported in the literature.

Anaphylaxis is an acute and fatal systemic allergic reaction to an allergen, and it can be an unpredictable and life-threatening cause during anesthesia. Latex is the second most common cause of anaphylaxis following the use of neuromuscular blocking agents during general anesthesia or surgery. We report on a 67-year-old male who had undergone surgery under general anesthesia without any problem but who presented with severe intraoperative anaphylaxis to latex surgical gloves. This case emphasizes the need for anesthesiologists to quickly diagnose and properly manage an allergic reaction in patients under general anesthesia.
Aged ; Anaphylaxis ; Anesthesia ; Anesthesia, General ; Gloves, Surgical ; Humans ; Hypersensitivity ; Latex ; Male ; Neuromuscular Blocking Agents

OBJECTIVES: The purpose of this study was to investigate the relationship between restricted activity due to oral diseases and oral health behaviors among adolescents. METHODS: A cross-sectional study design was used. The subjects were 238 middle school students and 231 high school students; a total of 469 students from 15 different schools located in 7 regions of Bucheon in Gyeonggi Province, Daejeon, and others. The adolescents who participated in the survey were chosen by convenience sampling. The association between restricted activities due to oral diseases and oral health behaviors was analyzed using multiple logistic regression analysis. RESULTS: The annual experience rate of oral diseases stood at 1.4 percent, while the number of days absent and early departures from school was 0.15 days per student. The rate of middle school students who were disturbed by oral disease with respect to sleep, eating, speaking, and/or schoolwork was 33.1 percent. In high school students, it was 40.6 percent. Dental pain and gingival bleeding were identified as major factors to the restriction of activities, and being disturbed while eating was related to cariogenic beverages. CONCLUSIONS: It would be of great social interest to support and promote oral health programs among adolescents. Therefore, a national survey of the status of activity restrictions due to oral diseases in adolescents should be implemented in order to make specific future plans.
Adolescent ; Cross-Sectional Studies ; Eating ; Hemorrhage ; Humans ; Logistic Models ; Oral Health

BACKGROUND: Weaning from mechanical ventilation is difficult in the intensive care unit (ICU). Many controversial questions remain unanswered concerning the predictors of weaning failure. This study investigates patient characteristics and delayed weaning after lung transplantation. METHODS: This study retrospectively reviewed the medical records of 17 lung transplantation patients from October 2012 to December 2013. Patients able to be weaned from mechanical ventilation within 8 days after surgery were assigned to an early group (n = 9), and the rest of the patients were assigned to the delayed group (n=8). Patients' intraoperative and postoperative characteristics were collected and analyzed, and conventional weaning predictors, including rapid shallow breathing index (RSBI), were also assessed. RESULTS: The results of the early group showed a significantly shorter ICU stay in addition to a shorter hospitalization overall. Notably, the early group had a higher body mass index (BMI) than the delayed group (20.7 vs. 16.9, p = 0.004). In addition, reopening occurred more frequently in the delayed group (1/9 vs. 5/8, p = 0.05). During spontaneous breathing trials, tidal volume (TV) and arterial oxygen tension were significantly higher in the early group compared to the delayed weaning group, but differences in RSBI and respiratory rate (RR) between groups were not statistically significant. CONCLUSIONS: Low BMI might be associated with delayed ventilator weaning in lung transplantation patients. In addition, instead of the traditional weaning predictors of RSBI and RR, TV might be a better predictor for ventilator weaning after lung transplantation.
Body Mass Index* ; Hospitalization ; Humans ; Intensive Care Units ; Lung Transplantation* ; Medical Records ; Oxygen ; Respiration ; Respiration, Artificial ; Respiratory Rate ; Retrospective Studies ; Tidal Volume ; Ventilator Weaning* ; Weaning

PURPOSE: To report 2 young female patients with bilateral posterior scleritis and serous retinal detachment. CASE SUMMARY: An 11-year-old girl (Case 1) and a 16-year-old girl (Case 2) visited our clinic with bilateral ocular pain, redness, and blurred vision. Slit lamp examinations revealed severe bilateral scleral injection and mild anterior chamber reactions. Fundus examinations showed bilateral serous retinal detachments in the macular area. In both patients, diffuse multifocal leaking and pooling were found at the macula in the early and late phase fluorescein angiography, respectively. On the B-mode ultrasounds and orbital images (MRI or CT), scleral thickening with retention of subtenons fluid were found. There were no systemic diseases associated with the conditions. We diagnosed the patients with bilateral posterior scleritis and administered systemic steroids. After systemic steroid treatment, all of the symptoms were alleviated. Three months after the regression, bilateral posterior scleritis recurred in patient 2. Oral cyclosporine 100 mg was additionally prescribed in addition to the previous medications that she had taken during her first treatment. CONCLUSIONS: Two young patients diagnosed with posterior scleritis and serous retinal detachment was treated with systemic steroids. With proper examination and treatment, posterior scleritis can be treated with no complications.
Adolescent ; Anterior Chamber ; Child ; Cyclosporine ; Female ; Fluorescein Angiography ; Humans ; Orbit ; Retention (Psychology) ; Retinal Detachment ; Retinaldehyde ; Scleritis ; Steroids ; Vision, Ocular

OBJECTIVES: The purpose of this study was to examine the association between vitamin C, vitamin D, and periodontal diseases in adults. METHODS: The data used for analysis were obtained from the sixth Korean National Health and Nutrition Examination Survey (2013-2014). Subjects were 2,702 adults aged from 19 to 64 years. Complex Chi-square tests and complex logistic regression analyses were used to assess the association between vitamins and periodontal status. RESULTS: There is no statistically significant association between vitamin C intake and periodontal status. Periodontal status of subjects with a low vitamin D (25-hydroxyvitamin D) level was better than that of the subjects with a high level (P<0.05). However, multivariate analysis demonstrated that this association is not statistically significant. CONCLUSIONS: More follow-up studies are necessary to determine the association of the vitamins C and D with the periodontal diseases.
Adult ; Ascorbic Acid ; Cross-Sectional Studies* ; Follow-Up Studies ; Humans ; Logistic Models ; Multivariate Analysis ; Nutrition Surveys ; Periodontal Diseases ; Vitamin D ; Vitamins*

PURPOSE: Deteriorated nutritional status is common during a hospital stay for esophagectomy in patients with esophageal cancer. Malnutrition in those patients is often marked compared with other gastrointestinal cancer. The purpose of this study is to evaluate the appropriateness of commercial peripheral parenteral nutrition (CPPN) use in patients who underwent Ivor-Lewis esophagectomy (I-L op). METHODS: Patients who were provided with CPPN after I-L op were enrolled in this study from January to May 2015. Body weight, height, nutritional status, length of hospital stay, duration of CPPN therapy, and parenteral nutrition (PN) induced complications were assessed, respectively, using electronic medical records. RESULTS: Thirty-nine patients were enrolled. Average age was 65.9 years and 36 patients were male. All patients were provided with the same CPPN. The duration of fasting and CPPN use was 5.8+/-1.4 days and 7.5+/-1.8 days, respectively. Calorie supported by CPPN was 22.6+/-3.5 kcal/kg/day and only 20.5% of patients (n=8) reached the daily target calories. Most frequent PN induced complication was phlebitis which occurred in 8 patients (20.5%). Calcium, magnesium, and transthyretin levels in serum were not monitored during the PN support period. CONCLUSION: The indications for CPPN were appropriate because the fasting duration in patients with I-L op was 5 to 10 days. Although a large portion of patients could not be supplied daily target calories, their nutrition status was not significantly changed on admission and at discharge. We did not find it necessary to individualize PN support for a short period after an I-L op in patients with esophageal cancer. Further study will be needed to determine why the incidence of phlebitis was dominant.
Body Weight ; Calcium ; Electronic Health Records ; Esophageal Neoplasms* ; Esophagectomy* ; Fasting ; Gastrointestinal Neoplasms ; Humans ; Incidence ; Length of Stay ; Magnesium ; Male ; Malnutrition ; Nutritional Status ; Parenteral Nutrition* ; Phlebitis ; Prealbumin