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*

Intracytoplasmic sperm injection (ICSI) recently has been utilized widely as the most successful technique to overcome the unfertilization problem in cases of severe male infertility in couples who could not be treated by conventional IVF. Recently, indications of ICSI have been extended further and more fertilized oocytes become available. Thus, it is necessary to examine the efficiency of freezing the surplus embryos obtained from ICSI. We compared the survival rate and the future outcome of cryopreserved embryos obtained either after conventional IVF or ICSI during the same period. After ICSI or IVF, five best-quality embryos from each patient were transferred in the stimulation cycle and the surplus pronuclear (PN) stage oocytes or multicellular embryos were cryopreserved by slow freezing protocol with 1,2-propanediol (PROH) as a cryoprotectant.4 total of 792 embryos from ICSI trial were thawed and 65.2% (516/792) survived. The survival rates of PN stage oocyte, multicellular embryo and PN + multicellular embryo were 63.5%, 68.2%, 64.0%, respectively. After 111 transfers, 34 pregnancies were achieved, corresponding to a clinical pregnancy rate of 30.6% per transfers. We thawed 1033 embryos from IVF trials and 57.5% (594/1033) survived. In IVF cycle, the survival rates of PN stage oocyte, multicellular embryo and PN + multicellular embryo were 58.2%, 65.2%, 40.2%, respectively. Thirty eight clinical pregnancies were established after 134 transfers, corresponding to a pregnancy rate of 28.4% per transfer The cleavage rate of thawed PN stage oocytes from ICSI trial (61.3%) was significantly higher than those from conventional IVF (53.4%). The developmental rates of good embryo (> or = grade II) in thawed PN stage oocytes obtained from conventional IVF and ICSI were 63% and 65%, respectively. We concluded that PN stage oocytes, multicellular embryos resulting from ICSI procedure can be successfully frozen/thawed with reasonable clinical pregnancy rates comparable to those of IVF.
Embryonic Structures* ; Family Characteristics ; Fertilization in Vitro* ; Freezing ; Humans ; Infertility, Male ; Male ; Oocytes ; Pregnancy ; Pregnancy Rate ; Propylene Glycol ; Sperm Injections, Intracytoplasmic* ; Survival Rate

The pleckstrin homology (PH) domain is a protein module of approximately 100 amino acids, that has been found in signaling molecules, including serinelthreonine kinase, GTPase-activating protein, phospholipase, and some cytoskeletal proteins. Although the specific function of PH domain has not been defined yet, it is believed that this domain is involved in the regulation of signal transduction pathway. The expression plasmids of human PLCg PH domains were constructed to see the roles of them in IL-6 signal transduction. When these expression plasmids are transfected into B9 cells, only N-terminal of PH domain inhibited IL-6-induced B9 cell proliferation. These results suggest that N-terminal of PH domain is critical for IL-6 signal transduction in B9 cells. To search the binding proteins associated PH domains of PLCy1 in B9 cells, Glutathione S-trnaferase (GST) fusion proteins containg PH domains were expressed in E. coli. Then, IL-6-dependent B9 cells were treated with 10 unit/ml IL-6 and the cell lysates were immunoprecipited with GST-PH doman fusion proteins. In vitro kinase assay of immune complex demonstrated that p38 (38 KDa) protein was coprecipitated with NC fusion protein, but IL-6 had no additional effect on it. When S-methaionine labelled cell lysates were used for immunoprecipitation, the same result was observed, conforming the association of p38 with NC motive of PH domain.
Amino Acids ; Antigen-Antibody Complex ; Carrier Proteins ; Cell Proliferation ; Cytoskeletal Proteins ; Glutathione ; GTPase-Activating Proteins ; Humans ; Hydrogen-Ion Concentration ; Immunoprecipitation ; Interleukin-6 ; Phospholipases ; Phosphotransferases ; Plasmids ; Signal Transduction

Multifetal pregnancy reduction(MFPR) appears to be an efficacious method for impro-ving the perinatal outcome of high order multifetal pregnancies(three or more fetuses). But it is controversial that larger initial fetal number before MFPR affects pregnancy outcomes adversely. The purpose of this study is to determine the affects of the initial fetal numbers on pregnancy outcomes and to compare the obstetrical outcomes according to the initial fe-tal numbers. Eighty four patients who conceived triplet or more by assisted reproductive technology(ART) in our infertility clinics and underwent MFPR to twins between January 1993 and December 1995. Sixteen patients were lost follow-up. Among the remaining 68 patients, four pateints were excluded from this study because of the pregnancy loss before 20 weeks gestation. The patients(n=64) were divided into three groups by the initial fetal number before reduction. 33 patients with triplet gestations(group 1), 18 patients with qua-druplets gestations(group 2), and 13 patients with quintuplet or more gestations(group 3) were retrospectively enrolled. Gestational age at delivery and birthweights were compared according to the initial fetal numbers. The mean maternal age was similar in each three groups. The results were as follows : 1) Although there was a trend of decreasing gestati-onal weeks at delivery and decreased birthweight in each groups(mean+/-SEM : 36.9+/-0.3, 34.7+/-1.3, 32.7+/-1.9 and 2,600+/-58, 2,161+/-215, 1,855+/-249 respectively), there were no stati-stical difference between group 1 and group 2, but there were significantly lower in group 3, compared with group1(p < 0.05). 2) The incidence of birth before 36 weeks gestation in each group 1, group 2, and group 3 were 12.1%, 38.9%, and 53.8% respectively(p < 0.05). 3) The incidence of low birthweight( < 2,500gm) in each group 1, group 2, and group 3 were 30.3%, 55.6%, and 69.2% respectively(p < 0.05). In conclusion, although MFPR reduced the high order multifetal pregnancy into twin pregnancy, the duration of gestation and the birth weight of newborn were still had a tendency of shortening and low respectively in high order multifetal pregnancy. Therefore strict control of the number of dominant follicles during superovulation and the number of transfered embryo in in vitro fertilization(IVF) is required for improving the pregnancy outcomes in ART.
Birth Weight ; Embryonic Structures ; Female ; Fertilization in Vitro ; Follow-Up Studies ; Gestational Age ; Humans ; Incidence ; Infant, Newborn ; Infertility ; Maternal Age ; Parturition ; Pregnancy ; Pregnancy Outcome* ; Pregnancy Reduction, Multifetal* ; Pregnancy* ; Pregnancy, Twin ; Quintuplets ; Reproductive Techniques, Assisted ; Retrospective Studies ; Superovulation ; Triplets

This study was performed to determine the effect of hydrosalpinx on the outcome with in vitro fertilization and embryo transfer(IVF-ET). Hydrosalpingeal fluid may leak into theuterine cavity during or after ovarian hyperstimulation and can cause deletorious effect onembryo or implantation. Herein, we reported the effect of hydrosalpinx on the cycle outcomeof IVF in controlled ovarian hyperstimulation cycles and cryopreserved-thawed embryotransfer cycles.In controlled ovarian hyperstimulation cycles, comparisons were made between 59 IVFcycles of 54 patients having tubal disease without hydrosalpinx(control group) and 36 IVFcycles of 35 patients carrying hydrosalpinx(hydrosalpinx group). Both clinical pregnancyand implantation rates were significantly lower in hydrosalpinx group(25.4 versus 8.3%,and 11.6 versus 2.0% respectively). Four ectopic pregnancies were noted in hydrosalpinxgroup compared to one in the control group.In cryopreserved-thawed embryo transfer cycles, comparisons were made between 27IVF cycles of 25 patients having tubal disease without hydrosalpinx(control group) and 13IVF cycles of 13 patients carrying hydrosalpinx(hydrosalpinx group). There was a tendencyof decreased pregnancy and implantation rates in hydrosalpinx group compared to the control(37.0 versus 15.4%, and 9.9% versus 4.0% respectively). One ectopic pregnancy was notedin the hydrosalpinx group compared to none in the control group.These data indicate that the presence of hydrosalpinx may negatively affect IVF outcome.We suggest that patients presenting with hydrosalpinx should consider surgical correctionto optimize their outcome with IVF procedure.
Cryopreservation ; Embryo Transfer ; Embryonic Structures ; Female ; Fertilization in Vitro ; Humans ; Pregnancy ; Pregnancy, Ectopic

PURPOSE: The aim of this study was to investigate the effect of tongue cleaner-equipped manual toothbrush on tooth cleanness, tongue cleanness and malodor index. MATERIALS AND METHODS: 504 subjects were included in this study. At 1st visit, basic information such as age, sex, smoking amount and alcohol consumption was recorded. Self assessment by individual subjects was performed regarding satisfaction to old toothbrush and toothbrushing habit. Tooth cleanness, tongue cleanness and malodor index was assessed by professional researcher. Tongue cleaner-equipped manual toothbrush was given to each subject with proper toothbrushing instruction. After 1 month passed, self assessment and researcher assessment regarding the same index were performed and analyzed statistically by chi-square test. RESULTS: At 1st visit subjects seem to ignore tongue cleansing and showed poor tooth cleanness index, tongue cleanness index and malodor index, however the same subjects were motivated to clean their tongue and teeth and presented statistically improved distribution pattern in tooth cleanness index, tongue cleanness index and malodor index after using tongue cleaner-equipped manual toothbrush(p<0.01). Satisfaction to tongue cleaner-equipped manual toothbrush was 98%. CONCLUSION: Tongue cleaner-equipped manual toothbrush would be an effective tool for maintaining good oral hygiene through improving tooth and tongue cleanness and preventing malodor formation.
Alcohol Drinking ; Oral Hygiene ; Self-Assessment ; Smoke ; Smoking ; Tongue ; Tooth ; Toothbrushing

PURPOSE: To assess the value of the bolus-tagging method for improving the image quality of contrast-enhanced MR abdominal angiography, and to evaluate the relationship between peak arterial enhancement time and patients' age, weight and heart rate. MATERIALS AND METHODS: Contrast-enhanced 3D FISP abdominal MR angiography was performed in 81 patients during a four-month period. The bolus-tagging method was used in a study group comprising 33 patients, and to this end, 1 ml of Gd-DTPA (gadolinium-diethylenetriamine penta-acetic acid) was administered. thirty sequential images (1 image/sec) were then obtained using turbo-FLASH sequencing. After determining peak arterial enhancement time from the time-to-signal intensity curve, optimal scan delay time can be calculated according to the formula used in our patient series. The 48 patients in whom the bolus-tagging method was not used comprised the control group ; in the study group scanning commenced at the optimal scan delay time (and at 10 seconds in the control group) after the administration of 0.2 mM/kg Gd-DTPA using an automatic power injector. Using a three-point scale we evaluated and compared between the two groups the success with which arterial images were obtained. In addition, vascular visibility -an indication of the quality of arteries and veins-was determined using a four-point scale. In the study group, the relationship between peak arterial enhancement time and patients' age, weight heart rate was also assessed. RESULTS: Pure arterial images were successfully obtained in 32 patients (97%) in the study group and in 40 (83%) in the control group. This difference was not statistically significant (p>.05). With regard to vascular visibility, diagnostic arterial images were seen in 30 patients (91%) in the study group and in 33 patients (69%) in the control group; arterial visibility was significantly better in the study group (p=.0197). On the other hand, the diagnostic venous images were seen in 31 patients (94%) in the study group and in 36 (75%) in the control group; there was no significant difference between the two groups (p=.2367). Peak arterial enhancement time increased significantly with age (r=.443, p=.0098); no correlation,however was seen between peak arterial enhancement time and weight (p>.05) or heart rate (p>.05). CONCLUSION: Used with contrast-enhanced 3-D FISP MR abdominal angiography, the bolus-tagging method provides better arterial visibility. Peak arterial enhancement time increased significantly with age.
Angiography* ; Arteries ; Gadolinium ; Gadolinium DTPA ; Hand ; Heart Rate ; Humans

PURPOSE: To assess the value of the bolus-tagging method for improving the image quality of contrast-enhanced MR abdominal angiography, and to evaluate the relationship between peak arterial enhancement time and patients' age, weight and heart rate. MATERIALS AND METHODS: Contrast-enhanced 3D FISP abdominal MR angiography was performed in 81 patients during a four-month period. The bolus-tagging method was used in a study group comprising 33 patients, and to this end, 1 ml of Gd-DTPA (gadolinium-diethylenetriamine penta-acetic acid) was administered. thirty sequential images (1 image/sec) were then obtained using turbo-FLASH sequencing. After determining peak arterial enhancement time from the time-to-signal intensity curve, optimal scan delay time can be calculated according to the formula used in our patient series. The 48 patients in whom the bolus-tagging method was not used comprised the control group ; in the study group scanning commenced at the optimal scan delay time (and at 10 seconds in the control group) after the administration of 0.2 mM/kg Gd-DTPA using an automatic power injector. Using a three-point scale we evaluated and compared between the two groups the success with which arterial images were obtained. In addition, vascular visibility -an indication of the quality of arteries and veins-was determined using a four-point scale. In the study group, the relationship between peak arterial enhancement time and patients' age, weight heart rate was also assessed. RESULTS: Pure arterial images were successfully obtained in 32 patients (97%) in the study group and in 40 (83%) in the control group. This difference was not statistically significant (p>.05). With regard to vascular visibility, diagnostic arterial images were seen in 30 patients (91%) in the study group and in 33 patients (69%) in the control group; arterial visibility was significantly better in the study group (p=.0197). On the other hand, the diagnostic venous images were seen in 31 patients (94%) in the study group and in 36 (75%) in the control group; there was no significant difference between the two groups (p=.2367). Peak arterial enhancement time increased significantly with age (r=.443, p=.0098); no correlation,however was seen between peak arterial enhancement time and weight (p>.05) or heart rate (p>.05). CONCLUSION: Used with contrast-enhanced 3-D FISP MR abdominal angiography, the bolus-tagging method provides better arterial visibility. Peak arterial enhancement time increased significantly with age.
Angiography* ; Arteries ; Gadolinium ; Gadolinium DTPA ; Hand ; Heart Rate ; Humans

The most common surgically retained foreign body is t506e laparotomy sponge, and since cotton sponges are inert, they do not undergo any specific decomposition or biochemical reaction. Pathologically, however, two types of foreign body reaction occur: either type there is an aseptic fibrinous response that creates adhesions and encapsulation, resulting in a foreign-body granuloma, or the response is exudative in nature and leads to abscess formation with or without secondary bacterial invasion. We describe the case of a 52-year-old woman with a past history of cholecystectomy in whom a foreign-body abscess mimicked a hepatic tumor. Index words : Peritoneum, abscess Foreign bodies
Abscess* ; Cholecystectomy ; Female ; Fibrin ; Foreign Bodies* ; Foreign-Body Reaction ; Granuloma, Foreign-Body ; Humans ; Laparotomy ; Middle Aged ; Peritoneum ; Porifera

No abstract available.
Hypothyroidism* ; Myasthenia Gravis*