Infection is one of the most serious complications following total hip replacement arthroplasty. Many modifications of procedures have been advocated in order to reduce the rate of infection with varying success. Incorporation of antibiotic to bone cement is one such approach. However, there still remains some reluctancy to adopt this method on account of dubious antibiotic effect at the expense of weakening of physical properties. Possible emergence of resistant organisms and hypersensitivity are additional drawbacks to be considered. The present experiments were undertaken to study the effectiveness of antibacterial activity of cement-antibiotic admixtures in vitro and in vivo as well as change of physical properties produced by the incorporation. As conclusions, antibiotic-mixed bone cements have evident effects on growth of inoculated organisms sensitive to added antibiotics whereas cured bone cement itself has been proved not to have any antibacterial activity. The leaching of antibiotics occurs fairly soon, the great majority of the amount within several days. The rest shows slow, delayed leaching over period of three weeks. The weakening of physical properties was not so significant to forbid the application. Resistance to tensile and bending stress was more reduced than that to compression stress. The mixing of two antibiotics(Cephaloridine and Gentamicin powder) together to bone cement revealed double-edged effectiveness to either of gram-positive or negative organisms without any significant illeffects on hardness of cured cement, It is suggested that mixture of two antibiotics to bone cement renders broader blind coverage to unknown causative micro-organisms of postoperative deep infection of total hip replacement arthroplasty.
Anti-Bacterial Agents ; Arthroplasty ; Arthroplasty, Replacement, Hip ; Bone Cements ; Gentamicins ; Hardness ; Hypersensitivity ; In Vitro Techniques ; Methods ; Microbial Viability ; Polymethyl Methacrylate

The congenital tracheoesophageal fistula without atresia of the esophagus is considered a rare variant, and the literature concerned to the tracheoesophageal fistula fistula without atresia is little in adult especially. The 22-year-old male was admitted to Yeungnam University Hospital with his chief complaints of weight loss (6 kg/6 months), abdominal discomfort, and intermittent coughing. The diagnosis was made by the endoscopy and esophagography. The fistula was 1.5 cm in diameter, 0.5 cm in length. The level was around second thoracic vertebra. The operation was performed transpleurally through the right third intercostals space and the fistula was secured with interrupted silk suture after division. The fibrotic adhesion was seen around the tracheoesophageal fistula. The postoperative course was uneventful, and postoperative esophagogram revealed no extraluminal leakage. Herewith we report this unusual case of isolated tracheo-esophageal fistula with review of literatures.
Adult ; Cough ; Diagnosis ; Endoscopy ; Esophagus* ; Fistula ; Humans ; Male ; Silk ; Spine ; Sutures ; Tracheoesophageal Fistula* ; Weight Loss ; Young Adult

No abstract available.
Adolescent ; Humans ; Personal Satisfaction ; Smoke* ; Smoking*

No abstract available.
Intestinal Mucosa* ; Macrophages* ; Salmonella typhimurium* ; Salmonella*

No abstract available.

OBJECTIVE: To compare the safety and efficacy of intravaginal misoprostol versus intracervical dinoprostone (prostaglandin E2 gel) for cervical ripening and labor induction. METHODS: 60 patients with indication for labor induction and unfavorable cervices were randomly assigned to receive either intravaginal misoprostol or intracervical dinoprostone. 50 microgram tablets of misoprostol were placed in the posterior vaginal fornix every 4 hours for a maximum of 3 doses or dinoprostone 0.5mg was placed into the endocervix every 6 hours for a maximum of 2doses. No more medication was given after either spontaneous rupture of membranes or beginning of active labor. RESULTS: Among 60 patients enrolled, 30 received misoprostol and 30 received dinoprostone. The average interval from start of induction to active labor was shorter in misoprostol group (6.5+/-3.2 hours) than in the dinoprostone group (10.7+/-7.3 hours) (p<0.05). Oxytocin augmentation of labor occurred more often in the dinoprostone group (36.7%) than in the misoprostol group (10.0%) (p<0.05). There was a higher prevalence of fetal distress (23.3% versus 3.3%) and tachysystole (16.6% versus 6.6%) in the misorprostol group than in the dinoprostone group(p<0.05). CONCLUSIONS: Vaginally administered misoprostol is an effective agent for cervical ripening and induction of labor. Furthermore, the cost of misoprostol ( 360/200microgram) is much less than that of dinoprostone ( 42,000/0.5mg). Cost benefits from administration of misoprostol are evident, especially in clinics under system of diagnosis-related group (DRG) : however when given at this dosage, it is associated with a higher prevalence of fetal distress and tachysystole than dinoprostone. Further studies to compare the safety of misoprostole to that of dinoprostone and to delineate an optimal dosing regimen for misoprostol are needed.
Cervical Ripening* ; Cost-Benefit Analysis ; Diagnosis-Related Groups ; Dinoprostone* ; Female ; Fetal Distress ; Humans ; Membranes ; Misoprostol* ; Oxytocin ; Pregnancy ; Prevalence ; Prospective Studies* ; Rupture, Spontaneous ; Tablets

The usefulness of microscopic examination of pure bile directly collected from the biliary tract during endoscopic retrograde cholangiography and without hormonal stimulation was evaluated in 86 patients. Cholesterol monohydrate crystal and/or calcium bilirubinate granule were observed in the bile of 64% of GB stones, 88% of CBD stones and l00% of IHD stones. But only 4% of non stone control group were positive crystals examinations. According to this results, microscopic examinations:of bile samples collected during endoscopic retrograde cholangiography exhibited a sensitivity and a specificity for cholelithiasis recognition of 82.3% and 95.8%, respectively, with a positive and negative predictive value of 98.1% and 67.6%, respectively. We conclude that microscopic bile examinations of bile samples collected during ERC is useful to investigate in patients with suspected cholelithiasis.
Bile* ; Biliary Tract ; Bilirubin ; Cholangiography* ; Cholangiopancreatography, Endoscopic Retrograde ; Cholelithiasis ; Cholesterol ; Gallstones ; Humans ; Sensitivity and Specificity

BACKGROUND: We compared the clinical outcomes of cardiac valve surgery in adult Jehovah's Witness patients refusing blood transfusion to those in non-Jehovah's Witness patients without any transfusion limitations. METHODS: From 2005 to 2014, 25 Jehovah's Witnesses (JW group) underwent cardiac valve surgery using a blood conservation strategy. Twenty-five matched control patients (non-JW group) were selected according to sex, age, operation date, and surgeon. Both groups were managed according to general guidelines of anticoagulation for valve surgery. RESULTS: The operative mortality rate was 4.0% in the JW group and 0% in the non-JW group (p = 1.000). There was no difference in postoperative major complications between the groups (p = 1.000). The overall survival rate at 5 and 10 years was 85.6% ± 7.9% and 85.6% ± 7.9% in the JW group, respectively, and 100.0% ± 0.0% and 66.7% ± 27.2% in the non-JW group (p = 0.313). The valve-related morbidity-free survival rates (p = 0.625) and late morbidity-free survival rates (p = 0.885) were not significantly different between the groups. CONCLUSIONS: Using a perioperative strategy for blood conservation, cardiac valve surgery without transfusion had comparable clinical outcomes in adult patients. This blood conservation strategy could be broadly applied to major surgeries with careful perioperative care.
Adult ; Blood Transfusion ; Bloodless Medical and Surgical Procedures* ; Heart Valves* ; Humans ; Jehovah's Witnesses* ; Mortality ; Perioperative Care ; Survival Rate

No abstract available.
Cholelithiasis* ; Diverticulum*

No abstract available.