In order to prevent cross-infection, the sterilization of used and/or contaminated anesthetic- apparatus is still a difficult problem in clinical practice, particularly, following anesthesia for known advanced pulmonary tuberculosis cases. Therefore the antibacterisl activities of, an amphoteric detergent, Dodecyl diaminoethyl glycin hydrochloride (Hygien 51) were tested in vitro as a disinfectant against mycobacteria (M. tuberculosis H37 Rv, M. bovis, M. avium, M. tuberculosis H37 Ra, M. phlei, B.C.G.) The antimycobacterial activity tests were performed according to the modified Kolmer method. The testing organisms were cultured in Dubos broth at 37 degrees C, and the detergent, Hygien 51, was: diluted with sterile distilled water to 1,3,5 and 10%. One half milliliter of culture was pipetted into each tube containing 4.5 ml of diluted detergent, and at intervals of 3, 15, 30, 60, 120, 180 and 240 minutes, a 4mm loopful of the material was removed from each tube, and transferred to Ogawa media. The tests were carried out at two different temperatures, 20 degrees C and 50 degrees C. The subcultures were incubated at 37 degrees C for more than 8 weeks. The results were obtained as follows: 1) At room temperature (20 degrees C), all mycobateria, except M. bovis, were destroyed by treatment- with 10% solution of the detergent for more than 60 minutes. M. bovis was relatively sensitive to the detergent, and was killed by 5% solution for 30 min. and 10% for 15 min., but M. avium. was very resistant, and was not killed by 10% solution for 240 min. 2) By treatment with the detergent at 50 degrees C, the antimycobacterial activities of the detergent were highly increased. All mycobacteria were destroyed by 1% solution for 180 min, and by 10% for less than 30 min at 50 degrees C. In the comparison of the antibacterial activities against mycobacteria and other bacteria, it shows that mycobacteria are generally more resistant to the detergent, Hygien 51.
Anesthesia ; Bacteria ; Detergents ; Sterilization ; Tuberculosis ; Tuberculosis, Pulmonary ; Water

PURPOSE: To find out whether or not the computed tomographic (CT) classification systems of the calcaneal fracture are efficient in illuminating displaced posterior facet fragment and the degree of displacement can be evaluated by analyzing serial CT images. MATERIALS AND METHODS: Seventy-seven hundred calcaneal fractures were classified by CT classification systems including Sanders classification, and the sagittal rotation angle of the posteior facet fragment was measured on the plain lateral radiograph. Among the serial axial CT images, a number of images with the cortical bone embedded in the cancellous portion were recorded and any significant relationship between each data were evaluated. RESULTS: The conventional CT classification systems are rather insufficient in illuminating the extent of sagittal rotatory displacement. However, the number of CT images in which the cortical radiodensity was observed showed a significantly related with the degree of displacement. CONCLUSION: The conventional CT classification of the calcaneal fractures is unsatisfactory in expressing the degree of sagittal rotatory displacement of the posterior facet fragment; this problem may be alleviated by observing the number of axial CT images in which cortical radiodensity was revealed within the calcaneal body.
Calcaneus ; Classification

The discovery of an ideal technique for sterilising contaminated respirators and other anesthesia equipment remains a major problems, The antimicrobial activities of a recently discovered disinfectant alktaline-glutaraldehyde(Cidex), studied in vitro against various species of bacteria and fungi. The antimicrobial activity tests were performed according to the modified Kolmer method. The testing organisms were cultured in broth media at 37 degrees C and 25 degrees C for 18 hours to 14 days, and the disinfectant was diluted with sterile distilled;water to 0.4% and 2.0%. One milliliter of cultured broth was transferred into disinfectant-containing media and after 1, 2, 5, 10, 20, 30 and 60 minutes, one loopful of the mateials was removed from the media and inoculated into the broth media. All of the subcultures were incubated at 37 degrees C for 24 hours and fungal subcultures were incubated at 25 degrees C for 14 days. Results were obtained as follows: 1) Most of the bacteria were completely growth-inhibited by treatment with 0.4% active alkaline-glutaraldehyde solution for 2 minutes except a few strains such as St. aureus, B. subtilis and M. tuberculosis, which required from 16 to 20 min. 2) Mycobacterium tuberculosis was relatively resistant but it could be growth-inhibited by treatment with 2.0% solution for 2 minutes. 3) Growth inhibiting of fungi could be obtained by treatment with 2.0% solution for 5 to 10 minutes.
Anesthesia ; Bacteria ; Fungi ; Glutaral* ; Mycobacterium tuberculosis ; Tuberculosis ; Ventilators, Mechanical

STUDY DESIGN: Retrospective study. OBJECTIVES: The purpose of this study was to compare factors that influence degenerative changes in patients undergoing total laminectomy and patients undergoing partial laminectomy. SUMMARY OF LITERATURE REVIEW: Lumbar or lumbosacral fusion with total or partial laminectomy may result in adjacent segment problems of the upper segment. However, the differences between the two procedures that may influence adjacent segment instability are still controversial. MATERIALS AND METHODS: We evaluated 95 patients, followed up for at least 2 years, who had been treated with short level (at most 2 levels) posterior lumbar interbody fusion with pedicle fixation, secondary to spinal stenosis. Treatment procedures included total laminectomy (42 cases) and partial laminectomy (53 cases). We analyzed the preoperative status of the intervertebral discs (Thompson grade), difference of disc height, and difference between preoperative segmental sagittal angle and last follow-up sagittal angle. We excluded cases that required revision secondary to infection, nonunion, or hematoma formation. However, we included cases that required revision due to adjacent segmental problems during the follow-up period. RESULTS: The mean age of the patients treated with total laminectomy was 59.0+/-10.9 years, and of the patients treated with partial laminectomy was 58.8+/-10.2 years. The preoperative Thompson grade showed no statistical difference. The difference in disc height and segmental sagittal angle between the preoperative and last follow-up examinations showed no statistical difference between the two groups. CONCLUSIONS: There was no significant difference in the radiographic or clinical outcomes based on removal or preservation of posterior structures. Nevertheless, we need further follow-up to evaluate adjacent segment degeneration.
Follow-Up Studies ; Hematoma ; Humans ; Intervertebral Disc ; Laminectomy ; Retrospective Studies ; Spinal Fusion ; Spinal Stenosis

Arterial blood gas analysis has become an integral part of the clinical evaluation of the patient with known or suspected pulmonary disease. However, when the results of the measurements show arterial hypoxemia which is out of proportion to the clinical and X-ray evidence of lung disease, we may consider potential errors in measurement involving the blood gas analyzer or methods of blood sample storage. We experienced spurious hypoxemia in a patient with extreme leukocytosis (220.0 X 10(3)/mm3) secondary to leukemia. The degree of PaO2 decay was blunted by placing the blood on ice.
Anoxia ; Blood Gas Analysis ; Humans ; Ice ; Leukemia ; Leukocytosis* ; Lung Diseases ; Oxygen*

OBJECTIVE: In Korea, direct lateral interbody fusion (DLIF) was started since 2011, using standard cage (6degrees lordotic angle, 18mm width). Recently, a new wider cage with higher lordotic angle (12degrees, 22mm) was introduced. The aim of our study is to compare the clinical and radiologic outcomes of the two cage types. METHODS: We selected patients underwent DLIF, 125 cases used standard cages (standard group) and 38 cases used new cages (wide group). We followed them up for more than 6 months, and their radiological and clinical outcomes were analyzed retrospectively. For radiologic outcomes, lumbar lordotic angle (LLA), segmental lordoic angle (SLA), disc angle (DA), foraminal height change (FH), subsidence and intraoperative endplate destruction (iED) were checked. Clinical outcomes were compared using visual analog scale (VAS) score, Oswestry disability index (ODI) score and complications. RESULTS: LLA and SLA showed no significant changes postoperatively in both groups. DA showed significant increase after surgery in the wide group (p<0.05), but not in the standard group. Subsidence was significantly lower in the wide group (p<0.05). There was no difference in clinical outcomes between the two groups. Additional posterior decompression was done more frequently in the wide group. Postoperative change of foraminal height was significantly lower in the wide group (p<0.05). The iED was observed more frequently in the wide group (p<0.05) especially at the anterior edge of cage. CONCLUSION: The new type of cage seems to result in more DA and less subsidence. But indirect foraminal decompression seems to be less effective than standard cage. Intraoperative endplate destruction occurs more frequently due to a steeper lordotic angle of the new cage.
Decompression ; Humans ; Korea ; Retrospective Studies ; Visual Analog Scale

PURPOSE: To evaluate changes in anterior chamber depth (ACD) and angle after phacoemulsification and intraocular lens implantation using anterior segment optical coherence tomography (AS-OCT). METHODS: Seventy-eight eyes of 69 patients had uneventful phacoemulsification and IOL implantation using a clear corneal incision. Anterior segment OCT images of nasal and temporal angle quadrants were obtained before and at one month after surgery. The angle-referenced (ACD1), pupil-referenced (ACD2), lens-referenced (ACD3) ACDs, crystalline lens rise (CLR), nasal and temporal iridocorneal angles, angle opening distance at 500 micrometer (AOD500), and trabecular iris surface area at 750 micrometer (TISA750) were measured. Preoperative and postoperative measurements were compared using paired sample t-tests. RESULTS: The mean ACD1 was 3.19+/-0.24 mm preoperatively and 3.22+/-0.21 mm at one month postoperatively (P=0.21); ACD2 was 2.99+/-0.40 mm preoperatively and 3.56+/-0.28 mm at one month postoperatively (P<0.05); ACD3 was 2.75+/-0.41 mm preoperatively and 4.00+/-0.27 mm at one month postoperatively (P<0.05). The mean iridocorneal angles, AOD500, and TISA750 for both nasal and temporal sides increased significantly at the postoperative examinations (P<0.05). CONCLUSIONS: Changes in anterior chamber angle after cataract surgery can be objectively quantified by anterior segment OCT. Deepening of the anterior chamber and widening of the nasal and temporal angles after cataract extraction were shown on AS-OCT.
Anterior Chamber ; Cataract ; Cataract Extraction ; Eye ; Humans ; Iris ; Lens Implantation, Intraocular ; Lens, Crystalline ; Phacoemulsification ; Tomography, Optical Coherence

PURPOSE: To describe the US findings of corpus luteum cyst rupture in order to elucidate the associated clinical features. MATERIALS AND METHODS: Twenty patients with proven corpus luteum cyst rupture were included in this study. The US findings of these patients were retrospectively analyzed in terms of the presence of designable cyst, size of the cyst, thickness and blood flow of the cyst wall, extension and echogenicity of peritoneal fluid, and involved site (right or left ovary). We also surveyed the clinical features such as the onset period according to the menstrual cycle, and the presence of suspectable cause. RESULTS: Fourteen of the 20 patients revealed designable cysts (mean diameter of 2.6 cm) with thick walled cysts (mean thickness, 4.6 mm, 2.4 -6.8 mm) and increased blood flow. Six patients didn 't reveal any cyst but only hematoma in adnexa. All patients had hemoperitoneum in the pelvic cavity, and the hemoperitoneum was extended to Morrison's pouch in 8 patients and to the subphrenic space in 6. The cysts occurred in the right adnexa in 15 patients and in the left in 5. Mean interval from the last menstrual period (LMP) was 26 days (13-44 days) and 6 of the 8 patients for whom it had been possible to obtain detailed history taking had had coitus just before the occurrence of symptom. CONCLUSION: When women who are hospitalized for acute abdomen and who are in luteal phase reveal US findings of hematoma or thick-walled cyst in adnexa and hemoperitoneum, a corpus luteum cyst rupture is highly suspected. In our case study the corpus luteum cyst rupture predominantly occurred in the right side, and the most suspectable cause was trauma such as coitus in the luteal phase.
Abdomen, Acute ; Ascitic Fluid ; Coitus ; Corpus Luteum* ; Female ; Hematoma ; Hemoperitoneum ; Humans ; Luteal Phase ; Menstrual Cycle ; Ovarian Cysts* ; Retrospective Studies ; Rupture

STUDY DESIGN: A retrospective study. OBJECTIVES: We analyzed the clinical results of thoracolumbar burst fractures, managed by posterior fixation of 2 segments above and 1 segment below, using an offset sublaminar hook. SUMMARY OF LITERATURE REVIEW: Mono-segment fixation above and below the injured vertebra, using posterior pedicle screw fixation, has the benefit of saving the uninjured mobile lumbar segment in thoracolumbar junction burst fracture patients. However, in a severely comminuted vertebral body, mono-segment fixation may not prevent loss of correction and metal failure. Options for such cases are additional anterior column support or long segment fixation, including 2 segments above and 1 below the injured vertebra. Instead of fixing 2 segments below the fracture level, fixation of one segment below, using the offset sublaminar hook, can save the uninjured segment, especially in the upper lumbar segment, with greater fixation strength than mono-segmental screws only. MATERIAL AND METHOD: The study included eleven patients with a thoracolumbar junction burst fracture, which underwent posterior fixation using pedicle screws in 2 segments above and 1 segment below, aided by an offset sublaminar hook. The mean follow-up period was 30.7 months (range, 24 to 58 months). Radiographs taken at follow-up were evaluated for implant loosening, correction loss, change in pedicle screw angle, and loss of vertebral height, adjacent segment instability and junctional degenerative change. The clinical results were collected in out-patient department. RESULTS: No implant loosening was noted. No case showed adjacent instability, acceleration of junctional degenerative change at the lower end of lumbar segment or hook dislodgement. Also, there were no junctional area related symptoms. CONCLUSION: For posterior surgery of thoracolumbar burst fractures, this construct, fixing 2 segments above and 1 segment below injured vertebra, aided by an offset sublaminar hook, was satisfactory in maintaining fracture reduction, and showed no instability or acceleration of degeneration on adjacent segnents.
Acceleration ; Follow-Up Studies ; Humans ; Outpatients ; Retrospective Studies ; Spine

Neurosyphilis is an infectious disease of the central nervous system caused by Treponema pallidum spirochete. There are several case reports on atypical manifestations of neurosyphilis, involving progressive cognitive dysfunction and seizures similar to those in herpes encephalitis. Seizures are common in patients with neurosyphilis, but they are usually associated with a positive Jarisch-Herxheimer reaction and status epilepticus is atypical as an initial manifestation of neurosyphilis. Here, we report on neurosyphilis patient whose initial symptom was nonconversive status epilepticus.
Central Nervous System ; Communicable Diseases ; Encephalitis, Herpes Simplex ; Humans ; Neurosyphilis* ; Seizures ; Spirochaetales ; Status Epilepticus* ; Treponema pallidum