OBJECTIVE: To assess the effect of fentanyl and midazolam on in vitro fertilization rate and early embryo development in a mouse IVF model. METHODS: Mouse oocytes were exposed in vitro to fentanyl at a concentration of 0(control), 50, 250, 500, 1000, 5000 pg/ml, and midazolam, 0(control), 2.5, 12.5, 25, 50, 250 ng/ml for 30 minutes, washed and inseminated. Thereafter fertilization was assessed. And subsequent in vitro development to the blastocyst stage was monitored daily. RESULTS: Where fertilization occurred, subsequent embryo cleavage and development up to the blastocyst stage was affected significantly by the presence of fentanyl and midazolam solution in the medium(i.e., 14% to 31%, 10% to 35%), in comparison with control group( 60%, 62%). CONCLUSION: It can be concluded from these experiments that even a brief exposure of cumulus enclosed oocytes to a low concentration of fentanyl, midazolam is deleterious to subsequent cleavage.
Anesthetics ; Animals ; Blastocyst ; Embryonic Development ; Embryonic Structures* ; Female ; Fentanyl* ; Fertilization ; Fertilization in Vitro* ; Mice* ; Midazolam* ; Oocytes ; Pregnancy

PURPOSE: The purpose of this study was to compare the effect of alcohol gel according to the amount and drying time in health personnel hand hygiene and to promote in their practice adequate and effective hand hygiene. METHODS: The cross-over experimental study was performed with 14 volunteers. Hands were artificially contaminated with 5 mL of 10(8) CFU/mL of Serratia marcescens (ATCC 14756) and four different alcohol gel hand hygiene methods varying by the amount of alcohol gel (2 mL vs. 1 mL) and drying time (complete vs. incomplete) were compared. Samples were collected by glove juice sampling procedures. RESULTS: Mean log reduction values of the four different hand hygiene methods were 2.22+/-0.36, 1.26+/-0.53, 1.49+/-0.60, 0.89+/-0.47 respectively for the 4 groups: adequate amount (2mL) and complete dry (30 seconds rubbing followed by 2 min air-dry), inadequate amount (1 mL) and complete dry, adequate amount and incomplete dry (15 seconds rubbing and no air-dry), and inadequate amount and incomplete dry. The difference was statistically significant in the adequate amount and complete dry group compared to other three groups (p<.001). CONCLUSION: Only alcohol gel hand hygiene with adequate amount and complete drying was satisfactory by U.S. FDA-TFM efficacy requirements for antiseptic hand hygiene products.
Adolescent ; Adult ; Anti-Infective Agents, Local/*pharmacology ; Cross-Over Studies ; Ethanol/chemistry/*pharmacology ; Gels/*chemistry ; Hand Hygiene/*methods ; Humans ; Middle Aged ; Serratia marcescens/*drug effects ; Time Factors ; Young Adult

PURPOSE: The purpose of this study was to investigate the pro-erectile potential of various urethral alpha blockers using pharmacological or electrical induction of erection in anesthesized rats. MATERIALS AND METHODS: To evaluate the influence on centrally mediated erection, intravenous administeration of terazosin, doxazosin(3, 10, 30microgram/kg), and tamsulosin (0.3, 1, 3microgram/kg), followed by submaximal subcutaneous apomorphine(50microgram/kg) administration, mean arterial pressure(MAP) and intracavernosal pressure(ICP) were recorded over 30 minutes in male anesthesized rats. The time to first response, peaks within 30 minutes, maximal ICP, area under the curve, percentage of ICP/MAP were compared. To evaluate the influence on peripherally induced erections, various doses of alpha antagonists and submaximal cavernous nerve stimulation(0.5ms, 2V, 10Hz) were combined. The ICP increase and ICP/MAP percentage were also compared. RESULTS: Although various dose response relationships were shown, all three alpha blockers enhanced erectile activity triggered by apomorphine. In terms of time to first response and peaks within 30 minutes, the proerectile effects of terazosin was most prominent whereas those of tamsulosin was minimal, requiring larger doses. In combining with cavernous nerve stimulation, doxazosin and tamsulosin showed moderate proerectile activity, but the highest dose of terazosin was required to enhance ICP increase induced by cavernous nerve stimulation. Despite their pressure lowering effects, all tested alpha adrenergic blockers significantly enhanced the ICP/MAP percentage. CONCLUSIONS: The present finding clearly indicated that alpha 1 selective antagonists can enhance erectile capacity when combined with central or peripheral stimuli for erection.
Adrenergic alpha-Antagonists ; Adrenergic Antagonists ; Animals ; Apomorphine ; Doxazosin ; Humans ; Male ; Models, Animal* ; Rats*

BACKGROUND: This is a retrospective, descriptive study, evaluating the observed agreement between 1996 & 2002 Centers for Disease Control and Prevention (CDC) definitions of nosocomial pneumonia (NP) for medical intensive care unit (MICU) and surgical intensive care unit (SICU) patients. METHODS: A total of 476 adult patients who were over 15 years of age and had been admitted to the MICU & SICU of a university hospital between August 1, 2005 and August 1, 2007 were enrolled. Data were collected from electronic medical records according to the 1996 & 2002 CDC definitions of NP. RESULTS: According to the 1996 CDC definitions of NP, there were a total of 116 NP cases and incidence rate was 11.6 per 1,000 patient-days; when analyzed with the 2002 CDC definitions of NP, 75 cases met the criteria and the incidence rate was 7.5 per 1,000 patient-days. Kappa value measuring agreement between the two definitions was 0.67 (95% confidence interval 0.601-0.706). When 1996 CDC definitions were compared with 2002 CDC definitions, sensitivity, specificity, positive predictive value, and negative predictive value were 93.3, 88.5, 60.3, and 98.6%, respectively. CONCLUSION: Even though the aforementioned NP criteria had been applied to the same study population, the number of patients that met the definitions changed depending on which criteria had been used. Therefore, it is necessary to consider the differences when making a comparison.
Adult ; Centers for Disease Control and Prevention (U.S.) ; Electronic Health Records ; Humans ; Incidence ; Critical Care ; Intensive Care Units ; Pneumonia ; Retrospective Studies ; Sensitivity and Specificity

No abstract available.
Carcinosarcoma* ; Female ; Ovary*

Purpose: The purpose of this study was to provide multifaceted interventions for nurses and to confirm changes in their knowledge, perception, and actual practice on the adequate storage, conditions, and transportation of culture specimens. Methods: A onegroup pretest-posttest experimental design was conducted with 41 nurses in two general wards of a tertiary acute care hospital in Seoul. Multifaceted interventions including education, feedback, posting guidelines and reminders, and improvement in specimen management accessibility were provided from May 2019 to January 2020. Outcomes were measured before and after the interventions. Knowledge and perception of the nurses were evaluated using self-reported questionnaires and actual practice by observation. Results: After the interventions, the average knowledge score on transportation time was significantly increased (Z = -4.89, p < .001). However, the knowledge score on storage methods was not significantly increased. The perception score was significantly increased (t = -3.19, p = .003). The proportion of specimen storage times, places, and conditions managed properly was significantly increased from 43.0% (46/107) to 77.1% (84/109) (p < .001). The average transportation time of blood samples to the laboratory significantly decreased from 3 hours 36 minutes ( ± 1 hour 52 minutes) to 3 hours 1 minute ( ± 1 hour 41 minutes) (t = 2.51, p = .013). The percentage of blood culture specimens arriving within 2 hours was increased significantly from 22.9% to 39.2% ( χ 2 = 6.90, p = .009). Conclusion The interventions were effective. However, some specimens remained in the ward longer than expected after the interventions. This requires further interventions.

PURPOSE: To evaluate the results between open reduction and internal fixation with the plate and percutaneous reduction by towel clip and intramedullary fixation with Steinmann pin for clavicle shaft fractures in adult. MATERIALS AND METHODS: We have studied the results in 33 cases with the plate, 35 cases with the Steinmann pin among total 68 cases of clavicle shaft fracture. The patients were followed up over a period of at least 12 months. The final postoperative outcome was analyzed with the clinical outcomes using Kang's criteria, radiological union time and operation time. RESULTS: The clinical outcome that was good or excellent according to the Kang's criteria showed a distribution of 88% in the group using the plate with 29 cases out of total 33 cases, 91% in the group using the Steinmann pin with 32 cases out of total 35 cases. The mean radiological union time was 8.9 weeks in the group using the plate, 9.1 weeks in the group using Steinmann pin. The mean operation time was 72 minutes in the group using the plate, whereas was 18 minutes in the group using Steinmann pin. CONCLUSION: In the treatment of adult clavicle shaft fracture, two groups did not show a significant statistical difference in clinical and radiological outcomes. However, the operation time and postoperative functional recovery was significantly shorter and faster in the group using Steinmann pin. Additionally economic and cosmetic aspect was more satisfactory in the group using Steinmann pin.
Adult* ; Clavicle* ; Humans

No abstract available.
Aneurysm* ; Carotid Artery, External* ; Neurofibromatoses*

We analyzed 20 cases of traumatic carotid cavernous fistula(CCF) during the recent 10 years The results are summarized as follows: 1) In 18 cases(90%), the clinical symptoms & signs of CCF occurred within 2 months after trauma. 2) The sites of fistulae were common in horizontal segment(40%) and at the junction(30%) between horizontal segment and posterior ascending segment of cavernous portion of internal carotid artery. 3) The main draining veins of CCF were the superior ophthalmic vein(90%) and the inferior petrosal sinus(70%). 4) The methods of treatment were occlusion of fistula with balloon(9 cases), occlusion of cavernous ICA with balloon(2 cases), ligation of cervical ICA with Poppen's clamp(4 cases) and trapping(2 cases). Two patients were not treated and another patient was healed spontaneously. 5) The frequency and severity of complication was significantly decreased in cases treated by detachable balloon occlusion than by direct cervical ICA ligation or trapping procedures. 6) The procedure using the self-sealed goldvalve balloon was simple, but had a risk of premature separation and premature deflation.
Balloon Occlusion ; Carotid Artery, Internal ; Fistula* ; Humans ; Ligation ; Veins

Direct operation for ruptured aneurysm should be the choice of treatment in elderly patients same as in younger cases. The early operation is an effective and reliable method to reduce the occurrence of rebleeding, vasospasm, ischemic complication, medical complication & to shorten lengths of hospitalization. To evaluate the risk of early operation of elderly patients with ruptured cerebral aneurysm. conducted a retrospective analysis 81 elderly patients with ruptured aneurysms who were over aged 60 years between Jan 1985 to June 1988. Of these, 47 case were performed early operation in which the direct intracranial operation was carried out within 3 days after last subarachnoid hemorrage. 77 % had favorable outcome and 13% died.
Aged* ; Aneurysm, Ruptured* ; Hospitalization ; Humans ; Intracranial Aneurysm ; Retrospective Studies