BACKGROUND: The purpose of our study is to evaluate the usefulness of cervicovaginal fetal fibronectin assay for the prediction of rupture of membrane and preterm labor. METHODS: A group of 39 pregnant women was involved in this prospective study. Out of 139 pregnant women, 96 were clinically diagnosed as ruptured membranes (group A). The remaining 43 of 139 pregnant women were clinically diagnosed as preterm labor(group B). The assay was performed by using the ROMCheckTM kit (Adeza Biomedical Corp., Sunnyvale, CA). RESULTS: In group 4, fetal fibronectin (fFN) positive rate is 55% (53 patients) and negative rate is 45% (43 patients). In group B, fFN positive rate is 56% (24 patients) and negative rate is 44% (19 patients). Both group of fFN positive patients show a significantly shorter interval from sampling to delivery than fFN negative patients. Also in group A, the percentage of fFN positive patients who delivered at less than 48 hours after sampling is greater than those with fFN negative patients and in group B, the preterm delivery rate is 79% with positive fFN and 37% with negative fFN. As a predictor for preterm delivery, the presence of fFN has the sensitivity 79%, the specificity 84%, the positive Predictive value 76% and the negative predictive value 86%. CONCLUSIONS: The result suggests that a positive fFN in pregnant women who have uterine contractions and ruptured membrane indicates a significant risk for preterm delivery and labor onset, and a negative fFN is a reassuring sign.
Female ; Fibronectins* ; Humans ; Labor Onset ; Membranes ; Obstetric Labor, Premature ; Pregnancy ; Pregnant Women* ; Prospective Studies ; Rupture ; Sensitivity and Specificity ; Uterine Contraction

No abstract available.
Blood Donors* ; Female ; Humans ; Pregnancy ; Pregnancy Trimester, Third* ; Pregnancy*

No abstract available.
Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus*

Lactobacillus sp., generally considered to be a harmless indigenous bacteria of the mucous membrane, occasionally causes serious infections. Lactobacillus endocarditis is a very rare disease, and no case has been reported in Korea. Gram-positive bacilli were isolated from blood cultures of a 41-year-old man with clinically suspected subacute bacterial endocarditis. The patient had a dental procedure 3 months prior to the infection. The isolate was identified as L. casei subsp. casei based on the cultural characteristics and gas liquid chromatography of metabolic products. The patient was treated with ampicillin and improved. When Lactobacillus is isolated from the blood of an endocarditis patient, the significance should be seriously considered. MeSH Terms:
Adult ; Endocarditis, Bacterial/*etiology ; Human ; Lactobacillus casei/*isolation & purification ; Male ; Septicemia/*etiology

Cervical myelopathy and radiculopathy are common pathologies that often improve with spinal decompression and fusion. Postoperative complications include pseudarthrosis, which can be challenging to diagnose and manage. We reviewed the literature with regard to risk factors, diagnosis, controversies, and management of cervical pseudarthrosis.
Decompression ; Diagnosis* ; Pathology ; Postoperative Complications ; Pseudarthrosis* ; Radiculopathy ; Risk Factors* ; Spinal Cord Diseases ; Spine*

Actinobacillus actinomycetemcomitans, a rare human pathogen, was repeatedly isolated from the blood of a 20-year-old male patient with patent ductus arteriosus who developed subacute bacterial endocarditis. Difficulties in isolating and identifying the organism are discussed. The bacterial isolate was found to be susceptible to various antimicrobial agents.
Actinobacillus/isolation & purification* ; Adult ; Blood/microbiology* ; Case Report ; Endocarditis, Subacute Bacterial/microbiology* ; Human ; Male ; Septicemia/microbiology

Campylobacter fetus subsp. fetus is a rare human pathogen, but can cause serious extraintestinal infections. Effective antimicrobial agent is required for the therapy, but we have very limited knowledge on the susceptibility of the organism. In this study, the susceptibility of 25 isolates of the organism to 14 antimicrobial agents was tested by an agar dilution method. Antimicrobial agents with low MIC ranges, in micrograms/ml, were: meropenem Y or = 0.25, dirithromycin < or = 0.5, gentamicin > or = 1, amikacin, ofloxacin, tetracycline and erythromycin < or = 2. The MIC range of cefepime was 0.5-8 micrograms/ml, but those of other beta-lactams were relatively high. All of the isolates were interpreted to be susceptible to cefepime, meropenem, amikacin, gentamicin, ofloxacin, tetracycline and dirithromycin. A significant proportion of the isolates were either intermediate or resistant to ampicillin, cephalothin, cefotaxime, aztreonam, loracarbef and erythromycin. In conclusion, the organism remains susceptible to aminoglycosides and tetracycline. Greater in vitro activity of meropenem, ofloxacin and dirithromycin require clinical evaluation.
Antibiotics/*pharmacology ; Blood/*microbiology ; Campylobacter fetus/*drug effects/isolation & purification ; Human ; Microbial Sensitivity Tests ; Synovial Fluid/*microbiology

This review comprehensively examines the evolution and current state of interbody cage technology for lumbar interbody fusion (LIF). This review highlights the biomechanical and clinical implications of the transition from traditional static cage designs to advanced expandable variants for spinal surgery. The review begins by exploring the early developments in cage materials, highlighting the roles of titanium and polyetheretherketone in the advancement of LIF techniques. This review also discusses the strengths and limitations of these materials, leading to innovations in surface modifications and the introduction of novel materials, such as tantalum, as alternative materials. Advancements in three-dimensional printing and surface modification technologies form a significant part of this review, emphasizing the role of these technologies in enhancing the biomechanical compatibility and osseointegration of interbody cages. In addition, this review explores the increase in biodegradable and composite materials such as polylactic acid and polycaprolactone, addressing their potential to mitigate long-term implant-related complications. A critical evaluation of static and expandable cages is presented, including their respective clinical and radiological outcomes. While static cages have been a mainstay of LIF, expandable cages are noted for their adaptability to the patient’s anatomy, reducing complications such as cage subsidence. However, this review highlights the ongoing debate and the lack of conclusive evidence regarding the superiority of either cage type in terms of clinical outcomes. Finally, this review proposes future directions for cage technology, focusing on the integration of bioactive substances and multifunctional coatings and the development of patient-specific implants. These advancements aim to further enhance the efficacy, safety, and personalized approach of spinal fusion surgeries. Moreover, this review offers a nuanced understanding of the evolving landscape of cage technology in LIF and provides insights into current practices and future possibilities in spinal surgery.

Adult spinal deformity (ASD) is one of the most challenging spinal disorders associated with broad range of clinical and radiological presentation. Correct selection of fusion levels in surgical planning for the management of adult spinal deformity is a complex task. Several classification systems and algorithms exist to assist surgeons in determining the appropriate levels to be instrumented. In this study, we describe our new simple decision making algorithm and selection of fusion level for ASD surgery in terms of adult idiopathic idiopathic scoliosis vs. degenerative scoliosis.
Adult* ; Classification ; Congenital Abnormalities* ; Decision Making* ; Humans ; Scoliosis ; Spinal Fusion ; Surgeons

BACKGROUND: The shortage of donor organs is the main problem that needs to be solved in Korea as well as in other countries. To expand the donor pool, we retrospectively reviewed the brain-dead patients who expired without organ donation in the neurosurgical intensive care units (NICU) and evaluated the potential deceased donors (PDDs). METHODS: Between January 2008 and December 2008, PDDs who expired without organ donation in the NICU were recruited from 52 secondary or tertiary referral hospitals in Korea. The data of a total 2,288 PDD cases were collected from the questionnaire. Of these, 1,980 cases were eligible for analysis. RESULTS: There were 1,166 males (58.9%) and 793 females (40.1%) with a mean age of 57.6+/-18.0 years (21.2% in the 5th decade; 21.0% in the 6th decade). The most common cause of death of PDDs was cerebrovascular accident (n=1,034; 52.2%). Glasgow Coma scale was 3 in 23.1% and 4 in 12.1% of the PDDs. Craniotomy was performed in 996 patients (50.3%). Sepsis developed in 276 patients (14.0%) among the total PPDs. Diagnostic procedure for assessment of brain death was performed in 194 patients (9.8%). The seroprevalence of HBsAg and HCVAb was 1.7% and 0.6%, respectively. The mean AST/ALT level on admission and after brain death were 80.9+/-344.9/49.0+/-162.19 and 308.6+/-1,485.2/142.5+/-596.27 IU/L, respectively. Uriney protein level was normal in 1,221 patients (61.7%) after brain death. Of the 1980 PDDs, 19 patients (1%) donated their organs for transplantation. CONCLUSION: Only a small percentage (1%) of PDDs in the NICU donated their organs in Korea. We suggest that continuous and active donor action is needed to increase organ donation from the potential deceased donors.
Brain Death ; Cause of Death ; Craniotomy ; Critical Care ; Female ; Glasgow Coma Scale ; Hepatitis B Surface Antigens ; Humans ; Intensive Care Units ; Korea ; Male ; Neurosurgery ; Surveys and Questionnaires ; Retrospective Studies ; Sepsis ; Seroepidemiologic Studies ; Stroke ; Tertiary Care Centers ; Tissue and Organ Procurement ; Tissue Donors ; Tuberculin