One hundred seven isolates of Staphylococcus aureus from bovine mastitis were investigated for colony morphology in serum-soft agar (SSA), autoagglutination in salt, and capsular serotype. Capsular polysaccharide (CP) was purified and quantified from the extracts of clinical isolates. Overall, 89 isolates (83.2%) were diffuse in the SSA, without any difference in the proportion of diffuse colony between type 5 and type 8 strains. Some strains exhibited compact colonies in the SSA and expressed CP as determined by an enzyme-linked immunosorbent assay, indicating that compact morphology does not exclude encapsulation. The majority of the strains (11/12) showed autoagglutination in the salt aggregation test. The serotype 336 accounted for 46.7% of the isolates followed by serotype 5 (12.1%) and serotype 8 (12.1%). Particularly, twenty-six (24.3%) isolates reacted with two serotypes; 7 for type 8/336 and 19 for type 5/336. Five isolates (4.7%) were nontypeable with monoclonal antibodies specific for CP serotype 5, 8, or 336. The CP concentration in culture supernatants varied with the serotypes, and the total amount of CP produced by cells grown in a liquid medium was much less than that produced by cells grown on a solid medium. The Western blotting indicated that the CP bands of S. aureus serotype 5 and 8 were ranged in the molecular mass of 58-84 kilodalton (kDa), with additional bands in the region of approximately >or= 48 or Agglutination Tests ; Animals ; Bacterial Vaccines/administration & dosage ; Cattle ; Cattle Diseases/immunology/microbiology ; Female ; Mastitis, Bovine/*microbiology ; Polysaccharides, Bacterial/*classification/isolation & purification ; Serotyping/methods/veterinary ; Staphylococcal Infections/immunology/*veterinary ; Staphylococcus aureus/*classification/*immunology/isolation & purification

BACKGROUND: While sleeping, humans frequently change their position; this is done to avoid direct and excessive pressure on the body surface, and is considered to be very important for the prevention of pressure sores. A patient who is under general anesthesia, however, cannot perform this reflex movement; maintaining the same position during an entire operation causes concentrated pressure on specific body surfaces, and this may result in complications such as allopecia, back pain, pressure sores and peripheral nerve damage. Because little is known about the relationship between surgical position and pressure on the body surface, position is in most clinical situations decided on the basis of experience and informed guesswork. In order to qualitatively and quantitatively determine weight-bearing areas, pressure on the body surface of patients was evaluated under general anesthesia. METHOD: Ten patients scheduled for elective surgery were selected for this study. They were all aged over 20 and ASA class 1. A mattress equipped with a force sensing resistor was placed on the operating table and used to determine pressure on the body surface. Pressure was measured before and after anesthesia was induced in the supine, lateral and prone position. The signal generated by this mattress was processed using an analogue-digital (AD) converter, then displayed as pressure distribution on a computer screen. Pressure points were compared qualitatively, and for quantitative measurement were digitally expressed. 'Pressure' here is mean pressure at each point calculated among ten patients. RESULTS: In the supine position, pressure was concentrated on the shoulder and sacral areas. Pressure distribution in these areas was 29.8% (shoulder) and 26.0% (sacral area) before anesthesia was induced, and 20.3% (shoulder) and 25.8% (sacral area) after induction. In the lateral position, the shoulder and trochanteric areas were identified as the main weight-bearing areas; pressure distribution was 11.2% and 8.1% before induction, and 21.6% and 15.3% after induction, respectively. In the prone position, the chest and abdomen were the main weight-bearing areas. Pressure distribution in the chest area was 30.8% before induction and 24.4% after. Operating table tilt in each surgical position also produced marked changes in pressure distribution. CONCLUSIONS: In each surgical position, weight-bearing areas were qualitatively and quantitatively determined before and after anesthesia.
Abdomen ; Anesthesia ; Anesthesia, General* ; Back Pain ; Femur ; Human Body* ; Humans* ; Operating Tables ; Peripheral Nerves ; Pressure Ulcer ; Prone Position ; Reflex ; Shoulder ; Supine Position ; Thorax ; Weight-Bearing

PURPOSE: To compare lens-save and simultaneous phacoemulsification with intraocular lens implantation in primary vitrectomy for phakic rhegmatogenous retinal detachment (RRD). METHODS: A retrospective comparative analysis of 54 consecutive eyes from 54 phakic RRD patients who underwent vitrectomy with a minimum of 12 months of follow-up was performed. The patients were divided into the vitrectomy group and the combined group (patients who underwent vitrectomy with concurrent cataract surgery). The main outcome measures were the best corrected visual acuity (BCVA), anatomical success rate, complications and cataract status according to LOCSIII grading. RESULTS: Baseline characteristics were similar in both groups, except for age and cataract status. The mean age was 46.9 year in the vitrectomy group (n = 20) and 60.5 years in the combined group (n = 34) (p < 0.001). The postoperative BCVA (log MAR) improved from 1.27 and 1.30 at baseline to 0.45 and 0.28 at 12 months (p < 0.05), respectively, which was not a significant difference between the 2 groups. In the vitrectomy group, cataract status was changed from 1.8 at baseline to 2.5 at 12 months (p = 0.001). Two patients (11.1%) had an additional cataract surgery performed. The primary anatomical success rate was 90.0% in the vitrectomy group and 94.1% in the combined group. CONCLUSIONS: The vitrectomy group and combined group had similar results in the repair of phakic RRD. Although postoperative cataract progression was noted, lens should be saved in vitrectomy for young patients, as significant cataract is uncommon.
Cataract ; Eye ; Follow-Up Studies ; Humans ; Lens Implantation, Intraocular ; Lenses, Intraocular ; Outcome Assessment (Health Care) ; Phacoemulsification ; Retinal Detachment ; Retinaldehyde ; Retrospective Studies ; Visual Acuity ; Vitrectomy

This study intended to review the precedents on plastic surgery medical malpractice lawsuits in lower-court trials, classify the reasons of 'limitation of liability' by type, and suggest a standard in the acknowledgement of limitation of liability ratio. The 30 lower-court's rulings on the cases bearing the medical negligence of the defendants acknowledged the liability ratio of the defendants between 30% and 100%. Ten cases ruled that the defendants were wholly responsible for the negligence or malpractice, while 20 cases acknowledged the limitation of liability principle. In the determination of damage compensation amount, the court considered the cause of the victim side, which contributed in the occurrence of the damage. The court also believed that it is against the idea of fairness to have the assailant pay the whole compensation, even there is no victim-side cause such as previous illness or physical constitution of the patient, and applies the legal doctrine on limitation of liability, which is an independent damage compensation adjustment system. Most of the rulings also limited the ratio of responsibility to certain extent. When considering that the legal doctrine on limitation of liability which supports concrete validity for the fair sharing of damage, the tangible classification of causes of limitation of liability suggested in this study would be a useful tool in forecasting the ruling of a plastic surgery medical malpractice lawsuit.
Humans ; *Liability, Legal ; Malpractice/*legislation & jurisprudence ; Reconstructive Surgical Procedures/adverse effects/legislation & jurisprudence ; Republic of Korea ; Surgery, Plastic/*adverse effects/*legislation & jurisprudence

Impalement injury is the subset of penetrating trauma, defined as fixed, elongated objects penetrate and remain in the human body cavity or region by relatively low velocity. We report an unusual case of facial and neck impalement where two dirty rusted iron bars penetrated forehead bilaterally and exited neck and ear respectively without causing major organ injuries. After thorough radiologic and physical evaluation, the patient got medical and surgical treatment. The patient was discharged without complication after four day of delayed wound closure. There have been no complications and sequelaes related with trauma, wound infection and scar contracture at 3-year follow-up. According to affected organs and pattern of impalement, individualized and multidisciplinary surgical approach should be considered. Following these guidelines as in this case, it was possible to achieve excellent clinical outcome in impalement injury.
Cicatrix ; Contracture ; Ear ; Follow-Up Studies ; Forehead ; Foreign Bodies ; Human Body ; Humans ; Iron* ; Neck* ; Wound Infection ; Wounds and Injuries

Most of treatments have been performed laparotomy, but the rapid advances in laparoscopic operative and laboratory techniques and instrument allowed to apply laparoscopic surgery to this disease. We have reviewed 342 cases of ectopic pregnancy from march 1994 to march 2001.The cornual pregnancies were 21 case (6.1%), and the laparoscopic management in 11 cases. The mean gestational age at the time of laparoscopic surgery was 9.1 1.2 (n=11) weeks, and laparotomy was 9.4 1.3 (n=10) weeks. There were no significant difference. The mean operation time of laparoscopic surgery was 72.8 25.5minutes, and laparotomy was 68.3 24.3minutes. The mean hospital days of laparoscopic surgery were 4.9 2.4days, and laparotomy were 6.6 2.3days. In conclusion, laparoscopic surgery can be used as effective and safe as laparotomy for cornual pregnancy.
Female ; Gestational Age ; Laparoscopy* ; Laparotomy* ; Pregnancy* ; Pregnancy, Ectopic

BACKGROUND AND OBJECTIVES: It has been known that the dominant driver of atrial fibrillation (AF) exists in the left atrium (LA) and the incidence of systemic thromboembolism is higher than that of pulmonary thromboembolism in patients with AF. Therefore, we hypothesized that histological and biochemical characteristics of the LA and the right atrium (RA) are different in patients with mitral valvular AF. SUBJECTS AND METHODS: We analyzed the histology and messenger ribonucleic acid (mRNA) or protein expression associated with endothelial function and thrombogenesis in 33 human atrial appendage tissues (20 LA tissues, 13 RA tissues) taken from 25 patients {57.7+/-11.3 years old, 44% males, AF: sinus rhythm (SR)=17:8} with mitral valve disease. We also performed whole mRNA quantification in 8 tissues (both LA and RA tissues from 4 patients) by using next generation sequencing (NGS). RESULTS: 1) The degree of fibrosis (p=0.001) and subendocardial smooth muscle thickness (p=0.004) were significantly greater in the LA than in the RA. 2) More advanced matrix fibrosis was found in the LA of patients with AF than in the LA of patients with SR (p=0.046), but not in the RA. 3) There was no LA-RA difference in protein (Western blot) and mRNA {quantitative real-time polymerase chain reaction (qRT-PCR)} expressions of NF-kappaB, 3-NT, CD31, E-selectin, inducible NO synthase, stromal cell-derived factor-1alpha, Endothelin-1, platelet-derived growth factor, myeloperoxidase, or NCX, except for higher mRNA expression of HCN4 in the RA (qRT-PCR, p=0.026) and that of KCNN1 in the LA (NGS, p=0.016). CONCLUSION: More advanced matrix and subendocardial remodeling were noticed in the LA than in the RA in patients with mitral valvular AF. However, the expressions of tissue factors associated with thrombogenesis were not significantly different between the RA and the LA.
Atrial Appendage ; Atrial Fibrillation* ; Chemokine CXCL12 ; E-Selectin ; Endothelin-1 ; Fibrosis ; Heart Atria* ; Humans ; Incidence ; Male ; Mitral Valve ; Muscle, Smooth ; NF-kappa B ; Nitric Oxide Synthase ; Peroxidase ; Platelet-Derived Growth Factor ; Pulmonary Embolism ; Real-Time Polymerase Chain Reaction ; RNA ; RNA, Messenger ; Thromboembolism ; Thromboplastin

No abstract available.
Acupuncture* ; Hand* ; Tenosynovitis* ; Tuberculosis*

PURPOSE: In the present study, the clinical characteristics and outcomes of neuroretinitis in Korea were investigated. METHODS: Seven consecutive patients with neuroretinitis from 2012 to 2015 were retrospectively reviewed. RESULTS: The present study included 9 eyes of 7 patients. The subjects consisted of 5 males and 2 females and the mean age was 45.1 ± 13.2 years. Two patients had Influenza-like symptoms and the others had no specific general symptoms. The mean best corrected visual acuity was logMAR 0.48 ± 0.55 (0-1.6) on the initial visit. Four patients 40 years of age or under had no abnormal findings in laboratory work-up. Conversely, 3 patients over 40 years of age were positive for Toxocara based on enzyme-linked immunosorbent assay (ELISA). Two of 3 patients positive for Toxocara were treated with albendazole and 1was not. Eight eyes had good visual recovery over 20/30 except for 1 patient who did not take the albendazole despite being positive for Toxocara detected using ELISA. CONCLUSIONS: Three of 7 patients with neuroretinitis in Korea showed positive results for Toxocara based on ELISA. In cases with seropositive Toxocara ELISA results, albendazole treatment should be considered.
Albendazole ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Korea* ; Male ; Optic Neuritis ; Retinitis* ; Retrospective Studies ; Toxocara ; Toxocariasis ; Visual Acuity

PURPOSE: Vaginal engorgement depends, in part, on the relaxation of vaginal smooth muscle. The aim of this study was to evaluate the role of nitric oxide(NO) in the relaxation of the vaginal smooth muscle. MATERIALS AND METHODS: New Zealand White female rabbits(n=8) were sacrificed and distal 1/3 of the vagina was dissected. Strips of vaginal tissues were immediately processed for isometric tension measurement in the organ bath. The vaginal strips were precontracted with phenylephrine and the responses to electrical field stimulation(EFS) or sodium nitroprusside were examined. Each preparations was also processed immunohistochemically to determine the presence of neuronal NO synthase(n-NOS) in the tissue. RESULTS: EFS caused a frequency-dependent relaxation, which was significantly inhibited in the presence of Nw-nitro-L-arginine methyl ester(L-NAME), a competitive inhibitor of NOS. Sodium nitroprusside, a NO donor, caused concentration-dependent relaxations in the vaginal tissue and the relaxation was not affected by L-NAME(10-4M). n-NOS immunoreactivity was detected in perivascular space and vicinity of vaginal smooth muscle. CONCLUSIONS: These results suggest that the relaxation of the rabbit vaginal smooth muscle is partly mediated by the NO pathway.
Baths ; Female ; Humans ; Muscle, Smooth* ; Neurons ; New Zealand ; Nitric Oxide* ; Nitroprusside ; Phenylephrine ; Relaxation* ; Tissue Donors ; Vagina