Risk factors related to the appearance of umbilical disorders in dairy calves / [Fatores de risco relacionados ao surgimento de afecções umbilicais em bezerros leiteiros]

The objective of this study was to determine the types of calve housing used in dairy farms, the prevalence of umbilical disorders and related risk factors. The 16 farms studied were visited to characterize the types of installation and possible risk factors, as well as information obtained from a questionnaire applied to the farmers. 806 Holstein calves were physically examined, in addition to collecting blood samples for the evaluation of Failures in Passive Immunity Transfer (FPIT), in animals that manifested inflammatory omphalopathies, and were also submitted to ultrasound examination. The prevalence of omphalopathies was assessed by Fisher's test, and multivariate logistic regression to assess risk factors. Eight types of installation were found: tropical house, suspended cage, collective stall, collective picket, Argentinean type, single-story cage, individual stall, and collective picket with chain. Omphalopathies accounted for 6.45% of the calves. Small size farms (up to 99 lactation cows) had high risk for umbilical disorders, ground floor collective calves, without side protection, with sand floor, in closed sheds and without heatstroke were considered risk factors for omphalopathies. Adequate colostrum and umbilical antisepsis are not associated with disease, its appearance being related to the housing conditions of the animals.(AU)

O objetivo deste estudo foi determinar os tipos de alojamento para bezerros leiteiros, a prevalência de onfalopatias e os fatores de risco relacionados. As 16 fazendas estudadas foram visitadas buscando-se caracterizar os tipos de instalação e os possíveis fatores de risco, além de informações obtidas de um questionário aplicado aos fazendeiros. Foram examinados fisicamente 806 bezerros da raça Holandesa, além da coleta de amostras de sangue, para avaliação da falha de transferência de imunidade passiva (FTIP), nos animais que manifestaram onfalopatias inflamatórias, sendo submetidos também ao exame ultrassonográfico. A prevalência das onfalopatias foi avaliada por teste de Fisher, e foi feita regressão logística multivariada a fim de se avaliarem os fatores de risco. Verificou-se oito tipos de instalação: casinha tropical, gaiola suspensa, baia coletiva, piquete coletivo, bezerreiro tipo argentino, gaiola térrea, baia individual e piquete coletivo com corrente. As onfalopatias corresponderam a 6,45% dos bezerros. Os bezerreiros coletivos térreos, sem proteções laterais, com piso de areia, borracha, concreto ou madeira, em galpões fechados, sem insolação, com alta densidade animal, antissepsia umbilical realizada por três dias e FTIP acima de 50% foram considerados fatores de risco para onfalopatias e possuem relação com o bezerreiro, sendo decisivas para evitar essas condições a colostragem e a antissepsia umbilical adequadas.(AU)

Impacto das superfícies de compressão na massagem cardíaca durante a reanimação cardiopulmonar: uma revisão integrativa / Impacto de las superficies de compresión en el masaje cardíaco durante la reanimación cardiopulmonar: una revisión integrativa / Impact of compression surfaces on cardiac massage during cardiopulmonary reanimation: an integrative review

Resumo Objetivo sintetizar as evidências disponíveis na literatura sobre os tipos de superfícies de compressão utilizadas na RCP e analisar quais características das superfícies de compressão têm impacto na eficácia da compressão torácica durante a RCP. Método revisão integrativa da literatura, cujos critérios de seleção e inclusão foram: artigos completos, em inglês, português ou espanhol e que respondessem a seguinte questão de pesquisa: "Quais são as características das superfícies de compressão que têm impacto na eficácia das compressões torácicas durante a RCP?". Realizada entre os meses de junho e julho de 2019. Resultados inclui-se 12 artigos de estudos experimentais, cuja extração de dados revelou 13 tipos diferentes de colchões. Em relação às pranchas, seis tamanhos diferentes foram relatados, com diferentes materiais. Constatou-se influências do tipo de superfície de compressão na força necessária para realizar as compressões torácicas. Conclusão as evidências apontam que colchões de maiores dimensões e com tecnologia para redução de pressão e camas mais largas apresentam impactos negativos na qualidade das compressões torácicas. Implicação para prática o conhecimento sobre a influência do tipo e características das superfícies de apoio na qualidade das compressões torácicas podem subsidiar profissionais na escolha e incorporação de tecnologias no ambiente hospitalar.

Resumen Objetivo Sintetizar la evidencia disponible en la literatura sobre los tipos de superficies de compresión utilizadas en la RCP y analizar qué características de las superficies de compresión tienen un impacto en la efectividad de la compresión torácica durante la RCP. Método Revisión bibliográfica integradora, cuyos criterios de selección e inclusión fueron: artículos completos, en inglés, portugués o español y que respondieran a la siguiente pregunta de investigación: "¿Cuáles son las características de las superficies de compresión que inciden en la efectividad de las compresiones torácicas durante la RCP?". Se llevó a cabo entre junio y julio de 2019. Resultados se incluyeron 12 artículos de estudios experimentales, cuya extracción de datos reveló 13 tipos diferentes de colchones. En cuanto a los Tabelaros, se reportaron seis tamaños diferentes, con diferentes materiales. Se encontraron influencias del tipo de superficie de compresión sobre la fuerza requerida para realizar las compresiones torácicas. Conclusión la evidencia señala que los colchones más grandes con tecnología de reducción de presión y las camas más grandes tienen impactos negativos en la calidad de las compresiones torácicas. Implicación para la práctica El conocimiento sobre la influencia del tipo y características de las superficies de apoyo en la calidad de las compresiones torácicas puede ayudar a los profesionales en la elección e incorporación de tecnologías en el ámbito hospitalario.

Abstract Objective To synthesize the available evidence in the literature on the types of compression surfaces used in CPR and to analyze which characteristics of the compression surfaces impact the effectiveness of chest compression during CPR. Method Integrative literature review, whose selection and inclusion criteria were complete articles, in English, Portuguese or Spanish and that answered the following research question: "What are the characteristics of the compression surfaces that impact the effectiveness of chest compressions during CPR?". It was carried out between June and July 2019. Results 12 articles from experimental studies were included. 13 different types of mattresses were found. Regarding the boards, six different sizes and many materials were reported. Influences of the type of compression surface on the force required to perform chest compressions were found. Conclusion Evidence points out that larger mattresses with pressure reduction technology and larger beds have negative impacts on the quality of chest compressions. Implication for practice Knowledge about the influence of the type and characteristics of support surfaces on the quality of chest compressions can support professionals in the choice and incorporation of technologies in the hospital environment.

Determinação das características físico-químicas e das miopatias do músculo Pectoralis major em frangos de corte criados em piso de plástico perfurado / Determination of the physical-chemical characteristics and myopathy of the Pectoralis major muscle in broiler chickens raised on perforated plastic floor

Esse estudo teve como objetivo avaliar a influência da criação de frangos de corte em pisos plásticos perfurados sobre a qualidade físico-química da carne e a incidência de miopatias peitorais. Para isso, os animais foram alojados em 14 box, em dois tratamentos, cama e piso, 25 animais por box. Para a capacidade de retenção de água as aves do tratamento piso apresentaram melhores resultados; no entanto, apresentaram maior perda de água por cocção. O músculo Pectoralis major dos animais criados no piso de plástico, apresentou menor valor de força de cisalhamento, entretanto, maior força de deformação. Para as miopatias, o peito dos frangos criados no piso de plástico apresentaram maior incidência de white striping, enquanto os que permaneceram na cama de casca de arroz apresentaram maior incidência de wooden breast. A criação de frangos de corte em pisos de plástico perfurados não influenciou as características físico-químicas da carne, bem como a incidência de miopatias peitorais.

Monitoramento de Salmonella spp. no sistema de criação de frangos de corte criados em pisos de plástico perfurados / Monitoring of Salmonella spp. in the system of chicken broilers created on perforated plastic floors

A Salmonellaé um problema dentro de granjas avícolas e abatedouros-frigoríficos. De caráter zoonótico, pode causar problemas ao homem. O estudo teve como objetivo avaliar o uso de pisos plásticos perfurados como substituto da cama de frango e a diminuição da carga microbiana. Os animais foram divididos em dois tratamentos: animais criados em cama (7 repetições) e animais criados no piso de plástico (7 repetições). Nos dias 4, 12, 25 e 40 de experimento, foram coletadas amostras de suabe de cloaca, suabe de arrasto do piso e amostras de cama para a contagem de coliformes totais, termotolerantes e Salmonella spp. Não foi possível encontrar diferença (p>0,0001) na contagem de coliformes entre os tratamentos. No teste presuntivo de Salmonella, até os 25 dias, os animais criados no piso tiveram as menores porcentagens de positivos. A utilização de pisos de plásticos e sua associação com protocolos higiênicos-sanitários pode ser uma estratégia para diminuir as contaminações bacterianas nos estabelecimentos avícolas comerciais e nas carcaças de frangos de corte.

O ambiente domiciliar e seus riscos para quedas em idosos: uma revisão integrativa da literatura / The home environment and its risks for falls in the elderly: an integrative literature review / El entorno del hogar y sus riesgos para caídas en ancianos: una revisión bibliográfica integradora

O objetivo deste estudo foi identificar os fatores de risco associados à queda de idosos em ambiente domiciliar, por meio de uma revisão integrativa, realizada nas bases de dados LILACS, MEDLINE e BDENF, no período de 2007 a 2017. Entre os fatores de risco para a queda de idosos estão: idade, utilização de medicamentos, desempenhar determinadas atividades cotidianas de vida, dentre as mais notadas: ao levantar-se da cama, subir escadas, tomar banho, presença de tapetes sem antiderrapante com ausência de barra no banheiro, e acesso difícil ao interruptor de luz, o que acaba facilitando a queda aos idosos. Diante dos resultados desta pesquisa, existe a necessidade de mais pesquisas nesta temática para, então, ampliar-se o desenvolvimento de ações preventivas e de promoção à saúde em idosos.

The objective of this study was to identify the risk factors associated with the fall of the elderly in the home environment, through an integrative review, performed in the LILACS, MEDLINE and BDENF databases, from 2007 to 2017. Among the factors of risk for the fall of the elderly are: age, use of medicines, performing certain daily activities of life, among the most noteworthy: when getting out of bed, climbing stairs, taking a bath, the presence of non-slip mats with no bar in the bathroom, and difficult access to the light switch, which makes the fall easier for the elderly. Given the results of this research, there is a need for further research on this subject to expand the development of preventive actions and health promotion in the elderly.

El objetivo de este estudio fue identificar los factores de riesgo asociados con la caída de los ancianos en el entorno del hogar, a través de una revisión integradora, realizada en las bases de datos LILACS, MEDLINE y BDENF, de 2007 a 2017. Entre los factores de Los riesgos para la caída de los ancianos son: edad, uso de medicamentos, realizar ciertas actividades diarias de la vida, entre los más notables: al levantarse de la cama, subir escaleras, bañarse, la presencia de tapetes antideslizantes sin barra en el baño y difícil acceso al interruptor de la luz, lo que facilita la caída de los ancianos. Dados los resultados de esta investigación, es necesario realizar más investigaciones sobre este tema para ampliar el desarrollo de acciones preventivas y la promoción de la salud en los ancianos.

Necessity of Research on Thirdhand Smoke for Maternal and Child Health

The causal relationship between cigarette smoking during pregnancy and adverse maternal and child health outcomes, such as preterm birth, low birth weight, and sudden infant death syndrome are well known. In addition, cigarette compounds are neurotoxic even at extremely low levels. Thirdhand smoke (THS) is the contamination that persists after secondhand tobacco smoke has been emitted into air. It refers to the tobacco-related gases and particles that become embedded in materials such as carpets, walls, furniture, blankets, and toys. THS is not strictly smoke but chemicals that adhere to surfaces from which they can be released back into the air, undergo chemical transformations, and/or accumulate. The concept of THS is a relatively new phenomenon in the environmental and public health field. Currently, the hazards of THS are not as well documented as the hazards of secondhand smoke. Furthermore, its health effects and biological effects are largely unknown. This review summarizes recent research progress in reproductive toxicology studies that use animal models and in vitro systems, studies of environmental contamination by THS, human exposure studies, and priorities for further research. Future research must be conducted to facilitate hazard identification, and exposure and risk assessment to address its health effect on susceptible populations, such as pregnant women and children. In addition, policies and laws concerning tobacco smoke will need to be reviewed and possibly revised with the role of THS considered as an indispensable component of a broader tobacco control strategy in maternal and child health.

Evaluation of Related Risk Factors in Number of Musculoskeletal Disorders Among Carpet Weavers in Iran

BACKGROUND: Musculoskeletal disorders (MSDs) are a common problem among carpet weavers. This study was undertaken to introduce affecting personal and occupational factors in developing the number of MSDs among carpet weavers. METHODS: A cross-sectional study was performed among 862 weavers in seven towns with regard to workhouse location in urban or rural regions. Data were collected by using questionnaires that contain personal, workplace, and information tools and the modified Nordic MSDs questionnaire. Statistical analysis was performed by applying Poisson and negative binomial mixed models using a full Bayesian hierarchical approach. The deviance information criterion was used for comparison between models and model selection. RESULTS: The majority of weavers (72%) were female and carpet weaving was the main job of 85.2% of workers. The negative binomial mixed model with lowest deviance information criterion was selected as the best model. The criteria showed the convergence of chains. Based on 95% Bayesian credible interval, the main job and weaving type variables statistically affected the number of MSDs, but variables age, sex, weaving comb, work experience, and carpet weaving looms were not significant. CONCLUSION: According to the results of this study, it can be concluded that occupational factors are associated with the number of MSDs developing among carpet weavers. Thus, using standard tools and decreasing hours of work per day can reduce frequency of MSDs among carpet weavers.

Molecular Identification of Cryptosporidium Species from Pet Snakes in Thailand

Cryptosporidium is an important pathogen causing gastrointestinal disease in snakes and is distributed worldwide. The main objectives of this study were to detect and identify Cryptosporidium species in captive snakes from exotic pet shops and snake farms in Thailand. In total, 165 fecal samples were examined from 8 snake species, boa constrictor (Boa constrictor constrictor), corn snake (Elaphe guttata), ball python (Python regius), milk snake (Lampropeltis triangulum), king snake (Lampropeltis getula), rock python (Python sebae), rainbow boa (Epicrates cenchria), and carpet python (Morelia spilota). Cryptosporidium oocysts were examined using the dimethyl sulfoxide (DMSO)-modified acid-fast staining and a molecular method based on nested-PCR, PCR-RFLP analysis, and sequencing amplification of the SSU rRNA gene. DMSO-modified acid-fast staining revealed the presence of Cryptosporidium oocysts in 12 out of 165 (7.3%) samples, whereas PCR produced positive results in 40 (24.2%) samples. Molecular characterization indicated the presence of Cryptosporidium parvum (mouse genotype) as the most common species in 24 samples (60%) from 5 species of snake followed by Cryptosporidium serpentis in 9 samples (22.5%) from 2 species of snake and Cryptosporidium muris in 3 samples (7.5%) from P. regius.

Evaluación sanitaria de factores de riesgos físicos en viviendas Petrocasas bajo un cambio de cubierta / Health evaluation of physical risk factors in petrohouses after roof replacement

Introducción: el problema de la vivienda tiene un alcance mundial. La solución del déficit cualitativo y cuantitativo de la vivienda en Cuba transita a través de diferentes soluciones. Varios asentamientos del país se han erigido con vivienda industrial prefabricada de cloruro de polivinil ­PVC- conocidas por Petrocasas. Algunos estudios reportan estrés térmico en estas viviendas, vinculado a débil ventilación y calentamiento de cierres expuestos al sol. Objetivo: realizar una evaluación de salud ambiental en factores de riesgos físicos en el ambiente interior de las viviendas relativo a la intemperie, tras un cambio del material de cubierta. Método: se plantea un estudio experimental evaluativo de factores de riesgos físicos en el ambiente interior de las viviendas petrocasas a partir de una propuesta de modificación del material de la cubierta con la intención de reducir el estrés térmico de las mismas. Fueron edificadas con este propósito dos viviendas petrocasas con igual orientación de fachada principal y diferente cubierta; ;una fue sustituida por poliestireno expandido y la otra mantiene cubierta original (aluminio y papel de asfalto).Se evaluaron comparativamente factores de riesgos físicos: ruido, componente magnético del campo electromagnético de baja frecuencia, iluminación natural, artificial, ventilación y, principalmente, microclima para valorar la eficacia del cambio introducido. La evaluación estadística se efectuó por descriptores, modelos de regresión y espectro de potencia bivariado con los paquetes estadísticos SPSS v. 17.0 y Statistica 8.0. Resultados: la vivienda Petrocasa con cubierta de aluminio ­ asfalto presenta un clima interior algo más desfavorable al bienestar térmico que aquella de poliestireno; la ventilación en ambas resulta deficiente. Conclusiones: el cambio de material de la cubierta ligera de la vivienda Petrocasa proporciona un clima interior algo más favorable al bienestar de sus residentes(AU)

Introduction: the housing problem is global in scope. Solution to qualitative and quantitative housing deficit in Cuba has been addressed from various different perspectives. Several settlements in the country have been built with prefabricated industrial houses made of polyvinyl chloride (PVC). These are known as petrohouses. Some studies have reported thermal stress inside these houses, resulting from insufficient ventilation and the heating of roofs exposed to the sun. Objective: carry out an environmental health evaluation of physical risk factors present in the indoor environment of petrohouses as compared with the outside environment after roof replacement. Method: an experimental evaluative study was conducted of physical risk factors present in the indoor environment of petrohouses based on a proposal of modification of the roof material with the purpose of reducing thermal stress. For this purpose, two petrohouses were built with the same orientation of their main facade, but different roof material. One was roofed with expanded polystyrene, while the other retained its original roof (aluminum sheets and asphalt paper). The following physical risk factors were evaluated comparatively: noise, magnetic component of the low frequency electromagnetic field, natural and artificial lighting, ventilation, and mainly microclimate, to evaluate the efficacy of the change made. Statistical evaluation was conducted with descriptors, regression models and bivariate power spectrum, using the statistical software packages SPSS v. 17.0 and Statistica v. 8.0. Results: indoor environment in the petrohouse with an aluminum-asphalt roof is somewhat more unfavorable in terms of thermal welfare than in the polystyrene-roofed house. Ventilation is deficient in both. Conclusions: roof replacement in petrohouses provides an indoor environment somewhat more favorable to the welfare of dwellers(AU)

Psychosocial Factors and Musculoskeletal Pain Among Rural Hand-woven Carpet Weavers in Iran

BACKGROUND: Musculoskeletal pain (MSP) is a common and disabling problem among carpet weavers and is linked to physical and psychosocial factors of work. This study aimed to determine the prevalence of MSP, its psychosocial risk factors, and association of pain in each pair of anatomical sites among carpet weavers. METHODS: A cross-sectional study was performed among 546 hand-woven carpet weavers in rural small-scale workshops of Iran. Data were collected by using parts of a standardized CUPID (Cultural and Psychosocial Influences on Disability) questionnaire focused on MSP in 10 body sites, including the low-back, neck, both right and left shoulders, elbows, wrists/hands, individual, physical and psychosocial risk factors. Statistical analysis was performed applying logistic regression models. RESULTS: Prevalence of MSP in at least one body site was 51.7% over the past month. The most common sites were low back and right shoulder pain 27.4% and 20.1%, respectively. A significant difference was found between the mean number of painful anatomical sites and the level of education, age, physical loading at work, time pressure, lack of support, and job dissatisfaction. In pairwise comparisons, strongest association was found between pain in each bilateral anatomical site (odds ratio = 11.6-35.3; p < 0.001). CONCLUSION: In home-based workshops of carpet weaving, psychosocial factors and physical loading were associated with MSP. This finding is consistent with studies conducted among other jobs. Considering the preventive programs, the same amount of attention should be paid to psychosocial risk factors and physical loading. Also, further longitudinal studies are needed to investigate the relationship of psychological factors.

[Prevalence of musculoskeletal disorders and its relation to working posture in Sanandaj hand-woven carpet weavers]

Carpet-weaving is one of the important and high risk occupations in Iran that has some ergonomic factors leading to musculoskeletal disorders. The aims of this study were to determine the prevalence of musculoskeletal disorders [MSDs] and posture assessment by NMQ and QEC method respectively, in female carpet weavers in Sanandaj. Material and In the present cross-sectional study, 250 female carpet hand-weavers were selected randomly and interviewed. To determine the prevalence of MSDs and assessment of work postures, we used Nordic Musculoskeletal Questionnaire [NMQ] and Quick Exposure Check [QEC] respectively. Using SPSS IBM 20 software, data were analyzed by chi-square and independent sample t-test. Prevalence of MSDs in the participants was 80.4%. The most common complaints were related to low back and shoulders with respective prevalence rates of 52 and 49.6% and the least common complaints were related to elbows and feet with prevalence rates of 20 and 26%, respectively. There was significant relationships between QEC scores and musculoskeletal symptoms prevalence rates in shoulder/arm, wrist/hand and neck [p<0.05]. Also, the relationship between the mean work background and daily work time in both groups [with MSDs and none] was significant [p<0.05]. It seems that long duration of daily work and repetitive task and maladjustment of the seat height in proportion to weaved carpet height were effective factors leading to the high prevalence of MSDS among participants which was also confirmed by posture assessment results. Timely adjustment of the seat height through designing adjustable seats and following ergonomic principles in workshops might be useful strategies to reduce prevalence of MSDs

Restoration of Facial Deformity Caused by a Radicular Cyst after Marsupialization / 대한이비인후과학회지

Radicular cyst is the most common type of odontogenic cyst. The cyst originates from the maxilla occasionally, causes facial deformation and displacement of adjacent structures. An 11-year-old girl visited the outpatient clinic with the left cheek swelling and facial asymmetry. The cheek lesion was hard, accompanied by tenderness. The computed tomography (CT) scans revealed a large unilocular radicular cyst, which involved the floor of the left maxillary sinus, the palatine and alveolar process of the left maxilla. It was treated by transnasal marsupialization under endoscopic guidance. At the one postoperative year follow-up, facial asymmetry was restored and the marsupialization site was closed. The follow-up CT scan showed that the site of a radicular cyst was restored by bone formation. Therefore, we report a case of radicular cyst accompanied with facial asymmetry, which was restored after marsupialization. We also discuss the mechanism about the restoration of facial asymmetry.

Clinical Availability of Waters' Projection in Sinus Elevation Procedures

Delayed Occurrence of Maxillary Sinusitis after Simultaneous Maxillary Sinus Augmentation and Implant: A Case Report and Literature Review

New Landmark for the Endoscopic Endonasal Transsphenoidal Approach of Pituitary Surgery

OBJECTIVE: To clarify the anatomical correlations of the sphenoid sinus with surrounding structures in the normal Korean population, and to identify surgical landmarks for safe sellar floor dissection in the anterior skull base by endoscopy and microscopy. METHODS: We reviewed the 196 brain magnetic resonance imaging findings showing a normal appearance, and measured the distances between anatomical landmarks. RESULTS: The mean distances from the base of the columella to the anterior wall of the sphenoid sinus and the sellar floor were 69.71+/-4.25 mm and 86.26+/-4.57 mm, respectively in the over 15 age group, and showed the smallest degree of variation among the measurements. The mean angles between the floor of the nasal cavity and the straight line connecting the base of the columella and the sellar floor were 29.45+/-3.25degrees and 24.75+/-4.00degrees in the over 15 and under 15 age groups, respectively. The mean values of both distances and angles increased with age until 15 years after which no further increases were evident. There were no significant differences in the measurements between males and females or among subjects with different degrees of pneumatization in the over 15 age group. CONCLUSION: The distances from the base of the columella to the sellar floor and the anterior wall of the sphenoid sinus, which were consistent among individuals, could be used as a surgical indicator to investigate the sellar floor in endoscopic or microscopic transsphenoidal approaches.

Variation and Characterization of Bacterial Communities Contaminating Two Saunas Operated at 64degrees C and 76degrees C

This study was performed to analyze 6 day-term variations in bacterial communities contaminating the floor of two dry saunas that were operated at 64degrees C (low temp) and 76degrees C (high temp). Bacteria were sampled daily from the saunas for 6 days from Monday to Saturday. Genomic DNA was isolated directly from bacteria-collected cotton swabs. The diversity of the bacterial communities collected from the saunas was analyzed using thermal gradient gel electrophoresis (TGGE). The total numbers of DNA bands separated by TGGE for bacteria collected from the low temp and high temp sauna were 20 and 18, respectively, during the 6 days. Seven of 20 bacteria in the low temp sauna and eight of 18 bacteria in the high temp sauna were detected more than three times over the 6 experimental days. Twelve of the 26 bacterial genera contaminating the saunas were cross detected. Bacteria belonging to the genera Moraxella and Acinetobacter were selectively detected in the low temp sauna, whereas those belonging to Aquaspirillum, Chromobacterium, Aquabacterium, Gulbenkiania, Pelomonas, and Aquitalea were selectively detected in the high temp sauna. Three species of bacteria contaminating both the low and high temp saunas were thermophile or thermoduric. The results indicate that the sauna-contaminating bacteria may have been transferred from outside the saunas by user traffic but did not inhabit the saunas.

A Case of Epidermolysis Bullosa Simplex (Other Generalized Type) / 대한피부과학회지

The other generalized type of epidermolysis bullosa simplex (EBS) is a genetic blistering skin disease, caused by a mutation of the genes encoding keratin 5 and 14. EBS starts at birth and is characterized by generalized blisters following a minor trauma that heals with hyperpigmentation. A 19-year-old man presented with 19-year history of multiple erythematous vesicles in a herpetiform arrangement on the trunk, axilla, and thigh with post-inflammatory hyper-pigmentations. On light and electron microscopy, the biopsy specimen showed intraepidermal blisters that formed within the basal keratinocyte. The serum from a patient with bullous pemphigoid antibody and laminin 5 antibody showed the linear deposition at the floor of the blister on immunofluorescence mapping study. On the basis of our clinical, microscopic, and immunofluorescence findings, we diagnosed the patient as having a generalized type of EBS. Herein, we report on an interesting case of the other generalized type of EBS.

Repair of Inferomedial Orbital Wall Fractures with Bony Strut Loss by Overlapping Absorbable Copolymer

PURPOSE: To report the results of surgical repairing of inferomedial orbital wall fractures accompanied with loss of bony strut by an overlapping method using Resorb X(R) plates (poly(D,L)-lactic acid). METHODS: To repair inferomedial orbital wall fractures with loss of bony strut, we bent the medial aspect of the plate for floor fracture according to the anatomical structure and then inserted the floor implant, which was supported by anterior, posterior and lateral margins of the floor fracture. Then, the medial implant, which was supported by the bent medial edge of the floor implant, was inserted. Postoperatively, we analyzed the outcomes of 21 patients regarding postoperative enophthalmos, limitation of eye movement (LOM) and diplopia. The diagonal lengths of the orbit in the operated side were compared with the non-traumatized side based on the coronal view of the postoperative CT scans to determine the success or failure of the reconstruction. RESULTS: The average postoperative enophthalmic value was 0.5 mm, and no significant differences between the orbital diagonal lengths of the operated and non-operated eyes were observed. The LOM shown in 7 out of 8 patients was completely resolved during the postoperative follow-up period. All patients with diplopia, including one patient who showed partial remission of LOM, experienced complete symptom resolution. No other complications related to the implant were recorded. CONCLUSIONS: Inferomedial orbital wall fractures with the loss of bony strut can be successfully repaired by the overlapping method using Resorb X(R) implants.

Anatomical Analysis of Intraorbital Structures Regarding Sinus Surgery Using Multiplanar Reconstruction of Computed Tomography Scans

OBJECTIVES: This study aimed to investigate the anatomy of the intraorbital structures regarding to endoscopic sinus surgery and external frontal sinus surgery analyzing computer tomography (CT) scans. METHODS: The CT scans of 100 patients were retrospectively evaluated. The anatomic relationships between the intraorbital structures and paranasal structures were measured using multiplanar reconstruction of the CT scan. RESULTS: The mean distances from the medial orbital floor (MOF) to the intraorbital structures were measured at the depth of the anterior ethmoid (AE), basal lamella (BL), and midportion of posterior ethmoid (PE) in the coronal planes respectively. The mean distances from the MOF to the medial rectus muscle and inferior rectus muscle at the depth of AE were approximately 8 mm and those distances in the BL and PE decreased rapidly. The mean distances from the MOF to the infraorbital nerve at the depth of the AE and BL were approximately more than 10 mm. The mean distances from the vertical axis, which passed through the MOF, to the superior oblique muscle and optic nerve at the depth of the PE were approximately 5 mm medially and 1 mm laterally. In addition, the mean distance from the midline to the trochlea of the superior oblique muscle was approximately 15 mm. CONCLUSIONS: Those measurements provide spatial information on the placements of the extraocular muscles within the orbit. The measurements will contribute to the avoidance of orbital complications during sinus surgery.

Giant plunging ranula: a case report

A ranula is a bluish, transparent, and thin-walled swelling in the floor of the mouth. They originate from the extravasation and subsequent accumulation of saliva from the sublingual gland. Ranulas are usually limited to the sublingual space but they sometimes extend to the submandibular space and parapharyngeal space, which is defined as a plunging ranula. A 21-year-old woman presented with a complaint of a large swelling in the left submandibular region. On contrast-enhanced CT images, it dissected across the midline, and extended to the parapharyngeal space posteriorly and to the submandibular space inferiorly. Several septa and a fluid-fluid level within the lesion were also demonstrated. We diagnosed this lesion as a ranula rather than cystic hygroma due to the location of its center and its sublingual tail sign. As plunging ranula and cystic hygroma are managed with different surgical approaches, it is important to differentiate them radiologically.