Usefulness of the waterless method for surgical hand washing：A comparison with the conventional scrub method

To evaluate the usefulness of the waterless hand washing method for surgical anti-sepsis, we conducted a microbial sampling study, comparing it to a conventional surgical scrub method. A total of 18 operating-room nurses were undertaking the following three-hand washing protocols : scrubbing with blushes using 4w/v% chlorhexidine gluconate (CHG) and also rubbing with CHG, followed by application of a 0.2w/v% CHG with ethanol (HS) preparation. (conventional method); rubbing with CHG and application of HS (two-stage surgical scrub method; TSS); rubbing with anti-septic soap and application of HS (waterless method; WL). Microbial sampling was conducted after hand washing using the glove juice method. No statistically significant differences in bacterial numbers were found among these three methods. The number of bacterially positive subjects was significantly higher in the conventional method than the TSS method. These results indicate that there are adverse effects of blush-scrubbing, as the detected bacteria were related to normal skin flora. As such, the WL method for hand anti-sepsis appears to be equivalent to the conventional surgical scrubbing method in terms of microbial detection. The WL method should therefore be introduced as a standard hand anti-sepsis method at the time of surgery because it is cost-effective as well as time-efficient

Adenine phosphoribosyltransferase部分欠損による2, 8-dihydroxyadenine結石症例

Inherited metabolic diseases resulting in urolithiasis secondary to urinary excretion of insoluble substances are rare but often present as urinary obstruction of renal insufficiency. We herein report a case of partial adenine phosphoribosyltransferase deficiency associated with 2, 8-dihydroxyadenine urolithiasis. In family members the propositus and his younger brother are homozygotes for defective APRT genes, and who exhibits the type II phenotype designated APRT*J (Japanese type)

A case of adult Meckel's diveticul um with gastrointestinal bleeding

Gastrointestinal bleeding is often intermittent and its souree may be difficult to locate, resulting in delay of definitve diagnosis. Melena usually denotes bleeding not only from the upper, and lower gastrointestine but from the small int estine. Adult Meckel's diverticulum with gastrointestinal beeding is a relatively rare disease and often presents difficulty in preoperative diagnosis. A 65-year-old man was admitted to our hospital due to melena. Upper and lower gastrointestional endoscopy revealed no bleeding stie. (99m)Tc-pertechnetate scintigraphy is well known as a useful tool for preoperative delineation of Meckel's diverticulm. (99m)Tc-pertechnetate scintigraphy was performed in this patient and succesfully depicted the lesion noninvasively. In surgery, Meckel's diverticulum was found at an oral stie 90 cm from the terminalileum, and a sleevereseection was performed. Histopathologically, the diver ticulum had ectopic gastric muco sa and two 5mm ulcers on the border of the gastric mucosa