PURPOSE: To develop and validate a scale suitable and efficient scale for use in clinical practice as to assess pain in premature infants. METHOD: Pain indicators identified by observation of preterm infants. A cohort of preterm infants was studied prospectively to determine the construct validity, inter-rater reliability, and internal consistency of the scale. The PIPS uses four indicators of pain: corrected gestational age, heart rate, oxygen saturation, behavioral state. The validation study included 45 premature infants with gestational age of 37 weeks or less. RESULTS: The inter-rater reliability of the PIPS was acceptable, with Pearson correlations ranging from .720 to .970. Internal consistency was high: Cronbach's alpha coefficients ranged from .551 to .653. There was a strong correlation between the PIPS and PIPP scores (each researcher's r=.743, each indicator's r=.914). Although gestational age showed no association between these factors and the sum, the other variables were positively associated with the sum. Time needed to calculate PIPS scores is was less than Premature Infant Pain Profile (PIPP) scores(p<.000). CONCLUSION: The validation data suggest that the PIPS is appropriate and efficient for assessing pain in premature infants. Further studies are required about to determine appropriate interventions for each pain score on the PIPS.
Cohort Studies ; Gestational Age ; Heart Rate ; Humans ; Infant, Newborn ; Infant, Premature* ; Oxygen ; Prospective Studies

Purpose: Children have few small alveoli, which reduce lung compliance; in contrast, their cartilaginous rib cage makes their chest wall highly compliant. This combination promotes lung collapse. Prolonged inspiratory to expiratory (I:E) ratio ventilation is used to optimize gas exchange and respiratory mechanics in surgery. However, the optimal ratio is unclear in children. We hypothesized that, compared to a 1:2 I:E ratio, a 1:1 I:E ratio would improve dynamic compliance and oxygenation, and affect the peak airway pressure in pediatric patients undergoing surgery. Materials and Methods: Forty-eight patients aged ≤6 years who were scheduled to undergo surgery under general anesthesia with an arterial line were randomly allocated to receive 1:1 (group 1:1) or 1:2 (group 1:2) I:E ratio ventilation. Airway pressure, respiratory system compliance, and arterial blood gas analyses were compared between groups immediately after induction (T0), 30 min after induction (T1), 60 min after induction (T2), immediately after surgery (T3), and on arrival at the post-anesthesia care unit (T4). Results: Peak and plateau airway pressures were significantly lower in group 1:1 than in group 1:2 at T1 (p=0.044 and 0.048, respectively). The dynamic and static compliances were significantly higher in group 1:1 than in group 1:2 at T1 (p=0.044 and 0.045, respectively). However, the partial pressure of oxygen did not significantly differ between groups. Conclusion Compared to a 1:2 I:E ratio, a 1:1 I:E ratio improved dynamic compliance and lowered the peak airway pressure without complications in pediatric patients. Nevertheless, our results do not support its use solely for improving oxygenation.

Purpose: Children have few small alveoli, which reduce lung compliance; in contrast, their cartilaginous rib cage makes their chest wall highly compliant. This combination promotes lung collapse. Prolonged inspiratory to expiratory (I:E) ratio ventilation is used to optimize gas exchange and respiratory mechanics in surgery. However, the optimal ratio is unclear in children. We hypothesized that, compared to a 1:2 I:E ratio, a 1:1 I:E ratio would improve dynamic compliance and oxygenation, and affect the peak airway pressure in pediatric patients undergoing surgery. Materials and Methods: Forty-eight patients aged ≤6 years who were scheduled to undergo surgery under general anesthesia with an arterial line were randomly allocated to receive 1:1 (group 1:1) or 1:2 (group 1:2) I:E ratio ventilation. Airway pressure, respiratory system compliance, and arterial blood gas analyses were compared between groups immediately after induction (T0), 30 min after induction (T1), 60 min after induction (T2), immediately after surgery (T3), and on arrival at the post-anesthesia care unit (T4). Results: Peak and plateau airway pressures were significantly lower in group 1:1 than in group 1:2 at T1 (p=0.044 and 0.048, respectively). The dynamic and static compliances were significantly higher in group 1:1 than in group 1:2 at T1 (p=0.044 and 0.045, respectively). However, the partial pressure of oxygen did not significantly differ between groups. Conclusion Compared to a 1:2 I:E ratio, a 1:1 I:E ratio improved dynamic compliance and lowered the peak airway pressure without complications in pediatric patients. Nevertheless, our results do not support its use solely for improving oxygenation.

The characteristics of metabolic pathways make them particularly amenable to layered graph drawing methods. This paper presents a visual Java-based tool for drawing and annotating biological pathways in twoand- a-half dimensions (2.5D) as an alternative to three dimensional (3D) visualizations. Such visualization allows user to display different groups of clustered nodes, in different parallel planes, and to see a detailed view of a group of objects in focus and its place in the context of the whole system. This tool is an extended version of J2dPathway.
Hypogonadism ; Metabolic Networks and Pathways ; Mitochondrial Diseases ; Ophthalmoplegia

The static approach of representing metabolic pathway diagrams offers no flexibility. Thus, many systems adopt automatic graph layout techniques to visualize the topological architecture of pathways. There are weaknesses, however, because automatically drawn figures are generally difficult to understand. The problem becomes even more serious when we attempt to visualize all of the information in a single, big picture, which usually results in a confusing diagram. To provide a partial solution to this thorny issue, we propose J2dpathway, a metabolic pathway atlas viewer that has node-abstracting features.
Metabolic Networks and Pathways ; Pliability

Renal artery stenosis (RAS) is commonly presented with hypertension and chronic kidney disease. We report a rare case of RAS occurring in a 78-year-old man who presented with nephrotic-range proteinuria. Renal biopsy on the left side was performed, and results showed mesangiopathic glomerulonephritis, which was not compatible with the cause of nephrotic-range proteinuria. Proteinuria was decreased by angiotensin receptor blocker, but azotemia was aggravated. Therefore, angiotensin receptor blocker was discontinued inevitably and thorough evaluation for the possibility of RAS was performed. Computed tomography angiography revealed significant RAS on the left side and a renal artery stent was inserted. After stenting, aortic dissection developed and progressed despite tight control of blood pressure. After inserting another stent graft through the true lumen of the left renal artery, the patient's renal function and proteinuria improved markedly.
Aged ; Angiography ; Angioplasty ; Angiotensins ; Azotemia ; Biopsy ; Blood Pressure ; Blood Vessel Prosthesis ; Glomerulonephritis ; Humans ; Hypertension ; Proteinuria* ; Renal Artery Obstruction* ; Renal Artery* ; Renal Insufficiency, Chronic ; Stents

BACKGROUND: Human diet and eating habits are formed in childhood so that eating habits in this period have a great impact on the nutritional status of children. Eating behaviors of children are formed by those of family members at home or their diet at preschool and mass media. The purpose of this study was to develop a program to build healthy dietary habits in preschoolers based on Social Cognitive Theory, which emphasizes the dynamic interaction among an action, an individual and its environment, and to explore the effects of the program. METHODS: A non-equivalent control group, pretest-posttest design was be used in this study. All participants were dyads of preschoolers and one of their parents collected from two day care centers, 18 for the experimental group and 16 for the control group. The program was evaluated by their Knowledge about Nutrition and Dietary Habits among Preschoolers and Parents Perception of Preschoolers' Dietary Habits. The program was conducted between March and June, 2015. RESULTS: At follow-up, knowledge related to nutrition (t=-2.74, p=0.010) and dietary habits (t=-3.67, p<0.001) among the preschoolers were significantly higher in the experimental group than in the control group. However, the perception of parents on the change of their children's eating habit didn't show significant difference (t=1.13, p=0.265). CONCLUSIONS: The results of this study is able to be used in dietary education of preschool children as one of the evidence, and be applied as an example of children's health promotion to help them have ideal eating habits, through cooperation with a university in community and day care centers.
Child ; Child, Preschool ; Day Care, Medical ; Diet ; Eating* ; Education ; Feeding Behavior ; Follow-Up Studies ; Food Habits ; Health Promotion ; Humans ; Mass Media ; Nutritional Status ; Parents

In order to discover lifespan-extending compounds made from natural resources, activity-guided fractionation of Zingiber officinale Roscoe (Zingiberaceae) ethanol extract was performed using the Caenorhabditis elegans (C. elegans) model system. The compound 6-gingerol was isolated from the most active ethyl acetate soluble fraction, and showed potent longevity-promoting activity. It also elevated the survival rate of worms against stressful environment including thermal, osmotic, and oxidative conditions. Additionally, 6-gingerol elevated the antioxidant enzyme activities of C. elegans, and showed a dose-depend reduction of intracellular reactive oxygen species (ROS) accumulation in worms. Further studies demonstrated that the increased stress tolerance of 6-gingerol-mediated worms could result from the promotion of stress resistance proteins such as heat shock protein (HSP-16.2) and superoxide dismutase (SOD-3). The lipofuscin levels in 6-gingerol treated intestinal worms were decreased in comparison to the control group. No significant 6-gingerol-related changes, including growth, food intake, reproduction, and movement were noted. These results suggest that 6-gingerol exerted longevity-promoting activities independently of these factors and could extend the human lifespan.
Caenorhabditis elegans* ; Caenorhabditis* ; Eating ; Ethanol ; Ginger* ; Heat-Shock Proteins ; Humans ; Lipofuscin ; Longevity* ; Natural Resources ; Reactive Oxygen Species ; Reproduction ; Superoxide Dismutase ; Survival Rate

BACKGROUND: The colitis-associated cancer exhibits different characteristics according to sex in the initiation and progression of the tumors. The aim of this study was to investigate the sex-associated difference in the azoxymethane/dextran sulfate sodium (AOM/DSS)-induced colitis-associated cancer model. METHODS: The AOM/DSS ICR mouse model was established to compare male with female, and then the severity of colitis-associated carcinogenesis was examined macroscopically and histologically regarding the number, size, and location of tumors. Subsequently, levels of colonic mucosal cytokine, interleukin (IL)-1β and myeloperoxidase (MPO) were assessed. RESULTS: At the 16th week, the tumor multiplicity and the pro-inflammatory factors differed according to sex. The total tumor number was significantly higher in male (P = 0.020) and the number of large tumors (diameter > 2 mm) was higher in male (P = 0.026). In male, the tumors located more in distal colon (P = 0.001). MPO was significantly higher in AOM/DSS-treated male mice compared to the control group (P = 0.003), whereas the corresponding female group showed no significant change (P = 0.086). Colonic IL-1β level significantly increased in AOM/DSS groups compared to control groups both in male and female (male, P = 0.014; female, P = 0.005). It was higher in male group; however, there was no statistical significance (P = 0.226). CONCLUSIONS: In AOM/DSS murine model, colitis-associated colon tumorigenesis are induced more severely in male mice than female probably by way of inflammatory mediators such as IL-1β and MPO. The sex-related differences at the animal model of colon cancer suggest the importance of approach to disease with sex-specific medicine in human.
Animals ; Carcinogenesis ; Colitis ; Colon* ; Colonic Neoplasms* ; Female ; Humans ; Interleukins ; Male ; Mice* ; Mice, Inbred ICR ; Models, Animal ; Peroxidase ; Sodium

PURPOSE: The purpose of this study was to evaluate the CT findings of parasitic ectopic infestation in theperitoneal cavity, a transitional route for parasites invading the gastrointestinal tract, to migrate to varioustarget organs. MATERIALS AND METHODS: CT scans of nine patients with pathologically(n=8) or serologically(n=1)proven intraperitoneal involvement of parasitic infestation were retrospectively reviewed. The primary causes ofparasitic infestation in nine patients were Paragonimus westermani(n=5), Sparganosis(n=2), and hepaticfascioliasis(n=2). We analyzed the CT findings with regard to the sites and patterns of lesions in the peritonealcavity and gastrointestinal track, as well as in other solid organs. The clinical features of these patients werealso evaluated. RESULTS: The clinical symptoms and signs were chronic abdominal pain and general weakness inseven patients, while peripheral blood eosinophilia was observed in four. The CT features of these nine patientsincluded multiseptated cystic masses of 2 -6cm, diameter (mean 4.1 +/-1.7cm) in the omentum or mesentery insix(67%), omental or mesenteric infiltration in seven(78%), focal peritoneal thickening in seven(78%),lymphadenopathy in five(56%), and ascites in four(44%). In six of the nine patients, the gastrointestinaltract(stomach in four, colon in one, both stomach and colon in one) was concomitantly involved with focal wallthickening. Branching patterns of hypoattenuating lesions were noted in the liver of three patients ; two of thesehad hepatic fascioliasis and one had paragonimiasis. CONCLUSION: Ectopic parasitic infestation in the peritonealcavity manifests as mass formation, adjacent gastrointestinal wall thickening, and focal peritonitis. Anunderstanding of these image features is important for both early diagnosis and adequate treatment.
Abdominal Pain ; Ascites ; Colon ; Early Diagnosis ; Eosinophilia ; Fascioliasis ; Gastrointestinal Tract* ; Humans ; Liver ; Mesentery ; Omentum ; Paragonimiasis ; Paragonimus ; Parasites ; Peritonitis ; Retrospective Studies ; Stomach ; Tomography, X-Ray Computed