PURPOSE: Perigraft seromas are a collection of clear and sterile ultrafiltered serum, encased by a fibrous pseudocapsule or within a well-circumscribed gray sponge-like soft tissue mass (gelatinoma) that develops around a patent prosthetic vascular graft. Seromas are unusual complications of hemodialysis grafting with a high rate of recurrence and graft loss. There is no effective therapy for patients and multiple operations and graft replacements often are followed by unsatisfactory results. We successfully replaced the transducing prosthesis segment with the great saphenous vein. The purpose of this study was to review the treatment of perigraft seromas complicating hemodialysis grafts using great saphenous vein interposition. METHOD: We reviewed the records of eight patients who had treatment of a perigraft seroma complicating hemodialysis with the great saphenous vein from January 2005 to December 2006. RESULT: The mean age of the patients was 51 years and three patients had a history of diabetes mellitus. The PTFE graft was placed at the brachiobrachial (loop) position of the forearm in six patients. The affected site was the arterial anastomosis in all cases. In all cases, the transuding segment of the prosthesis was successfully replaced with the greater saphenous vein and excision of the pseudo-capsule. There was no recurrence. CONCLUSION: If rerouting of prosthetic material through a new anatomic route is difficult, treatment of perigraft seroma can be successfully achieved by the removal of the original graft and as much of the seroma as possible, including the pseudocapsule. The transducing proximal segment of the prosthesis at the arterial anastomosis was successfully replaced with a reversed greater saphenous vein, placed along the same route. This procedure resulted in resolution of the seroma with preservation of the original graft. This procedure was safe and effective for the treatment of perigraft seromas.
Diabetes Mellitus ; Forearm ; Humans ; Polytetrafluoroethylene ; Prostheses and Implants ; Recurrence ; Renal Dialysis* ; Saphenous Vein* ; Seroma* ; Transplants*

PURPOSE: We evaluated the psychometric properties of a questionnaire on the acceptance of the quality improvement information system (QIIS) among long-term care workers (mostly nurses). METHODS: The questionnaire composes of 21 preliminary questions with 5 domains based on the Technology Acceptance Model and related literature reviews. We developed a prototype web-based comprehensive resident assessment system, and collected data from 126 subjects at 75 long-term care facilities and hospitals, who used the system and responded to the questionnaire. A priori factor structure was developed using an exploratory factor analysis and validated by a confirmatory factor analysis; its reliability was also evaluated. RESULTS: A total of 16 items were yielded, and 5 factors were extracted from the explanatory factor analysis: Usage Intention, Perceived Usefulness, Perceived Ease of Use, Social Influence, and Innovative Characteristics. The five-factor structure model had a good fit (Tucker-Lewis index [TLI]=.976; comparative fit index [CFI]=.969; standardized root mean squared residual [SRMR]=.052; root mean square error of approximation [RMSEA]=.048), and the items were internally consistent(Cronbach's α=.91). CONCLUSION: The questionnaire was valid and reliable to measure the technology acceptance of QIIS among long-term care workers, using the prototype.
Health Information Systems ; Information Systems* ; Intention ; Long-Term Care* ; Psychometrics* ; Quality Improvement*

Background: Few studies have examined the performance of the public long-term care insurance (LTCI) from the perspective of geographic equity. This study investigated regional variations and associated factors in the supply and utilization of nursing home care within and also between Japan and Korea. Methods: A comparative dataset was developed by extracting data from 2013–2015 LTCI statistics yearbooks and Organization for Economic Cooperation and Development regional statistics, as well as other comparable data in Japan and Korea. The unit of analysis was the prefecture in Japan and the province in Korea. We computed variation indices and conducted regression analyses for regional variations within each country and decomposition analyses to examine the variations between the countries. Results: The overall regional supply and use of nursing home care were higher in Japan, but the regional variations in Korea were larger than in Japan. In both countries, the nursing home supply was negatively associated with the proportion of older people with independent living. Nursing home use was also negatively associated with the supply of hospital beds and home care agencies in Korea; the relationship was the opposite in Japan, however. The country-based differences were more likely to be explained by differences in the distributions of the variables included in the analytical model than country-specific characteristics. Conclusion Regional-level nursing home supply and use were unequal in both countries, and the contributing factors were not the same. Policy efforts are needed to advance regional equality in long-term care (LTC) and collaboration between health and LTC institutions for frail older people, especially in Korea.

Various microrobots are being studied for potential biomedical applications including targeted cell transportation, precise drug delivery, opening blocked blood vessels, micro-surgery, sensing, and scaffolding. Precise magnetic field control system is a coil system for wireless control of those microrobots for personalized and minimally invasive treatments. The microrobots for possible biomedical applications are fabricated by micro-electro-mechanical systems (MEMS) and nano-electro-mechanical systems (NEMS) technologies. In this review, fabrication technologies for scaffold and ciliary microrobots will be introduced and their control methods will be discussed. Various materials are being used for the fabrication of the microrobot such as SU-8, IP-Dip, IP-L, silicon, etc. The scaffold and ciliary microrobots are fabricated by SU-8, IP-Dip, and IP-L because these materials showed the maximum performance for three-dimensional (3D) microrobots using a 3D laser lithography system. All or part of the structures are coated with nickel and titanium layers after fabrication of the structures for magnetic control and biocompatibility, respectively, of the microrobots.
Blood Vessels ; Humans ; Magnetic Fields ; Micro-Electrical-Mechanical Systems ; Nickel ; Silicon ; Titanium ; Transportation

Various microrobots are being studied for potential biomedical applications including targeted cell transportation, precise drug delivery, opening blocked blood vessels, micro-surgery, sensing, and scaffolding. Precise magnetic field control system is a coil system for wireless control of those microrobots for personalized and minimally invasive treatments. The microrobots for possible biomedical applications are fabricated by micro-electro-mechanical systems (MEMS) and nano-electro-mechanical systems (NEMS) technologies. In this review, fabrication technologies for scaffold and ciliary microrobots will be introduced and their control methods will be discussed. Various materials are being used for the fabrication of the microrobot such as SU-8, IP-Dip, IP-L, silicon, etc. The scaffold and ciliary microrobots are fabricated by SU-8, IP-Dip, and IP-L because these materials showed the maximum performance for three-dimensional (3D) microrobots using a 3D laser lithography system. All or part of the structures are coated with nickel and titanium layers after fabrication of the structures for magnetic control and biocompatibility, respectively, of the microrobots.
Blood Vessels ; Humans ; Magnetic Fields ; Micro-Electrical-Mechanical Systems ; Nickel ; Silicon ; Titanium ; Transportation