Benign idiopathic neonatal convulsion is a rare disorder which has no family history of convulsion and develops before and after the 5th day in a healthy full-term neonate. Its characteristics appear focal, or multifocal clonic seizures but rare tonic seizures lasting about several minutes. It reveals non-specific findings in neurologic examination, neuroimaging and EEG(electroencephalography) so that it should be differentiated from those diseases such as eletronic imbalance, inborn errors of metabolism, other neonatal epileptic syndromes. We report two healthy full-term female neonates presented with multifocal clonic seizures before and after the 5th day after birth. They had no family history of convulsion, fetal asphyxia, fetal and maternal problems and the neurologic examination and neuroimagings were normal. The convulsions were controlled by intravenous phenobarbital injection. They had no more convulsions ever since and showed normal development at the follow-up performed one year later. We experienced a rare disorder, benign neonatal convulsion in healthy full-term neonates. We hope this report will help its diagnosis and treatment and prevent unnecessary long- term anticonvulsant medication.
Asphyxia ; Epilepsy, Benign Neonatal ; Female ; Follow-Up Studies ; Humans ; Infant, Newborn ; Metabolism, Inborn Errors ; Neuroimaging ; Neurologic Examination ; Parturition ; Phenobarbital ; Seizures

The fashion of vascular anastomosis, end-to-end or end-to-side (E-to-S), are depended upon surgeon's preference or surgical situations. In E-to-S anastomosis two different methods of arteriotomy are applicable but it has been suggested the type, either elliptical or slit arteriotomy, play a different role in the flow hemodynamics. We thought that the difference is more considerable in microvascular surgery. This study examines the effects of elliptical versus slit arteriotomy on morphologic vessel patency. Twenty male Sprague-Dawley rats were divided into two groups of ten rats each. Both carotid arteries were selected as a experimental model. During the procedures the rat brain was tolerable to ischemia and all animals were survived after operations. The morphologic analysis of anastomosis site was through resin-casting method with scanning electromicroscopic examination. The results showed notable difference between two groups in three-dimensional morphology at two-month of operation. This difference may affect the flow hemodynamics and long-term vessel patency. In microvascular anastomosis, the mortpologic difference of the elliptical arteriotomy is worse than slit arteriotomy which compromises the vessel circumference.
Animals ; Brain ; Carotid Arteries ; Hemodynamics ; Humans ; Ischemia ; Male ; Models, Theoretical ; Rats ; Rats, Sprague-Dawley

PURPOSE: To evaluate the incidence of disc extrusion and neurologic deficit, the relation between disc extrusion and neurologic deficit and the treatment results according to our basic treatment principles in lower cervical facet joint fracture and dislocations MATERIALS AND METHODS: Twelve patients were evaluated, 8 male and 4 female with an average age of 41 years comprised the group. Six injuries were attributable to automobile accidents, 5 to fall from building, bed, floor and hill, and one to stand on her head. One case was distractive-flexion stage (DFS) 1, 9 cases with DFS 2 and 2 cases with DFS 3. Plain X-ray, CT, Myelo CT and MRI were used as a diagnostic tools. As a treatment criteria, feasibility of closed reduction, status of neuroglogic injury, and stability of injured spine were considered. Anterior cervical discectomy and fusion in accompanied disc extrusion, posterior reduction and fusion with triple wiring in unreduced dislocation, and anterior decompression and fusion in incomplete cord and root injury were selected as a basic treatment principles. RESULTS: Ten out of 12 cases (83%) showed neurologic deficits, 2 complete cord injury, 1 incomplete cord injury, and 7 radiculopathy. Nine out of 12 (75%) demonstrated disc extrusion and all disc extruded patients had neurologic deficits. Anterior cervical discectomy and fusion (ACDF) were performed in 5 cases, ACDF and posterior reduction with triple wiring (PRTW) in 4 cases, PRTW in 1 case, and skull traction and philadelphia brace in 2 cases. Seven radiculpathy patients were completely recovered and one incomplete cord injury patient can ambulate with spastic gait after surgery. There were 2 bed sore and 1 pneumonia in complications. CONCLUSION: Soft disc extrusion should be evaluated carefully with MRI and CT in lower cervical spine injury with the facet joint fracture-dislocations before the decision of treatment. As disc extrusion always accompanies neurologic deficit, it must be surgically treated by anterior cervical discectomy and fusion.
Automobiles ; Braces ; Decompression ; Diskectomy ; Dislocations* ; Female ; Gait Disorders, Neurologic ; Head ; Humans ; Incidence ; Magnetic Resonance Imaging ; Male ; Neurologic Manifestations ; Pneumonia ; Pressure Ulcer ; Radiculopathy ; Skull ; Spine ; Traction ; Zygapophyseal Joint*

PURPOSE: The purpose of this study was to identify the knowledge and compliance of guidelines for safe handling of antineoplastic agents among the oncology nurses. METHODS: The participants were 186 nurses from oncology-hematology unit, and outpatient's infusion room in a tertiary hospital. The levels of knowledge of safety guidelines and compliance with safe handling of antineoplastic agents of oncology nurses were measured using structured questionnaires from October 1 to November 30, 2014. RESULTS: Oncology nurses' knowledge of guideline for safe handling of antineoplastic agents presented an average 79.7 out of 100 points. Compliance with safe handling of antineoplastic agents presented an average 4.28 (range: 2.9~5) out of 5 points. The knowledge of guidelines for safe handling of antineoplastic agents was related with oncology experience (F=3.78, p=.012). There were positive relationships of knowledge and compliance with safe handling of antineoplastic agents (r=0.23, p=.002). CONCLUSION: The findings showed that there was a need to establish efficient guidelines for the safe handling of antineoplastic agents and develop our structured, continuous educational program for the improvement of safe practices related to the handling of antineoplastic agents. The developed and enhanced that guideline and educational program would contribute to improvement of staff and patient safety related to the handling of antineoplastic agents.
Antineoplastic Agents* ; Compliance* ; Patient Safety ; Tertiary Care Centers*

The treatment of massive bone and soft tissue defect in the lower leg has a high complication rate of nonunion, chronic infection, and amputation without well-vascularized tissue coverage of the open fracture. Despite adequate free soft tissue coverage, massive skeletal defect may result in segmental bone defects, angulation deformity, and limb length discrepancies. In the last decade, major advances have occurred in the Ilizarov method of distraction osteogenesis in lower leg salvage as a delayed procedure or simultaneous distraction after free-tissue transfer. The authors have performed Ilizarov transport in conjunction with muscle and musculocutaneous flap coverage in nine cases of lower leg salvage. The flaps consist of rectus, gracilis, latissimus dorsi, parascapular, and serratus muscle or musculocutaneous fashioning using ipsilateral or contralateral pedicle in consideration of vessel condiation. Revision, recorticotomy and flap elevation were also used as a secondary procedure for satisfactory results. The conclusions, were as follows: 1) Multidisciplinary team approach with conjoining departments at the time of preoperative evaluation, postoperative care and rehabilitation care; 2) Muscle flap covered with split-thickness skin graft was preferred to musculocutaneous flap; 3) To reduce the total reconstructive period, simultaneous free tissue transfer with Ilizarov distraction should be considered.
Amputation ; Congenital Abnormalities ; Extremities ; Fractures, Open ; Ilizarov Technique ; Leg* ; Myocutaneous Flap ; Osteogenesis* ; Osteogenesis, Distraction ; Postoperative Care ; Rehabilitation ; Skin ; Superficial Back Muscles ; Transplants

A 13-month-old boy had irregularly shaped, erythematous to dusky red, slightly raised patches and plaques on the left antecubital fossa and arm for 7 months. The lesions were firm and tender. Histopathologically the lesion consisted of small, circumscribed, angiomatous tufts and lobules with a cannonball appearance scattered throughout dermis, a characteristic feature of tufted angioma. For 15 weeks, interferon-a intralesional injections have been performed and the lesions showed an improvement.
Arm ; Dermis ; Hemangioma* ; Humans ; Infant ; Injections, Intralesional ; Interferon-alpha* ; Male

Purpose: Multi-echo gradient echo (mGRE) images are used to acquire and analyze multiple echo signals. As the number of acquired echoes increases, more information on the voxel decay changes can be obtained, facilitating myelin water fraction (MWF) mapping.However, an increase in the acquired echoes leads to an increase in scan time. In this study, we developed a workflow to reduce the scan time using a two-stage neural network approach, which extrapolates additional echo images using mGRE data. Materials and Methods: In Stage 1, a pseudo-T1 map was estimated using a U-net network combined with a simple signal model to correct the bias between two mGRE acquired with different scan parameters. The pseudo-T1 map was used to generate an initial echo time (TE) image from the mGRE images. In Stage 2, subsequent TE images were predicted from the initial echo image generated using a trained prediction network. The results were quantitatively compared with those obtained using a fitting algorithm. The MWF mapping results were then compared. Results: The proposed model exhibited better root mean square error, structural similarity index measure, and peak signal-to-noise ratio, as well as a higher correlation with the MWF analysis compared to the fitting algorithm. Conclusion These results demonstrate that the proposed network can effectively reduce the scan time for mGRE image acquisition.

Purpose: Multi-echo gradient echo (mGRE) images are used to acquire and analyze multiple echo signals. As the number of acquired echoes increases, more information on the voxel decay changes can be obtained, facilitating myelin water fraction (MWF) mapping.However, an increase in the acquired echoes leads to an increase in scan time. In this study, we developed a workflow to reduce the scan time using a two-stage neural network approach, which extrapolates additional echo images using mGRE data. Materials and Methods: In Stage 1, a pseudo-T1 map was estimated using a U-net network combined with a simple signal model to correct the bias between two mGRE acquired with different scan parameters. The pseudo-T1 map was used to generate an initial echo time (TE) image from the mGRE images. In Stage 2, subsequent TE images were predicted from the initial echo image generated using a trained prediction network. The results were quantitatively compared with those obtained using a fitting algorithm. The MWF mapping results were then compared. Results: The proposed model exhibited better root mean square error, structural similarity index measure, and peak signal-to-noise ratio, as well as a higher correlation with the MWF analysis compared to the fitting algorithm. Conclusion These results demonstrate that the proposed network can effectively reduce the scan time for mGRE image acquisition.

Purpose: Multi-echo gradient echo (mGRE) images are used to acquire and analyze multiple echo signals. As the number of acquired echoes increases, more information on the voxel decay changes can be obtained, facilitating myelin water fraction (MWF) mapping.However, an increase in the acquired echoes leads to an increase in scan time. In this study, we developed a workflow to reduce the scan time using a two-stage neural network approach, which extrapolates additional echo images using mGRE data. Materials and Methods: In Stage 1, a pseudo-T1 map was estimated using a U-net network combined with a simple signal model to correct the bias between two mGRE acquired with different scan parameters. The pseudo-T1 map was used to generate an initial echo time (TE) image from the mGRE images. In Stage 2, subsequent TE images were predicted from the initial echo image generated using a trained prediction network. The results were quantitatively compared with those obtained using a fitting algorithm. The MWF mapping results were then compared. Results: The proposed model exhibited better root mean square error, structural similarity index measure, and peak signal-to-noise ratio, as well as a higher correlation with the MWF analysis compared to the fitting algorithm. Conclusion These results demonstrate that the proposed network can effectively reduce the scan time for mGRE image acquisition.

No Abstract Available.
Humans ; Renal Dialysis*