Purpose: Breastfeeding is the optimal method for feeding a newborn. But insufficient breast milk is the major reason why mothers give up breastfeeding. Herbal galactagogues have been used increasingly to treat postpartum hypogalactia. This study examined the effect of an herbal tea containing Chrysanthemum indicum, as the main ingredient, on milk production in lactating rats. Methods: The herbal tea contained C. indicum (27%), Foeniculum vulgare Mill (21%), Pimpinella anisum (18.2%), Carum carvi (16.1%), Urtica dioica (14.7%), and Gardenia jasminoides (3%). Sixteen lactating Sprague-Dawley (SD) rats were divided randomly into 2 groups, the normal control group (NC; n = 8), and the galactagogue herbal tea group (GHT; n = 8) for 7 days. Lactating rats were administered the decoction of an herbal galactagogue mixture by oral gavage or the same amount of distilled water and milk production was assessed by measuring the pups' weights during the suckling period. The blood concentrations of prolactin, cortisol, oxytocin levels and mammary gland tissues were examined to assess the effects of the galactagogue. Results: Milk production was 9.2% higher in the GHT group given the herbal tea than in the NC group and the difference was statistically significant. The cortisol level in the GHT group was 17.2% higher than the NC group. The herbal tea containing C. indicum increased the size of the alveoli epithelium cells and the mammary lobe. Conclusion The present study revealed the potential of herbal tea containing C. indicum to enhance milk production in postpartum SD rats.

BACKGROUND: Liver transplantation (LT) is a complicated procedure with a high incidence of postoperative acute kidney injury (AKI). Previous studies indicate that even transient or mild post-LT AKI can result in critical conditions, including prolonged stays in hospitals and intensive care units and increased morbidity and mortality. The aim of this study was to investigate the association between body mass index (BMI) and occurrence of AKI in LT recipients. METHODS: Medical data from 203 patients who received LT surgery from January 2010 to August 2016 in a single university hospital setting were retrospectively collected and analyzed. Patients were classified as either underweight (BMI <20 kg/m²) or normal weight (20 ≤ BMI < 30 kg/m²). Demographic data, anesthetic methods, complications, and perioperative laboratory test values of each patient were assessed. Propensity analyses and logistic regression were performed to evaluate the association between BMI and post-LT AKI. RESULTS: There was no significant difference in occurrence of post-LT AKI between underweight and normal weight patients. The underweight patient group had significantly longer hospital stay compared with the normal weight patient group (P = 0.023). CONCLUSIONS: BMI classification was neither a positive nor negative predictor of postoperative AKI occurrence. However, patients with lower BMI had significantly longer hospital stay compared with their counterparts. Although our study was limited by its retrospective design, our observations suggest that lower BMI might play a role in post-LT AKI.
Acute Kidney Injury* ; Body Mass Index* ; Classification ; Humans ; Incidence ; Intensive Care Units ; Length of Stay ; Liver Transplantation* ; Liver* ; Logistic Models ; Mortality ; Retrospective Studies* ; Thinness

Purpose: To assess the clinical outcomes of scleral buckling (SB) without subretinal fluid drainage (SRFD) on primary rhegmatogenous retinal detachment (RRD). Methods: The medical records of patients with RRD treated via SB without SRFD from March 2009 to Feb 2018 were retrospectively reviewed. Cases with histories of previous intraocular surgery (except cataract removal) were excluded. The primary and final surgical success rates were the main outcome measures. Pre- and post-operative visual acuity and intraocular pressure (IOP), factors that might affect the surgical success rate, secondary operative procedures, re-operation rates, and complications were analyzed. Results: A total of 66 eyes of 66 patients were included. The mean patient age was 38.9 ± 18.6 years and the mean symptom duration 19.23 ± 25.14 days. The retinae were reattached after single surgeries on 57 eyes (success rate 86.36%); the final success rate was 100% after a second operation (when necessary). Of the nine eyes requiring additional surgery, seven required vitrectomy and two vitrectomy combined with buckle revision. The mean preoperative logMAR visual acuity of 0.578 ± 0.647 improved to 0.518 ± 0.512 at 1 month after surgery (p < 0.001) and to 0.262 ± 0.372 at the last follow-up visit (p < 0.001). The postoperative IOP was higher than the preoperative IOP at 3 months (p = 0.024). Conclusions Scleral buckling without SRFD used to treat primary RRD afforded a high reattachment rate (compared to those of previous reports employing vitrectomy or scleral buckling with SRFD). Given the possible complications of SRFD, our method may be a safe and feasible surgical option, affording good results with few complications in patients with primary RRD.

Purpose: To assess the clinical outcomes of scleral buckling (SB) without subretinal fluid drainage (SRFD) on primary rhegmatogenous retinal detachment (RRD). Methods: The medical records of patients with RRD treated via SB without SRFD from March 2009 to Feb 2018 were retrospectively reviewed. Cases with histories of previous intraocular surgery (except cataract removal) were excluded. The primary and final surgical success rates were the main outcome measures. Pre- and post-operative visual acuity and intraocular pressure (IOP), factors that might affect the surgical success rate, secondary operative procedures, re-operation rates, and complications were analyzed. Results: A total of 66 eyes of 66 patients were included. The mean patient age was 38.9 ± 18.6 years and the mean symptom duration 19.23 ± 25.14 days. The retinae were reattached after single surgeries on 57 eyes (success rate 86.36%); the final success rate was 100% after a second operation (when necessary). Of the nine eyes requiring additional surgery, seven required vitrectomy and two vitrectomy combined with buckle revision. The mean preoperative logMAR visual acuity of 0.578 ± 0.647 improved to 0.518 ± 0.512 at 1 month after surgery (p < 0.001) and to 0.262 ± 0.372 at the last follow-up visit (p < 0.001). The postoperative IOP was higher than the preoperative IOP at 3 months (p = 0.024). Conclusions Scleral buckling without SRFD used to treat primary RRD afforded a high reattachment rate (compared to those of previous reports employing vitrectomy or scleral buckling with SRFD). Given the possible complications of SRFD, our method may be a safe and feasible surgical option, affording good results with few complications in patients with primary RRD.

Deep vein thrombosis (DVT), which usually occurs in the lower extremities, is the presence of a blood clot within a deep vein that causes symptoms by breaking the venous return. Many cases of calf vein DVT are asymptomatic, or display only mild symptoms. But in the case of a proximal DVT, it affects the venous flow through the entire lower extremity, which results in a post-thrombotic syndrome, or a pulmonary embolism, if the proper treatment isn't performed. The diagnosis of the DVT is made by a radiologic examination. An ultrasound is often used as a first line of diagnosis, but on the other hand, computed tomography venography has also been gaining traction as an alternative method. If diagnosed, finding the cause of the DVT is important, and in the case of a symptomatic proximal DVT, the combination of anticoagulation and interventional treatment can be used towards the recovery of the venous return, preventing complications.

No abstract available.
Anesthesia* ; Bronchial Spasm* ; Humans ; Infant, Newborn ; Infant, Premature* ; Ventilation*

Endometriosis of the rectum is unusual condition, since it represents an invasion of previously normal bowel by hormone-dependent nonmalignant cell from uterus of the same patient. It is estimated that the incidence of endometriosis is about 8-15% of reproductive women, of whom 3-34% show intestinal invasion of rectosigmoid colon, appendix, ileum, and cecum in order of decreasing frequency. Symptoms related bowel involvement may vary from none to complete intestinal obstruction. Because the mucosa is involved infrequently there is rarely rectal bleeding. X-ray and sigmoidoscopic studies are usually negative. It was not reported that colonic endometriosis was confirmed by endoscopic biopsy. Recently we experienced a case of rectal endometriosis which presented itself as a cyclic rectal bleeding with abdominal pain and diagnosed by colonoscopic biopsy.
Abdominal Pain ; Appendix ; Biopsy* ; Cecum ; Colon ; Colonoscopy ; Endometriosis* ; Female ; Hemorrhage ; Humans ; Ileum ; Incidence ; Intestinal Obstruction ; Mucous Membrane ; Rectum ; Uterus

PURPOSE: Trampoline-related injuries are steadily increasing. To our knowledge, there have been very few studies on trampoline injuries in Asia. The purpose of this study is to report the characteristics of pediatric trampoline injuries in Korea. MATERIALS AND METHODS: We conducted a nationwide retrospective cohort study. Data were collected from prospective nationwide databases (Emergency Department-based Injury In-depth Surveillance databases of the Korea Centers for Disease Control and Prevention) for patients who visited emergency departments (EDs) after injuries during 2011–2016. RESULTS: Of 263712 patients between 0 and 17 years of age, 2799 patients with trampoline injuries visited EDs. The median age of the patients was 5 years (interquartile range, 3–8 years), and 63% of the patients were under 6 years old. Of the patients, 1526 (54.2%) were male. Seventy-six percent of injuries occurred at trampoline parks. Trampoline injuries and trampoline park injuries have increased steadily, while ages at injury have gradually decreased year by year (p < 0.001). Injury locations included the lower extremity (47%), head and face (24%), and upper extremity (24%). A fracture was sustained by 886 (31.7%) patients. The distal humerus and proximal tibia were the most common fracture sites (34% and 23%, respectively). Fractures occurred more commonly in trampoline parks than in homes (33.7% vs. 21.1%, p < 0.001). CONCLUSION: In Korea, pediatric trampoline injuries and trampoline park injuries have tended to increase, while ages at injury have tended to decrease. Policies to prevent trampoline injuries are needed.
Asia ; Centers for Disease Control and Prevention (U.S.) ; Cohort Studies ; Emergency Service, Hospital ; Fractures, Bone ; Head ; Humans ; Humerus ; Korea* ; Lower Extremity ; Male ; Pediatrics ; Prospective Studies ; Retrospective Studies ; Tibia ; Upper Extremity ; Wounds and Injuries

BACKGROUND: Preterm labor and miscarriage may occur in stressful situations, such as a surgical operation or infection during pregnancy. Pharyngeal and buccal abscess and facial bone fractures are inevitable dental surgeries in pregnant patients. Remifentanil is an opioid analgesic that is commonly used for general anesthesia and sedation. Nonetheless, no study has investigated the effects of remifentanil on amniotic epithelial cells. This study evaluated the effects of remifentanil on the factors related to uterine contraction and its mechanism of action on amniotic epithelial cells.METHODS: Amniotic epithelial cells were preconditioned at various concentrations of remifentanil for 1 h, followed by 24-h lipopolysaccharide (LPS) exposure. MTT assays were performed to assess the cell viability in each group. The effects of remifentanil on factors related to uterine contractions in amniotic epithelial cells were assessed using a nitric oxide (NO) assay, western blot examinations of the expression of nuclear factor-kappa B (NF-κB), cyclooxygenase 2 (COX2), and prostaglandin E2 (PGE₂), and RT-PCR examinations of the expression of the proinflammatory cytokines interleukin (IL)-1β and tumor necrosis factor-alpha (TNF-α).RESULTS: Remifentanil did not affect viability and nitric oxide production of amniotic epithelial cells. Western blot analysis revealed that remifentanil preconditioning resulted in decreased expressions of NF-κB and PGE2 in the cells in LPS-induced inflammation, and a tendency of decreased COX2 expression. The results were statistically significant only at high concentration. RT-PCR revealed reduced expressions of IL-1β and TNF-α.CONCLUSION: Preconditioning with remifentanil does not affect the viability of amniotic epithelial cells but reduces the expression of factors related to uterine contractions in situations where cell inflammation is induced by LPS, which is an important inducer of preterm labor. These findings provide evidence that remifentanil may inhibit preterm labor in clinical settings.
Abortion, Spontaneous ; Abscess ; Anesthesia, General ; Blotting, Western ; Cell Survival ; Cyclooxygenase 2 ; Cytokines ; Dinoprostone ; Epithelial Cells ; Facial Bones ; Female ; Humans ; Inflammation ; Interleukins ; Lipopolysaccharides ; NF-kappa B ; Nitric Oxide ; Obstetric Labor, Premature ; Pregnancy ; Tumor Necrosis Factor-alpha ; Uterine Contraction

We report our experience of unexpected low expiratory concentration of sevoflurane 0.8 vol%, low inspired fraction of oxygen 31%, and high value of bispctral index (BIS) 62 with sevoflurlane vaporizer setting 2.0 vol% and the inspired fraction of oxygen 50% during general anesthesia of a 56-year-old man undergoing elective laparoscopic hemicolectomy. The anesthesia machine (Cato edition, Drager, Lubeck, Germany) with a piston-based, electronically controlled ventilator was used for anesthesia. We checked thoroughly all the possible causes of the discrepancy of anesthetic gas concentration, and then detected the partial disconnection of fresh gas outlet. But there were no alarm signs of anesthetic monitor with adequate ventilator function. This malfunction of anesthetic gas supply without alarm signs may lead to hypoxia and awareness of patients. The intraoperative monitoring of anesthetic gas analyzer and BIS may be essential to detect the malfunction of anesthesia machine.
Anesthesia ; Anesthesia, General* ; Anoxia ; Humans ; Methyl Ethers ; Middle Aged ; Monitoring, Intraoperative ; Nebulizers and Vaporizers ; Oxygen ; Ventilators, Mechanical