PURPOSE: The goal of prosthetic replacement of the shoulder is the restoration of the normal anatomy of the joint. MATERIALS AND METHODS: The physician should review the variations in normal anatomy because it does vary widely and the placement of the prosthetic needs to be modified to accommodate the variations. RESULTS AND CONCLUSION: Several factors including anatomic, prosthetic and surgical ones can lead to the best clinical results, and these are described.
Joints ; Mechanics ; Prostheses and Implants ; Shoulder

Purpose: The purpose of this study is to identify the educational needs of virtual reality simulations that can be applied to novice nurses during the waiting period before starting work in a hospital. Methods: A convergent mixed methods was used. The survey data were collected from 230 novice nurses, and a focus group interview was conducted with 6 new nurses. The data were collected from November 2022 to January 2023. Descriptive statistics, a frequency analysis, independent t-test, and an Importance-Performance Analysis were performed using SPSS 24.0. Results: Appropriate topics for virtual reality simulation education were indicated to be medications and intravenous injections, which are high priority topics in quantitative and qualitative research. The novice nurses wanted group activity training three to four times a week for two weeks before beginning work in a hospital. They also wanted an immersive virtual reality system based on a real hospital environment. Conclusion Based on the above results, this study provides basic data for the development of a virtual reality simulation education that can improve the adaptation of novice nurses to clinical practice. A strategy was suggested to utilize the waiting time before beginning work in a hospital as educational time.

A 3-year-old boy with purulent otitis media received a chest radiograph as the part of a routine work up. The patient was normal appearing, in no acute distress. The patient's lung and heart sounds were clear and normal. The patient's abdomen was soft, non-distended, and non-tender. An anterior cardiophrenic mass was incidentally identified on the lateral chest radiograph. A computed tomography scan demonstrated a diaphragmatic hernia with bowel loops in the retrosternal space. An exploratory operation revealed a diaphragmatic defect (4 cm in diameter) on the left side of the falciform ligament, through which transverse colon was protruded. There was no hernia sac, and the defect was closed with interrupted No. 2 silk sutures. The child was discharged on the 8th postoperative day without any complications. During 6 months of follow-up period, recurrence was not noticed.
Abdomen ; Child ; Child, Preschool* ; Colon, Transverse ; Follow-Up Studies ; Heart Sounds ; Hernia* ; Hernia, Diaphragmatic ; Humans ; Ligaments ; Lung ; Male* ; Otitis Media, Suppurative ; Radiography, Thoracic ; Recurrence ; Silk ; Sutures

OBJECTIVES: This study was designed to evaluate the synergistic antibacterial effect of xylitol and ursolic acid (UA) against oral biofilms in vitro. MATERIALS AND METHODS: S. mutans UA 159 (wild type), S. mutans KCOM 1207, KCOM 1128 and S. sobrinus ATCC 33478 were used. The susceptibility of S. mutans to UA and xylitol was evaluated using a broth microdilution method. Based on the results, combined susceptibility was evaluated using optimal inhibitory combinations (OIC), optimal bactericidal combinations (OBC), and fractional inhibitory concentrations (FIC). The anti-biofilm activity of xylitol and UA on Streptococcus spp. was evaluated by growing cells in 24-well polystyrene microtiter plates for the biofilm assay. Significant mean differences among experimental groups were determined by Fisher's Least Significant Difference (p < 0.05). RESULTS: The synergistic interactions between xylitol and UA were observed against all tested strains, showing the FICs < 1. The combined treatment of xylitol and UA inhibited the biofilm formation significantly and also prevented pH decline to critical value of 5.5 effectively. The biofilm disassembly was substantially influenced by different age of biofilm when exposed to the combined treatment of xylitol and UA. Comparing to the single strain, relatively higher concentration of xylitol and UA was needed for inhibiting and disassembling biofilm formed by a mixed culture of S. mutans 159 and S. sobrinus 33478. CONCLUSIONS: This study demonstrated that xylitol and UA, synergistic inhibitors, can be a potential agent for enhancing the antimicrobial and anti-biofilm efficacy against S. mutans and S. sobrinus in the oral environment.
Biofilms* ; Hydrogen-Ion Concentration ; Polystyrenes ; Streptococcus ; Streptococcus mutans ; Streptococcus sobrinus ; Xylitol*

No abstract available.
Anemia, Hemolytic, Autoimmune*

No abstract available.
Anemia, Hemolytic, Autoimmune*

PURPOSE: Serum screening test to detect specific immunoglobulin E (IgE) is an important step for the assessment of potential allergenicity of genetically modified (GM) food. The purpose of this study was to evaluate the usefulness of pooled serum for serum screening instead of individual serum. METHODS: Children with allergic disease were recruited and those who were sensitized to peanut or egg white were selected to obtain their sera. Sensitization to these foods was determined when the level of specific IgE was over 0.35 kU/L by ImmunoCAP. The patients were divided into subgroups according to their level of specific IgE. Raw proteins were extracted and immunoblot analysis was performed to compare the immunoreactivity between individual serum and pooled serum. RESULTS: Pooled serum from peanut-sensitized allergic children showed all the bands which were shown in immunoblot analysis by using individual serum and peanut protein extract. These findings were demonstrated both in pooled serum with low level of peanut-specific IgE and in those with high level of peanut-specific IgE. Likewise, there was no difference in the immunoreactivity between individual serum and pooled serum from egg white-sensitized allergic children. CONCLUSION: Pooled serum can be used as an alternative to individual serum for the serum screening in the allergenicity assessment of GM food.
Child ; Egg White ; Food, Genetically Modified ; Humans ; Immunoglobulin E ; Immunoglobulins ; Mass Screening ; Ovum ; Proteins

Most patients experience pain relief and functional improvement after arthroscopic rotator cuff repair. In some patients, however, symptoms still remain after surgery. Failed rotator cuff repair is a complex outcome of biological, technical, and traumatic factors. Moreover, re-tears might or might not be the main cause for patients with persistent pain after rotator cuff repair. Therefore, a thorough understanding of the patient's history, physical examination, and appropriate imaging studies will be needed to evaluate and manage these patients. The patient's age, functional requirement, quality of the rotator cuff, preoperative range of motion, quality of the deltoid, and glenohumeral arthritis are factors to consider before performing revisional rotator cuff repair. Preoperative patient education is as important as the surgical technique for successful revisional rotator cuff repair.
Arthritis ; Humans ; Patient Education as Topic ; Physical Examination ; Range of Motion, Articular ; Rotator Cuff

Background: Hereditary angioedema (HAE) is a rare disease caused by the deficiency of C1 esterase inhibitor. HAE has a risk of life-threatening complications such as capillary leak syndrome (CLS) and disseminated intravascular coagulation (DIC).Case: A 42-year-old man with HAE presented for deceased-donor kidney transplantation. Prophylactic fresh frozen plasma (FFP) was given before surgery because of the risk of edema development. With careful management during anesthesia, there were no problems during surgery. However, generalized edema, hypotension, hypoalbuminemia, massive drainage of serosanguineous fluids from the intraabdominal space, and DIC occurred on the day after surgery. CLS was suspected and sustained hypotension with generalized edema became worse despite treatment with albumin, danazol, FFP, and vasoactive drugs. The patient’s condition worsened despite intensive care and he died due to shock. Conclusions The anesthesiologist should prepare for the critical complications of HAE and prepare the appropriate treatment options.

Background: The purpose of this study was to evaluate the radiologic results of total shoulder arthroplasty using computerized three-dimensional (3D) templating in preoperative planning. Methods: Ten patients who underwent total shoulder arthroplasty using 3D templating preoperatively were enrolled in this study. A specialized computer program was used to reconstruct the 3D images of the shoulder from the computed tomographic images. The 3D images of various sizes of prostheses were used as the template in surgical planning of the shoulder arthroplasty. The size of the glenoid, humeral head, and stem measured in 3D templating were compared with those used in actual operation. Anatomical parameters, such as humeral head size, radius of curvature, and greater tuberosity to humeral head distance of the replaced shoulder, were measured and compared with those of the contralateral normal shoulder. Results: The agreement rates between the glenoid size, head size, head thickness, and stem size estimated preoperatively by 3D templating and those measured in operation were 100%, 100%, 100%, and 80%, respectively. The difference in humeral head size, radius of curvature, and greater tuberosity to humeral head distance between the replaced shoulder and contralateral shoulder was 1.31 mm, 0.87 mm, and 1.17 mm, respectively. Conclusions In total shoulder arthroplasty, 3D templating seems to enable accurate prediction of sizes of the prostheses to be inserted and thus replication of normal anatomy.