PURPOSE: We investigated the reference line closer to the true femoral anteversion on only the cutting surface of the proximal femoral neck during the femoral stem insertion in cementless total hip arthroplasty. MATERIALS AND METHODS: A postoperative CT of both hips was taken to observe the positioning of the stem and its correlation with the true anteversion of the contralateral side of 33 consecutive patients after unilateral primary cementless total hip arthroplasty with avascular necrosis of the femoral head. We defined several parameters and measured the true anteversion on the contralateral side and the stem anteversion on the lesion side. RESULTS: The average of the midcortical angle was 13.9 degrees +/-6.8 degrees on the lesion side and 0.1 degrees +/-1.3 degrees less than the true anteversion on the contralateral side. CONCLUSION: The study has shown that anteversion using a midline between the anterior cortical line and the posterior cortical line is compatible with the true femoral anteversion.
Arthroplasty, Replacement, Hip* ; Femur Neck ; Head ; Hip ; Humans ; Necrosis

No abstract available.
Peanut Hypersensitivity

Purpose: This study aimed to explore the experience of clinical nurses regarding training programs for critically ill patients with coronavirus disease 2019 (COVID-19) and their educational needs. Methods: Qualitative data were analyzed using content analysis, and quantitative data were analyzed according to Borich's formula. Data for the study were collected in March 2021 from 16 nurses who had completed a nursing program for critically ill patients with COVID-19 and were working at three hospitals designated for COVID-19. Results: Participants' experiences were classified into three major categories, namely “Participation experiences and perceptions of the training program,” “Recommendations for improving the training program,” and “Perceptions of working in an infectious environment,” and 10 subcategories. According to Borich's formula, the most pressing educational needs in respiratory and non-respiratory nursing, respectively, were for “nursing care for patients on extracorporeal membrane oxygenation” and “application of continuous renal replacement therapy and caring for patients.” Conclusion To prepare for the periodic emergence of communicable infectious diseases throughout the world and cultivate nursing staff to care for critically ill patients, it is necessary to develop nursing education programs with content corresponding to nurses' needs. This study can be used as base data for cultivating nursing staff for critically ill patients with communicable infectious diseases in keeping with clinical nurses’ educational needs and basic educational materials for nursing students.

Behcet's disease is a multisystem autoimmune disease with vasculitic features, and major vascular involvement occurs in 7.7-60% of patients. Venous lesions are more common than arterial lesions and arterial thrombotic events are relatively rare. We report a patient with Behcet's disease who developed a splenic infarct associated with splenic thrombotic arteritis. A 44-year-old man who had been diagnosed with Behcet's disease 5 years earlier presented with left flank pain lasting for 5 days. Laboratory tests revealed an elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Computed tomography (CT) and three-dimensional CT showed a wedge-shaped splenic infarct and thrombus in the splenic artery. We treated him with low-molecular-weight heparin and prednisolone. The symptoms improved within 6 days of hospitalization, after which we stopped the heparin and added methotrexate and azathioprine. Splenic infarct should be ruled out if patients with Behcet's disease complain of new left-sided abdominal pain.
Abdominal Pain ; Adult ; Arteritis ; Autoimmune Diseases ; Azathioprine ; Blood Sedimentation ; C-Reactive Protein ; Flank Pain ; Heparin ; Heparin, Low-Molecular-Weight ; Hospitalization ; Humans ; Methotrexate ; Prednisolone ; Splenic Artery ; Splenic Infarction ; Thrombosis

Behcet's disease is a multisystem autoimmune disease with vasculitic features, and major vascular involvement occurs in 7.7-60% of patients. Venous lesions are more common than arterial lesions and arterial thrombotic events are relatively rare. We report a patient with Behcet's disease who developed a splenic infarct associated with splenic thrombotic arteritis. A 44-year-old man who had been diagnosed with Behcet's disease 5 years earlier presented with left flank pain lasting for 5 days. Laboratory tests revealed an elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Computed tomography (CT) and three-dimensional CT showed a wedge-shaped splenic infarct and thrombus in the splenic artery. We treated him with low-molecular-weight heparin and prednisolone. The symptoms improved within 6 days of hospitalization, after which we stopped the heparin and added methotrexate and azathioprine. Splenic infarct should be ruled out if patients with Behcet's disease complain of new left-sided abdominal pain.
Abdominal Pain ; Adult ; Arteritis ; Autoimmune Diseases ; Azathioprine ; Blood Sedimentation ; C-Reactive Protein ; Flank Pain ; Heparin ; Heparin, Low-Molecular-Weight ; Hospitalization ; Humans ; Methotrexate ; Prednisolone ; Splenic Artery ; Splenic Infarction ; Thrombosis

No abstract available.
Leukemia, Myelomonocytic, Acute* ; Skin*

No abstract available.
Leukemia, Myelomonocytic, Acute* ; Skin*

OBJECTIVE: to investigate the effect of high glucose and spent peritoneal dialysate on the TGF-beta1 synthesis of cultured human peritoneal MC(HPMC); to examine the effect of costimulation with high glucose or dialysate and cytokines, interleukin-1beta(IL-1beta) and tumor necrosis factor-alpha(TNF-alpha), on transforming growth factor(TGF-beta1) synthesis of HPMC. DISIGN: HPMCs were exposed to different concentrations of glucose(30, 60 & 90 mM/L) or spent peritoneal dialysate for 48 hours in the absence or presence of IL-1beta(1ng/ml) and TNF-alpha(1ng/ml). TGF-beta1 mRNA expression was assessed by Northern blot analysis and TGF-beta1 protein synthesis and release by Western blot analysis with immunoprecipitation. RESULTS: Exposure of MC to high glucose condition(30mM, 60mM & 90mM of D- glucose) induced 2.3-, 3.6- and 4.0-fold increases in TGF-beta1 mRNA expression of MC with enhanced TGF-beta1 protein synthesis and secretion into the media. Incubation with spent dialysate also significantly increased TGF-beta1 mRNA expression & protein secretion compared to control media(P<0.05) Stimulation with IL-1beta(1ng/ml) or TNF-alpha(1ng/ml) significantly increased TGF-beta1 mRNA expression after 48 hours above the control level by 2.7-fold and 2.1-fold, respectively. However, TNF-alpha-induced increase in TGF-beta1 mRNA expression was not translated into TGF-beta1 protein secretion whereas IL-1beta stimulation induced a significant increase in TGF-beta1 protein secretion as well as TGF-beta1 mRNA expression. Combined stimulation of high glucose or spent dialysate together with IL-1beta or TNF-alpha showed a greater increase in TGF-beta1 mRNA expression and protein secretion compared to stimulation with high glucose or spent dialysate alone. CONCLUSION: Our results clearly show that high glucose concentration of peritoneal dialysate and spent dialysate themselves might be sufficient to stimulate the production of TGF-beta1 by peritoneal mesothelial cell. This state of chronic induction of TGF-beta1 is further exaggerated in the presence of peritonitis because of stimulatory effect of proinflammatory cytokines, resulting in the augmented TGF-beta1 synthesis, thus promoting peritoneal fibrosis.
Blotting, Northern ; Blotting, Western ; Cytokines ; Glucose ; Humans* ; Immunoprecipitation ; Necrosis ; Peritoneal Fibrosis ; Peritonitis ; RNA, Messenger ; Transforming Growth Factor beta1 ; Tumor Necrosis Factor-alpha

The changes of arterial carbon dioxide partial pressure considerably influence cerebral blood flow and different anesthetic agents have different effects on cerebrovascular physiology. However the importance of these differences in neuroanesthetic practice are unclear. Transcranial Doppler ultrasonography allows the noninvasive direct measurements of cerebral blood flow velocity and direction in the basal brain arteries. The authors performed transcranial Doppler ultrasonography to measure the blood flow velocity of middle cerebral artery in 12 patients who were anesthetized with 10 mcg/kg of fentanyl and 66 % nitrous oxide in oxygen(fentanyl group) and 12 patients with 1.0 vo1% isoflurane and 66 % nitrous oxide in oxygen(isoflurane group) during normocapnia(P(ET)CO(2)=38 mmHg) and hypocapnia(P(ET)CO(2)=28 mmHg)state. The carbon dioxide reactivity was expressed as the changes in mean blood flow velocity per unit changes in endtidal carbon dioxide partial pressure(P(ET)CO(2)). Mean blood flow velocity of middle cerebral artery decreased from 46.6+/-8.9 cm/s to 30.0+/-5.3 cm/s in the fentanyl group and 42.7+/-5.6 cm/s to 32.5+/-4.6 cm/s in the isoflurane group as the P(ET)CO(2) decreased from 38 mmHg to 28 mmHg. There was a significant difference between the CO2 reactivity of fentanyl group(1.7+/-0.7 cm/s/mmHg) and isoflurane group(1,0+/-0,2 cm/s/mmHg) (p<0.05). It is concluded that hyperventilation is more likely to affect cerebral blood flow during fentanyl-nitrous oxide anesthesia than during isoflurane-nitrous oxide anesthesia.
Anesthesia ; Anesthetics ; Arteries ; Blood Flow Velocity ; Brain ; Carbon Dioxide ; Fentanyl* ; Humans ; Hyperventilation ; Isoflurane* ; Middle Cerebral Artery ; Nitrous Oxide ; Partial Pressure ; Physiology ; Ultrasonography, Doppler, Transcranial

The brachial plexus block is a valuable method of providing anesthesia for the surgery of forearm and hand. Common technique for brachial plexus block include axillary, supraclaviculer, and interscalene approaches. The supraclavicular brachial plexus block offers adventages, ie, high success rate, rapid onset of action and relatively complete block over axillary and interscalene approach, but may be associated with pneumothorax. We marked the P point which was placed on the upper margin of clavicle that crossed the first rib on the chest PA film and marked on the skin of the patient and inserted 23G scalp needle at that point to the first rib. We performed this modified technique of supraclavicular brachial plexus block using chest PA film in 20 patients and there was no incidence of pneumothorax after this block but general anesthesia was sdministered in one case because of incomplete block. We recommend that this modified technique guided by chest PA film for supraclavicular block is simple, reliable and may reduce the incidence of pneumothorax and to increase the success rate in difficult case such as patient with extremely obesity.
Anesthesia ; Anesthesia, General ; Brachial Plexus* ; Clavicle ; Forearm ; Hand ; Humans ; Incidence ; Needles ; Obesity ; Pneumothorax ; Ribs ; Scalp ; Skin ; Thorax*