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

BACKGROUND: Although urticaria is a common skin reaction pattern occuring at some time in the life of approximately 15% to 20% of the population, the exact prevalence of food-induced acute or chronic urticaria remains unknown. OBJECT: The purpose of this study was to determine the prevalence of specific food allergies in patients with urticaria and the potential utility of the skin prick test and CAP-RAST FEIA in the diagnosis of food allergy. METHODS: One hundred patients with urticaria were evaluated for food hypersensitivity by history, eosinophil count, IgE, skin prick test, CAP-RAST FEIA, and open food challenge test (OFCT). RESULTS: 1) The prevalence of specific food allergies in the study population was 35% in history and 8, 18 and 6% in prick, CAP-RAST FEIA and OFCT, respectively. 2) The frequent food allergens were milk, egg, peanut, and wheat. 3) There were no correlations between the duration of urticaria and prick test, CAP-RAST FEIA and OFCT results. 4) Serum IgE levels were correlated with the prick test and CAP-RAST FEIA results, but not the OFCT results. 5) According to the history, 35 patients with urticaria answered that their symptoms were related to food, and of the 35 patients, positive reactions to the prick test and CAP-RAST FEIA were observed in 6 and 10 patients, respectively. Among the other 65 patients who answered that there was no relation between urticaria and food, 2 patients reacted positively to the prick test and 8 patients showed positive result to CAP-RAST FEIA. CONCLUSION: In contrast to high prevalence of food history, the prevalence of food-induced allergic urticaria in Korean patients is only 6%. In contrast to the prick test, CAP-RAST FEIA provides a standardized measurement of food specific IgE antibodies, which may be more useful diagnostic test than prick test to diagnose food allergy in urticaria.
Allergens ; Antibodies ; Diagnosis ; Diagnostic Tests, Routine ; Eosinophils ; Food Hypersensitivity* ; Humans ; Immunoglobulin E ; Milk ; Ovum ; Prevalence ; Skin ; Triticum ; Urticaria*

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*

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

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