PURPOSE: This study was done to compare breast feeding rates and factors influencing feeding practice between late preterm (34< or =GA<37) and preterm infants (GA<34). METHODS: A survey was done of 207 late preterm and 117 preterm infants in neonatal intensive care units (NICU) of 4 university hospitals in D city. Data were collected from July 2009 to June 2010 from 324 medical records in the NICU. Breast-feeding at home was checked either by telephone survey or questioning during hospital visits. RESULTS: Rate of breast feeding for late preterm infants was significantly lower than for preterm infants. There was no significant difference in breast-feeding at home. We found differences in factors influencing breast feeding between the two groups. Factors influencing feeding for late preterm infants were type of delivery, mothers' occupation, feeding type during hospitalization, time elapse from hospital discharge, total admission days, infant's body weight at first feeding and length of NPO (nothing by mouth). Factors influencing feeding for preterm infants were birth order, maternal disease and obstetric complications, and one-minute Apgar score. CONCLUSION: Results of the study show low rates of breast-feeding for late preterm infants indicating a need for breast-feeding education for mothers of these infants.
Body Weight ; Breast Feeding/*statistics & numerical data ; Female ; Gestational Age ; Humans ; Infant, Newborn ; Infant, Premature ; Intensive Care Units, Neonatal ; Interviews as Topic ; Length of Stay ; Male ; Mothers/*psychology ; Occupations ; Time Factors

Bochdalek hernia through Bochdalek foramen, defect at the posterolateral side of the diaphragm is one of the congenital diaphragmatic hernias. It usually occurs in infants, but very rare in old age and also on the right side. We experienced the right-side Bochdalek hernia including kidney herniation in 68 years old man man ifested by hemoptysis. CT scan revealed diaphragmatic defect and herniated liver, colon and kidney. Thoracotomy was performed and the 10 cm-sized large defect was closed with patch. After then, the patient has been well without symptom.
Aged ; Colon ; Diaphragm ; Hemoptysis ; Hernia* ; Hernia, Diaphragmatic ; Humans ; Infant ; Kidney* ; Liver ; Thoracotomy ; Tomography, X-Ray Computed

PURPOSE: The purpose of this study was to identify status and characteristics of patients who have been readmitted to ICU, and to analyze risk factors associated with the readmission to ICU within 48hours.METHODS: Data were collected from patient's electronic medical reports from one hospital in B city. Participants were 2,937 patients aged 18 years old or older admitted to the ICU. Data were analyzed using odd ratios (ORs) from multivariate logistic regressions.RESULTS: 2.2% of the 2,937 patients were early readmitted to ICU. Risk factors for early readmission to ICU were existence of respiratory disease, use of mechanical ventilator, and duration of hospitalization (longer).CONCLUSION: The assessment on the respiratory system of the patient who will be discharged from the ICU was identified as an important nursing activity. Therefore, the respiratory system management and education should be actively conducted. In addition, early ICU readmission may be prevented and decreased if a link was built to share the information on patient condition between the ICU and general wards.
Critical Care ; Education ; Hospitalization ; Humans ; Intensive Care Units ; Logistic Models ; Nursing ; Patient Readmission ; Patients' Rooms ; Respiratory System ; Risk Factors ; Ventilators, Mechanical

Previously believed to solely play a supportive role in the central nervous system, astrocytes are now considered active players in normal brain function. Evidence in recent decades extends their contributions beyond the classically held brain glue role; it's now known that astrocytes act as a unique excitable component with functions extending into local network modulation, synaptic plasticity, and memory formation, and postinjury repair. In this review article, we highlight our growing understanding of astrocyte function and physiology, the increasing role of gliotransmitters in neuron-glia communication, and the role of astrocytes in modulating synaptic plasticity and cognitive function. Owing to the duality of both beneficial and deleterious roles attributed to astrocytes, we also discuss the implications of this new knowledge as it applies to neurological disorders including Alzheimer disease, epilepsy, and schizophrenia.
Adhesives* ; Alzheimer Disease ; Astrocytes* ; Brain ; Central Nervous System ; Cognition ; Epilepsy ; Memory ; Nervous System Diseases* ; Neuronal Plasticity* ; Physiology ; Schizophrenia

Synapses are sites of high energy demand which are dependent on high levels of mitochondrial derived adenosine triphosphate. Mitochondria within synaptic structures are key for maintenance of functional neurotransmission and this critical biological process is modulated by energy metabolism, mitochondrial distribution, mitochondrial trafficking, and cellular synaptic calcium flux. Synapse loss is presumed to be an early yet progressive pathological event in Alzheimer disease (AD), resulting in impaired cognitive function and memory loss which is particularly prevalent at later stages of disease. Supporting evidence from AD patients and animal models suggests that pathological mitochondrial dynamics indeed occurs early and is highly associated with synaptic lesions and degeneration in AD neurons. This review comprehensively highlights recent findings that describe how synaptic mitochondria pathology involves dysfunctional trafficking of this organelle, to maladaptive epigenetic contributions affecting mitochondrial function in AD. We further discuss how these negative, dynamic alterations impact synaptic function associated with AD. Finally, this review explores how antioxidant therapeutic approaches targeting mitochondria in AD can further clinical research and basic science investigations to advance our in-depth understanding of the pathogenesis of AD.

Selective cervical nerve root block is executed for patients who have symptoms of cervical radiculopathy for diagnostic and therapeutic purposes. However several catastrophic complications caused by this procedure have been reported including neurological complications. A 43-year-old male received a C5 selective cervical nerve root block procedure due to continuous radiating pain even after cervical discectomy and interbody fusion was performed. At the time of the procedure, the contrast outline revealed reflux of the nerve root and epidural space. But after the procedure was performed, the patient experienced decreased sensation in the upper and low extremities as well as motor paralysis of both extremities. Our sspecting diagnosis was anterior spinal artery syndrome but both sensory and motor functions were subsequently recovered within a few hours after the procedure was completed. Due to the difficult nature of this case, we reported these complications and reviewed current literature related to this study.
Adult ; Anterior Spinal Artery Syndrome ; Diskectomy ; Epidural Space ; Extremities ; Humans ; Injections, Spinal ; Male ; Paralysis ; Quadriplegia ; Radiculopathy ; Sensation ; Spinal Nerve Roots

OBJECTIVE: To investigate the relationship between serum creatine kinase (CK) level and pulmonary function in Duchenne muscular dystrophy (DMD). METHODS: A total of 202 patients with DMD admitted to the Department of Rehabilitation Medicine, Gangnam Severance Hospital were enrolled from January 1, 1999 to March 31, 2015. Seventeen patients were excluded. Data collected from the 185 patients included age, height, weight, body mass index, pulmonary function tests including forced vital capacity (FVC), peak cough flow, maximal expiratory pressure (MEP), and maximal inspiratory pressure (MIP), and laboratory measurements (serum level of CK, CK-MB, troponin-T, and B-type natriuretic peptide). FVC, MEP, and MIP were expressed as percentages of predicted normal values. RESULTS: Serum CK activities were elevated above normal levels, even in the oldest DMD group. Serum CK level was strongly correlated with pulmonary functions of sitting FVC (p<0.001), supine FVC (p<0.001), MIP (p=0.004), and MEP (p<0.001). CONCLUSION: Serum CK level is a reliable screening test even in patients with advanced DMD, and is a strong predictor of pulmonary functions.
Body Weight ; Cough ; Creatine Kinase* ; Creatine* ; Humans ; Mass Screening ; Muscular Dystrophy, Duchenne* ; Reference Values ; Rehabilitation ; Respiratory Function Tests ; Troponin T ; Vital Capacity

STATE OF PROBLEM: Zirconia all-ceramic restoration fabricated with CAM system is on an increasing trend in dentistry. However, evaluation of the marginal and internal fits of zirconia bridge seldomly have been reported. PURPOSE: This study was to evaluate the fit of margin and internal surface in posterior 3-unit zirconia bridge framework fabricated with CAM system(DeguDent, Germany). MATERIAL AND METHOD: Preparations of secondary premolar and secondary molar on artificial resin model were performed for fabrication of 3-unit posterior bridge framework. Fits of 5 zirconia bridge framework were compared with 5 precious ceramo-metal alloy framework(V-GnathosPlus, Metalor, Switzerland), and prepared margins were designed to chamfer and shoulder finishing line. Each framework was cemented to epoxy resin model with reinforced glass ionomer(FujiCEM, GC Co., Japan), embedded in acrylic resin and sectioned in two planes, mesiodistal and buccolingual. Samples were divided into six pieces by sectioning and had two pieces of each surface(i.e. mesial, distal, buccal and lingual surface) per abutment, so there were eight measuring points in each abutment. External gap was measured at the margin and internal gaps were measured at the margin, axial and occlusal surface. Gaps were observed under the measuring microscope(Compact measuring microscope STM5; Olympus, Japan) at a magnification of * 100. T-test were used to determine the statistic significance of the different gaps between zirconia and metal framework. RESULTS AND CONCLUSION: 1. External and internal marginal gaps of zirconia and metal framework were in clinically acceptable range. External marginal gaps were not different significantly between zirconia(81.9 micrometer) and metal(81.3 micrometer) framework and internal marginal gaps of zirconia(44.6 micrometer) were smaller than those of metal framework(58.6 micrometer). 2. Internal axial gaps of zirconia framework(96.7 micrometer) were larger than those of metal framework(78.1 micrometer) significantly and adversely, internal occlusal gaps of zirconia framework(89.4 micrometer) were smaller than those of metal framework(104.9 micrometer) significantly. 3. There were no significant differences in external and internal marginal gaps between chamfer and shoulder finish line when zirconia frameworks were fabricated.
Alloys ; Bicuspid ; Dentistry ; Glass ; Molar ; Shoulder

There are no reports regarding pneumomediastinum caused by thoracic epidural block complications. We believe that it is possible to experience an occurrence of pneumomediastinum caused by air in the epidural space after performing a thoracic epidural block using the loss of resistance (LOR) technique with air. We report a witnessed case where pneumomediastinum appeared after a thoracic epidural block. Pneumorrrhachis, paravertebral muscle emphysema, and pneumomediastinum were diagnosed by Positron Emission Tomography-Computed Tomography. Although extremely rare, pneumomediastinum can be caused by an epidural block using LOR technique with air. In order to avoid the above danger, the use of saline or very minimal amount of air is required during a careful LOR technique.
Electrons ; Emphysema ; Epidural Space ; Injections, Epidural ; Mediastinal Emphysema ; Muscles ; Wit and Humor as Topic

Rhabdomyolysis is defined as necrosis of the skeletal muscle fibers with release of the intracellular muscle constituents, including myoglobins,into the blood and urine. Severe myoglobinemia causes obstruction and necrosis of the renal tubule, resulting in acute renal failure (ARF). In this case, a patient with rhabdomyolysis-induced ARF was in recovery phase after treatment with fluid replacement and continuous renal replacement therapy (CRRT). However, a sudden relapse of severe myoglobinemia occurred during CRRT. To remove myoglobinas rapidly as possible, we applied two sessions of plasmapheresis (total plasma exchange, TPE) in addition to CRRT for two days. The myoglobin level of the patient successfully decreased by 91%, and clinical symptoms and laboratory-measuredabnormalities subsequently improved. If severe myoglobinemia is persistent, or if relapse in spite of CRRT occurs, it would be reasonable to consider TPEas an additional therapy.
Acute Kidney Injury ; Humans ; Muscle Fibers, Skeletal ; Myoglobin* ; Necrosis ; Plasma Exchange ; Plasmapheresis* ; Recurrence ; Renal Replacement Therapy ; Rhabdomyolysis*