No abstract available.
Animals ; Epithelium* ; Gene Expression* ; Laser Capture Microdissection* ; Mice* ; Microarray Analysis* ; Phenobarbital*

PURPOSE: To evaluate the clinical characteristics of intertrochanteric or subtrochanteric fractures associated with ipsilateral femoral shaft fractures and assess the surgical outcomes of a novel, closed intramedullary nailing surgical approach designed to minimize fixation failure. MATERIALS AND METHODS: Between May 2013 and April 2017, 31 patients with intertrochanteric or subtrochanteric fractures associated with ipsilateral femoral shaft fractures treated with closed intramedullary nailing or long proximal femoral nail antirotation (PFNA) were enrolled in this study. Preoperative data included age, sex, injury severity score, body mass index, location of shaft fracture, injury mechanism, accompanying traumatic injury, walking ability before injury, and surgical timing. Perioperative outcomes, including follow-up period, types of intramedullary nails, number of blocking screws used, operation time, and blood loss were assessed. Radiologic outcomes, including union rate, time from surgery to union, and femoral shortening, and clinical outcomes, including hip flexion, walking ability, and Harris hip score were also evaluated. RESULTS: A total of 29 unions (93.5%) were achieved. The time to union was 16.8 months (range, 11–25 months) for hip fractures (15.7 weeks for intertrochanteric fractures and 21.7 weeks for subtrochanteric fractures) and 22.8 months for femoral shaft fractures. There were no significant differences in surgical outcomes between the two groups except for type of intramedullary nail. CONCLUSION: Closed intramedullary nailing in the treatment of intertrochanteric or subtrochanteric fractures associated with ipsilateral femoral shaft fractures may be a good surgical option. However, fixation of femoral shaft fractures might not be sufficient depending on the implant design.
Body Mass Index ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Hip ; Hip Fractures ; Humans ; Injury Severity Score ; Walking

STUDY DESIGN: A prospective study is to evaluate the cervical range of motion through the analysis of the plain films of the cer-vical spine. OBJECTIVE: To provide criteria validity for the cervical lordosis, range of motion and segmental motion of each segment using normal Korean adults, as guide lines for the radiographic diagnosis and treatment of cervical diseases. MATERIALS AND METHODS: One hundred and four healthy Korean adults were examined. Roentgenographic lateral views were taken in neutral, active flexion and extension positions. Measurement of the range of motion and segmental motion of the cer-vical spine, using the technique of Penning and Bakke, were independently made by two observers. RESULTS: The mean angle of the lordosis and the range of motion were 19.8degrees+/-8.4degrees and 63.1degrees+/-11.2degrees respectively, and the range of motion of each segment were 10.3degrees+/-2.9degrees, 9.2degrees+/-3.0degrees, 13.5degrees+/-7.2degrees 15.1degrees+/-4.3degrees, 15.6degrees+/-4.4degrees and 13.0degrees+/-5.0degrees and C1-2, C2-3, C3-4, C4-5, C5-6 and C6-7, respectively. There were no differences in the lordotic angle between the ages and genders. The range of motion decreased with increasing age, but there was no difference between genders. The segmental motion was no different between genders, but decreased significantly with increasing age on segments C1-2, C5-6 and C6-7. CONCLUSIONS: No significant differences were found in the range of cervical motion of each segment and the lordotic angle of the Korean population compared with those of other populations. The range of cervical motion also decreased with increasing age. These data provide guidelines in the dynamics of cervical spine and for the roentgenographic diagnosis and treatment of cervi-cal diseases.
Adult ; Animals ; Diagnosis ; Humans ; Lordosis ; Prospective Studies ; Range of Motion, Articular* ; Spine*

Profound hypoglycemia results in significant brain injury because glucose is essential for normal brain functioning. We present here a case of transient neonatal hypoglycemia with diffuse brain injury. Magnetic resonance imaging was performed 2 days after onset, and this revealed bilateral regions of restricted diffusion in the parietal, occipital, frontal and temporal lobes. On the T1-weighted images, the regions showed indistinct gray matter-white matter differentiation. There were subtle high signal intensity lesions along the corresponding regions of the FLAIR and T2-weighted images.
Brain Injuries* ; Brain* ; Diffusion ; Glucose ; Hypoglycemia* ; Magnetic Resonance Imaging ; Rabeprazole ; Temporal Lobe

BACKGROUND: Infections are the second leading cause of morbidity and mortality in hemodialysis patients. Vascular access is a major risk factor for infection-related hospitalization and mortality. This study aimed to characterize the presenting features and outcome of vascular access infection in hemodialysis patients. MATERIALS AND METHODS: Between May 2003 and March 2010, 224 patients admitted to a 750 bed tertiary care hospital for treatment of vascular access infection were retrospectively analyzed. Vascular access infections were defined by local infection signs (pus or redness) at the vascular access site or by a positive blood culture with no known source other than the vascular access. RESULTS: Of the 224 patients, 179 (79.7%) had an arteriovenous (AV) graft, 28 (12.5%) had a tunneled cuffed catheter, 12 (5.4%) had AV fistulas, and five (2.2%) had a temporary central catheter. The mean+/-SD time between the creation of each type of vascular access and onset of infection were as follows: temporary central catheter 46.6+/-36.9 days, tunneled cuffed catheter 180.3+/-168.8 days, AV fistulas 928.6+/-1,299.7 days, and AV graft 1,066.3+/-1321.1 days (P value=0.006). The most common causative organism was Staphylococcus aureus (62.5%; methicillin-susceptible 35.2%, methicillin-resistant 27.3%) followed by coagulase negative staphylococci (17.0%) and gram negative bacilli (15.9%). The involved vascular accesses in infected cases were: temporary central catheter (4/5, 80%), tunneled cuffed catheter (13/27, 48%), AV graft (68/179, 38%) and AV fistulas (4/12, 33%). The complications of vascular access infection included septic pulmonary embolism (n=9, 4%), pneumonia (n=9, 4%), endocarditis (n=6, 2.7%), osteomyelitis (n=3, 1.3%) and abdominal abscess (n=2, 0.9%). A multivariable analysis showed that Staphylococcus aureus was a risk factor of septic pulmonary embolism and osteomyelitis. The all-cause mortality was 8.4%, 30-day mortality was 2.2% and infection-related mortality was 5.4%. CONCLUSIONS: Staphylococcus was responsible for 79.5% of infections, with methicillin-susceptible S. aureus being the most commonly implicated strain. Temporary accesses have the potential to become infected earlier. Septic pulmonary embolism and pneumonia were common complications. Efforts should be focused on prevention and early detection of VA infection with pulmonary complications.
Abdominal Abscess ; Catheter-Related Infections ; Catheters ; Coagulase ; Endocarditis ; Fistula ; Hospitalization ; Humans ; Methicillin Resistance ; Osteomyelitis ; Pneumonia ; Pulmonary Embolism ; Renal Dialysis ; Retrospective Studies ; Risk Factors ; Sprains and Strains ; Staphylococcus ; Staphylococcus aureus ; Tertiary Healthcare ; Transplants

Purpose: This study aimed to examine the impact of fear and perception of infection risk on depression among service workers during prolonged Covid-19 service, and to provide basic data on the impact of COVID-19 prevention on the psychological health of service workers. Methods: Data were collected from workers nationwide from May 24 to 31, 2021. The data were analyzed using the t-test, ANOVA, Scheffé test, Pearson’s correlation coefficient, and multiple regression analysis, using SPSS 28. Results: It was found that 44.3% of the participants experienced depression (PHQ-9 total scores ≥ 10) during the Covid-19 pandemic. The general characteristics of service workers that made a difference in the level of depression were health status, smoking, and perception of infection risk. Conclusion Social support from institutions is needed to treat depression caused by Covid-19 among workers in the service sector.

Background: This study tries to compare and analyze the removal effect of dental plaque of general dentifrice and pregnant women’s dentifrice and quantify the results to provide basic data so that consumers can make reasonable choices when purchasing dentifrice, and also increase interest in the dental plaque. Methods: After forming a dental plaque (carbohydrate porridge) on the labial surface of the bovine teeth, a disclosing agent was applied. Then the same experimenter brushed the surface of the bovine teeth using an electric toothbrush and took photographs using a DSLR camera. Thereafter, the residual amount of dental plaque was analyzed using the ImageJ program, and SPSS 26.0 was used for statistical processing. Results: The average residual amount of dental plaque using the general dentifrice was 11.71% for Perio, 9.45% for Cliden, and 8.47% for 2080, and the average residual amount for the three types was approximately 9.88%. The average residual amount of dental plaque of pregnant women’s dentifrice was 13.95% for Jeninmothers, 12.53% for Tntnmoms, and 12.63% for Mommiracle, and the average residual amount of the three types was approximately 13.04%. On comparing the average residual amount of dental plaque between general and pregnant women’s dentifrices, it was observed to be 3.16% higher for the latter. However, the results were not statistically significant. Conclusion According to the research results, there was no significant difference in removal effects of general dentifrice and pregnant women’s dentifrice. In addition, when a pregnant woman uses the right toothbrushing method with pregnant women’s dentifrice, it can prevent or inhibit the progression of the gestational periodontal disease. Therefore, we recommend pregnant women to use pregnant women’s dentifrices.

BACKGROUND: Mediastinoscopy is generally performed to confirm mediastinal lymph node metastasis in lung cancer patients. It still remains controversial whether mediastinoscopy should be performed in all patients with resectable non-small cell lung cancer (NSCLC). We studied the clinical value of mediastinoscopy in preoperative staging in NSCLC. MATERIAL AND METHOD: We retrospectively studied 90 NSCLC patients who underwent radiological evaluation and mediastinoscopy followed by surgical resection from March 2002 to December 2004. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of each evaluation method were assessed and compared. RESULT: Specificity, PPV, NPV, and accuracy of mediastinoscopy were superior to those of radiological evaluation, but there was no significant difference in sensitivity. The sensitivity of mediastinoscopy was 28.6% in 62 patients with radiological N0/1 disease and 72.7% in 28 patients with radiological N2/3 disease. Seven of eight patients in whom positive nodes were not detected by the mediastinoscopy had subcarinal lymph node metastasis. CONCLUSION: Considering its invasiveness, the difficulty to reach certain node stations, and its low sensitivity in radiological N0/1 disease, mediastinoscopy should be selectively performed in radiological N2/3 disease rather than in all radiological cancer stages.
Carcinoma, Non-Small-Cell Lung* ; Humans ; Lung Neoplasms ; Lymph Nodes ; Mediastinoscopy* ; Neoplasm Metastasis ; Retrospective Studies ; Sensitivity and Specificity

A 33-year old male was admitted due to continuous high spiking fever for 2 months via local clinic. He had been diagnosed pulmonary tuberculosis at local clinic. However, spiking fever had not been controlled by anti-tuberculous medications. Chest PA showed confluent consolidation on right upper & mid-lung field. 5 anti-tuberculous regimens (Streptomycin, Isoniazid, Rifampin, Ethambutol, Pyrazinamaide) were administered initially and steroid therapy was followed for relieving toxic symptoms Very slowly resolved chest X-ray lesion and continuous fever suggested the possibility of misdiagnosis. After 60th hospital day, the chest X-ray lesion was resolved gradually and fever subsided almost completely. He was discharged on 76th hospital day with anti-tuberculous drugs and steroid(prednisolon), without any other problems except sustained mild fever.
Diagnostic Errors ; Ethambutol ; Fever* ; Humans ; Isoniazid ; Male ; Pneumonia* ; Rifampin ; Thorax ; Tuberculosis, Pulmonary

A 35-years-old man was hospitalized with gene-ralized edema. 6 months ago, the patient was operated by radical subtotal gastrectomy for advanced gastric adenocarcinoma. The patient presented with multiple liver metastasis and the massive proteinuria. The patients renal biopsy revealed minimal change nephrotic syndrome and treated with prednisolone and diuretics. The patient was improved clinical symptome and decreased 24 hours urine protein. In literature reviewed, gastric carcinoma was not associated with minimal change nephrotic syndrome. We experienced advanced gastric carcinoma associated with minimal change nephrotic syndrome, thus we report it.
Adenocarcinoma* ; Biopsy ; Diuretics ; Edema ; Gastrectomy ; Humans ; Liver* ; Neoplasm Metastasis* ; Nephrosis, Lipoid* ; Prednisolone ; Proteinuria