PURPOSE: Prolonged fetal hypoxia stimulates erythropoiesis in fetal life and induces increased nucleated erythrocytes(NRBC) counts at the early newborn period. To evaluate the relationship between prolonged fetal hypoxia and neonatal intraventricular hemorrhage (IVH), and the prediction of neonatal IVH by neonatal NRBC. METHODS: We compared the daily courses of the absolute NRBC count in preterm new- boms at 34 weeks' gestation or earlier with(n=17) and without(n=20) IVH for 7 days of life. RESULTS: Absolute NRBC counts at birth were higher in neonates with IVH than in control neonates(2,499/mm3+/-3,748 and 412/mm3+/-272, respectively, P=0.0022). The cut-off value of 1,000/mm3 for absolute NRBC counts at birth showed the best parameter estimate of the predictive model for IVH at early newborn period with 100% of positive predictive value and 74.1% of negative predictive value. CONCLUSION: Prolonged fetal hypoxia inducing fetal erythropoiesis near labor is closely related to IVH at early newborn period. Thabsolute NRBC counts at birth is the very important predictable marker for the condition.
Erythroblasts* ; Erythropoiesis ; Fetal Hypoxia ; Hemorrhage* ; Humans ; Infant, Newborn* ; Parturition ; Pregnancy

Since Green et al has introduced a new technique of retrograde intramedullary nail, the use of retrograde interlocking intramedullary nails has been recommended as one of the treatment options for the distal femoral fracture. However there are some disadvantages that an arthrotomy is required for insertion and the knee joint could often be violated. Authors present a simple, arthroscopically assisted method using the retrograde intramedullary nailing for distal femoral fractures with minimal invasiveness to the knee. From March 1995 to March 1997, the retrograde intramedullary nail was used to treat 9 distal femoral fractures. Five of 9 patients were fractured at the distal shaft of the femur and others were fractured at the supracondylar region of the femur. Only one of the fractures was open injury(Gustilo-Anderson grade II). Significant concomitant knee joint injuries were revealed through the arthroscopy in 3 patients. Eight of 9 fractures healed by 5 months, but one fracture was not healed and required bone grafting. Average knee range of motion was 130. Complications included 1 nonunion and 1 hardware failure. There were no patellofemoral problems and no posttraumatic arthritis of the knee joint. This arthroscope-assisted method have some potential benefits that include decreased risk of damage to the knee joint, early evaluation and treatment of the associated knee joint injuries, and accurate placement of the nail.
Arthritis ; Arthroscopy* ; Bone Transplantation ; Femoral Fractures* ; Femur ; Fracture Fixation, Intramedullary ; Humans ; Knee ; Knee Joint ; Range of Motion, Articular

We experienced a case of primary hepatic actinomycosis which was initially diagnosed by means of fine needle aspiration. The patient was a 31-year-old emaciated man with a 2-month history of 10 kg weight loss, right upper quadrant pain and flank pain. The liver was palpable and tender on physical examination. Computerized tomography scan of the liver showed two ill-defined hypodense masses in gallbladder fossa and inferior pole of right lobe. Hepatocellular carcinoma was clinically suspected. A CT-guided fine needle aspiration was performed. Microscopically, smears showed numerous radiating clusters of filamentous bacteria with many neutrophils and monocytes in necrotic background. The symptoms were improved by incision and drainage and massive administration of penicillin.
Actinomycosis ; Adult ; Bacteria ; Biopsy, Fine-Needle ; Breast ; Carcinoma, Hepatocellular ; Diverticulum* ; Drainage ; Fibroadenoma ; Flank Pain ; Gallbladder ; Humans ; Infarction ; Liver ; Monocytes ; Neutrophils ; Penicillins ; Physical Examination ; Vesico-Ureteral Reflux* ; Weight Loss

PURPOSE: This study was performed to explore the effect of senior simulation on nurses' attitudes toward the elderly. METHOD: Twenty-seven nurses working in various settings such as acute hospitals, community health centers, geriatric hospitals, and clinics were recruited. Among them, 25 subjects completed the whole experimental protocol. Aging Semantic Differential Scaling was utilized to evaluate attitudes toward the elderly and 'Suit for Experiencing Being Aged' from the Sakamoto Model was provided for the experiment. Before and after the experiment subjects filled out questionnaires. RESULT: Attitude score before experiment was 4.36, which indicates neutral attitude. Objective attitude scores were not different significantly after experiment. However subjective statements indicated attitude changes in a positive way. CONCLUSION: Senior simulation can affect nurses' attitude toward elderly in subjective way. That is, nurses became more empathetic and understanding to elderly's physical limitations and felt more initiative nursing approach were needed in caring elderly.
Adult ; *Aged ; *Attitude of Health Personnel ; Female ; Humans ; Nurse-Patient Relations ; Nurses/*psychology ; *Patient Simulation

Poland syndrome is characterized by an absent of the pectoralis major muscle, with ipsilateral defect of the upper extremity, usually syndactyly. The incidence of this syndrome has been estimated at 1 per 32,000 persons and more than 400 patients have been described worldwide after Alfred Poland's report. but there was no report of Poland syndrome associated with Diabetic Mellitus in childhood. Recently, we experienced a 14 year-old female patient who showed typical Poland syndrome, a left pectoralis muscle hypoplasia and left synbrachydactyly, associated with Diabetes mellitus complicated by ketoacidosis.
Adolescent ; Diabetes Mellitus ; Diabetic Ketoacidosis* ; Female ; Humans ; Incidence ; Ketosis ; Pectoralis Muscles ; Poland Syndrome* ; Poland* ; Syndactyly ; Upper Extremity

Spontaneous intracranial hypotension (SIH) is caused by single or multiple cerebrospinal fluid (CSF) leaks in the spine with the prototypical symptom of postural headache. One of the characteristic MRI features in SIH is intracranial venous engorgement. This report presents a case of SIH with engorgement of the bilateral superior ophthalmic veins (SOVs) which resume their normal diameters by the third day of successful epidural blood patches (EBPs). We define this phenomenon as the "reversal of the SOV" sign.
Aged ; *Blood Patch, Epidural ; Cerebrospinal Fluid Rhinorrhea/*complications ; Diagnosis, Differential ; Humans ; Intracranial Hypotension/*diagnosis/etiology/*therapy ; *Magnetic Resonance Imaging ; Male ; Orbit/*blood supply

BACKGROUND/OBJECTIVES: There is growing interest in herbal medicines for managing age-related diseases, such as Alzheimer's and Parkinson’s. Safflower seeds (Carthamus tinctorius L. seeds, CTS) and dandelions (Taraxacum coreanum, TC) are widely used to treat bone- or inflammation-related diseases in Oriental countries. This study investigated the protective effect of the CTS–TC combination on scopolamine (Sco)-induced memory deficits through inflammatory response and cholinergic function. Moreover, marker components such as serotonin, N-(p-coumaroyl) serotonin, N-feruloylserotonin, chlorogenic acid, and chicoric acid in the CTS–TC combination were analyzed for their potential benefits on memory function.MATERIALS/METHODS: Water extracts of CTS, TC, and the CTS–TC combination at various ratios (4:1, 1:1, and 1:4) (100 mg/kg) were orally administered to mice for 14 days. Sco (1 mg/kg) was intraperitoneally injected into the mice before each behavioral test. T-maze and novel object recognition tests were conducted to monitor behavioral changes after the treatment.Western blotting was performed to detect protein expression. In addition, the presence of 5 biomarkers, serotonin, N-(p-coumaroyl) serotonin, N-feruloylserotonin, chlorogenic acid, and chicoric acid, was analyzed using high-performance liquid chromatography (HPLC). RESULTS: Behavioral tests showed that the CTS–TC combination enhanced memory function in Sco-injected mice. Inflammation-related proteins (inducible nitric oxide synthase, cyclooxygenase-2, and glial fibrillary acidic protein) were downregulated after treatment with the CTS–TC combination. The acetylcholinesterase protein expression was also downregulated.HPLC analysis revealed that N-feruloylserotonin and chicoric acid were the predominant components, followed by N-(p-coumaroyl) serotonin, chlorogenic acid, and serotonin. CONCLUSION These findings suggest that the CTS–TC combination protects against Sco-induced memory deficits by inhibiting inflammatory responses and cholinergic dysfunction. N-feruloylserotonin and chicoric acid, along with N-(p-coumaroyl) serotonin, chlorogenic acid, and serotonin, might be biomarkers for the CTS–TC combination, and their effects on memory protection warrant further study.

BACKGROUND/OBJECTIVES: There is growing interest in herbal medicines for managing age-related diseases, such as Alzheimer's and Parkinson’s. Safflower seeds (Carthamus tinctorius L. seeds, CTS) and dandelions (Taraxacum coreanum, TC) are widely used to treat bone- or inflammation-related diseases in Oriental countries. This study investigated the protective effect of the CTS–TC combination on scopolamine (Sco)-induced memory deficits through inflammatory response and cholinergic function. Moreover, marker components such as serotonin, N-(p-coumaroyl) serotonin, N-feruloylserotonin, chlorogenic acid, and chicoric acid in the CTS–TC combination were analyzed for their potential benefits on memory function.MATERIALS/METHODS: Water extracts of CTS, TC, and the CTS–TC combination at various ratios (4:1, 1:1, and 1:4) (100 mg/kg) were orally administered to mice for 14 days. Sco (1 mg/kg) was intraperitoneally injected into the mice before each behavioral test. T-maze and novel object recognition tests were conducted to monitor behavioral changes after the treatment.Western blotting was performed to detect protein expression. In addition, the presence of 5 biomarkers, serotonin, N-(p-coumaroyl) serotonin, N-feruloylserotonin, chlorogenic acid, and chicoric acid, was analyzed using high-performance liquid chromatography (HPLC). RESULTS: Behavioral tests showed that the CTS–TC combination enhanced memory function in Sco-injected mice. Inflammation-related proteins (inducible nitric oxide synthase, cyclooxygenase-2, and glial fibrillary acidic protein) were downregulated after treatment with the CTS–TC combination. The acetylcholinesterase protein expression was also downregulated.HPLC analysis revealed that N-feruloylserotonin and chicoric acid were the predominant components, followed by N-(p-coumaroyl) serotonin, chlorogenic acid, and serotonin. CONCLUSION These findings suggest that the CTS–TC combination protects against Sco-induced memory deficits by inhibiting inflammatory responses and cholinergic dysfunction. N-feruloylserotonin and chicoric acid, along with N-(p-coumaroyl) serotonin, chlorogenic acid, and serotonin, might be biomarkers for the CTS–TC combination, and their effects on memory protection warrant further study.

BACKGROUND/OBJECTIVES: There is growing interest in herbal medicines for managing age-related diseases, such as Alzheimer's and Parkinson’s. Safflower seeds (Carthamus tinctorius L. seeds, CTS) and dandelions (Taraxacum coreanum, TC) are widely used to treat bone- or inflammation-related diseases in Oriental countries. This study investigated the protective effect of the CTS–TC combination on scopolamine (Sco)-induced memory deficits through inflammatory response and cholinergic function. Moreover, marker components such as serotonin, N-(p-coumaroyl) serotonin, N-feruloylserotonin, chlorogenic acid, and chicoric acid in the CTS–TC combination were analyzed for their potential benefits on memory function.MATERIALS/METHODS: Water extracts of CTS, TC, and the CTS–TC combination at various ratios (4:1, 1:1, and 1:4) (100 mg/kg) were orally administered to mice for 14 days. Sco (1 mg/kg) was intraperitoneally injected into the mice before each behavioral test. T-maze and novel object recognition tests were conducted to monitor behavioral changes after the treatment.Western blotting was performed to detect protein expression. In addition, the presence of 5 biomarkers, serotonin, N-(p-coumaroyl) serotonin, N-feruloylserotonin, chlorogenic acid, and chicoric acid, was analyzed using high-performance liquid chromatography (HPLC). RESULTS: Behavioral tests showed that the CTS–TC combination enhanced memory function in Sco-injected mice. Inflammation-related proteins (inducible nitric oxide synthase, cyclooxygenase-2, and glial fibrillary acidic protein) were downregulated after treatment with the CTS–TC combination. The acetylcholinesterase protein expression was also downregulated.HPLC analysis revealed that N-feruloylserotonin and chicoric acid were the predominant components, followed by N-(p-coumaroyl) serotonin, chlorogenic acid, and serotonin. CONCLUSION These findings suggest that the CTS–TC combination protects against Sco-induced memory deficits by inhibiting inflammatory responses and cholinergic dysfunction. N-feruloylserotonin and chicoric acid, along with N-(p-coumaroyl) serotonin, chlorogenic acid, and serotonin, might be biomarkers for the CTS–TC combination, and their effects on memory protection warrant further study.

This study reports the outcomes of a collaborative program between dialysis clinics and a referral hospital, which consisted of clinical monitoring and supplementary routine surveillance, for improving the quality of vascular access care. Methods: This retrospective observational study was performed at five dialysis clinics as part of a 2-year collaborative program (2019–2020) in conjunction with a hospital-based dialysis access management center. A total of 392 hemodialysis patients (arteriovenous fistula [AVF], n = 339 and arteriovenous graft [AVG], n = 53) were included. Outcome measures included the prognosis of vascular access, clinic satisfaction, and referral rate to the hospital. Results: Increased vascular access flow was observed and critical flow events decreased from the first to the second year (AVF: 18.3% vs. 12.7%, p < 0.001; AVG: 26.2% vs. 20.1%, p = 0.30). There were fewer percutaneous transluminal angioplasty events in the AVG group (0.77 per person-year vs. 0.51 per person-year, p = 0.005). New AVF or AVG creation events also remained low. All dialysis clinics were satisfied with the program. The overall referral rate from the participating clinics increased (65.7% vs. 72.0%) during the study period independently of the physical distance between the dialysis clinic and the hospital. Conclusion: The collaboration between dialysis clinics and a referral hospital for improving the quality of vascular access care was successful in this study, and the model can be used by other clinics and hospitals looking to improve care coordination in dialysis patients.