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Purpose: Cancellous bone harvested from the distal radius has been used in various hand surgeries, but studies on its use in scaphoid waist nonunions are insufficient. We investigated the usefulness of cancellous bone graft from the distal radius and headless screw fixation in unstable scaphoid waist nonunion. Methods: Thirty-one patients who underwent cancellous bone graft from the distal radius and headless screw fixation for unstable scaphoid waist nonunion with follow-up for at least 1 year were included. Bone union time, the number of patients with bone union at six and 12 weeks, total number of patients with bone union at last follow-up, and bone union on the computed tomography (CT) image at postoperative six weeks were evaluated. Further, pre- and postoperative radiological measurements, such as scaphoid length and height, lateral intra-scaphoid angle, and height-to-length ratio, and functional outcomes were compared. Additionally, inter-observer reliability of radiologic parameters was checked. Results: Bone union was achieved in 29 patients. There were two nonunions (6.5%). Bone union time was 10.7 (range, 6–26) weeks. Eighteen (58%) and 25 patients (80.6%) were diagnosed with bone union on the plain radiographs at six and 12 weeks, respectively. Twenty-two patients (71%) were diagnosed with bone union on CT performed at six weeks. Radiological measurements and functional outcomes improved postoperatively. The scaphoid length showed good inter-observer agreement. Conclusions: In treating unstable scaphoid waist nonunion, cancellous bone graft from the distal radius and headless screw fixation achieved 93.5% union and improved radiological measurements as well as functional outcomes. [ABSTRACT FROM AUTHOR]

Febrile neutropenia (FN) and chemotherapy-induced neutropenia (CIN) are common conditions that lead to dose reduction or delayed chemotherapy in patients with diffuse large B-cell lymphoma (DLBCL). Primary prophylaxis (PP) with long-acting granulocyte colony-stimulating factor (G-CSF) was introduced in South Korea in 2014. We aimed to investigate the effects of PP on FN-related hospitalization and death in patients with DLBCL receiving rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). Korean individuals (n = 11,491) with incident DLBCL and receiving R-CHOP during 2010–2016 were followed for FN-related hospitalization and mortality. The PP exposure group (patients during 2014–2015, n = 3599), patients during 2010–2016 (n = 11,491), and patients receiving PP during 2014–2016 (n = 4421) were compared with the non-exposure group (patients during July 2011–June 2013, n = 3017), patients in 2013 (n = 1596), and patients not receiving PP during 2014–2016 (n = 1289), respectively. Multivariable-adjusted hazard ratios (HRs) were calculated using the Cox model. The PP exposure group had 16% lower FN-related hospitalizations than the non-exposure group (HR = 0.84, P < 0.001). PP exposure had no beneficial effect on 1-year (HR = 0.98, P = 0.782) and 5-year mortality (HR = 0.97, P = 0.474). Patients in 2014 (HR = 0.85, P < 0.001), 2015 (HR = 0.88, P = 0.003), and 2016 (HR = 0.80, P < 0.001) had a decreased risk of FN-related hospitalizations compared with those in 2013. Among patients receiving their first R-CHOP cycle during 2014–2016, the HR for FN-related hospitalization was 0.90 (P = 0.014) in PP users compared with non-users. PP with a long-acting G-CSF lowered the FN-related hospitalization risk but did not benefit survival in patients with DLBCL receiving R-CHOP. [ABSTRACT FROM AUTHOR]

Background and Objectives: The novel double-pigtail catheter (DPC) has an additional pigtail coiling at the mid-shaft with multiple centripetal side holes. The present study aimed to investigate the advantages and efficacy of DPC in overcoming the complications of conventional single-pigtail catheters (SPC) used to drain pleural effusion. Materials and Methods: Between July 2018 and December 2019, 382 pleural effusion drainage procedures were reviewed retrospectively (DPC, n = 156; SPC without multiple side holes, n = 110; SPC with multiple side holes (SPC + M), n = 116). All patients showed shifting pleural effusions in the decubitus view of the chest radiography. All catheters were 10.2 Fr in diameter. One interventional radiologist performed all procedures and used the same anchoring technique. Complications (dysfunctional retraction, complete dislodgement, blockage, and atraumatic pneumothorax) were compared among the catheters using chi-square and Fisher's exact tests. Clinical success was defined as an improvement in pleural effusion within three days without additional procedures. Survival analysis was performed to calculate the indwelling time. Results: The dysfunctional retraction rate of DPC was significantly lower than that of the other catheters (p < 0.001). Complete dislodgement did not occur in any of the DPC cases. The clinical success rate of DPC (90.1%) was the highest. The estimated indwelling times were nine (95% confidence interval (CI): 7.3–10.7), eight (95% CI: 6.6–9.4), and seven (95% CI: 6.3–7.7) days for SPC, SPC + M, and DPC, respectively, with DPC showing a significant difference (p < 0.05). Conclusions: DPC had a lower dysfunctional retraction rate compared to conventional drainage catheters. Furthermore, DPC was efficient for pleural effusion drainage with a shorter indwelling time. [ABSTRACT FROM AUTHOR]

Distal phalanx fractures are the most common injuries of the hand, and K-wire fixation is commonly performed for unstable fractures. However, there is no consensus regarding the number of K-wires to use in bone fixation. We aimed to compare the results between single and dual K-wire pinning. This retrospective study enrolled patients who underwent K-wire pinning for unstable distal phalanx fractures, including the shaft and tuft, from June 2016 through April 2020. We divided patients into two groups based on the number of K-wires used for bone fixation (single vs. dual). Clinical and radiographic data were measured and compared between the two groups. Additionally, multivariable logistic analysis was performed to identify the risk factors for nonunion. A total of 80 patients were enrolled. Among them, 27 were managed with a single K-wire and 53 with a dual K-wire. There was no significant difference in the union rate between the single and dual K-wire groups (77.7% vs. 84.9%, respectively), but time to union was significantly longer in the single K-wire group (11.3 vs. 8.4 weeks; p =.003). The presence of a bone gap after fixation was a risk factor for nonunion. Our study showed that the union rate was comparable between single and dual K-wire pinning in distal phalanx fractures. However, dual K-wire pinning shortened the union time. [ABSTRACT FROM AUTHOR]

Background: Hyperthermia is relatively rare during general anesthesia; however, a few studies have been conducted on hyperthermia and the neuromuscular blockade (NMB) induced by rocuronium, and the reversal of NMB by sugammadex. We investigated the effect of hyperthermia status on the NMB induced by rocuronium, and its reversal by sugammadex, in isolated phrenic nerve hemidiaphragm (PNHD) preparations of the rat. Methods: Thirty-three male Sprague-Dawley rat PNHD preparations were randomly assigned to three groups at different temperatures (36 °C, 38 °C, and 40 °C; each group, n = 11, in Krebs solution). The train-of-four (TOF) and twitch height responses were checked mechanomyographically. The PNHD were treated with progressively increasing doses of rocuronium and three effective concentrations (ECs), EC50, EC90, and EC95, of rocuronium were analyzed in each group via nonlinear regression analysis. Then, sugammadex was administered in doses equimolar to rocuronium. Thereafter, the T1 height (%), TOFR (%) and the duration index were measured. Results: The EC of rocuronium (EC50, EC90, and EC95) decreased significantly in accordance with increasing temperature. The groups at 36 °C and 40 °C showed clear differences in all areas (all P < 0.001). Moreover, the T1 height (%) and the duration index upon sugammadex administration showed faster recovery results in the36 °C than the 38 °C and 40 °C groups. Conclusion: A rise of temperature from 38 °C to 40 °C in rat PNHD preparations proportionally enhanced the NMB induced by rocuronium. In addition, equimolar doses of sugammadex to the administered rocuronium showed a slower recovery time as the temperature rises. [ABSTRACT FROM AUTHOR]

Backgrounds: Metabolic syndrome (MetS) is an adverse health effect that can be associated with pesticide exposure. However, there are few epidemiologic studies on the relationship between pesticide use and MetS incidence. Methods: We examined the causal relationship between pesticide use and MetS incidence in a rural population. We used Data from the Korea Farmers Cohort study of 1,162 participants. Poisson regression with a robust error variance was used to calculate relative risks (RRs) and 95% confidence intervals (CIs) to estimate the relationship between pesticide exposure and MetS. Results: The incidence of MetS was 20.7%. Pesticide use increased the RR of MetS incidence. In women, we observed a low-dose effect related to MetS and pesticide exposure. Conclusion: Pesticide exposure was related to the incidence of MetS; the causal relationship differed in men and women. [ABSTRACT FROM AUTHOR]

Backgrounds: Ethylenethiourea (ETU) is one of the main metabolite of ethylenebisdithiocarbamate fungicides and potential exposure is highest for workers involved in rubber and fungicide production. Exposure of ETU induces endocrine disruption, teratogenesis, carcinogenicity, and goitrogenicity.Methods: ETU was administrated at concentration of 2 mg/kg/day for 58 weeks in C57BL/6 mice. After 58 weeks, blood samples were analyzed serum lipid profile, hepatic function dices, and plasma levels of creatine and blood urea nitrogen. Isolated kidneys were stained with haematoxylin-eosin. Analysis of miRNA expression profile was conducted on Affymetrix miRNA 4.0 Array.Results: Chronic diet of ETU induced body weight loss, increased serum triglyceride and total cholesterol, increased plasma creatine and blood urea nitrogen, injured glomerulus and nephron tubule, induced severe hydronephrosis and polycystic kidney. ETU diet increased expression levels of the biomarker of renal injury and fibrosis in kidney. miR-17~92 cluster and miR-182-5p associated with cyst progression were increased in expression levels on the kidney.Conclusion: Chronic exposure to ETU at low concentrations results in functional and structural damage to the kidney, and increases cyst formation in the kidney. [ABSTRACT FROM AUTHOR]

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Background: This study was designed to compare the efficacy of remifentanil and alfentanil without the venous occlusion technique in preventing the withdrawal response associated with rocuronium injection in children. Methods: One hundred and twenty children aged between 3 and 10 years were randomly allocated into one of four groups to receive either i.v. remifentanil 0.5 μg·kg−1 (remi 0.5 group), remifentanil 1 μg·kg−1 (remi 1.0 group), alfentanil 15 μg·kg−1 (alfentanil group) or saline 5 ml (saline group). Anesthesia was induced with 2.5% thiopental sodium 5 mg·kg−1 and the test drug was injected over 30 s. One minute later, 1% rocuronium 0.6 mg·kg−1 was injected over 5 s and the response was recorded. Mean arterial pressure (MAP) and heart rate (HR) were recorded on arrival in the operating room, before and 1 min after tracheal intubation. Results: The incidence of withdrawal movement in the saline group (93%) was significantly higher than that in the remi 0.5, remi 1.0, and alfentanil groups (53%, 17%, and 20%, respectively) ( P < 0.05). The incidence in the remi 1.0 and alfentanil groups was significantly less than that in the remi 0.5 group ( P < 0.05). After intubation, MAP and HR were significantly higher in the saline group than that in remi 1.0 and alfentanil groups. Conclusions: Both remifentanil 1 μg·kg−1 and alfentanil 15 μg·kg−1 can be used to prevent rocuronium-associated withdrawal movement in children because they are equally effective and attenuate the increase in MAP and HR after intubation. [ABSTRACT FROM AUTHOR]

Aim: We examined Korean nurses professional quality of life, emotional labour and workplace violence to guide development of interventions to improve nurses professional quality of life. Background: Nurses face heavy exposure to emotional labour and workplace violence. Stress experienced by nurses reduces compassion satisfaction and increases compassion fatigue. Methods: Participants comprised 399 clinical nurses chosen by convenience sampling. Questionnaires measured demographic characteristics, emotional labour, workplace violence and professional quality of life. Results: Nurses professional quality of life was affected by emotional labour and workplace violence. Graduate educational level, emotional exposure and emotional supervision were associated with compassion satisfaction. Burnout was commonly associated with emotional exposure, experience and supervision of workplace violence. Secondary traumatic stress was associated with emotional exposure and experience of workplace violence. Conclusions: We elucidated the relationship between professional quality of life, emotional labour and workplace violence. Raising professional quality of life among nurses requires regular analysis of emotional labour and provision of organizational‐level interventions. Counselling programmes that address violence prevention education and comprehensive response strategies among nurses and policies that foster an organizational culture of respect and cooperation in hospitals are needed. SUMMARY STATEMENT: What is already known about this topic? Promoting nurses professional quality of life is important in managing the quality of nursing care.Nurses with exposure to emotional labour show negative health effects, reduced willingness and ability to work, frequent absences, dissatisfaction and turnoverWorkplace violence negatively affects professional quality of life among clinical nurses. What is already known about this topic? Compassion satisfaction was highly related to organizational management systems for emotional labour and workplace violence.Burnout was associated with the magnitude of exposure to emotional labour and experience of workplace violence and negative organizational management systems for workplace violence.Secondary traumatic stress was associated with the magnitude of exposure to emotional labour and experience of workplace violence. The implications of this paper: To increase nurses professional quality of life, organizational management systems that address and reduce emotional labour and workplace violence are critical.It is necessary to develop programmes that address violence prevention education and comprehensive response strategies regarding emotional labour.Counselling programmes that address violence prevention education and comprehensive response strategies among nurses and policies that foster an organizational culture of respect and cooperation in hospitals are needed. [ABSTRACT FROM AUTHOR]