Choi, Kyunghak;Jung, Kwang-Hwan;Keum, Min Ae;Kim, Sungjeep;Kim, Jihoon T;Kyoung, Kyu-Hyouck
Journal of Trauma and Injury
/
v.33
no.1
/
pp.18-22
/
2020
Purpose: Damage control laparotomy has contributed to improved survival rates for severe abdominal injuries. A large part of severe abdominal injury occurs with a concomitant pelvic bone fracture. The safety and effectiveness of internal fixation of pelvic bone fracture(s) has not been established. The aim of the present study was to evaluate infection risk in the pelvic surgical site in patients who underwent emergent abdominal surgery. Methods: This single-center retrospective observational study was based on data collected from a prospectively maintained registry between January 2015 and June 2019. Patients who underwent laparotomy and pelvic internal fixation were included. Individuals <18 and ≥80 years of age, those with no microbiological investigations, and those who underwent one-stage abdominal surgery were excluded. Comprehensive statistical comparative analysis was not performed due to the small number of enrolled patients. Results: A total of six patients met the inclusion criteria, and the most common injury mechanism was anterior-posterior compression (67%). The average duration of open abdomen was 98 hours (range, 44-98), and the time interval between abdominal closure and pelvic surgery was 98 hours. One patient (16.7%) died due to multi-organ dysfunction syndrome. Micro-organisms were identified in the abdominal surgical site in five patients (83%), with no micro-organisms in pelvic surgical sites. There was no unplanned implant removal. Conclusions: Internal fixation of pelvic bone fracture(s) could be performed in the state of open abdomen, and the advantages of early fixation may countervail the risks for cross contamination.
Shi A Kim;Jae Kwang Yun;Geun Dong Lee;Dong Kwan Kim;Sehoon Choi
Journal of Chest Surgery
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v.56
no.1
/
pp.6-13
/
2023
Background: Coronavirus disease 2019 (COVID-19) has been found to cause life-threatening respiratory failure, which can progress to irreversible lung damage. Lung transplantation can be a life-saving treatment in patients with terminal lung disease (e.g., acute respiratory distress syndrome caused by infection). This study aimed to present the clinical course and results after initial lung transplantation in patients with severe COVID-19 who did not recover even with optimal medical care. Methods: From August 2019 to February 2022, this study enrolled 10 patients with COVID-19 (5 men; median age, 55.7 years) who underwent lung transplantation at a single center in Korea. All patients' characteristics, clinical pathway, overall survival, complications, and operative data were collected and analyzed. Results: Veno-venous extracorporeal membrane oxygenation or an oxygenator in a right ventricular assist device circuit was applied to 90% of the patients, and the median length of extracorporeal life support before operation was 48.5 days. There were no cases of mortality after a median follow-up of 372.8 days (interquartile range, 262.25-489 days). The major complications included the requirement for postoperative extracorporeal membrane oxygenation support in 2 cases (20%), re-transplantation in 1 case (10%), and re-exploration due to bleeding in 2 cases (20%). During the follow-up period, 3 out of 10 patients died. Conclusion: Excellent early outcomes were observed for patients who underwent lung transplantation. Thus, lung transplantation can be an effective and feasible treatment for patients with end-stage lung disease caused by COVID-19.
Acute renal failure is a well known serious complication following open heart surgery and is associated with a significant increase in morbidity and mortality rate. From 1984 to 1990, 33 patients who had acute renal failure following cardiopulmonary bypass received renal replacement therapy. PD[Peritonial dialysis] was employed in 11 patients and CAVH[continous arteriovenous hemofiltration] was employed in 22 patients. Their age ranged from 3 months to 64 years[mean 25.5$\pm$7.8 years]. The disease entities included congenital cardiac anomaly in 18, valvular heart disease in 15 and aorta disease in 2 cases. Low cardiac output was thought as a primary cause of ARF except two redo valve cases who showed severe Aemolysis k depressed renal function preoperatively. Mean serum BUN and creatinine level at the onset renal replacement therapy were 65$\pm$8 mg/dl and 3.5$\pm$0.4 mg/dl respectively, declining only after reaching peak level 7&10 days following the onset of therapy. Overall hospital mortality was 72.7%[24/33]; 81%[9/11] in PD group and 68.2% [15/22] in CAVH group respectively. The primary cause of death was low cardiac output & hemodynamic depression in all the cases. The fatal complications included multiorgan failure in 7, disseminated intravascular coagulation and sepsis in 6, neurologic damage in 4 and mediastinitis in 3 cases. No measurable differences were observed between CAVH and PD group upon consequence of acute renal failure and disease per se. The age at operation, BUN/Cr level at the onset of bypass and highest BUN/Cr level and the consequence of low output status were regarded as important risk factors, determining outcome of ARF and success of renal replacement therapy. Thus, we concluded that althoght the prognosis is largely determined by severity of low cardiac output status and other organ complication, early institution of renal replacement therapy with other intensive supportive measures could improve salvage rate in established ARF patients following CPB.
Azhary, Nevin M Al;Kamel, Mahmoud M;Ismail, Yahia M;Mahmoud, Amal A;Radwan, Enas M
Asian Pacific Journal of Cancer Prevention
/
v.17
no.11
/
pp.4945-4949
/
2016
Background: Breast cancer is the commonest cancer in Egyptian females. Nrf2 is involved in oxidative stress while P73 functions in response to DNA damage. This study aimed to assess the role of Nrf2 promoter and P73 G4C14 to A4T14 SNPs in breast cancer in Egypt. Patients: Eighty-five female patients with breast tumours (41 malignant, 44 benign) were included. Nrf2 (rs6721961) and p73 (G4A) SNPs were determined by PCR- CTPP assay. Results: Genotype frequencies of the Nrf2 promoter SNP were 34.2% and 37.9% for AA in benign and malignant groups respectively, and 43.9% and 40.5% for CC and, 21.9 % and 21.6% for CA. Genotype frequencies for the P73 G4A SNP were 52.9% and 44.7% for GA in benign and malignant groups respectively, and 47.1% and 55.3% for GG. Discussion: Nrf2 genotypes in pre - and post-menopausal patients, showed significantly different distributions in the 2 patient groups, the AA genotype being significantly more common in pre-menopausal patients. The P73 G4A SNP showed no relation to age of disease onset. Conclusion: The Nrf2 (rs6721961) AA genotype might be related to early breast cancer onset. In contrast the P73 G4A polymorphism showed no relation to either disease risk or age at presentation.
Background: Diabetic peripheral polyneuropathy (DPN) is associated with a variety of symptoms. Nerve conduction studies (NCSs) are considered to be the gold standard of nerve damage assessments, but these studies are often dissociated from the subjective symptoms observed in DPN patients. Thus, the aim of the present study was to investigate the correlations between NCS parameters and neuropathic symptoms quantified using the Michigan Neuropathy Screening Instrument (MNSI). Methods: Patients with type 2 diabetes mellitus (T2DM) with or without symptoms of neuropathy were retrospectively enrolled. Demographic data, clinical laboratory data, MNSI score, and NCS results were collected for analysis; DPN was diagnosed based on the MNSI score (${\geq}3.0$) and abnormal NCS results. Pearson's correlation coefficients were used to evaluate the relationships between MNSI score and NCS variables. Results: The final analyses included 198 patients (115 men and 83 women) with a mean age of $62.6{\pm}12.7$ years and a mean duration of diabetes of $12.7{\pm}8.4$ years. The mean MNSI score was 2.8 (range, 0.0-9.0), and 69 patients (34.8%) were diagnosed with DPN. The MNSI score was positively correlated with the median motor nerve latency and negatively correlated with the median motor, ulnar sensory, peroneal, tibial, and sural nerve conduction velocities (NCVs). When the patients were categorized into quartiles according to MNSI score, peroneal nerve conduction velocity was significantly lower in the second MNSI quartile than in the first MNSI quartile (p = 0.001). A multivariate analysis revealed that the peroneal NCV was independently associated with MNSI score after adjusting for age, sex, and glycosylated hemoglobin A1c (HbA1c) levels. Conclusions: The present results indicate that a decrease in peroneal NCV was responsible for early sensory deficits in T2DM patients.
Suicides have been considered to be one of the grave problems of modern societies. According to recent police statistics of Republic of Korea, 28.6 suicides in every 100, 000 were reported. Psychiatric Patients are believed to be predisposed to suicidal tendencies. This study was performed to investigate the characteristics of suicidal attempts and to analyse the environmental factors involved in the suicidal accidents of patients admitted to psychiatric hospitals. Records of 66 suicidal accidents from three psychiatric hospitals during the period of January 1971 through June 1971 were sampled. Data were analysed by percentile score. Results are as follows; 1. The age group of 21~30yrs. was revealed to be the highest in frequency of suicidal attempts (50.0%) Among the unsuccessful suicides; the age group of 31~40yrs. in men and the age group of 21~30 yrs. in women revealed to be the highest in frequency-Among the unsuccessful suicides; the age group of 21-30 yrs. in both sex revealed to be the highest in frequency. 2. Suicidal accidents occurred more frequently to the unmarried(63.6%)- Among the successful suicides; higher frequency was shown to unmarried in men and the frequency is contrasted in women. Among the unsuccessful; the unmarried in both sex were revealed to be highest in frequency. 3. Schizophrenia was revealed the highest of suicidal attempts in frequency (81.8%). 4, Suicides were most frequently attempted in the spring(46, 9%). Among the successful suicides; highest frequencies were shown in men in tile winter and in women in the summer season. Among the unsuccessful suicides :highest frequencies were shown in men in the winter and in women in the spring. 5. Suicidal attempts were most frequently occurred in hospital wards (40.9%), In women, unsuccessful attempts were found to be the highest on authorized leave at their homes. 6. The hanging was revealed to be the most frequently adopted methods for suicidal attempts (31.8%). Among the successful suicides; hanging was the most frequent method adopted in men white in women the drug over-dose, Among the unsuccessful suicides ; stabbing by sharp devices while in women drug-overdosage was adopted as well 7. The most frequently adopted instrument of different suicidal attempts were: house-hold wrapper (26.3%) in cases of hanging, knives (31.8%) in cases of stabbing, and drugs. 8. The suicidal attempts have occurred most frequently at dawn through early morning (2-6A. M.) (34.8%). Among the successful suicides i most frequent time of occurrence on week-days were revealed to be dawn, while on holidays the occurrence were in the evening as well Among the unsuccessful; the most frequent time of occurrence was the day hours while on holidays at dawn. 9. Suicidal attempts within the hospital ward were first noticed by nurses most frequently (42.2%). 10. Manifestations such as restlessness, depression, self-depreciation were revealed to be the most frequent pre-suicidal attempt behavior characteristics. 11. Among the successful suicides ; manifestations of physical damage were found on the neck while among unsuccessful attempts, the damages were found on exterminates.
Ahn, Sang Hyun;Kim, Jae Kyu;Cheon, Jin Hong;Kim, Ki Bong
The Journal of Pediatrics of Korean Medicine
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v.31
no.1
/
pp.43-51
/
2017
Objectives Hataedock method is a Korean medical therapy which removes fetal toxin by orally administering herbal decoction to neonates. This study was to observe skin damage and anti-inflammatory effect via regulating IL-4 activity in NC/Nga mice which were induced atopic dermatitis (AD)-like skin lesion by Dermatophagoides (D.) farinae after applying Douchi Hataedock method. Methods NC/Nga mice with 3 weeks of gestational age were used. Each 10 mice were allocated to the control group (Ctrl), the AD-induced group (AE), and the group which induced AD after administering Douchi extract (GT). After 4 weeks from administering Douchi extract to the mice, the primary AD was induced by applying D. farinae extract 6 times per week for 3 weeks and then the secondary AD was induced by the same method after 1 week from the primary AD induction. To identify the skin damage and anti-inflammatory effect, we observed LxR, IL-4, Fc ${\varepsilon}$ receptor, substance P, and $NF-{\kappa}B$. Results The GT group showed alleviation of skin injury and decrease in capillary angiogenesis. Stratum corneum damage, epithelial cell hyperplasia, lymphocyte infiltration, and capillary distribution relatively decreased in the GT group. LxR-positive reaction in the GT group were increased by 53% than that of the AE group. IL-4 production, $Fc{\varepsilon}$ receptor activity, and substance P-positive reaction in the GT group were decreased by 82%, 42%, and 82% respectively compare to those of the AE group. $NF-{\kappa}B$-positive reaction in the GT group were decreased by 15% compare to that of the AE group. Conclusions Hataedock method with Douchi extract alleviated AD via reducing inflammatory cytokines secreted at the early stage of AD. Thus, Douchi Hataedock method has a beneficial effect for the prevention and treatment of AD.
Avoiding cardiopulmonary bypass (CPB) in coronary artery bypass grafting (CAB G) has been known to reduce early mortality and morbidity. Diabetes Mellitus is a significant risk factor for adverse early and late outcomes after CABG. We compared the clinical results of off-pump CABG versus on-pump CABG in diabetes patients. Material and Method: 682 patients (424 off-pump CABG and 258 on-pump CABG) underwent isolated coronary artery bypass grafting between January 2001 and June 2003. Data were collected 242 patient who had diabetes. Among them, 154 patients underwent off-pump CABG and 90 patients underwent on-pump CABG. We analyzed the preoperative risk factors and postoperative results between 2 groups. Result: Two groups did not show statistical differences in age, sex, coronary and operative risk factors. Operative time was significantly shorter in off-pump CABG, however, number of grafts was fewer in off-pump CABG. Postoperative inotropic usage was lower in off-pump CABG. Postoperative CK-MB level was lower in off-pump CABG, and ICU stay and ventilation time was significantly shorter in off-pump CABG. However, there was no statistical difference between 2 groups in operative mortality, reoperation rate, perioperative myocardial infarction, wound infection, renal failure, neurological complications and hospital stay. Conclusion: Off-pump CABG group showed less myocardial damage and early recovery. We concluded that off-pump CABG is the more reasonable technique in diabetes patients although two techniques showed good results. The long-term follow up and prospective study may be warranted.
Ku, Bon-Il;Choi, Min-Kyu;Kang, Shin-Ku;Park, Tae-Seon;Kim, Young-Doo;Park, Hong-Kyu;Ko, Jae-Kwon;Lee, Byun-woo
Journal of the Korean Society of International Agriculture
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v.23
no.5
/
pp.520-530
/
2011
This study was carried out to evaluate the possibility of rice double cropping in Korea by assessing the growth and yield performance of rice cultivars transplanted at the extremely-early date. When the transplanted rice seedling was exposed to low temperature below 0℃, the survival rate decreased drastically. However, short exposure to below 0℃ one or two times did not damage transplanted rice seedling so severely. Thus, the earliest transplanting in spring would be possible when minimum temperature rises above 0℃. Compared with the conventional seedling nursery tray (CSNT), seedling rearing with the potted nursery tray was more effective for increasing leaf age and seedling dry weight during nursery period. In the first rice cropping, rice cultivation with seedlings reared in PSNT showed shorter growth duration and cumulative temperature from transplanting to heading than that with seedlings reared in CSNT. The earliest heading date on July 4 in Jinbuolbyeo was earlier by two to three days than that of Dunaebyeo. If rice has not exposed to cold damage, the earliest heading date of Jinbujolbyeo can advance to June 30 or July 1. In this case, rice harvest would be possible on August 5, enabling the rice transplanting of the second rice cropping before August 10. At transplanting time with low temperature damage rice yield were less than 400 kg/10a while rice yield exceeded 400 kg/10a at transplanting time without low temperature damage.
Recently, in order to reduce a damage of chloride attack and hydration heat in marine concrete structures, blended cement in mixing the marine concrete is widely used. Long term strength development is distinct in concrete with blended cement and it also has excellent resistance to chloride attack and reduction of hydration heat. However, blended cement has a characteristic of relatively low compressive strength in early age of 28 days. On the other hand, a high level of compressive strength is required in the Standard Specification for marine concrete mix design. Such concrete mix design satisfying Standard Specification is effective to chloride attack but disadvantageous for hydration heat reduction due to large quantity of binder. In this study, the material properties of marine concrete considering water-binder ratio and binder type are experimentally investigated. Through the research results, compressive strength in blended cement at the age of 56 days is similar although it has smaller compressive strength at the age of 28 days compared with result of OPC (ordinary portland cement). Even though blended cement has a large water-binder ratio and small unit of binder content, chloride ion diffusion coefficient is still small and hydration heat is also found to be reduced. For meeting the required compressive strength in Standard Specification for marine concrete at 28 days, the increased unit content of binder is needed but the increased hydration heat is also expected.
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