• Title/Summary/Keyword: intervention treatment

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Needle Decompression for Trauma Patients: Chest Wall Thickness and Size of the Needle (외상 환자에 대한 바늘감압술에서 흉벽 두께와 바늘 길이의 관계)

  • Kim, Jee-Wan;Jeong, Jin-Woo;Cho, Suck-Ju;Yeom, Seok-Ran;Han, Sang-Kyoon;Park, Sung-Wook
    • Journal of Trauma and Injury
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    • v.23 no.2
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    • pp.63-67
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    • 2010
  • Purpose: A tension pneumothorax is a fatal condition that requires immediate intervention. Although a definitive treatment for a tension pneumothorax is a tube thoracostomy, needle decompression can provide temporary relief, that is lifesaving. The traditional procedure for needle decompression involves inserting a needle or catheter at the second intercostal space, the midclavicular line. Recent evidence suggests that the commonly used catheters do not have sufficiently penetrate the chest wall. There are also claims that a lateral approach to needle decompression is easier and safer than the traditional anterior approach. The purpose of this study is to evaluate the optimal approach for needle decompression for the Korean population by measuring chest wall thicknesses at the points used for both the anterior and the lateral approaches. Methods: The chest wall thickness (CWT) of trauma victims who visited the Emergency Center of Pusan National University Hospital was measured by computed tomography (CT) images. The CWT was measured at the points used for the anterior and the lateral methods and was compared with the length of commonly used catheters, which is 45 mm. Results: The mean CWT at the second intercostal space, the midclavicular line, was shorter than the CWT at the 5th intercostal space, the anterior axillary line. However, the percentage of patients whose CWT was greater than 45 mm was larger when measured anteriorly (8.2%) that when measure laterally (5.7%). Female patients and those older than 60 were more likely to have an anterior CWT greater than 45 mm (28.2% for females and 15.5% for those older than 60). Conclusion: The percentage of trauma victims in Korea whose CWT is greater than 45 mm is lower than the values previously reported by other countries. However, females and older patients tend to have thicker chest walls, so the lateral approach would be suggested when performing needle decompression for such patients with suspected tension pneumothoraces.

β-lapachone-Induced Apoptosis of Human Gastric Carcinoma AGS Cells Is Caspase-Dependent and Regulated by the PI3K/Akt Pathway

  • Yu, Hai Yang;Kim, Sung Ok;Jin, Cheng-Yun;Kim, Gi-Young;Kim, Wun-Jae;Yoo, Young Hyun;Choi, Yung Hyun
    • Biomolecules & Therapeutics
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    • v.22 no.3
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    • pp.184-192
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    • 2014
  • ${\beta}$-lapachone is a naturally occurring quinone that selectively induces apoptotic cell death in a variety of human cancer cells in vitro and in vivo; however, its mechanism of action needs to be further elaborated. In this study, we investigated the effects of ${\beta}$-lapachone on the induction of apoptosis in human gastric carcinoma AGS cells. ${\beta}$-lapachone significantly inhibited cellular proliferation, and some typical apoptotic characteristics such as chromatin condensation and an increase in the population of sub-G1 hypodiploid cells were observed in ${\beta}$-lapachone-treated AGS cells. Treatment with ${\beta}$-lapachone caused mitochondrial transmembrane potential dissipation, stimulated the mitochondria-mediated intrinsic apoptotic pathway, as indicated by caspase-9 activation, cytochrome c release, Bcl-2 downregulation and Bax upregulation, as well as death receptor-mediated extrinsic apoptotic pathway, as indicated by activation of caspase-8 and truncation of Bid. This process was accompanied by activation of caspase-3 and concomitant with cleavage of poly(ADP-ribose) polymerase. The general caspase inhibitor, z-VAD-fmk, significantly abolished ${\beta}$-lapachone-induced cell death and inhibited growth. Further analysis demonstrated that the induction of apoptosis by ${\beta}$-lapachone was accompanied by inactivation of the phosphatidylinositol 3-kinase (PI3K)/Akt signaling pathway. The PI3K inhibitor LY29004 significantly increased ${\beta}$-lapachone-induced apoptosis and growth inhibition. Taken together, these findings indicate that the apoptotic activity of ${\beta}$-lapachone is probably regulated by a caspase-dependent cascade through activation of both intrinsic and extrinsic signaling pathways, and that inhibition of the PI3K/Akt signaling may contribute to ${\beta}$-lapachone-mediated AGS cell growth inhibition and apoptosis induction.

Spermidine Protects against Oxidative Stress in Inflammation Models Using Macrophages and Zebrafish

  • Jeong, Jin-Woo;Cha, Hee-Jae;Han, Min Ho;Hwang, Su Jung;Lee, Dae-Sung;Yoo, Jong Su;Choi, Il-Whan;Kim, Suhkmann;Kim, Heui-Soo;Kim, Gi-Young;Hong, Su Hyun;Park, Cheol;Lee, Hyo-Jong;Choi, Yung Hyun
    • Biomolecules & Therapeutics
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    • v.26 no.2
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    • pp.146-156
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    • 2018
  • Spermidine is a naturally occurring polyamine compound that has recently emerged with anti-aging properties and suppresses inflammation and oxidation. However, its mechanisms of action on anti-inflammatory and antioxidant effects have not been fully elucidated. In this study, the potential of spermidine for reducing pro-inflammatory and oxidative effects in lipopolysaccharide (LPS)-stimulated macrophages and zebrafish was explored. Our data indicate that spermidine significantly inhibited the production of pro-inflammatory mediators such as nitric oxide (NO) and prostaglandin $E_2$ ($PGE_2$), and cytokines including tumor necrosis $factor-{\alpha}$ and $interleukin-1{\beta}$ in RAW 264.7 macrophages without any significant cytotoxicity. The protective effects of spermidine accompanied by a marked suppression in their regulatory gene expression at the transcription levels. Spermidine also attenuated the nuclear translocation of $NF-{\kappa}B$ p65 subunit and reduced LPS-induced intracellular accumulation of reactive oxygen species (ROS) in RAW 264.7 macrophages. Moreover, spermidine prevented the LPS-induced NO production and ROS accumulation in zebrafish larvae and was found to be associated with a diminished recruitment of neutrophils and macrophages. Although more work is needed to fully understand the critical role of spermidine on the inhibition of inflammation-associated migration of immune cells, our findings clearly demonstrate that spermidine may be a potential therapeutic intervention for the treatment of inflammatory and oxidative disorders.

Aerodynamic Features and Voice Therapy Interventions of Functional Voice Disorder after Thyroidectomy (갑상선 절제 술 후 기능적 음성장애의 공기역학적 특징과 음성치료 중재)

  • Lee, Chang-Yoon;An, Soo-Youn;Chang, Hyun;Jeong, Hee Seok;Son, Hee Young
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.26 no.1
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    • pp.25-33
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    • 2015
  • Background and Objectives:The objective of this study was to investigate the features of post-thyroidectomy subjective voice disorder by Voice Handicap Index (VHI) and Voice Symptom Scale (VOISS) through aerodynamic analysis and to investigate the appropriate voice therapy intervention. Materials and Methods:Twenty post-thyroidectomy patients who had no recurrent laryngeal nerve paralysis through laryngeal stroboscopy were enrolled for this study. Acoustic and aerodynamic evaluations were performed before operation, 2 weeks and 3 months after operation. Subjective voice evaluation was performed by VHI and VOISS. Aerodynamic evaluation was compared and analysed by maximum phonation time(MPT), phonation threshold pressure(PTP), mean air flow rate(MFR), etc. Subjective voice evaluation was surveyed through VHI and VOISS. To evaluate patients' symptoms related to functional voice disorder, scores on physical domain in VHI and VOISS were selected to be compared for each session. Results: The 10 out of 20 participants who complained of voice symptoms had no significant difference with pre-operation in acoustic evaluation, but all showed higher scores on 2 weeks and 3 months after operation compared to pre-operation, in VHI-physical domain and selected questionnaires in VOISS. They reduced MPT and increased PTP value simultaneously. Laryngeal massage and breathing training were simultaneously treated to them, 5 participants resulting in improvement in MPT and PTP compared to pre-treatment. Conclusion:Patients who complained voice change with no organic damage after thyroidectomy were all shown to have reduced MPT and increased PTP in some by aerodynamic evaluations. Reduced MPT may imply some problem in air flow beneath glottis. Increased PTP suggests much more effort in vocalization mechanism than pre-operation. Comparing aerodynamic evaluations in post-thyroidectomy may provide information on behavioral interventions. Additionally, study on laryngeal massage and breathing training simultaneously treated to patients with such voice disorder is needed to be conducted with larger number of participants.

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Early caries detection using optical coherence tomography: a review of the literature (광간섭단층촬영술을 이용한 치아우식증의 발견)

  • Park, Young-Seok;Cho, Byeong-Hoon;Lee, Seung-Pyo;Shon, Won-Jun
    • Restorative Dentistry and Endodontics
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    • v.36 no.5
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    • pp.367-376
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    • 2011
  • Early detection of carious lesions increases the possibility of treatment without the need for surgical intervention. Optical coherence tomography (OCT) is an emerging three-dimensional imaging technique that has been successfully used in other medical fields, such as ophthalmology for optical biopsy, and is a prospective candidate for early caries detection. The technique is based on low coherence interferometry and is advantageous in that it is non-invasive, does not use ionizing radiation, and can render threedimensional images. A brief history of the development of this technique and its principles are discussed in this paper. There have been numerous studies on caries detection, which were mostly in vitro or ex vivo experiments. Through these studies, the feasibility of OCT for caries detection was confirmed. However, further research should be performed, including in vivo studies of OCT applications, in order to prove the clinical usefulness of this technique. In addition, some technological problems must be resolved in the near future to allow for the use of OCT in everyday practice.

Effects of Chitosan on the Toxicity of Environmental Pollutants (해양바이오물질이 PCB의 독성작용에 미치는 영향)

  • Lee, Hyon-Gyo;Kim, Hae-Young;Yang, Jae-Ho
    • Journal of Marine Bioscience and Biotechnology
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    • v.2 no.2
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    • pp.102-107
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    • 2007
  • Environmental contamination becomes a great public concern as our society gets industrialized rapidly. The present study examine the role of chitosan in a effort to intervene the environmental pollutant-induced toxicity. PCB-induced neurotoxicity with respect to the PKC signaling was examined. Since the developing neuron is particularly sensitive to PCB-induced neurotoxicity, we isolated cerebellar granule cells derived from 7-day old SD rats and grew cells in culture for additional 7 days to mimic PND-14 conditions. PCB showed the alteration of PKC signaling pathway. The alteration was structure-dependent. Mono-ortho-substituted congeners at a high dose showed a significant increase of total PKC activity at [$^3H$]PDBu binding assay, indicating that mono-ortho-substituted congeners are more neuroactive than non-ortho-substituted congeners in neuronal cells. PKC isoforms were immunoblotted with respective monoclonal antibodies. PKC-beta II and -epsilon were activated with mono-ortho-substituted congeners exposure. The result suggests that the position with ortho has a higher potential of altering the signaling pathway. Alteration of PKC was blocked with treatment of high molecular weight of chitosan. The study demonstrated that the ortho position in PCBs are important in assessing the structure-activity relationship. The results suggest a potential use of marine bioactive materials as a means of nutritional intervention to prevent the harmful effects of pollutant-derived toxicity.

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Standard Clinical Procedure(Critical Pathway) on Dental Conscious Sedation for the Disabled Children (장애아동 진정치료에 대한 표준진료지침의 개발)

  • Kim, Minsu;Bae, Youngeun;Kim, Jiyeon;Jo, Anna;Yoon, Hyunseo;Song, Eunju;Jeong, Taesung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.42 no.3
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    • pp.226-232
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    • 2015
  • Critical pathway (CP) defines the optimal care process, sequencing and timing of intervention by multidisciplinary health care teams for a particular diagnosis and procedure. The aim of the study was to evaluate the clinical usefulness and the satisfaction of patients and dental staff after implementation of a critical pathway for the dental treatment of disabled children and adolescents under conscious sedation. Thirty patients are divided in two groups (Pre-CP and CP) at the department of Pediatric Dentistry of Pusan National University Dental Hospital. The satisfaction levels of patients/guardians and the staff members were collected by survey questionnaire. The parents' satisfaction was significantly improved after the implementation of CP. Also, medical/dental staff members were highly satisfied with its usefulness. The application of a critical pathway for disabled children and adolescents might be useful and improve the satisfaction of the parents and medical/dental staff members.

The Factors Affecting the Registration Rates for Emergency Department Based Post-suicidal Care Program (응급실 기반 자살 시도자 사후 관리사업의 등록률에 영향을 미치는 인자)

  • Lee, Junchul;Kang, Hyung Goo;Kim, Changsun;Oh, Jaehoon;Lim, Taeho;Ahn, Dong Hyun;Lee, Jung Im;Park, Min Hee;Kim, Kyung Hee
    • Journal of The Korean Society of Clinical Toxicology
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    • v.13 no.1
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    • pp.25-32
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    • 2015
  • Purpose: The aim of this study was to investigate the independent factors associated with the registration rate for the community-based post suicidal care program in the emergency department (ED). Methods: This prospective observational study was conducted between March and December 2013 at the academic ED at the tertiary urban hospital. During the study period, the pre-designed registry was recorded. The variables examined included the following: patients' demographic data (Sex, age, address, type of insurance, marital status, level of education, and history of previous psychiatric disease), suicide-related data (suicidal methods, combined drink of alcohol and number of previous attempts), and management-related data (disposition at ED, physician's training level, etc.). Univariated and multivariated logistic regression analyses were performed for identification of factors affecting the registration rate for the community-based post suicidal care program. Results: A total of 163 suicides were included during the study period. Of these, 33 (20.2%) patients were registered in the post-suicide care program. Factors including a patient's address (OR: 14.92, 95% CI: 3.606-61.711), immediate intervention by psychiatric healthcare center (OR: 5.05, CI: 1.688-15.134), admissions in hospital (OR: 3.69, CI: 1.286-10.605), and history of previous psychiatric disease (OR: 3.52, CI: 1.216-10.201) showed significant association with registration for the program. Conclusion: The community-based post-suicidal care program, which is available 24 hours a day, should be operated in each district in order to increase the registration rate. Emergency physicians should actively consider the inpatient treatment program for suicidal patients and strongly recommend registration to the program, particularly for patients without previous history of psychiatric disease.

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The Change of Cardiothoracic Ratio after Ligation of Patent Ductus Arteriosus in Adult -Report of 30 cases- (성인의 동맥관 개존증 결찰술 시행후 심흉비의 변화 -30례 보고-)

  • 황상원;이연재;김한용;유병하
    • Journal of Chest Surgery
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    • v.32 no.1
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    • pp.22-26
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    • 1999
  • Background: Treatment of adult patent ductus arteriosus(PDA) has many difficulty such as pulmonary hypertension, arterial wall calcification, aneurysmal chage of ductus. We tried to evaluate the effect of surgical interruption of PDA on postopeative change of heart size. Material and Method : From 1987 to 1997 we experienced 30 cases of the ligation of patent ductus arteriosus in adult at the department of cardiovacular surgery in Masan Samsung General Hospital. Result: There were 9 males and 21 females and their ages ranged from 16 to 44 years, with a mean age of 26.1 years. 15 patients had pulmonary hypertension and 9 patients complained of dyspnea with a degree of functional NYHA class III. Operation method was double or triple ligation using Teflon felt. Postoperative complications were wound dehiscence in 3 patients and transient hoarseness in 1 patient. The mean preoperative cardiothoracic ratio was 54.7%, and mean postoperative cardiothoracic ratio was 51.9%. The change of cardiothoracic ratio was more typical in the cases who had congestive heart failure. Their mean preoperative cardiothoracic ratio was 64.8% and the mean postoperative cardiothoracic ratio was 58.5% there was no postoperative deaths. Conclusion: We canclude that the improvement in cardiothoracic ratio may result from surgical intervention of PDA.

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CHARACTERISTICS OF THE SALIVARY PROTEINS IN THE CHILDREN WITH RAMPANT DENTAL CARIES (다발성 치아우식증 소아에서 타액 단백질의 특성)

  • Yang, Ho-Jeong;Chang, Hee-Soon;Lee, Sung-Ill;Choi, Byung-Jai
    • Journal of the korean academy of Pediatric Dentistry
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    • v.23 no.2
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    • pp.415-427
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    • 1996
  • As a part of host factors of dental caries, saliva has been well known for its important role in relation to dental caries. The studies on its physical and chemical characteristics on development and progress of dental caries has been conducted. Recently, various comparisons between saliva of caries-susceptable individuals and caries-free individuals has been done and the efforts to understand the mechanisms of salivary intervention of development and progress of dental caries is actively in progress. In this study, 15 children with rampant dental caries and 15 caries free children without any systemic diseases from the ages of 2 to 5 were chosen for the experiment and the whole saliva and parotid saliva from each individuals were collected and protein compositions were compared using polyacrylamide gel electrophoresis (PAGE). As results of this study, in parotid saliva, there was no difference in protein compositions between the rampant dental caries and the caries free children. While electrophoresis was done with the whole saliva, protein with 120 KDa was found in children with rampant dental caries. However, this protein was not found or unclear, if any for the caries free group. (Exceptionally, clear protein band was present for one person.) Protein compositions of whole saliva of rampant dental caries group was compared before and after the caries control and thick and clear protein bands of about 120 KDa were found in both cases. Protein compostions of caries free children and adults were identical. Quantitative analysis of protein was done for the rampant dental caries group and the control group and no significant difference was found. Taken all together, protein with molecular weight of 120 KDa, found in rampant dental caries group, was still present when the treatment for the dental caries was done so it can be assumed that this protein has no interrelation with the presence of active carious lesions during saliva collecting. It can also be presumed that this specific salivary protein with the molecular weight of 120 KDa found in rampant dental caries group has effect on development and progress of dental caries. Identification on this protein with the molecular-weight of 120 KDa and the role of this protein against dental caries remain to be solved.

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