• Title/Summary/Keyword: treatment delays

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Evidence-based management of isolated dentoalveolar fractures: a systematic review

  • Samriddhi Burman;Babu Lal;Ragavi Alagarsamy;Jitendra Kumar;Ankush Ankush;Anshul J. Rai;Md Yunus
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.50 no.3
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    • pp.123-133
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    • 2024
  • Dentoalveolar (DA) trauma, which can involve tooth, alveolar bone, and surrounding soft tissues, is a significant dentofacial emergency. In emergency settings, physicians might lack comprehensive knowledge of timely procedures, causing delays for specialist referral. This systematic review assesses the literature on isolated DA fractures, emphasizing intervention timing and splinting techniques and duration in both children and adults. This systematic review adhered to PRISMA guidelines and involved a thorough search across PubMed, Google Scholar, Semantic Scholar, and the Cochrane Library from January 1980 to December 2022. Inclusion and exclusion criteria guided study selection, with data extraction and analysis centered on demographics, etiology, injury site, diagnostics, treatment timelines, and outcomes in pediatric (2-12 years) and adult (>12 years) populations. This review analyzed 26 studies, categorized by age into pediatrics (2-12 years) and adults (>12 years). Falls were a common etiology, primarily affecting the anterior maxilla. Immediate management involved replantation, repositioning, and splinting within 24 hours (pediatric) or 48 hours (adult). Composite resin-bonded splints were common. Endodontic treatment was done within a timeframe of 3 days to 12 weeks for children and 2-12 weeks for adults. Tailored management based on patient age, tooth development stage, time elapsed, and resource availability is essential.

A retrospective analysis of toxic alcohol poisoning (급성 독성 알코올 중독에 대한 후향적 분석)

  • Jin Kim;Yu Jin Lee;Tae Kyu Ahn;Soo Kang
    • Journal of The Korean Society of Clinical Toxicology
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    • v.21 no.2
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    • pp.143-150
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    • 2023
  • Purpose: This study aimed to compare the clinical features of methanol and ethylene glycol poisoning. Methods: This single-center retrospective observational study included patients with toxic alcohol poisoning who visited a regional emergency medical center. Patients with methanol and ethylene glycol poisoning from January 2004 to June 2023 were selected for the study using diagnostic codes. Results: Twenty-two patients with toxic alcohol poisoning visited during the study period, with 11 patients for each category. Compared to methanol poisoning, ethylene glycol poisoning patients were more likely to have consumed alcohol for suicidal purposes (n=4 [36.36%] vs. n=8 [72.73%]) and were more likely to be drowsy (n=0 vs. n=6 [54.55%], p=0.016). The anion gap (25.43±8.35 mmol/L vs. 13.22±6.23 mmol/L, p=0.001) and lactic acid levels (1.785 [1.3-2.785] mmol/L vs. 9.90 [4.20-11.81] mmol/L, p=0.007) were higher in ethylene glycol poisoning patients than in methanol poisoning patients. Among alcohol dehydrogenase blockers, oral ethanol was administered to 10 patients (45.45%) (n=4 [36.36%] vs. n=6 [54.55%]), and intravenous ethanol was administered to six patients (n=4 [36.36%] vs. n=2 [18.18%]). Fomepizole was administered to two patients (9.09%) each, and renal replacement therapy was non-significantly more common in patients with ethylene glycol poisoning (n=8 [72.73%] vs. n=3 [27.27%], p=0.128). Three patients had delays in diagnosis and treatment, and while there were no fatalities, one patient was left with permanent vision damage. Conclusion: Because these are uncommon types of poisoning and the clinical presentation is difficult to recognize early, healthcare providers should be familiar with toxic alcohol types and screen for them to ensure proper diagnosis and treatment.

Mechanism of Wenshen Xuanbi Decoction in the treatment of osteoarthritis based on network pharmacology and experimental verification

  • Hankun You;Siyuan Song;Deren Liu;Tongsen Ren;Song Jiang Yin;Peng Wu;Jun Mao
    • The Korean Journal of Physiology and Pharmacology
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    • v.28 no.1
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    • pp.59-72
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    • 2024
  • To investigate the mechanism of Wenshen Xuanbi Decoction (WSXB) in treating osteoarthritis (OA) via network pharmacology, bioinformatics analysis, and experimental verification. The active components and prediction targets of WSXB were obtained from the TCMSP database and Swiss Target Prediction website, respectively. OA-related genes were retrieved from GeneCards and OMIM databases. Protein-protein interaction and functional enrichment analyses were performed, resulting in the construction of the Herb-Component-Target network. In addition, differential genes of OA were obtained from the GEO database to verify the potential mechanism of WSXB in OA treatment. Subsequently, potential active components were subjected to molecular verification with the hub targets. Finally, we selected the most crucial hub targets and pathways for experimental verification in vitro. The active components in the study included quercetin, linolenic acid, methyl linoleate, isobergapten, and beta-sitosterol. AKT1, tumor necrosis factor (TNF), interleukin (IL)-6, GAPDH, and CTNNB1 were identified as the most crucial hub targets. Molecular docking revealed that the active components and hub targets exhibited strong binding energy. Experimental verification demonstrated that the mRNA and protein expression levels of IL-6, IL-17, and TNF in the WSXB group were lower than those in the KOA group (p < 0.05). WSXB exhibits a chondroprotective effect on OA and delays disease progression. The mechanism is potentially related to the suppression of IL-17 and TNF signaling pathways and the down-regulation of IL-6.

A Study on the Improvement of Delay Compensation System in Defense Industry R&D (방위산업 R&D 지체상금 제도 개선방안 연구)

  • Kim, Sun-Young
    • Industry Promotion Research
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    • v.5 no.3
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    • pp.37-44
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    • 2020
  • Currently, the delayed compensation system, which does not reflect the R&D characteristics of the defense industry, is being applied, causing problems such as worsening management of defense companies and delayed power generation. The purpose of this study is to contribute to the development of the defense industry and the efficient promotion of combat capability by studying the improvement plan of the delayed compensation system reflecting the R&D characteristics of the defense industry. The research analyzed the defense industry R&D characteristics, national R&D, delayed compensation rate, reduction and exemption procedures and existing studies. Further, the Delphi technique was applied based on the status of the delayed compensation and the analysis of the cause of delay. It has been studied that it is not appropriate to apply the 'manufacturing and purchasing' standard of commercial products to defense industry R&D where the latest technology is applied and the success is unclear. Four measures were drawn to prevent delays, including the selection of excellent technology companies, and three measures to reduce delay compensation and apply differentials for rational treatment in case of delays. Just as the defense industry R&D is carried out under the Defense Acquisition Program Act due to the nature of the R&D industry, the defense industry will develop if the delayed compensation system is improved to reflect the R&D characteristics of the defense industry, and it will contribute to the acquisition of an efficient and economic weapons system.

Improvement of the Trauma Care Process by Implementation of a Computerized Physician Order Entry-Based Trauma Team Approach

  • Lee, Ji-hwan;Lee, Jin-hee;You, Je-sung;Chung, Sung-phil;Kim, Hyun-jong;Cho, Jun-ho;Kim, Min-joung;Chung, Hyun-soo
    • Quality Improvement in Health Care
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    • v.21 no.2
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    • pp.12-24
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    • 2015
  • Purpose: The need for the rapid evaluation and treatment of emergency department patients with major trauma is essential. A computerized physician order entry (CPOE) system can improve communication and provide immediate access to information with the goal of reducing ED time delays. The aim of this study was to report on the operation of a trauma CPOE program and demonstrate its usefulness by comparing time intervals from ED arrival to various evaluation steps before and after implementation of the program. Methods: This was a before-and-after observational study from a single emergency department at an academic center. The CPOE program was implemented for 6 months and compared with the data collected from the pre-CPOE implementation period. The efficacy of the program was assessed by comparing the time difference before and after CPOE implementation based on the following factors: total boarding time in ED, door-to-disposition decision time, door-to-blood-test report time, door-to-X-ray time, door-to-CT time, and door-to-transfusion time. Results: Over a period of 6 months, the CPOE was activated for a total of 17 patients. Total boarding time was reduced significantly after implementation [median, 641.5 minutes (IQR, 367.3-859.3) versus289.0 minutes (IQR, 140.0-508.0) for pre-CPOE vs. post-CPOE, respectively, p< 0.05). Time intervals for all evaluation steps were reduced after implementation of the program. The improvements in the door-to-blood-test and door-to-CT times were both statistically significant. Conclusion: This study demonstrated that a standard CPOE system can be successfully implemented and can reduce ED time delays in managing trauma patients.

Fragile X Syndrome and it's Association with Autism (약체X염색체 증후군과 자폐증과의 연관)

  • Yang, Moon-Bong
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.3 no.1
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    • pp.147-157
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    • 1992
  • The fragile X syndrome, which is considered to be synonymous with the Martin-Bell syndrome, is a relatively common form of X-linked mental retardation. The syndrome seems to occure in many different ethnic groups and its prevalence among mentally retarded males has been estimated to be in the order of 2 to 6%. The karyotypic hallmark of the syndrome is made up with a pronounced constriction near each tip of the long arm of the X chromosome(fragile site), shown in vitro only under conditions in which thymidylate production is blocked(lowered folate levels). Special culture media are needed to demonstrate this constriction site. Major clinical features associated with the syndrome include macroorchidism, large or prominent ears, significant emotional and behavioral dysfunctions such as hyperactivity, self-injury, lack of eye contact and social interaction, schizophrenia, autism, etc., and speech and language dysfunctions ranging from nonverbal to verbal speech with moderate to severe expressive language delays. Some have minor clinical features in common such as an increase in birth weight high forehead, prognathism, increased head circumference in infancy and childhood which did not persist into adult life. The recent research findings have shown that the fragile X syndrome is associated with infantile autism. Many patients with the fragile X syndrome fulfill the diagnostic criteria for infantile autism. Therefore it is recommendable that any patient with developmental delays and autism or autistic manifestations should have a chromosomal analysis, including fragile X examination. In the present review, historical aspects, incidence, and clinical features are presented. Recent anecdotal reports of the association with autism and the clinical improvement following high dose folic acid treatment will be discussed.

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SonazoidTM versus SonoVue® for Diagnosing Hepatocellular Carcinoma Using Contrast-Enhanced Ultrasound in At-Risk Individuals: A Prospective, Single-Center, Intraindividual, Noninferiority Study

  • Hyo-Jin Kang;Jeong Min Lee;Jeong Hee Yoon;Jeongin Yoo;Yunhee Choi;Ijin Joo;Joon Koo Han
    • Korean Journal of Radiology
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    • v.23 no.11
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    • pp.1067-1077
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    • 2022
  • Objective: To determine whether Sonazoid-enhanced ultrasound (SZUS) was noninferior to SonoVue-enhanced ultrasound (SVUS) in diagnosing hepatocellular carcinoma (HCC) using the same diagnostic criteria. Materials and Methods: This prospective, single-center, noninferiority study (NCT04847726) enrolled 105 at-risk participants (71 male; mean age ± standard deviation, 63 ± 11 years; range, 26-86 years) with treatment-naïve solid hepatic nodules (≥ 1 cm). All participants underwent same-day SZUS (experimental method) and SVUS (control method) for one representative nodule per participant. Images were interpreted by three readers (the operator and two independent readers). All malignancies were diagnosed histopathologically, while the benignity of other lesions was confirmed by follow-up stability or pathology. The primary endpoint was per-lesion diagnostic accuracy for HCC pooled across three readers using the conventional contrast-enhanced ultrasound diagnostic criteria, including arterial phase hyperenhancement followed by mild (assessed within 2 minutes after contrast injection) and late (≥ 60 seconds with a delay of 5 minutes) washout. The noninferiority delta was -10%p. Furthermore, different time delays were compared as washout criteria in SZUS, including delays of 2, 5, and > 10 minutes. Results: A total of 105 lesions (HCCs [n = 61], non-HCC malignancies [n = 19], and benign [n = 25]) were evaluated. Using the 5-minutes washout criterion, per-lesion accuracy of SZUS pooled across the three readers (72.4%; 95% confidence interval [CI], 64.1%-79.3%) was noninferior to that of SVUS (71.4%; 95% CI, 63.1%-78.6%), meeting the statistical criterion for non-inferiority (difference of 0.95%p; 95% CI, -3.8%p-5.7%p). The arterial phase hyperenhancement combined with the 5-minutes washout criterion showed the same sensitivity as that of the > 10-minutes criterion (59.0% vs. 59.0%, p = 0.989), and the specificities were not significantly different (90.9% vs. 86.4%, p = 0.072). Conclusion: SZUS was noninferior to SVUS for diagnosing HCC in at-risk patients using the same diagnostic criteria. No significant improvement in HCC diagnosis was observed by extending the washout time delay from 5 to 10 minutes.

Fruit Quality of 1-Methylcyclopropene Treated 'Formosa' Plum on the Shelf Life at Ambient Temperature (1-Methylcyclopropene이 'Formosa' 자두의 품질과 유통기간 연장)

  • Jung, Jae-Hoon;Kim, Young-Chil;Jung, Seok-Kyu
    • Horticultural Science & Technology
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    • v.28 no.3
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    • pp.429-433
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    • 2010
  • The effects of 1-methylcyclopropene (1-MCP) for controlling ripening processes such as weight loss, fruit softening, soluble solids content (SSC), titratable acidity (TA), and fruit skin color were investigated and also the possibility that 1-MCP can inhibit the development of brown rot was explored in 'Formosa' plum ($Prunus$ $domestica$ L.). Fruit were treated with $1{\mu}L{\cdot}L^{-1}$ 1-MCP on the day of harvest and one day after harvest for 16 h at ambient temperature ($20^{\circ}C$), followed by 14 days of shelf life. 1-MCP treatment delayed fruit softening, weight loss and changes in skin color and TA during the shelf life period, but did not affect SSC. These 1-MCP effects were similar with and without delayed treatment. 1-MCP treatment inhibited the development of brown rot caused by $Monilinia$ $laxa$ during storage. Our data shows that treatment delays of ${\geq}1$ day before 1-MCP application had no negative effect of fruit softening, fruit skin color, and TA at ambient temperature ($20^{\circ}C$). Overall, these results indicate that 1-MCP can be used to maintain the quality of non-refrigerated plums.

4-F-PCP, a Novel PCP Analog Ameliorates the Depressive-Like Behavior of Chronic Social Defeat Stress Mice via NMDA Receptor Antagonism

  • Darlene Mae D., Ortiz;Mikyung, Kim;Hyun Jun, Lee;Chrislean Jun, Botanas;Raly James Perez, Custodio;Leandro, Val Sayson;Nicole, Bon Campomayor;Chaeyeon, Lee;Yong Sup, Lee;Jae Hoon, Cheong;Hee Jin, Kim
    • Biomolecules & Therapeutics
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    • v.31 no.2
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    • pp.227-239
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    • 2023
  • Major depressive disorder is a leading cause of disability in more than 280 million people worldwide. Monoamine-based antidepressants are currently used to treat depression, but delays in treatment effects and lack of responses are major reasons for the need to develop faster and more efficient antidepressants. Studies show that ketamine (KET), a PCP analog, produces antidepressant effects within a few hours of administration that lasts up to a week. However, the use of KET has raised concerns about side effects, as well as the risk of abuse. 4 -F-PCP analog is a novel PCP analog that is also an NMDA receptor antagonist, structurally similar to KET, and might potentially elicit similar antidepressant effects, however, there has been no study on this subject yet. Herein, we investigate whether 4-F-PCP displays antidepressant effects and explored their potential therapeutic mechanisms. 4-F-PCP at 3 and 10 mg/kg doses showed antidepressant-like effects and repeated treatments maintained its effects. Furthermore, treatment with 4-F-PCP rescued the decreased expression of proteins most likely involved in depression and synaptic plasticity. Changes in the excitatory amino acid transporters (EAAT2, EAAT3, EAAT4) were also seen following drug treatment. Lastly, we assessed the possible side effects of 4-F-PCP after long-term treatment (up to 21 days). Results show that 4-F-PCP at 3 mg/kg dose did not alter the cognitive function of mice. Overall, current findings provide significant implications for future research not only with PCP analogs but also on the next generation of different types of antidepressants.

A case of imipramine induced toxicity with Brugada electrocardiographic pattern in a toddler (Brugada 심전도 양상을 포함한 이미프라민에 의한 독성 부작용 1예)

  • Choi, Woo-Yeon;Park, Soo-Min;Han, Ui-Jeong;Kim, Young-Nam;Cho, Young-Kuk;Ma, Jae-Sook
    • Clinical and Experimental Pediatrics
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    • v.51 no.11
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    • pp.1232-1235
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    • 2008
  • Imipramine, a tricyclic antidepressant (TCA), is used for the treatment of non-polar depression and nocturnal enuresis in children in whom an organic pathology has been excluded, anxiety disorders, and neuropathic pain. Clinical toxicity following the treatment of TCAs, including imipramine, is well known. The anticholinergic effects initially present include a dry mouth, ileus, dilated pupils, urinary retention, and mild sinus tachycardia. The central nervous system toxicity includes delirium, agitation, restlessness, hallucinations, convulsions, and CNS depression or coma. However, the most life-threatening toxicity remains the development of cardiac dysrhythmias. Conduction delays such as QRS and corrected QT prolongation, wide QRS complex tachycardia, and the Brugada electrocardiographic pattern have been reported. Sodium bicarbonate decreases QRS widening and suppresses dysrhythmias by providing excess sodium to reverse the TCA-induced sodium-channel blockade and possibly by binding directly to the myocardium. There are no pediatric case reports on imipramine or other TCA associated toxicity in Korea. Here, we describe a patient who presented with convulsions, tachycardia with a wide QRS complex, a Brugada electrocardiographic pattern, and anuresis associated with an accidental overdose of imipramine and the outcome of treatment with sodium bicarbonate.