PURPOSE: This study aimed to explore the protective factors of demoralization in cancer patients via investigation of cancer patients' demographic and disease characteristics. METHODS: This was a cross-sectional descriptive study. We used a structured questionnaire, which contained items on demographic and disease characteristics, as well as the Demoralization Scale Mandarin Version (DS-MV), with a cutoff of 30 or more indicating high demoralization. Data were analyzed with age-matched and gender-matched conditional logistic regression analysis. For the study, 428 questionnaires were delivered and 411 were recovered. After being age-matched and gender-matched, 182 participants of high demoralization (DS-MV > 30) and low demoralization (DS-MV ≤ 30) were obtained respectively, for a total of 364 participants. RESULTS: Cancer patients' demoralization was significantly related to family support (p = .019), education (p = .049), and monthly income (p = .001). Family support [odds ratio = 0.38; p = .028; 95% confidence interval (0.16, 0.91)] and monthly income [odds ratio = 0.49; p = .009; 95% confidence interval (0.29, 0.84)] were protective factors of demoralization in cancer patients. CONCLUSION: Early and appropriate demoralization assessment of cancer patients' demographic and disease characteristics is very important in clinical settings. Healthcare providers might regularly monitor demoralization in cancer patients, and develop related nursing care guidelines or treatment for demoralization in cancer patients. The study results can be a reference for healthcare providers who work with cancer patients.
Education ; Health Personnel ; Humans ; Logistic Models ; Nursing Care ; Odds Ratio ; Protective Factors* ; Taiwan*

Metastasis from unknown primary is always a challenge because finding the true primary tumor significantly affects subsequent management. We present a case of malignant abdominal wall nodule initially diagnosed as metastasis from hepatocellular carcinoma through excisional biopsy and immunohistochemical (IHC) staining. Dual-tracer positron emission tomography/computed tomography (PET/CT) with 11 C-acetate and 18 F-FDG, however, showed metabolic findings in favor of metastasis from lung origin, which was finally confirmed by ensuing a lung biopsy with additional IHC stains. This case illustrates the complementary molecular role of PET to pathology, particularly when dual-tracer or multi-tracer PET is used in conjunction with pathology methods for cross referencing and confirmation.

Background: Echocardiography is a primary tool used by veterinarians to evaluate heart diseases. In recent years, various studies have targeted standard echocardiographic values for different breeds. Reference data are currently lacking in Maltese dogs and it is important to fill this gap as this breed is predisposed to myxomatous mitral valve disease, which is a volume overload disease. Objectives: To establish the normal echocardiographic parameters for Maltese dogs. Methods: In total, 23 healthy Maltese dogs were involved in this study. Blood pressure measurements, thoracic radiography, and complete transthoracic echocardiography were performed. The effects of body weight, age and sex were evaluated, and the correlations between weight and linear and volumetric dimensions were calculated by regression analysis. Results: The mean vertebral heart size was 9.1 ± 0.4. Aside from the ejection fraction, fractional shortening, and the left atrial to aorta root ratio, all the other echocardiographic parameters were significantly correlated with weight. Conclusion This study describes normal echocardiographic parameters that may be useful in the echocardiographic evaluation of Maltese dogs.

Background: Echocardiography is a primary tool used by veterinarians to evaluate heart diseases. In recent years, various studies have targeted standard echocardiographic values for different breeds. Reference data are currently lacking in Maltese dogs and it is important to fill this gap as this breed is predisposed to myxomatous mitral valve disease, which is a volume overload disease. Objectives: To establish the normal echocardiographic parameters for Maltese dogs. Methods: In total, 23 healthy Maltese dogs were involved in this study. Blood pressure measurements, thoracic radiography, and complete transthoracic echocardiography were performed. The effects of body weight, age and sex were evaluated, and the correlations between weight and linear and volumetric dimensions were calculated by regression analysis. Results: The mean vertebral heart size was 9.1 ± 0.4. Aside from the ejection fraction, fractional shortening, and the left atrial to aorta root ratio, all the other echocardiographic parameters were significantly correlated with weight. Conclusion This study describes normal echocardiographic parameters that may be useful in the echocardiographic evaluation of Maltese dogs.

This study aimed to compare the clinical presentations of Aeromonas hydrophila, A. veronii biovar sobria and A. caviae monomicrobial bacteremia by a retrospective method at three hospitals in Taiwan during an 8-yr period. There were 87 patients with A. hydrophila bacteremia, 45 with A. veronii biovar sobria bacteremia and 22 with A. caviae bacteremia. Compared with A. hydrophila and A. veronii biovar sobria bacteremia, A. caviae bacteremia was more healthcare-associated (45 vs 30 and 16%; P = 0.031). The patients with A. caviae bacteremias were less likely to have liver cirrhosis (27 vs 62 and 64%; P = 0.007) and severe complications such as shock (9 vs 40 and 47%; P = 0.009) and thrombocytopenia (45 vs 67 and 87%; P = 0.002). The APACHE II score was the most important risk factor of Aeromonas bacteremia-associated mortalities. The APACHE II scores of A. caviae bacteremias were lower than A. hydrophila bacteremia and A. veronii biovar sobria bacteremia (7 vs 14 and 16 points; P = 0.002). In conclusion, the clinical presentation of A. caviae bacteremia was much different from A. hydrophila and A. veronii biovar sobria bacteremia. The severity and mortality of A. caviae bacteremia were lower than A. hydrophila or A. veronii biovar sobria bacteremia.
APACHE ; Adult ; Aeromonas caviae/drug effects/*pathogenicity ; Aeromonas hydrophila/drug effects/*pathogenicity ; Aged ; Aged, 80 and over ; Bacteremia/complications/drug therapy/*microbiology/mortality ; Cross Infection/microbiology ; Female ; Gram-Negative Bacterial Infections/complications/drug therapy/*microbiology/mortality ; Humans ; Liver Cirrhosis/microbiology ; Male ; Middle Aged ; Retrospective Studies ; Shock, Septic/microbiology ; Taiwan ; Thrombocytopenia/complications ; Young Adult

PURPOSE: It is well known the advantages of scalp donor split thickness skin graft(STSG) in deep burn wound because of its scarless donor healing, and good color match in face. Inspite of the advantages of scalp as a skin donor site during split thickness skin graft some authors report the frequent postoperative folliculitis, and partial alopecia on scalp donor site. We had experienced 21 burn patients, who had full thickness skin defects caused by burn injuries, were successfully managed with scalp donor split thickness skin graft with our optimal donor management protocols. METHODS: We had 21 deep burn patients, who were managed with thin STSG from scalp donor for coverage of full thickness skin defects. The operative techniques of the harvesting scalp STSG, and scalp donor dressing care are such as followings. After the infiltration of the donor scalp area with 1:1,000,000 epinephrine diluted with saline, then usually 0.012~0.015 inch thickness skin were harvested with air driven Zimmer® dermatome. On postoperative 6days, the one layer of adhered Vaseline gauze at donor scalp site was manually removed, and the entire scalp was cleansed with water. After then the daily hair washing was continued to remove the desiccated scaly crust with thick exudate at the growing hair and follicle. RESULTS: The scalp split thickness skin graft at the recipient sites in 21 burn patients were survived completely. Ranges of patient's age were 8 months to 56. The size ranges of scalp STSG were 2×2 cm~12×15 cm. The grafted scalp donor STSG were survived in all cases. The mean epithelialization period of scalp donor was 7.2 days. The one case of transient folliculitis (5%) from the postoperative 8days was occurred, and it was disappeared slowly with vigorous daily hair washing, antiseptics and systemic antibiotics. In all cases, there was no micro-alopecia or alopecia, and scars in scalp donor after follow ups. The donor site pain was markedly disappeared within 1~2 postoperative day. The hemorrhage from the scalp donor site during operation was not noticeable. The newly growing hair at the scalp donor was noted from the 3 postoperative days by palpation or unaided eye through the Vaseline gauze dressing. The average lengths of newly growing hair shaft are 2~3 mm in postoperative 8 days, 5~6 mm in postoperative 14 days. CONCLUSION: We had successful reconstruction of postburn skin defects using scalp donor split thickness skin graft without donor scars, persistent folliculitis or alopecia on scalp donor. From the postoperative 6~7 days after harvesting the scalp donor STSG, early vigorous daily washing with water and open dressing of scalp donor site should be recommended in order to prevent folliculitis. After long-term follow ups, the scalp split skin grafted recipient sites showed reliable, and relatively good color match with surrounding skin in face and dorsum of hand.
Alopecia ; Anti-Bacterial Agents ; Anti-Infective Agents, Local ; Bandages ; Burns* ; Cicatrix ; Epinephrine ; Exudates and Transudates ; Folliculitis ; Follow-Up Studies ; Hair ; Hand ; Hemorrhage ; Humans ; Palpation ; Petrolatum ; Scalp* ; Skin* ; Tissue Donors* ; Transplants* ; Water ; Wounds and Injuries

PURPOSE: Despite the decline in tuberculosis (TB) incidence and mortality rates in the Republic of Korea through a national TB control program, TB remains one of the most critical infectious diseases in Korean children. We investigated the trends and research areas of published articles on TB in Korean children and adolescents. METHODS: In 6 Korean and overseas databases, we searched titles and abstracts including “tuberculo*” or “TB,” “child*” or “adolescen*” or “neonat*” or “infant*” or “pediatric*,” and “korea*.” The publication type, publication year, research areas, journal title, and research subjects were analyzed. RESULTS: Out of the 257 searched documents, 120 papers were included in the analysis. Of these, 82 were original articles (68.3%), 33 case reports (27.5%), 4 review articles (3.3%), and 1 guideline (0.8%). In the original articles, the most common subject of studies was the clinical characteristics of patients with TB (36.6%), followed by diagnostics (29.3%), contact investigations (9.8%), epidemiology (6.1%), treatment (4.9%), vaccine (3.6%), latent TB infection (3.6%), complications (3.6%), and surveys on perception of TB (2.4%). From 1962, 4 articles were published in the 1960s, 10 articles in the 1970s, 11 articles in the 1980s, 22 articles in the 1990s, 26 articles in the 2000s, and 47 articles since 2010. CONCLUSIONS: The amount of research on TB in Korean children has increased over the past 5 decades; however, it has mainly focused on the clinical characteristics and diagnostics. Research in different areas, such as treatment and vaccine, is needed in the future.
Adolescent ; Child ; Communicable Diseases ; Epidemiology ; Humans ; Incidence ; Korea ; Mortality ; Publications ; Republic of Korea ; Research Subjects ; Tuberculosis

This paper presents our clinical experiences for reconstruction of the linear depressed postburn scar band by rhombus subcutaneous pedicle skin flap (RSPF). We report new RSPF, it’s versatility, and effectiveness for correction of the mild to moderate linear depressed postburn scar band. To correct the postburn scar band, we have newly designed the Rhombus Subcutaneous Pedicle Skin Flap (RSPF), which is made as rhombus-shaped skin flap on the inside of scar band. After excision of burn scar band, the each vertex of RSPF flap is advanced into the skin defects at apex of extended skin incision, which is starting from the upper and lower portion of the removed burn scar band at a near right angle. This flap can add more extra skin to adjacent superior and inferior area of excised scar band. We have experienced 2 cases of RSPF for reconstruction of linear depressed postburn scar band deformities in lower extremity. After 3 weeks to 3 months postoperative follow ups, relatively satisfactory results were obtained in all cases. We had successfully reconstructed the linear depressed postburn scar postburn band of lower extremity using the rhombus subcutaneous pedicle skin flap. For the correction of mild to moderate sized linear depressed postburn scar band deformities in extremity, the RSPF is simple, and very effective without donor morbidity.

Purpose: Due to rapid changes in the industrial structure in last decade, the wider various types of chemical agents were introduced. Burn surgeons should be well-informed with rapid changes of chemical burns. We present the recent incidence trends of causing agents of chemical burns. Methods: From 2010 to 2019, 92 chemical burn victims were included in this study. A retrospective study was made about the type, distribution and incidence of the causing agents of chemical burns. Initial treatments of most chemical burn wounds are copious saline irrigation by tap water, except hydrofluoric acid burn cases managed by 10% calcium gluconate injection. In alkali chemical burns on extremity, if thin eschars appear in postburn 2∼3 days, acute early surgical escharectomy and split thickness skin graft were done. Results: More than 9 types of major chemicals causing chemical burns were surveyed, and the most common causing agent of chemical burns was Hydrofluoric acid (23.9%) followed by Acetic acid (19.6%) and Sodium hydroxide (8.7%). Conclusion From 2010 to 2019, changes in the causing agent of chemical burns are that the types of major causing agents of chemical burns have increased and the distribution and incidence of causing agents have changed compared to previous reports. According to this study, more than 9 types of major chemicals causing chemical burns were surveyed, and the most common causing agent of chemical burns was Hydrofluoric acid (23.9%) followed by Acetic acid, Sodium hydroxide.

BACKGROUND: Nuclear enzyme poly (ADP-ribose) polymerase (PARP) activated by DNA damage participates in DNA repair. However, overactivation of PARP could be an important pathogenic mechanism of ischemic cell death. We investigated the protective effect of an inhibitor of PARP, 3-aminobenzamide (3-AB), against ischemia/reperfusion injury in ischemic stroke model. METHODS: Occlusion of left middle cerebral artery (MCA) was done by intraluminal filament technique in 24 rats weighing from 315 g to 358 g, and reperfusion was done at 2 hours after occlusion. To evaluate the effect of PARP inhibitor in ischemic stroke, 3-AB was administered to 12 rats (3-AB group) 10 minutes before artificial occlusion of left MCA. Infarct area was confirmed by using 2, 3, 5-triphenyltetrazolium chloride stain. The immunoreactivities of poly (ADP-ribose) reflecting activity of enzyme PARP and activated caspase-3 were compared in infarct, peri-infarct and normal zones in 3-AB group and 12 controls. RESULTS: The volume of infarction was decreased about 34% in 3-AB group compared with controls. In 3-AB group, immunoreactivities of PAR were significantly reduced in ischemic regions, especially peri-infarct zone, but those of activated caspase-3 were significantly increased in same region. CONCLUSIONS: These results suggest that treatment of PARP inhibitor can reduce the infarct volume by converting necrotic cell death into apoptosis. PARP inhibition can be another potential neuroprotective strategy in ischemic stroke.
Animals ; Apoptosis ; Caspase 3 ; Cell Death ; DNA Damage ; DNA Repair ; Infarction ; Middle Cerebral Artery ; Rats ; Reperfusion ; Stroke*