Healing is an intricate, interdependent process that involves complex interactions between cells, the microcellular environment, biochemical mediators and extracellular matrix molecules. The goals of wound healing are to minimize bloods loss, to replace any defect with new tissue, and to restore an intact epithelial barrier as rapidly as possible. The rate of wound healing is limited by the available vascular supply and the rate of formation of new capillaries and matrix molecules, which are heavily influenced by locally-acting growth factors that affect proliferation, angiogenesis, chemotaxis, gene expression, proteinases, and protein production. We present a new method for wound control and treatment, the V.A.C (vacuum-assisted closure) technique. It places open-cell foam dressing into the wound cavity and applies subatmospheric pressure. The application of subatmospheric pressure accelerates the rate of wound healing by the foollowing two mechanisms: 1. Removal of excessive interstitial fluids, which decrease localized edema, reduce concentration of inhibitory factors, and increase local blood flow. 2. Transmission of mechanical forces to surrounding tissues with resultant deformation of the extracellular matrix and cells, which then increase protein and matrix synthesis as well as cell proliferation. We applied it to 17 patients: 1 Livedo vasculitis, 1 burned by flame 3 pressure sores, 1 extravasation injury, 1 wound infection, 2 wound disruption, and 8 diabetes mellitus feet. In the end, most of the remaining wounds were treated with a simple split-thickness skin graft and the results were encouraging. We concluded that the V.A.C technique may be an effective substitute to help promote wound healing. It could be especially helpful in chronic complicated wounds in aging or debilitated patients who can not tolerate aggressive surgical procedures.
Aging ; Bandages ; Burns ; Capillaries ; Cell Proliferation ; Chemotaxis ; Diabetes Mellitus ; Edema ; Extracellular Fluid ; Extracellular Matrix ; Foot ; Gene Expression ; Humans ; Intercellular Signaling Peptides and Proteins ; Peptide Hydrolases ; Pressure Ulcer ; Skin ; Transplants ; Vasculitis ; Wound Healing* ; Wound Infection ; Wounds and Injuries*

A 49-year-old woman with anemia who developed headache and seizure after blood transfusion was diagnosed with posterior reversible encephalopathy syndrome (PRES). Magnetic resonance imaging showed typical PRES findings including lesions in bilateral parieto-occipital subcortical white matter and overlying cortex. Only a few cases of PRES after transfusion have been reported and this case is unique in that there was a latent period between infusion and development of PRES. We postulate that rapid change of hemoglobin level may disrupt cerebral autoregulation and result in delayed PRES. We suggest that neurological symptoms after blood transfusion should be appropriately investigated.

Purpose: We investigated the satisfaction of physical therapy course according to teaching ways after COVID-19. Methods: 336 students in major of physical therapy were recruited in this study. Based on the classification of subjects in the national examination, the questionnaire was divided into 6 subjects in the basic field of physical therapy, 2 subjects in the field of physical therapy diagnostic evaluation, 8 subjects in the field of physical therapy intervention, and 3 subjects in other fields. The Likert scale was used. Results: In the basic field of physical therapy, all subjects were shown the high score of the satisfactory in face-to-face classes except for the public health and medical law compared to the non-face-to-face classes and mixed classes. Regarding the field of physical therapy diagnostic evaluation, the principle of diagnostic evaluation was shown the high score of the satisfactory in face-to-face classes compared to the non-face-to-face classes and mixed classes. In the field of physical therapy intervention, all subjects were shown the high score of the satisfactory in face-to-face classes compared to the non-face-to-face classes and mixed classes. Conclusion We found that the face-to-face classes in most of subjects was shown the high score of satisfactory. We believed that our results can be used as basic data for physical therapy major learning methods.

A soft rot of fruits caused by Mucor racemosus occurred on cherry tomato collected in Agricultural Products Wholesale Market in Jinju, Korea. The disease infection usually occurred wounded areas after cracking of fruits. At first, the lesions started with water soaked and rapidly softened and diseased lesion gradually expanded. Colonies were white to brownish to gray in color. Sporangia were 32~54 microm in size and globose in shape. Sporangiophores were 8~14 microm in width. Sporangiospores were 5~12 x 4~8 microm in size, ellipsoidal to subglobose in shape. Columella was 27~42 microm in size, obovoid, ellipsoidal, cylindrical-ellipsoidal, slightly pyriform in shape. Chlamydospores were numerous in sporangiophores and barrelshaped when young, subglobose in old cultures. Optimum growth temperature was about 25degrees C. The fungus was identified as M. racemosus Fres. This is the first report of soft rot on cherry tomato caused by M. racemosus in Korea.
Fruit ; Fungi ; Gyeongsangnam-do ; Korea* ; Lycopersicon esculentum* ; Mucor* ; Prunus ; Sporangia ; Water ; Wounds and Injuries

We describe a 46-year-old woman with hypokalemic paralysis as the initial manifestation of Sjorgen's syndrome. Sjorgen's syndrome is an autoimmune exocrinopathy, characterized by keratoconjuntivitis sicca and xerostomia. Among the extraglandular manifestations of Sjorgen's syndrome, renal tubular involvement, especially renal tubular acidosis, is the most often latent or minimally symptomatic. Renal tubular acidosis is estimated to be present in 25~30 percent of the cases. Hypokalemic paralysis may serve as a clinical marker for more severe renal disease in patient who has primary Sjorgen's syndrome with renal tubular acidosis, even though it is a rare manifestation of Sjorgen's syndrome.
Acidosis, Renal Tubular ; Biomarkers ; Female ; Humans ; Hypokalemic Periodic Paralysis* ; Middle Aged ; Paralysis ; Xerostomia

OBJECTIVES: We aimed to compare and distinguish the characteristics of anaphylaxis and angioedema, especially with oral mucosal involvement and treatment of patients who visited the Pediatric Emergency Department. METHODS: We retrospectively analyzed patients under age 18-year-old who were diagnosed with anaphylaxis and angioedema with oral mucosal involvement and treated with epinephrine from May 2008 to May 2013 in a single Pediatric Emergency Department in Seoul, Korea. We evaluated their past history, possible triggering causes, symptoms, vital signs and treatment and discharge with education. RESULTS: During the study period the total cases of anaphylaxis were 79 and angioedema with oral mucosal involvement were 218. The age of patients with anaphylaxis was significantly higher (6.6+/-4.9 years vs. 4.1+/-3.3 years). The heart rate relative to age was significantly higher in the anaphylaxis group (49.4% vs. 36.2%). After discharge from the Emergency Center, 3.8% of anaphylaxis patients were prescribed an epinephrine injection. Education to avoid the triggering factor was provided in 32.9% of anaphylaxis group and 17.4% in the angioedema group. CONCLUSION: Besides blood pressure, we should pay attention to the heart rate in pediatric patients with severe allergic reactions. More active follow-up of anaphylaxis and angioedema with oral mucosal involvement is needed to educate parents and prescribe emergency medication.
Adolescent ; Anaphylaxis* ; Angioedema* ; Blood Pressure ; Child ; Education ; Emergencies ; Emergency Service, Hospital* ; Epinephrine ; Heart Rate ; Humans ; Hypersensitivity ; Korea ; Parents ; Retrospective Studies ; Seoul ; Vital Signs

OBJECTIVES: This study examined the influence of different sizes of spoons (normal spoon, 8.3 cc vs small spoon, 4 cc) on eating rate, energy intake and the satiety levels of female college students. METHODS: Twenty four healthy female college students participated in this study once a week for 2 weeks. Two hundred ten grams of cooked rice and 250 g of beef shank soup with a normal spoon and same amount of rice and soup with a small size spoon were served to the same participants over two consecutive weeks. After each lunch, the eating rate, energy intake, and the satiety levels were measured. RESULTS: Results showed that the subjects who were using a small spoon ate less beef shank soup (149.0 kcal) (p < 0.01) and had lower total energy intake (423.3 kcal) (p < 0.05) than using a normal spoon (178.7 and 461.1 kcal, respectively). Also, the meal time (15.7 min) (p < 0.01), a serving per one spoon (8.6 g) (p < 0.001), and eating rate (27.9 g/min) (p < 0.001) of those who used a small spoon were significantly different than that of those who used a normal spoon (13.6 min, 12.5 g and 35.7 g/min, respectively). However, despite consuming less energy at lunch, the level of satiety after eating from the small spoon was not significantly different from the normal spoon immediately after, 1 hour after and 2 hour after lunch. CONCLUSIONS: Our results revealed that students were able to control their eating rate by using a small spoon and they could feel full enough even though they eat less. In conclusion, eating rate decrease by using a small spoon may play an important role in food intake.
Eating* ; Energy Intake* ; Female* ; Humans ; Lunch ; Meals

Hyperhomocysteinemia has been recognized as an independent risk factor which causes atherosclerosis. The genetic mutation in MTHFR, an enzyme required for efficient homocysteine metabolism, produces a thermolabile enzyme with reduced activity. It has been suggested that thermolabile MTHFR is associated with vascular disease due to increased plasma homocysteine concentration. This study is a preliminary research for identifying the relationship between the MTHFR gene mutation and hypertensive subjects by examining the prevalence of 677 C-- Africa ; Atherosclerosis ; Chungcheongnam-do ; Genotype ; Health Services ; Homocysteine ; Humans ; Hyperhomocysteinemia ; Hypertension ; Metabolism ; Methylenetetrahydrofolate Reductase (NADPH2)* ; Plasma ; Prevalence ; Risk Factors ; Vascular Diseases

PURPOSE: In 2000, the American Heart Association and International Liaison Committee on Resuscitation published guidelines for CPR (Cardiopulmonary Resuscitation), and these guidelines were revised in 2005. Many physicians perform CPR differently than suggested by these guidelines. We investigated guideline conformation rates for CPR by non-emergency physicians. METHODS: From January 1st, 2005, to December 31st, 2005, and from January 1st, 2007, to September 30th, 2007, 103 in-hospital CPR cases were enrolled. We separated the 103 cases into two groups: 2005 patients and 2007 patients. Fifty-two cases in the 2005 group and 51 cases in the 2007 group were enrolled. The defibrillation method, defibrillation energy, epinephrine use, and atropine use were analyzed. RESULTS: Nineteen cases (82.6%) in the 2005 group and three cases (21.4%) in the 2007 group were performed using the appropriate defibrillation method (p=0.0002). Seventeen cases (73.9%) in the 2005 group and four cases (28.6%) in the 2007 group received the appropriate defibrillation energy (p=0.0069). Seven cases (14.0%) in the 2005 group and 16 cases (32.0%) in the 2007 group used the appropriate epinephrine dose (p=0.0325). Fourteen cases (28.0%) in the 2005 patient group and 14 cases (29.2%) in the 2007 patient group used the appropriate atropine dose (p=0.8983). CONCLUSION: Although CPR guidelines were renewed in 2005, many physicians do not follow these guidelines. We suggest that adequate information, education, feedback, and further study are needed for guideline conformation.
American Heart Association ; Atropine ; Cardiopulmonary Resuscitation ; Electric Countershock ; Epinephrine ; Humans ; Resuscitation