This study was performed to evaluate the sedative and analgesic effects of xylazine (X) and tramadol (T) intravenously (IV) administered to horses. Six thoroughbred saddle horses each received X (1.0 mg/kg), T (2.0 mg/kg), and a combination of XT (1.0 and 2.0 mg/kg, respectively) IV. Heart rate (HR), respiratory rate (RR), rectal temperature (RT), indirect arterial pressure (IAP), capillary refill time (CRT), sedation, and analgesia (using electrical stimulation and pinprick) were measured before and after drug administration. HR and RR significantly decreased from basal values with X and XT treatments, and significantly increased with T treatment (p < 0.05). RT and IAP also significantly increased with T treatment (p < 0.05). CRT did not change significantly with any treatments. The onset of sedation and analgesia were approximately 5 min after both X and XT treatments; however, the XT combination produced a longer duration of sedation and analgesia than X alone. Two horses in the XT treatment group displayed excited transient behavior within 5 min of drug administration. The results suggest that the XT combination is useful for sedation and analgesia in horses. However, careful monitoring for excited behavior shortly after administration is recommended.
Analgesics, Opioid/administration & dosage/*pharmacology ; Animals ; Blood Pressure ; Drug Therapy, Combination ; Female ; Heart Rate ; Horses/*physiology ; Hypnotics and Sedatives/administration & dosage/*pharmacology ; Male ; Respiratory Rate ; Tramadol/administration & dosage/*pharmacology ; Xylazine/administration & dosage/*pharmacology

Objectives: . Otitis media is a common infection worldwide. Owing to the limited number of ear specialists and rapid development of telemedicine, several trials have been conducted to develop novel diagnostic strategies to improve the diagnostic accuracy and screening of patients with otologic diseases based on abnormal otoscopic findings. Although these strategies have demonstrated high diagnostic accuracy for the tympanic membrane (TM), the insufficient explainability of these techniques limits their deployment in clinical practice. Methods: . We used a deep convolutional neural network (CNN) model based on the segmentation of a normal TM into five substructures (malleus, umbo, cone of light, pars flaccida, and annulus) to identify abnormalities in otoscopic ear images. The mask R-CNN algorithm learned the labeled images. Subsequently, we evaluated the diagnostic performance of combinations of the five substructures using a three-layer fully connected neural network to determine whether ear disease was present. Results: . We obtained the receiver operating characteristic (ROC) curve of the optimal conditions for the presence or absence of eardrum diseases according to each substructure separately or combinations of substructures. The highest area under the curve (0.911) was found for a combination of the malleus, cone of light, and umbo, compared with the corresponding areas under the curve of 0.737–0.873 for each substructure. Thus, an algorithm using these five important normal anatomical structures could prove to be explainable and effective in screening abnormal TMs. Conclusion . This automated algorithm can improve diagnostic accuracy by discriminating between normal and abnormal TMs and can facilitate appropriate and timely referral consultations to improve patients’ quality of life in the context of primary care.

BACKGROUND: Some opioids have been shown to attenuate an ischemia-reperfusion injury in an isolated-heart model. The aim of this study was to evaluate the effect of sufentanil on the cardiac function in isolated-heart models when given before and after prolonged periods of low flow ischemia. METHODS: Isolated rat hearts were stabilized for 30 minutes and subdivided into four groups (each n = 7). The control group was subjected to low flow ischemia (LFI 0.3 ml/min) of 5% dextrose water for 30 minutes, followed by perfusion with a modified Krebs solution at a constant pressure for 60 minutes. In the sufentanil groups, different sufentanil (12.5 mg/L, 25 mg/L, 50 mg/L) doses were administered with the modified Krebs solution after 30 minutes of stabilization until the end of the experiment with the exception of the LFI group. The left ventricular end systolic pressure (LVESP), dP/dt max, heart rate and coronary flow were measured. After reperfusion, the infarct size of all groups was measured. RESULTS: The control and the sufentanil groups had a lower LVESP, dP/dt max, coronary effluent flow and arrhythmia duration after ischemia and reperfusion than those before ischemia. The infarct sizes in the sufentanil groups were smaller than those in the control group. However the infarct sizes of the sufentanil groups were similar. CONCLUSION: Sufentanil reduces the infarct size but does not improve the post-ischemic functional dysfunction.
Analgesics, Opioid ; Animals ; Arrhythmias, Cardiac ; Blood Pressure ; Glucose ; Heart ; Heart Rate ; Ischemia ; Models, Animal* ; Perfusion ; Rats* ; Reperfusion ; Reperfusion Injury ; Sufentanil* ; Ventricular Function, Left ; Water

Congenital cytomegalovirus (CMV) infections are usually asymptomatic in newborns or may present with rash, hepatosplenomegaly, jaundice, pneumonia, and the development of central nervous system sequelae. Gastrointestinal involvement of congenital CMV infection complicating stricture has been rarely reported, especially in children. We report a case of a 2-month-old body who presented with bloody stool since 3 days of age. Hemotochezia was attributable to CMV colitis with colonic stricture, which was confirmed by histopathology, serologic studies and virus culture. Clinical status of the patient improved with intravenous administration of ganciclovir.
Administration, Intravenous ; Central Nervous System ; Child ; Colitis* ; Colon* ; Constriction, Pathologic* ; Cytomegalovirus* ; Exanthema ; Ganciclovir ; Humans ; Infant ; Infant, Newborn ; Jaundice ; Pneumonia

PURPOSE: Major trauma patients should be transferred to a definitive care facility as early as possible because prompt management will prevent death. This study was designed to discover the obstacles leading to delayed transfers under the current emergency medical system in Korea and whether there are any negative outcomes associated with conducting procedures at primary care hospitals prior to transferring patients to higher levels of care. METHODS: The medical records of major trauma patients with an Injury Severity Score above 15 within the past year were reviewed. Patients were divided three groups as follows: (A) came directly to our emergency center, (B) were transferred without CT or MRI scan at the primary care hospital and (C) transferred with CT or MRI scans. The transfer time of each group were compared and analyzed statistically. Additionally, the number and type of imaging performed at the primary care hospital were analyzed. RESULTS: All qualified patients (n=276) were enrolled in this study: 121 patients in group A; 104 in group B; 51 in group C. There was a statistically significant difference in the transfer time between the three groups (p-value<0.001), and 79 (28.6%) were transferred to an emergency medical center within one hour. In group C, CT or MRI scans were performed an average of 1.86 times at the primary care hospital, and the median transfer time was 4 hours 5 minutes. CONCLUSION: Only 28.6% of the cases in the study arrived within the golden hour at a definitive care facility. Such delays are in part the result of prolonged times at the primary care hospital for radiologic examinations, such as CT or MRI scans. Major multiple trauma patients should be transferred to a definitive care facility directly or as soon as the primary survey and the resuscitation of Advanced Trauma Life Support guideline are completed at the primary care hospital.
Advanced Trauma Life Support Care ; Emergencies ; Humans ; Injury Severity Score ; Korea ; Magnetic Resonance Imaging ; Medical Records ; Multiple Trauma ; Porphyrins ; Primary Health Care ; Resuscitation

BACKGROUND: The purpose of this study is to investigate relationship between the horse racing addiction and the health status indicators. METHODS: Surveys were conducted with visitors of the Korea Racing Association in Gyeonggi-do, from September 1 to September 24, 2017. We used the questionnaire, which contains questions to assess the horse racing addiction, mood depression, health-related quality of life, smoking amount, alcohol dependency, etc. Survey data were analyzed through t-test, chi-square test, logistic regression analysis, and multiple regression analysis by SPSS program (IBM Corp., Chicago, IL, USA). RESULTS: The pathological gambling group was 47.5% (n=38) of the visitors, and they showed a different racecourse use behavior compared to the normal group. In addition, we found that the pathological gambling group had a significantly different health-related quality of life score and a depression score from the normal group, and that the addiction score and the depression score had a linear correlation. CONCLUSIONS: Among the racecourse visitors, the ratio of the pathological gambler was considerably high, and the pathological gambling group showed different health-related quality of life score and a depression score compared to the normal group; especially, the depression score has a significant correlation with horse racing addiction. Therefore, the horse racing association and the health authorities should recognize the seriousness of the horse racing addiction, make an effort to select high risk users, and prepare a program to prevent pathological gambling.
Continental Population Groups ; Depression ; Gambling ; Gyeonggi-do ; Health Status Indicators ; Horses ; Humans ; Korea ; Logistic Models ; Quality of Life ; Smoke ; Smoking

OBJECTIVE: The purpose of this study was to investigate the stress distribution on the orthodontic mini-implant (OMI) surface and periodontal ligament of the maxillary first and second molars as well as the tooth displacement according to the OMI position in the dragon helix appliance during scissors-bite correction. METHODS: OMIs were placed at two maxillary positions, between the first and the second premolars (group 1) and between the second premolar and the first molar (group 2). The stress distribution area (SDA) was analyzed by three-dimensional finite element analysis. RESULTS: The maximal SDA of the OMI did not differ between the groups. It was located at the cervical area and palatal root apex of the maxillary first molar in groups 1 and 2, respectively, indicating less tipping in group 2. The minimal SDA was located at the root and furcation area of the maxillary second molar in groups 1 and 2, respectively, indicating greater palatal crown displacement in group 2. CONCLUSIONS: Placement of the OMI between the maxillary second premolar and the maxillary first molar to serve as an indirect anchor in the dragon helix appliance minimizes anchorage loss while maximizing the effect on scissors-bite correction.
Bicuspid ; Crowns ; Displacement (Psychology) ; Finite Element Analysis ; Molar ; Periodontal Ligament ; Tooth

PURPOSE: This study evaluated the clinical and radiological results after reinforcement of the weakened medial joint capsule using Internal Brace (Arthrex) for treating severe hallux valgus. MATERIALS AND METHODS: This study reviewed 56 cases of 50 patients that were followed-up postoperatively for at least 12 months, from September 2017 until August 2018. An extended distal chevron osteotomy combined with a distal soft-tissue release was performed by a single surgeon to treat severe hallux valgus. Internal Brace was applied in 12 cases (group A) who had weakened medial joint capsules, and capsulorrhaphy was performed in 44 cases (group B), and these two groups were compared postoperatively for the clinical and radiological results. The postoperative complications were also investigated. RESULTS: No significant differences at 1-year follow-up on the Manchester-Oxford Foot Questionnaire and the patients' satisfaction scores were found between the two groups (p=0.905 and p=0.668, respectively). For the radiology, the changes of the values between before surgery and at 1-year follow-up according to the group showed no significant differences in the hallux valgus angle, intermetatarsal angle, and the hallux interphalangeal angle (p=0.986, p=0.516, p=0.754, respectively). Recurrence of hallux valgus was reported in two cases in group A, and in three cases in group B. Transfer metatarsalgia occurred in 4 cases in group B. CONCLUSION Based on these results, we recommend the capsule reinforcing technique using Internal Brace as a successful operative option for treating a weakened medial capsule in patients with severe hallux valgus.

BACKGROUND: The purpose of this study is to investigate relationship between the horse racing addiction and the health status indicators. METHODS: Surveys were conducted with visitors of the Korea Racing Association in Gyeonggi-do, from September 1 to September 24, 2017. We used the questionnaire, which contains questions to assess the horse racing addiction, mood depression, health-related quality of life, smoking amount, alcohol dependency, etc. Survey data were analyzed through t-test, chi-square test, logistic regression analysis, and multiple regression analysis by SPSS program (IBM Corp., Chicago, IL, USA). RESULTS: The pathological gambling group was 47.5% (n=38) of the visitors, and they showed a different racecourse use behavior compared to the normal group. In addition, we found that the pathological gambling group had a significantly different health-related quality of life score and a depression score from the normal group, and that the addiction score and the depression score had a linear correlation. CONCLUSIONS Among the racecourse visitors, the ratio of the pathological gambler was considerably high, and the pathological gambling group showed different health-related quality of life score and a depression score compared to the normal group; especially, the depression score has a significant correlation with horse racing addiction. Therefore, the horse racing association and the health authorities should recognize the seriousness of the horse racing addiction, make an effort to select high risk users, and prepare a program to prevent pathological gambling.

OBJECTIVES: The aim of this study was to evaluate the effect of a school-based social skills training program on peer relationships in children and adolescents and to assess the plan for effective school-based mental health services. METHODS: The Child and Adolescent Mental Health Promotion Team of Bugok National Hospital conducted 7-sessioned school-based social skills training for elementary and middle school students (n=90). Changes in peer relationships were evaluated before and after application of the program using a name generator question. RESULTS: The social skills training program increased peer relations, indicating significant changes in social network indices. CONCLUSION: The social skills training program positively influenced peer relationships. The school-based social skills training program can be expected to have positive effects on school-based mental health services. Future investigation is needed to validate the long term effects of this program.
Adolescent ; Child ; Education ; Humans ; Mental Health ; Mental Health Services ; Social Skills