The A-1000 (Elmeca, Co. Ltd., Seoul, Korea) electrical automatic airway suction device, was designed to operate as a customizable repeated closed suction device. It can be used for patients with intubation or tracheostomy tubes. This is the first recorded case of the use of the A-1000 in a general ward patient with a tracheostomy tube. A 91-year-old man presented having attempted suicide by hanging and was admitted to this institution. Although extubation was performed in the intensive care unit, the patient required 2 reintubations. The tracheostomy was performed, and the A-1000 was applied. After weaning from mechanical ventilation, the patient was transferred to the General Ward with a tracheostomy tube in place for effective removal of sputum by the A-1000. The tracheostomy tube was successfully removed, and the patient was discharged. The effectiveness and safety of the A-1000 needs further study by expanding the applications of this device.

BACKGROUND: The immune thrombocytopenia (ITP) criteria were newly standardized by the International Working Group. Thus, we analyzed the natural course of childhood chronic ITP to predict the prognosis based on the revised criteria. METHODS: The medical records of children with chronic ITP from May 2000 to February 2013 in our institute were reviewed. RESULTS: Forty-seven children with chronic ITP who were not undergoing corticosteroid therapy were included. Their initial platelet count was 23+/-25x10(9)/L, and age at diagnosis was 6.3+/-4.1 years. The follow-up period was 5.4+/-3.7 years. Among them, 44.7% (21/47) showed spontaneous remission and maintained a platelet count > or =100x10(9)/L. And 66.0% (31/47) maintained a platelet count > or =50x10(9)/L until the last follow-up date. The time periods required for the platelet count to be maintained > or =50x10(9)/L and > or =100 x10(9)/L were 3.1+/-2.7 and 3.6+/-2.7 years. Age at diagnosis in the > or =50x10(9)/L group (5.7+/-4.4 years) was significantly lower than the age at diagnosis in the <50x10(9)/L group (7.4+/-3.3 years) (P=0.040). And follow-up period was the factor influencing prognosis between the > or =100x10(9)/L group and <50x10(9)/L group (P=0.022). CONCLUSION: Approximately 45% of children with chronic ITP recovered spontaneously about 3-4 years after the diagnosis and 2/3 of patients maintained a platelet count > or =50x10(9)/L, relatively safe state. Age at diagnosis of ITP and follow-up period were the factors influencing prognosis in this study.
Child ; Diagnosis ; Follow-Up Studies ; Humans ; Medical Records ; Platelet Count ; Prognosis ; Remission, Spontaneous ; Thrombocytopenia*

PURPOSE: The ability to perform chromosome analysis of cryopreserved cord blood mononuclear cells is important for future retrospective studies. We compared the karyotypes of cryopreserved cells with cells before cryopreservation. METHODS: One cord blood (CB) sample was obtained from normal healthy volunteer. Karyotype analysis was performed before cryopreservation. After mononuclear cell separation with Ficoll-Hypaque, the mononuclear cells were cryopreserved by programmed controlled-rate freezer and then transferred into the liquid nitrogen (-196 degrees C) for 3 days. After rapid thawing, cytogenetic analysis was performed as the same method for each sample by different conditions. The samples were divided by three groups. The first group was no culture before cryopreservation, the second group was 72 hours culture before cryopreservation, but no 24 hours culture after thawing and the third group was 72 hours culture before cryopreservation and 24 hours culture after thawing. RESULTS: The chromosome analysis was successful in the second and third groups of CB sample. CONCLUSION: The successful result from CB samples may suggest the usefulness of long-term cryopreservation for retrospective study in various clinical settings including hematologic malignancies.
Cell Separation ; Cryopreservation ; Cytogenetic Analysis ; Fetal Blood ; Karyotype ; Nitrogen ; Retrospective Studies

Despite being a very new field, forensic imaging is rapidly being used in forensic medical practices around the world. Computed tomography images are being produced and used for many reasons. Forensic imaging is being used for preliminary examination of serious findings before a routine autopsy, as it might help to give positive proof in some cases. Some major preliminary findings, such as brain hemorrhage, cardiac tamponade, or aortic dissection, can then be substantiated with the results of the physical autopsy. Forensic imaging techniques may also provide additive evidence about the cause of death such as pneumothorax, ileus, gas embolism, and aspiration that are difficult to detect with the traditional surgical autopsy techniques. Forensic imaging is also proving useful outside the autopsy room; forensic anthropologists and odontologists are using images to help them determine the age, sex, and even lifestyle of human specimens. Finally, forensic images have also begun to function as a form of record keeping in complex cases.
Autopsy* ; Cardiac Tamponade ; Cause of Death ; Embolism, Air ; Humans ; Ileus ; Intracranial Hemorrhages ; Life Style ; Pneumothorax