Background: Intradural-intramedullary intervertebral disc extrusion (IIVDE) is a rare condition of intervertebral disc disease. However, the diagnosis of IIVDE is challenging because the prognosis and imaging characteristics are poorly characterized. Objectives: We aimed to describe the clinical and imaging characteristics of tentatively diagnosed IIVDE in dogs to assess the prognostic utility of neurological grade and magnetic resonance imaging (MRI) findings. Methods: Twenty dogs were included in this retrospective cohort study. Results: Nonchondrodystrophic breeds (n = 16) were more predisposed than chondrodystrophic breeds. Most dogs showed acute onset of clinical signs. Neurological examination at admission showed predominant non-ambulatory paraparesis (n = 9); paresis (n = 16) was confirmed more frequently than paralysis (n = 4). Follow-up neurological examination results were only available for 11 dogs, ten of whom showed neurological improvement and 8 showed successful outcomes at 1 month. The characteristic MRI findings include thoracic vertebra (T)2 hyperintense, T1 hypointense, intramedullary linear tracts with reduced disc volume, and cleft of the annulus fibrosus. None of the MRI measurements were significantly correlated with neurological grade at admission. Neurological grade did not differ according to the presence of parenchymal hemorrhage, parenchymal contrast enhancement, and meningeal contrast enhancement. Neurological grades at admission showed a statistical correlation with those observed at the 1-month follow-up (r = 0.814, p = 0.02). Conclusions IIVDE is a rare form of disc extrusion commonly experienced after physical activity or trauma and most frequently affects the cranial-cervical and thoracolumbar regions of nonchondrodystrophic dog breeds. Neurological score at admission emerged as a more useful prognostic indicator than MRI findings in dogs with suspected IIVDE.

A 6-year-old Dachshund was presented with acute, non-localized pain without neurological dysfunction. Radiography revealed multiple calcifications of intervertebral discs and narrowing of disc space in the thoracolumbar region. Computed tomography and magnetic resonance imaging revealed calcified disc-like material entrapped in the left extraforaminal area and showed a displaced nerve root. Fenestration and removal of the extruded disc material were performed in a routine manner. Histopathological examination showed degenerative disc materials with severe calcification both in the nucleus pulposus and around the annulus fibrosis. Based on imaging, surgical, and histopathologic results, the dog was diagnosed with far lateral lumbar disc extrusion.
Animals ; Child ; Dogs ; Fibrosis ; Humans ; Intervertebral Disc ; Magnetic Resonance Imaging ; Radiography

PURPOSE: The aim of this study was to identify an adequate chest compression site with measurement of the sternal length of young Korean adults. METHODS: We measured the distance from the suprasternal notch to the lower end of the sternum by palpation and width of heel above the carpal bone end 1 cm (H1), 2 cm (H2) in young Korean adults. We also measured weight, height, and BMI of participants. We then compared correlation of each collected variant to sternal length and heel length. RESULTS: A total of 200 young adults (100 men, 100 women) were enrolled. In measurement of the mean sternal length (SL), no difference was observed between men (19.9 cm) and women (19.6 cm) (p<0.05). However, height, weight, and BMI showed positive correlation with SL (R2 value, BMI=6.7, height=9.2, weight=10.4). After participants were divided into four groups based on gender and mean height, we calculated mean H2 and SL/2 of each group. The mean H2 and SL/2 of the group composed of men above mean height was 8.5 cm and 10.2 cm. The same value for the group of men below mean height was 8.5 cm and 9.7 cm. The mean H2 and SL/2 of the group composed of women above mean height was 7.5 cm and 10.1 cm. The same values for the group of women below mean height were 7.3 cm and 9.6 cm. The mean SL/2 was always higher than the mean H2 in different height groups. CONCLUSION: Compression just above the lower end of the sternum by heel on the hand is appropriate in men. In contrast, when performing chest compression in women, chest compression at the level of the sternum away from the width of the index finger of the sternal end is recommended.
Adult* ; Cardiopulmonary Resuscitation ; Carpal Bones ; Female ; Fingers ; Hand ; Heel ; Humans ; Male ; Palpation ; Sternum ; Thorax* ; Young Adult

The correction of author order.
Adult* ; Humans ; Korea* ; Mortality*

No abstract available.
Bile Duct Neoplasms/complications/*diagnosis ; *Bile Ducts, Intrahepatic/chemistry/pathology/radiography ; Biopsy ; Cholangiocarcinoma/complications/*diagnosis ; Diagnosis, Differential ; Fever/diagnosis/*etiology ; Humans ; Immunohistochemistry ; Leukocytosis/*diagnosis/etiology ; *Liver/chemistry/pathology/radiography ; Liver Abscess, Pyogenic/*diagnosis ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Paraneoplastic Syndromes/*diagnosis/etiology ; Predictive Value of Tests ; Tomography, Spiral Computed ; Tumor Markers, Biological/analysis

Objectives: Artificial intelligence (AI) technologies are developing very rapidly in the medical field, but have yet to be actively used in actual clinical settings. Ensuring reliability is essential to disseminating technologies, necessitating a wide range of research and subsequent social consensus on requirements for trustworthy AI. Methods: This review divided the requirements for trustworthy medical AI into explainability, fairness, privacy protection, and robustness, investigated research trends in the literature on AI in healthcare, and explored the criteria for trustworthy AI in the medical field. Results: Explainability provides a basis for determining whether healthcare providers would refer to the output of an AI model, which requires the further development of explainable AI technology, evaluation methods, and user interfaces. For AI fairness, the primary task is to identify evaluation metrics optimized for the medical field. As for privacy and robustness, further development of technologies is needed, especially in defending training data or AI algorithms against adversarial attacks. Conclusions In the future, detailed standards need to be established according to the issues that medical AI would solve or the clinical field where medical AI would be used. Furthermore, these criteria should be reflected in AI-related regulations, such as AI development guidelines and approval processes for medical devices.

BACKGROUND: This study investigated the health behaviors of North Korean, multicultural, and Korean family adolescents in Korea. METHODS: The study subjects were from the Korea youth risk behavior web-based survey (2011-2013) dataset. We identified 1,954 multicultural family adolescents and twice as many Korean family adolescents. Frequency analysis was used to assess nativity and nationality of the parents, and the chi-square test was used to compare the general characteristics and health behavior of the multicultural and Korean families. Conditional multiple logistic regression was used to compare health behavior between multicultural and Korean families. RESULTS: Of the 5,862 multicultural and Korean family adolescents, current smoking in North Korean family adolescents was higher than Korean family adolescents (adjusted odds ratio [aOR], 2.32; 95% confidence interval [CI], 1.60-3.35) after adjusting for sex, school year, perceived school record, family structure, father's education, mother's education, perceived economic status, place of residence, and survey year. A high drinking rate was significantly greater in North Korean family adolescents compared to Korean family adolescents (aOR, 2.94; 95% CI, 1.89-4.57). Odds ratios for sufficient physical activity of vigorous intensity (aOR, 1.82; 95% CI, 1.31-2.54) were significantly higher in North Korean family adolescents than in Korean family adolescents. Fast food intake (aOR, 1.96; 95% CI, 1.34-2.86) was significantly higher in North Korean family adolescents compared to Korean family adolescents. CONCLUSION: There were differences in health behavior between North Korean, multicultural, and Korean family adolescents. Further studies are needed to investigate the factors associated with these differences.
Adolescent* ; Chi-Square Distribution ; Cultural Diversity ; Dataset ; Democratic People's Republic of Korea ; Drinking ; Education ; Ethnic Groups ; Fast Foods ; Health Behavior* ; Humans ; Korea* ; Logistic Models ; Motor Activity ; Odds Ratio ; Parents ; Risk-Taking* ; Smoke ; Smoking

Purpose: Recently, high-protein diets have become highly popular, and the market for protein products has steadily increased in Korea together with the development of various types of such products. However, there is limited information on the consumption of protein supplements (PS) or protein-fortified foods (PF). Thus, this study aimed to evaluate the use of PS/PF among young adults in Jeju. Methods: A total of 350 adults (140 men and 210 women) aged 19–39 years voluntarily participated in this study from June 2022 to May 2023. PS/PF use was measured using a questionnaire. Dietary intake was assessed using a 24-hour dietary recall. Results: Approximately 31.4% of the participants (n = 110) had consumed PS/PF for more than 2 weeks during the past year and 71.8% of them (n = 79) were still consuming these products (PS/PF consumers). The PS/PF consumers tended to be male and physically active (p < 0.05 for all). The most frequent reason for PS/PF use was muscle gain (59.5%), followed by protein supplementation (19.0%) and body fat loss (13.9%), and the most frequent type of PS/PF consumed was powders (70.6%), followed by drinks (17.7%) and bars (8.8%). The PS/PF consumers tended to consume a high-protein low-carbohydrate diet compared to the non-consumers. The prevalence of consuming dietary protein less than the estimated average requirement (EAR) was significantly lower in PS/PF consumers (13.9%) compared to non-consumers (25.4%; p = 0.0316). Conclusion These findings indicate that the necessity of protein supplementation should be determined based on the current dietary protein intake and individual requirements. The study also provides the basic information for establishing guidelines for appropriate protein intake.

The aim of this study was to investigate the efficiency of domestic physician-staffed helicopter emergency medical service (HEMS) for the transport of patients with severe trauma to a hospital. The study included patients with blunt trauma who were transported to our hospital by physician-staffed HEMS (Group P; n = 100) or nonphysician-staffed HEMS (Group NP; n = 80). Basic patient characteristics, transport time, treatment procedures, and medical treatment outcomes assessed using the Trauma and Injury Severity Score (TRISS) were compared between groups. We also assessed patients who were transported to the hospital within 3 h of injury in Groups P (Group P3; n = 50) and NP (Group NP3; n = 74). The severity of injury was higher, transport time was longer, and time from hospital arrival to operation room transfer was shorter for Group P than for Group NP (P < 0.001). Although Group P patients exhibited better medical treatment outcomes compared with Group NP, the difference was not statistically significant (P = 0.134 vs. 0.730). However, the difference in outcomes was statistically significant between Groups P3 and NP3 (P = 0.035 vs. 0.546). Under the current domestic trauma patient transport system in South Korea, physician-staffed HEMS are expected to increase the survival of patients with severe trauma. In particular, better treatment outcomes are expected if dedicated trauma resuscitation teams actively intervene in the medical treatment process from the transport stage and if patients are transported to a hospital to receive definitive care within 3 hours of injury.
Adult* ; Aircraft ; Emergencies ; Emergency Medical Services ; Humans ; Injury Severity Score ; Korea* ; Mortality* ; Resuscitation ; Trauma Centers ; Treatment Outcome

PURPOSE: The purpose of this study was to verify the utility of existing Trauma and Injury Severity Score (TRISS) coefficients and to propose a new prediction model with a new set of TRISS coefficients or predictors. MATERIALS AND METHODS: Of the blunt adult trauma patients who were admitted to our hospital in 2014, those eligible for Korea Trauma Data Bank entry were selected to collect the TRISS predictors. The study data were input into the TRISS formula to obtain "probability of survival" values, which were examined for consistency with actual patient survival status. For TRISS coefficients, Major Trauma Outcome Study-derived values revised in 1995 and National Trauma Data Bank-derived and National Sample Project-derived coefficients revised in 2009 were used. Additionally, using a logistic regression method, a new set of coefficients was derived from our medical center's database. Areas under the receiver operating characteristic (ROC) curve (AUC) for each prediction ability were obtained, and a pairwise comparison of ROC curves was performed. RESULTS: In the statistical analysis, the AUCs (0.879-0.899) for predicting outcomes were lower than those of other countries. However, by adjusting the TRISS score using a continuous variable rather than a code for age, we were able to achieve higher AUCs [0.913 (95% confidence interval, 0.899 to 0.926)]. CONCLUSION: These results support further studies that will allow a more accurate prediction of prognosis for trauma patients. Furthermore, Korean TRISS coefficients or a new prediction model suited for Korea needs to be developed using a sufficiently sized sample.
Adolescent ; Adult ; Aged ; Databases, Factual ; Female ; Humans ; *Injury Severity Score ; Logistic Models ; Male ; Middle Aged ; Predictive Value of Tests ; Probability ; Prognosis ; ROC Curve ; Republic of Korea ; Trauma Centers/statistics & numerical data ; *Trauma Severity Indices ; Wounds, Nonpenetrating/*diagnosis