This study examined the effects of myristate on an asymbiotic culture of Rhizoglomus intraradices, a species of arbuscular mycorrhizal fungi (AMF; Glomeromycota). Mycelial growth and sporulation in a modified medium containing myristate were observed. The findings demonstrated that myristate induced R. intraradices spore formation, with daughter spores having a smaller diameter than the parent spores. This observation is consistent with previous studies on other Rhizoglomus species. Further studies are needed to investigate the potential for continuous culture, mass production using daughter spores, and the application of AMF colonization techniques in plants.

Spontaneous tonsillar hemorrhage (STH) is an extremely rare event. Usually, the causes of STH are ascribed to vessel wall erosion secondary to bacterial or viral infection of tonsils. Other causes include vascular or tumorous lesions around tonsil, coagulation disorders and idiopathic one. On one hand, the total number of reported STH has slightly increased because STH is defined as all forms of "bleeding tonsils", including even minor bleeding. On the other hand, the portion of the total STH that is life-threatening has become relatively few. Management of STH involves the use of antibiotics, and early tonsillectomy is recommended. We have experienced a case of a 29 year-old female with tonsillar hemorrhage in the absence of any identifiable cause. We report the case with a review of the related literatures.
Anti-Bacterial Agents ; Female ; Glycosaminoglycans ; Hand ; Hemorrhage ; Humans ; Palatine Tonsil ; Tonsillectomy

Robotic central pancreatectomy has not been widely performed because of its rare indications, technical difficulties, and concern about the high complication rate. We reviewed six robotic central pancreatectomy cases between May 2016 and June 2021 at a single institution. This multimedia article aims to introduce our technique of robotic central pancreatectomy with perioperative and follow-up outcomes. All patients experienced biochemical leakage of postoperative pancreatic fistula, except in one with a grade B pancreatic fistula, which resulted in a pseudocyst formation and was successfully managed by endoscopic internal drainage. All patients achieved completely negative resection margins. There was no new-onset diabetes mellitus or recurrence during the median follow-up period of 13.5 months (range, 10–74 months). With an acceptable complication rate and the preservation of pancreatic function, robotic central pancreatectomy could be a good surgical option for patients with benign and borderline malignant tumors of the pancreatic neck or proximal body.

PURPOSE: For determining the prognosis of critically injured patients, transporting patients to medical facilities capable of providing proper assessment and management, running rapid assessment and making rapid decisions, and providing aggressive resuscitation is vital. Considering the high mortality and morbidity rates in critically injured patients, various studies have been conducted in efforts to reduce those rates. However, studies related to diagnostic factors for predicting severity in critically injured patients are still lacking. Furthermore, patients showing stable vital signs and alert mental status, who are injured via a severe trauma mechanism, may be at a risk of not receiving rapid assessment and management. Thus, this study investigates diagnostic factors, including physical examination and laboratory results, that may help predict severity in trauma patients injured via a severe trauma mechanism, but showing stable vital signs. METHODS: From March 2010 to December 2011, all trauma patients who fit into a diagnostic category that activated a major trauma team in CHA Bundang Medical Center were analyzed retrospectively. The retrospective analysis was based on prospective medical records completed at the time of arrival in the emergency department and on sequential laboratory test results. PASW statistics 18(SPSS Inc., Chicago, IL, USA) was used for the statistical analysis. Patients with relatively stable vital signs and alert mental status were selected based on a revised trauma score of more than 7 points. The final diagnosis of major trauma was made based on an injury severity score of greater than 16 points. Diagnostic variables include systolic blood pressure and respiratory rate, glasgow coma scale, initial result from focused abdominal sonography for trauma, and laboratory results from blood tests and urine analyses. To confirm the true significance of the measured values, we applied the Kolmogorov-Smirnov one sample test and the Shapiro-Wilk test. When significance was confirmed, the Student's t-test was used for comparison; when significance was not confirmed, the Mann-Whitney u-test was used. The results of focused abdominal sonography for trauma (FAST) and factors of urine analysis were analyzed using the Chi-square test or Fisher's exact test. Variables with statistical significance were selected as prognostics factors, and they were analyzed using a multivariate logistics regression model. RESULTS: A total of 269 patients activated the major trauma team. Excluding 91 patients who scored a revised trauma score of less than 7 points, 178 patients were subdivided by injury severity score to determine the final major trauma patients. Twenty-one(21) patients from 106 major trauma patients and 9 patients from 72 minor trauma patients were also excluded due to missing medical records or untested blood and urine analysis. The investigated variables with p-values less than 0.05 include the glasgow coma scale, respiratory rate, white blood cell count (WBC), serum AST and ALT, serum creatinine, blood in spot urine, and protein in spot urine. These variables could, thus, be prognostic factors in major trauma patients. A multivariate logistics regression analysis on those 8 variables showed the respiratory rate (p=0.034), WBC (p=0.005) and blood in spot urine (p=0.041) to be independent prognostic factors for predicting the clinical course of major trauma patients. CONCLUSION: In trauma patients injured via a severe trauma mechanism, but showing stable vital signs and alert mental status, the respiratory rate, WBC count and blood in the urine can be used as predictable factors for severity. Using those laboratory results, rapid assessment of major trauma patients may shorten the time to diagnosis and the time for management.
Blood Pressure ; Chicago ; Creatinine ; Emergencies ; Glasgow Coma Scale ; Hematologic Tests ; Humans ; Injury Severity Score ; Leukocyte Count ; Medical Records ; Multivariate Analysis ; Organization and Administration ; Physical Examination ; Prognosis ; Prospective Studies ; Respiratory Rate ; Resuscitation ; Retrospective Studies ; Running ; Vital Signs

We studied 16 male patients complaining of impotence after trauma. Underlying causes of injury were posterior urethral injury (9 patients), pevic bone fracture (3 patients), perineal burn (2 patients), penile fracture (1 patient) and spinal cord injury (1 patient). Rigiscan was used for diagnostic test and compared with other erectile function tests (Papaverine injection test, Snap Gauge test, PBI(penile brachial index) and PDI (penile digital index) test, AVS (audiovisual stimulation) and Erectiometer tests. The results obtained were as follows: 1. In 9 patients shown normal rigiscan, the number of erection was 1.56+/-0.87 times per night, duration was 14.2+/-7.54 minutes at tip and 20.1+/-9.42 minutes at base, tumescence change was 2.30+/-1.64 cm at tip and 3.40+/-0.73 cm at base, rigidity was 66.28+/-13.33% at tip and 78.86+/-21.43% at base. 2. Among 9 patients shown normal rigiscan, 8 patients showed partial to full rigid erection in intracavernous Papaverine injection test. 3. In 7 patients shown abnormal rigiscan, the findings of Snap Gauge test, AVS test and Erectiometer test showed slight to absent responses, but 9 patients shown normal rigiscan presented variable findings. 4. 13 patients with PBI > or=0.75 and 15 patients with PDI > or =0.77 showed normal rigiscan. but patients shown abnormal rigiscan presented variable findings of PBI and PDI tests. Conclusively, rigiscan and intracavernous Papaverine injection test showed high corresponding rate, but other erectile function tests presented variable findings in patients complaining of impotence after trauma.
Burns ; Diagnostic Tests, Routine ; Erectile Dysfunction* ; Fractures, Bone ; Humans ; Male ; Papaverine ; Spinal Cord Injuries

We studied 16 male patients complaining of impotence after trauma. Underlying causes of injury were posterior urethral injury (9 patients), pevic bone fracture (3 patients), perineal burn (2 patients), penile fracture (1 patient) and spinal cord injury (1 patient). Rigiscan was used for diagnostic test and compared with other erectile function tests (Papaverine injection test, Snap Gauge test, PBI(penile brachial index) and PDI (penile digital index) test, AVS (audiovisual stimulation) and Erectiometer tests. The results obtained were as follows: 1. In 9 patients shown normal rigiscan, the number of erection was 1.56+/-0.87 times per night, duration was 14.2+/-7.54 minutes at tip and 20.1+/-9.42 minutes at base, tumescence change was 2.30+/-1.64 cm at tip and 3.40+/-0.73 cm at base, rigidity was 66.28+/-13.33% at tip and 78.86+/-21.43% at base. 2. Among 9 patients shown normal rigiscan, 8 patients showed partial to full rigid erection in intracavernous Papaverine injection test. 3. In 7 patients shown abnormal rigiscan, the findings of Snap Gauge test, AVS test and Erectiometer test showed slight to absent responses, but 9 patients shown normal rigiscan presented variable findings. 4. 13 patients with PBI > or=0.75 and 15 patients with PDI > or =0.77 showed normal rigiscan. but patients shown abnormal rigiscan presented variable findings of PBI and PDI tests. Conclusively, rigiscan and intracavernous Papaverine injection test showed high corresponding rate, but other erectile function tests presented variable findings in patients complaining of impotence after trauma.
Burns ; Diagnostic Tests, Routine ; Erectile Dysfunction* ; Fractures, Bone ; Humans ; Male ; Papaverine ; Spinal Cord Injuries

The aim of this study was to characterize a new fungal species, Acremonium conglutinatum, isolated from air samples collected in Wando, South Korea. Phylogenetic analysis based on the internal transcribed spacer and large subunit regions revealed its unique position within the genus Acremonium. The isolated strain displayed distinct morphological characteristics, including ellipsoid or bent-ellipsoid conidia formed in clusters on the phialides. These features differentiate the new species from closely related species within the genus. This study describes the morphological and molecular characteristics of A. conglutinatum and emphasizes its phylogenetic relationships with other Acremonium spp. The identification of this novel species contributes to our understanding of the diversity and ecological role of Acremonium.

PURPOSE: The aim of the study was to validate abbreviated mortality in emergency department sepsis (MEDS) scoring system by comparing it with original MEDS score and to assess the prognostic value of other prognostic factor for sepsis patients including multiple organ dysfunction score (MODS), sepsis-related organ failure assessment (SOFA) score, and serum procalcitonin level. METHODS: Adult patients visiting emergency department (ED) with evidence of septic shock were enrolled to the study. MEDS score, MODS, and SOFA score were calculated based on initial clinical data. Receiver-operating characteristics (ROC) analyses were used to assess the prognostic factors for predicting mortality. Kaplan-Meier survival analyses (KMSA) were used to determine whether the prognostic factors had correlation with survival time. RESULTS: Only MODS showed significant predicting power for mortality (p=0.003, area under curve=0.625). Estimated median survival of all the patients calculated by KMSA was 11.0 (standard error 1.7) days, and predefined criteria of all prognostic factors showed significant differences in survival time. CONCLUSION: MEDS, abbreviated MEDS, MODS, and SOFA scoring systems were useful factors for predicting survival time of septic shock patients visiting ED.
Adult ; Calcitonin ; Emergencies ; Humans ; Multiple Organ Failure ; Organ Dysfunction Scores ; Prognosis ; Protein Precursors ; Sepsis ; Shock, Septic

PURPOSE: A few studies have assessed the factors affecting the prognoses for major trauma patients and those improving the circumstances when dealing with the trauma system. In that light, we analyzed factors, such as pre-hospital factors, the time to admission, the length of stay in the emergency department (ED) and emergency operation, influencing the outcomes for trauma patients. METHODS: The patients who visited our emergency department from April 1, 2009, to February 29, 2011, due to major trauma were enrolled in the study. The inclusion criterion was a revised trauma score (RTS) < 7 or injury severity score (ISS) > or = 16. We used reviews of medical records, to analyze each step of emergency medical care with respect to patients' sex, age, visit time and visit date. Continuous variables were described as a median with an interquartile range, and we compared the variables between the survival and the mortality groups by using the Mann-Whitney U test. Fisher's exact test was used for nominal variables. Using the variables that showed statistical significance in univariate comparisons, we performed a logistic regression analysis, and we tested the model's adequacy by the using the Hosmer-Lemeshow method. RESULTS: A total of 261 patients with major trauma satisfied either the RTS score criterion or the ISS score criterion. Excluding 12 patients with missing data, 249 patients were included in this study. The overall mortality rate was 16.9%. Time to ED arrival, time to admission, time of ED stay, RTS, ISS, and visit date being a holiday showed statistically significant differences between the survival and the mortality groups in the univariate analysis. RTS, ISS, length of ED stay, and visit date being a holiday showed statistical significance in the multivariate analysis. CONCLUSION: The mortality rate did not show a significant relationship with the time to ED arrival, use of 119, on time to admission. Rather, it elicited a quite significant correlation with the trauma scoring system (RTS and ISS), the time of ED stay, and the visit date being a holiday.
Emergencies ; Emergency Medical Services ; Holidays ; Humans ; Injury Severity Score ; Length of Stay ; Light ; Logistic Models ; Medical Records ; Prognosis

Purpose: Despite the increasing number of robotic pancreaticoduodenectomies, laparoscopic pancreaticoduodenectomy (LPD) and LPD with robotic reconstruction (LPD-RR) are still valuable surgical options for minimally invasive pancreaticoduodenectomy (MIPD). This study introduces the surgical techniques, tips, and outcomes of our experience with LPD and LPD-RR. Methods: Between March 2014 and July 2021, 122 and 48 patients underwent LPD and LPDRR respectively, at CHA Bundang Medical Center in Korea. The operative settings, procedures, and trocar placements were identical in both approaches; however, different trocars were used. We introduced our techniques of retraction methods for Kocherization and uncinate process dissection, pancreatic reconstruction, pancreatic division, and protection using the round ligament. The perioperative surgical outcomes of LPD and LPD-RR were compared. Results: Baseline demographics of patients in the LPD and LPD-RR groups were comparable, but the LPD group had older age (65.5 ± 11.6 years vs. 60.0 ± 14.1 years, p = 0.009) and lesser preoperative chemotherapy (15.6% vs. 35.4%, p = 0.008). The proportion of malignant disease was similar (LPD group, 86.1% vs. LPD-RR group, 83.3%; p = 0.759). Perioperative outcomes were also comparable, including operative time, estimated blood loss, clinically relevant postoperative pancreatic fistula (LPD group, 9.0% vs. LPD-RR group, 10.4%; p = 0.684), and major postoperative complication rates (LPD group, 14.8% vs. LPD-RR group, 6.2%; p = 0.082). Conclusion Both LPD and LPR-RR can be safely performed by experienced surgeons with acceptable surgical outcomes. Further investigations are required to evaluate the objective benefits of robotic surgical systems in MIPD and establish widely acceptable standardized MIPD techniques.