The survival rate of commotio cordis is low, and there is often associated neurological disability if return of spontaneous circulation (ROSC) can be achieved. We report a case of commotio cordis treated with therapeutic hypothermia (TH) that demonstrated a favorable outcome. A 16-year-old female was transferred to our emergency department (ED) for collapse after being struck in the chest with a dodgeball. She has no history of heart problems. She was brought to our ED with pulseless ventricular tachycardia (VT), and ROSC was achieved with defibrillation. She was comatose at our ED and was treated with TH at a target temperature of 33degrees C for 24 hours. After transfer to the intensive care unit, pulseless VT occurred, and defibrillation was performed twice. She recovered to baseline neurologic status with the exception of some memory difficulties.
Adolescent ; Coma ; Commotio Cordis* ; Emergency Service, Hospital ; Female ; Heart ; Humans ; Hypothermia* ; Intensive Care Units ; Memory ; Survival Rate ; Tachycardia ; Tachycardia, Ventricular* ; Thoracic Injuries ; Thorax

PURPOSE: To compare clinical outcomes after intravitreal injection of triamcinolone acetonide or bevacizumab for the treatment of macular edema secondary to branch retinal vein occlusion. METHODS: Sixty-six patients received an intravitreal injection of either triamcinolone acetonide or bevacizumab. Patients were retrospectively reviewed. Thirty-three out of 66 patients were treated with an intravitreal injection of triamcinolone acetonide, while the other 33 patients received a bevacizumab injection. All patients underwent a visual acuity test, optical coherence tomography imaging and ophthalmoscopic examination throughout the follow-up. RESULTS: In the triamcinolone group, central macular thickness (CMT) decreased from 496.69 +/- 153.01 micrometer at baseline to 313.06 +/- 150.14 micrometer at the six-month follow-up visit, while in the bevacizumab group, CMT decreased from 441.30 +/- 185.79 micrometer to 295.67 +/- 188.80 micrometer (p<0.05). In the triamcinolone group, best-corrected visual acuity (BCVA) improved from logMAR 0.92 +/- 0.70 at baseline to logMAR 0.53 +/- 0.43 at the six-month follow-up visit, and in the bevacizumab group, BCVA improved from logMAR 0.74 +/- 0.47 to logMAR 0.34 +/- 0.33 (p<0.05). CONCLUSIONS: The therapeutic effects of intravitreal triamcinolone acetonide showed no significant differences compared with those of intravitreal bevacizumab with regard to anatomical and functional outcomes.
Antibodies, Monoclonal, Humanized ; Follow-Up Studies ; Humans ; Intravitreal Injections ; Macular Edema ; Retinal Vein ; Retinal Vein Occlusion ; Retinaldehyde ; Retrospective Studies ; Tomography, Optical Coherence ; Triamcinolone ; Triamcinolone Acetonide ; Visual Acuity ; Bevacizumab

In order to investigate the beneficial effects of 0.5 or 1.0 g/kg Korean garlic juice against the embryotoxicity of 20 mg/kg methylmercury chloride (MMC, CH3HgCl), pregnant Fisher 344 rats were simultaneously orally administered on day 7 of gestation. On day 20 of gestation the dams were laparotomized under ether anesthesia, and the fetuses were removed and examined for toxicity of methylmercury. Garlic juice depressed the toxicity in terms of some parameters. In the case of simultaneous treatment with 0.1 g/kg garlic juice and MMC, rates of increase were 17.5% in maternal body weight, 13.2% and 41.9% in fetal and litters' weight respectively, and 37.0% in fetal survival rate. Decreasing rates were 10.0% in maternal death rate, and 6.9% and 31.3% in pre- and post-implantation loss respectively. Decreasing rates of mercury levels in dams were 67.2% in liver, 57.6% in brain, 47.2% in kidney, 42.1% in spleen and 40.9% in blood. As well, decreasing rates of mercury level in fetuses were 54.9% in all body burden, 55.9% in liver, 46.7% in kidney and 37% in brain, respectively. The number of fetal ossification centers were reduced by 23.8% to 58.0% following simultaneous treatment with 1.0 g/kg garlic juice. These findings indicated that garlic juice effectively inhibited the embryotoxicity of methylmercury in pregnant Fischer 344 rats.
Animal ; Body Weight/drug effects ; Embryo/drug effects* ; Embryo Loss/prevention & control ; Embryo Loss/chemically induced ; Female ; Fetal Weight/drug effects ; Garlic* ; Methylmercury Compounds/toxicity* ; Methylmercury Compounds/pharmacokinetics ; Osteogenesis/drug effects ; Pregnancy ; Rats ; Rats, Inbred F344 ; Tissue Distribution

Patients with HIV infection may be at increased risk of thrombosis. A variety of mechanism have been proposed to account for hypercoagulability in HIV-infected patients. These include decreased plasma concentrations of protein S, opportunistic infection, tumor such as Kaposi's sarcoma, drugs such as megestrol acetate, protease inhibitor, and presence of anticardiolipin antibody. The authors report three cases of thrombosis in AIDS patients. One case was renal vein thrombosis associated with abnormalities of protein S and anticardiolipin IgG. Two cases were pulmonary embolism associated with megestrol acetate.
Acquired Immunodeficiency Syndrome* ; Antibodies, Anticardiolipin ; HIV Infections ; Humans ; Immunoglobulin G ; Megestrol Acetate ; Opportunistic Infections ; Plasma ; Protease Inhibitors ; Protein S ; Pulmonary Embolism ; Renal Veins ; Sarcoma, Kaposi ; Thrombophilia ; Thrombosis*

Patients with HIV infection may be at increased risk of thrombosis. A variety of mechanism have been proposed to account for hypercoagulability in HIV-infected patients. These include decreased plasma concentrations of protein S, opportunistic infection, tumor such as Kaposi's sarcoma, drugs such as megestrol acetate, protease inhibitor, and presence of anticardiolipin antibody. The authors report three cases of thrombosis in AIDS patients. One case was renal vein thrombosis associated with abnormalities of protein S and anticardiolipin IgG. Two cases were pulmonary embolism associated with megestrol acetate.
Acquired Immunodeficiency Syndrome* ; Antibodies, Anticardiolipin ; HIV Infections ; Humans ; Immunoglobulin G ; Megestrol Acetate ; Opportunistic Infections ; Plasma ; Protease Inhibitors ; Protein S ; Pulmonary Embolism ; Renal Veins ; Sarcoma, Kaposi ; Thrombophilia ; Thrombosis*

Ganglion cysts originating from the volar wrist joint are usually found on the volar side. A case report has described a patient with a dorsal wrist ganglion originating from the scapholunate ligament and appearing at a volar location. However, no cases of volar wrist ganglia appearing on the dorsal wrist have been reported. Herein, we present a rare case of a large dorsal ganglion cyst originating from the volar scaphotrapeziotrapezoidal (STT) joint that pierced the first dorsal interosseous muscle, leading to dorsal bulging. A 40-year-old woman presented with a progressively growing mass over the dorsal aspect of her left wrist and mild pain. Preoperative imaging showed a ganglion cyst originating from the volar side of the STT joint. The ganglion was successfully removed through open surgery. In conclusion, since ganglion cysts occurring in the dorsal wrist, especially if there is deviation to the radial side, may originate from the volar midcarpal joint, magnetic resonance imaging is necessary to reduce the risk of recurrence and minimize the likelihood of postoperative complications.

Ganglion cysts originating from the volar wrist joint are usually found on the volar side. A case report has described a patient with a dorsal wrist ganglion originating from the scapholunate ligament and appearing at a volar location. However, no cases of volar wrist ganglia appearing on the dorsal wrist have been reported. Herein, we present a rare case of a large dorsal ganglion cyst originating from the volar scaphotrapeziotrapezoidal (STT) joint that pierced the first dorsal interosseous muscle, leading to dorsal bulging. A 40-year-old woman presented with a progressively growing mass over the dorsal aspect of her left wrist and mild pain. Preoperative imaging showed a ganglion cyst originating from the volar side of the STT joint. The ganglion was successfully removed through open surgery. In conclusion, since ganglion cysts occurring in the dorsal wrist, especially if there is deviation to the radial side, may originate from the volar midcarpal joint, magnetic resonance imaging is necessary to reduce the risk of recurrence and minimize the likelihood of postoperative complications.

Ganglion cysts originating from the volar wrist joint are usually found on the volar side. A case report has described a patient with a dorsal wrist ganglion originating from the scapholunate ligament and appearing at a volar location. However, no cases of volar wrist ganglia appearing on the dorsal wrist have been reported. Herein, we present a rare case of a large dorsal ganglion cyst originating from the volar scaphotrapeziotrapezoidal (STT) joint that pierced the first dorsal interosseous muscle, leading to dorsal bulging. A 40-year-old woman presented with a progressively growing mass over the dorsal aspect of her left wrist and mild pain. Preoperative imaging showed a ganglion cyst originating from the volar side of the STT joint. The ganglion was successfully removed through open surgery. In conclusion, since ganglion cysts occurring in the dorsal wrist, especially if there is deviation to the radial side, may originate from the volar midcarpal joint, magnetic resonance imaging is necessary to reduce the risk of recurrence and minimize the likelihood of postoperative complications.

No study has examined the effectiveness of backboards and air deflation for achieving adequate chest compression (CC) depth on air mattresses with the typical configurations seen in intensive care units. To determine this efficacy, we measured mattress compression depth (MCD, mm) on these surfaces using dual accelerometers. Eight cardiopulmonary resuscitation providers performed CCs on manikins lying on 4 different surfaces using a visual feedback system. The surfaces were as follows: A, a bed frame; B, a deflated air mattress placed on top of a foam mattress laid on a bed frame; C, a typical air mattress configuration with an inflated air mattress placed on a foam mattress laid on a bed frame; and D, C with a backboard. Deflation of the air mattress decreased MCD significantly (B; 14.74 +/- 1.36 vs C; 30.16 +/- 3.96, P < 0.001). The use of a backboard also decreased MCD (C; 30.16 +/- 3.96 vs D; 25.46 +/- 2.89, P = 0.002). However, deflation of the air mattress decreased MCD more than use of a backboard (B; 14.74 +/- 1.36 vs D; 25.46 +/- 2.89, P = 0.002). The use of a both a backboard and a deflated air mattress in this configuration reduces MCD and thus helps achieve accurate CC depth during cardiopulmonary resuscitation.
Beds ; Cardiopulmonary Resuscitation/*instrumentation/methods ; *Compressive Strength ; Equipment Design ; Heart Massage/*instrumentation/methods ; Humans ; Intensive Care Units ; Manikins ; Prospective Studies

OBJECTIVES: Cardiovascular disease is the leading cause of death and a major source of workers' compensation claims in Korea. Since 2000 the Korea Occupational Safety and Health Agency (KOSHA), working through local occupational health institutions, has supported cardiovascular disease prevention programs at a number of companies in Korea. The purpose of this study was to assess the short-term effects of this effort. METHODS: A total of 11,077 workers at risk were enrolled in the workplace cardiovascular disease prevention program and 5,902 workers (53.3%) completed the 1-year course during 2007. The program consisted of a medical checkup and health counseling for the workers by occupational health nurses. The guidelines for this prevention program were adopted from KOSHA Code H-11-2004. To determine the program's effectiveness, the workers' risks for cardiovascular disease were assessed before and one year after completion of the program. RESULTS: The intervention led to significant reductions in the mean systolic and diastolic blood pressures of 4.9 mmHg and 3.1 mmHg, respectively. Mean total cholesterol and BMI were also reduced significantly by 8.4 g/dl and 0.1 kg/m2. The rate of smoking was decreased by 6.0% and the percentage of workers engaging in regular exercise was increased by 23.1%. Of the 3,530 workers with the low risk and above, the overall cardiovascular risk was improved in 1,734 (49.1%) of them. CONCLUSIONS: The cardiovascular disease prevention program supported by the Korea Occupational Safety and Health Agency reduces cardiovascular diseases risks among workers and may improve the health status of workers in Korea.
Cardiovascular Diseases ; Cause of Death ; Cholesterol ; Counseling ; Government Programs ; Health Promotion ; Korea ; Occupational Health ; Smoke ; Smoking ; Workers' Compensation