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

Background: Rapid triage reduces the patients' stay time at an emergency department (ED). The Korean Triage Acuity Scale (KTAS) is mandatorily applied at EDs in South Korea.For rapid triage, we studied machine learning-based triage systems composed of a speech recognition model and natural language processing-based classification. Methods: We simulated 762 triage cases that consisted of 18 classes with six types of the main symptom (chest pain, dyspnea, fever, stroke, abdominal pain, and headache) and three levels of KTAS. In addition, we recorded conversations between emergency patients and clinicians during the simulation. We used speech recognition models to transcribe the conversation. Bidirectional Encoder Representation from Transformers (BERT), support vector machine (SVM), random forest (RF), and k-nearest neighbors (KNN) were used for KTAS and symptom classification. Additionally, we evaluated the Shapley Additive exPlanations (SHAP) values of features to interpret the classifiers. Results: The character error rate of the speech recognition model was reduced to 25.21% through transfer learning. With auto-transcribed scripts, support vector machine (area under the receiver operating characteristic curve [AUROC], 0.86; 95% confidence interval [CI], 0.81–0.9), KNN (AUROC, 0.89; 95% CI, 0.85–0.93), RF (AUROC, 0.86; 95% CI, 0.82–0.9) and BERT (AUROC, 0.82; 95% CI, 0.75–0.87) achieved excellent classification performance.Based on SHAP, we found “stress”, “pain score point”, “fever”, “breath”, “head” and “chest” were the important vocabularies for determining KTAS and symptoms. Conclusion We demonstrated the potential of an automatic KTAS classification system using speech recognition models, machine learning and BERT-based classifiers.

Background: Rapid triage reduces the patients' stay time at an emergency department (ED). The Korean Triage Acuity Scale (KTAS) is mandatorily applied at EDs in South Korea.For rapid triage, we studied machine learning-based triage systems composed of a speech recognition model and natural language processing-based classification. Methods: We simulated 762 triage cases that consisted of 18 classes with six types of the main symptom (chest pain, dyspnea, fever, stroke, abdominal pain, and headache) and three levels of KTAS. In addition, we recorded conversations between emergency patients and clinicians during the simulation. We used speech recognition models to transcribe the conversation. Bidirectional Encoder Representation from Transformers (BERT), support vector machine (SVM), random forest (RF), and k-nearest neighbors (KNN) were used for KTAS and symptom classification. Additionally, we evaluated the Shapley Additive exPlanations (SHAP) values of features to interpret the classifiers. Results: The character error rate of the speech recognition model was reduced to 25.21% through transfer learning. With auto-transcribed scripts, support vector machine (area under the receiver operating characteristic curve [AUROC], 0.86; 95% confidence interval [CI], 0.81–0.9), KNN (AUROC, 0.89; 95% CI, 0.85–0.93), RF (AUROC, 0.86; 95% CI, 0.82–0.9) and BERT (AUROC, 0.82; 95% CI, 0.75–0.87) achieved excellent classification performance.Based on SHAP, we found “stress”, “pain score point”, “fever”, “breath”, “head” and “chest” were the important vocabularies for determining KTAS and symptoms. Conclusion We demonstrated the potential of an automatic KTAS classification system using speech recognition models, machine learning and BERT-based classifiers.

BACKGROUND/OBJECTIVES: Seaweeds have been reported to have various health beneficial effects. In this study, we investigated the potential anti-obesity and anti-inflammatory effects of four types of domestic brown seaweeds in a high-fat diet-induced obese mouse model and bone marrow-derived macrophages (BMDM). MATERIALS/METHODS: Male C57BL/6N mice were fed low-fat diet (LFD), high-fat diet (HFD) or HFD containing Undaria Pinnatifida, HFD containing Laminaria Japonica (LJ), HFD containing Sargassum Fulvellum, or HFD containing Hizikia Fusiforme (HF) for 16 weeks. RESULTS: Brown seaweed supplementation did not affect long-term HFD-associated changes in body weight or adiposity, although mice fed HFD + LJ or HFD + HF gained slightly less body weight compared with those fed HFD at the beginning of feeding. Despite being obese, mice fed HFD + LJ appeared to show improved insulin sensitivity compared to mice fed HFD. Consistently, we observed significantly reduced blood glucose concentrations in mice fed HFD + LJ compared with those of mice fed HFD. Although no significant differences in adipocyte size were detected among the HFD-fed groups, consumption of seaweeds decreased formation of HFD-induced crown-like structures in gonadal adipose tissue as well as plasma inflammatory cytokines. BMDM from mice fed HFDs with seaweeds showed differential regulation of pro-inflammatory cytokines such as IL-1beta and IL-6 compared with BMDM from mice fed HFD by LPS stimulation. CONCLUSION: Although seaweed consumption did not prevent long-term HFD-induced obesity in C57BL/6N mice, it reduced insulin resistance (IR) and circulation of pro-inflammatory cytokines. Therefore, seaweeds may ameliorate systemic inflammation and IR in obesity partially due to inhibition of inflammatory signaling in adipose tissue cells as well as bone marrow-derived immune cells.
Adipocytes ; Adipose Tissue ; Adiposity ; Animals ; Blood Glucose ; Body Weight ; Cytokines ; Diet, Fat-Restricted ; Diet, High-Fat ; Gonads ; Humans ; Inflammation ; Insulin Resistance ; Interleukin-6 ; Laminaria ; Macrophages ; Male ; Mice ; Mice, Obese* ; Obesity ; Plasma ; Sargassum ; Seaweed ; Undaria

Sulfoxaflor is the first insecticide belonging to the sulfoximine class and is efficient against sap-feeding insects that are resistant to other insecticides. Sulfoxaflor acts as a neurotoxin to the central nervous system of insects compared with very low toxicity to mammalian. We report on a case of a 67-year-old male who ingested insecticide and received conservative treatment for mild metabolic acidosis and gastrointestinal symptoms.
Acidosis ; Aged ; Central Nervous System ; Humans ; Insecticides ; Insects ; Male ; Poisoning*

PURPOSE: The use of an autogenous fat graft has become a common procedure in plastic surgery. However, questions remain concerning on the viability of fat cells and preservation method of aspirated fat. The purpose of this study is to examine the viability of fat cells stored at -20degrees C in the freezer for 1 year after harvest from abdominal liposuction. METHODS: Eighteen adults(aged from 24 to 65 years, 16 female and 2 male) were selected for this study. Harvested aspirated fat tissues were obtained by suction-assisted lipectomy and frozen at -20degrees C commercial refrigerator for one year(average 12.5 months). The viability of fat cells in specimens were measured after thawing. The numbers of viable cells were measured on a fluorescence microscope after staining with fluorescein diacetate and propidium iodide. GPDH(Glycerol-3-phosphate dehydrogenase) activity was measured. Cell culture was done for 3 weeks. RESULTS: There were no viable cells under the fluorescence microscope, no detectable GPDH activity, and no cultured cells. CONCLUSION: These findings suggest that aspirated fat after frozen storage for one year at -20degrees C freezer is inadequate to reuse.
Adipocytes ; Cell Culture Techniques ; Cryopreservation ; Female ; Fluorescein ; Fluoresceins ; Fluorescence ; Humans ; Lipectomy ; Propidium ; Surgery, Plastic ; Transplants

BACKGROUND: This study quantitatively and qualitatively analyzed the characteristics and trends of papers published in the Journal of the Korean Geriatrics Society. METHODS: Original articles, case reports, review articles published from 2006 to 2013 were retrospectively examined. All of the article research topics, paper-specific corresponding author's affiliations and number of authors were investigated. Original articles were separated and grouped according to research designs. Using the Korean Citation Index, impact factor of this journal was examined and compared with four related journals. RESULTS: Of the 276 articles analyzed, 159 (57.6%) were original articles, 145 (91.2%) were analytic studies, and 36 (22.6%) were experimental studies. The proportion of original articles accounted for about 60% until 2007 but decreased to 41.0% in 2013. By clinical study topics, 37 studies (13.4%) addressed the understanding of geriatric diseases and 45 studies (16.3%) were focused on nervous system diseases. The median number of authors for the 276 studies was 6. Internal medicine accounted for the largest proportion of corresponding author's affiliation (109 studies, 39.5%) studies. Impact factor of the journal increased from 0.05 (4th position) in 2009 to 0.48 (3rd position) in 2011. CONCLUSION: Articles published in the Journal of the Korean Geriatrics Society increasingly included experimental studies based on evidence-centered medicine, with the proportion of original articles decreasing. The impact factor increased annually along with the journal ranking, compared with other journals. Journal of the Korean Geriatrics Society is judged to be qualitatively improving.
Bibliometrics* ; Geriatrics* ; Internal Medicine ; Nervous System Diseases ; Publications ; Research Design ; Retrospective Studies

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

PURPOSE: This study was conducted to assess the satisfaction, and factors influencing the satisfaction, of patients and guardians with the internal environment and safety of ambulances in Korea. METHODS: Participants were patients and guardians who were transported by public emergency medical service ambulance to an emergency medical center in June 2015. Data were collected using self-administered questionnaires. The degree of satisfaction with the ambulance was categorized as satisfaction (Likert scale 4 or 5) or dissatisfaction (Likert scale 1 or 2). The questionnaires comprised 3 categories: 1) demographics, 2) internal environment (space, light, temperature, humidity, soundproof, and odor), and 3) safety (vibration, leaning of body, and falling objects). RESULTS: Among 84 cases, 80.5% of patients and 83.7% of guardians gave positive responses regarding general satisfaction with the internal environment of the ambulance, but these percentages were lower regarding adequacy of space and light. Four factors had a statistically significantly influence on the degree of satisfaction: 1) sex of guardian regarding adequacy of space, 2) number of guardians regarding general satisfaction, 3) severity of patient regarding guardian's satisfaction with space, 4) diagnosis of patient (trauma vs non-trauma) regarding vibration during transport (all p<0.05). CONCLUSION: Overall, patients and guardians were satisfied with the internal environment and safety of ambulances except for adequacy of space and light.
Ambulances* ; Demography ; Diagnosis ; Emergencies* ; Emergency Medical Services* ; Humans ; Humidity ; Korea* ; Patient Satisfaction ; Pilot Projects* ; Vibration

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