Extracorporeal membrane oxygenation (ECMO) has been used successfully in critically ill patients with traumatic lung injury and offers an additional treatment modality. ECMO is mainly used as a bridge treatment to delayed surgical management; however, only a few case reports have presented the successful application of ECMO as intraoperative support during the surgical repair of traumatic bronchial injury. A 38-year-old man visited our hospital after a blunt chest trauma. His chest imaging showed hemopneumothorax in the left hemithorax and a finding suspicious for left main bronchus rupture. Bronchoscopy was performed and confirmed a tear in the left main bronchus and a congenital tracheal bronchus. We decided to provide venovenous ECMO support during surgery for bronchial repair. We successfully performed main bronchial repair in this traumatic patient with a congenital tracheal bronchus. We suggest that venovenous ECMO offers a good option for the treatment of bronchial rupture when adequate ventilation is not possible.
Adult ; Bronchi ; Bronchoscopy ; Critical Illness ; Extracorporeal Membrane Oxygenation* ; Hemopneumothorax ; Humans ; Lung Injury ; Rupture* ; Tears ; Thorax ; Ventilation ; Wounds, Nonpenetrating

BACKGROUND: In the thymus, developing thymocytes continually interact with thymic epithelial cell components. Self MHC restriction of mature T cells are imposed in the thymus through interaction of immature double positive thymocytes and thymic cortical epithelial cells. The site of negative selection, however, is a matter of debate. Through systemic injection of anti-TCR antibody or antigenic peptides, investigators suggested that most of the negative selection occurs in the thymic cortex. But the requirements for negative selection, i.e cellular counterparts and costimulatory molecules are more available in the medulla or cortico-medullary junction rather than in the thymic cortex. METHODS: The direct and indirect pathways of thymocyte death after systemic anti-TCR antibody injection were separated through several experimental systems. B6 mice were either adrenalectomized or sham-adrenalectomized to evaluate the role of endogenous glucocorticoids from adrenal gland. Role of TNF were evaluated through using TNF receptor double knockout mice. RESULTS: We found that without indirectly acting mediators such as TNF-alpha or corticosteroid, double positive thymocyte death were minimal by systemic injection of anti-TCR antibody in TNF receptor double knockout neonatal mice. Also by analyzing neonatal wild-type mice with adoptively transferred mature T cells, only peripheral activation of mature T cells could induce extensive double positive thymocyte death. CONCLUSION: Thus, systemically injected anti-TCR antibody mediated thymocyte death are mostly induced through indirect pathway.
Adrenal Cortex Hormones* ; Adrenal Glands ; Animals ; Epithelial Cells ; Glucocorticoids ; Humans ; Mice ; Mice, Knockout ; Peptides ; Receptors, Tumor Necrosis Factor ; Research Personnel ; T-Lymphocytes ; Thymocytes* ; Thymus Gland ; Tumor Necrosis Factor-alpha

Objective: The study aimed to investigate whether mindfulness could mitigate the impact of job and interpersonal demands arising from stressful organizational cultures in predicting depression during the COVID-19 pandemic. Methods: A total of 280 Korean physical therapists participated in this study. To verify the mediated moderation model, this study implemented an SPSS 26.0 PROCESS Macro (v.3.5) that was based on the verification of Hayes' conditional indirect effect. Results: The study confirmed the moderated mediation effect of mindfulness on the mediating relationship between stressful organizational culture, job demands/interpersonal demands, and depression. Moreover, the conditional indirect effect of mindfulness was found to be statistically significant. However, the impact on interpersonal stress differed from anticipated outcomes. Conclusions Mindfulness, applicable within the framework of the Job Demands-Resources model theory, served as a resource variable and moderated the impact of organizational culture on members' depression. Amidst ongoing debates on mindfulness effectiveness, this study partially confirmed its potential within the Job Demands-Resources model, suggesting a role in mitigating the influence of organizational culture on members' depression as a resource variable.

Objective: The study aimed to investigate whether mindfulness could mitigate the impact of job and interpersonal demands arising from stressful organizational cultures in predicting depression during the COVID-19 pandemic. Methods: A total of 280 Korean physical therapists participated in this study. To verify the mediated moderation model, this study implemented an SPSS 26.0 PROCESS Macro (v.3.5) that was based on the verification of Hayes' conditional indirect effect. Results: The study confirmed the moderated mediation effect of mindfulness on the mediating relationship between stressful organizational culture, job demands/interpersonal demands, and depression. Moreover, the conditional indirect effect of mindfulness was found to be statistically significant. However, the impact on interpersonal stress differed from anticipated outcomes. Conclusions Mindfulness, applicable within the framework of the Job Demands-Resources model theory, served as a resource variable and moderated the impact of organizational culture on members' depression. Amidst ongoing debates on mindfulness effectiveness, this study partially confirmed its potential within the Job Demands-Resources model, suggesting a role in mitigating the influence of organizational culture on members' depression as a resource variable.

Objective: The study aimed to investigate whether mindfulness could mitigate the impact of job and interpersonal demands arising from stressful organizational cultures in predicting depression during the COVID-19 pandemic. Methods: A total of 280 Korean physical therapists participated in this study. To verify the mediated moderation model, this study implemented an SPSS 26.0 PROCESS Macro (v.3.5) that was based on the verification of Hayes' conditional indirect effect. Results: The study confirmed the moderated mediation effect of mindfulness on the mediating relationship between stressful organizational culture, job demands/interpersonal demands, and depression. Moreover, the conditional indirect effect of mindfulness was found to be statistically significant. However, the impact on interpersonal stress differed from anticipated outcomes. Conclusions Mindfulness, applicable within the framework of the Job Demands-Resources model theory, served as a resource variable and moderated the impact of organizational culture on members' depression. Amidst ongoing debates on mindfulness effectiveness, this study partially confirmed its potential within the Job Demands-Resources model, suggesting a role in mitigating the influence of organizational culture on members' depression as a resource variable.

Objective: The study aimed to investigate whether mindfulness could mitigate the impact of job and interpersonal demands arising from stressful organizational cultures in predicting depression during the COVID-19 pandemic. Methods: A total of 280 Korean physical therapists participated in this study. To verify the mediated moderation model, this study implemented an SPSS 26.0 PROCESS Macro (v.3.5) that was based on the verification of Hayes' conditional indirect effect. Results: The study confirmed the moderated mediation effect of mindfulness on the mediating relationship between stressful organizational culture, job demands/interpersonal demands, and depression. Moreover, the conditional indirect effect of mindfulness was found to be statistically significant. However, the impact on interpersonal stress differed from anticipated outcomes. Conclusions Mindfulness, applicable within the framework of the Job Demands-Resources model theory, served as a resource variable and moderated the impact of organizational culture on members' depression. Amidst ongoing debates on mindfulness effectiveness, this study partially confirmed its potential within the Job Demands-Resources model, suggesting a role in mitigating the influence of organizational culture on members' depression as a resource variable.

Objective: The study aimed to investigate whether mindfulness could mitigate the impact of job and interpersonal demands arising from stressful organizational cultures in predicting depression during the COVID-19 pandemic. Methods: A total of 280 Korean physical therapists participated in this study. To verify the mediated moderation model, this study implemented an SPSS 26.0 PROCESS Macro (v.3.5) that was based on the verification of Hayes' conditional indirect effect. Results: The study confirmed the moderated mediation effect of mindfulness on the mediating relationship between stressful organizational culture, job demands/interpersonal demands, and depression. Moreover, the conditional indirect effect of mindfulness was found to be statistically significant. However, the impact on interpersonal stress differed from anticipated outcomes. Conclusions Mindfulness, applicable within the framework of the Job Demands-Resources model theory, served as a resource variable and moderated the impact of organizational culture on members' depression. Amidst ongoing debates on mindfulness effectiveness, this study partially confirmed its potential within the Job Demands-Resources model, suggesting a role in mitigating the influence of organizational culture on members' depression as a resource variable.

This study evaluated the outcomes of off-pump coronary artery bypass surgery (OPCAB) with severe left ventricular dysfunction using composite bilateral internal thoracic artery grafting. From January 2001 to December 2008, 1,842 patients underwent primary isolated OPCAB with composite bilateral internal thoracic artery grafting. A total of 131 of these patients were diagnosed with a severely depressed preoperative left ventricle ejection fraction (LVEF) (< or =0.35). These patient outcomes were compared with the outcomes of 830 patients that had mildly or moderately depressed LVEF (0.36 to 0.59) and 881 patients with normal LVEF (>0.6). The early mortality for patients with severe LVEF was 2.3%. The 3-yr and 7-yr survival rate for patients with severe LV dysfunction was 86.0% and 82.8%, respectively. Multivariate analysis showed that severe LV dysfunction EF increased the risk of all-cause death (P=0.012; hazard ratio [HR],2.14; 95% confidence interval [CI],1.19-3.88) and the risk of cardiac-related death (P=0.008; HR,3.38; 95% CI, 1.37-8.341). The study identified positive surgical outcomes of OPCAB, although severe LVEF was associated with two-fold increase in mortality risk compared with patients who had normal LVEF.
Coronary Artery Bypass, Off-Pump/methods/*mortality ; Female ; Heart ; Humans ; Male ; Mammary Arteries/*transplantation ; Middle Aged ; Retrospective Studies ; Stroke Volume ; Survival Rate ; Treatment Outcome ; Vascular Grafting/methods/*mortality ; Ventricular Dysfunction, Left/mortality/*surgery ; Ventricular Function, Left

Extracorporeal membrane oxygenation (ECMO) has been used successfully in critically ill patients with traumatic lung injury and offers an additional treatment modality. ECMO is mainly used as a bridge treatment to delayed surgical management; however, only a few case reports have presented the successful application of ECMO as intraoperative support during the surgical repair of traumatic bronchial injury. A 38-year-old man visited our hospital after a blunt chest trauma. His chest imaging showed hemopneumothorax in the left hemithorax and a finding suspicious for left main bronchus rupture. Bronchoscopy was performed and confirmed a tear in the left main bronchus and a congenital tracheal bronchus. We decided to provide venovenous ECMO support during surgery for bronchial repair. We successfully performed main bronchial repair in this traumatic patient with a congenital tracheal bronchus. We suggest that venovenous ECMO offers a good option for the treatment of bronchial rupture when adequate ventilation is not possible.
Adult ; Bronchi ; Bronchoscopy ; Critical Illness ; Extracorporeal Membrane Oxygenation ; Hemopneumothorax ; Humans ; Lung Injury ; Rupture ; Tears ; Thorax ; Ventilation ; Wounds, Nonpenetrating

We examined the precision, accuracy, and capability of detecting changes of Dual-Energy X-ray Absorptiometry (DXA) for the measurements of total-body weight (TBW), total-body fat weight (TBFW), and total-body lean weight (TBLW) in an 8-week follow-up study of rats. Twenty male rats (4-week) were divided into 2 diet groups. For 8 weeks, we measured body composition (TBW, TBFW, TBLW) by DXA and TBW by an electronic scale once a week. In week 8, we measured body composition 5 times by DXA and TBFW by dissecting experiment (EXP) of euthanized rats (12-week). Total-body fat ratio (TBFR) was defined as TBFW/(TBFW+TBLW). The precision of DXA was evaluated by measuring the coefficient of variation (CV) and accuracy was evaluated by comparing DXA-derived data with EXP data. The capability of detecting changes of DXA in follow-up study was verified by analyzing the trend of DXA-derived values over the 8 weeks. For TBW, TBFW, TBLW of DXA, CVs were 0.02 ± 0.01, 0.10 ± 0.05, 0.03 ± 0.02 and errors were − 6.996 ± 3.429 (r = 0.999), + 14.729 ± 3.663 (r = 0.982), − 21.725 ± 4.223 (r = 0.991), respectively. Prediction models were [EXP TBW = − 31.767 + 1.085 (DXA TBW), R2 = 0.998, root mean square error (RMSE) = 1.842] and [EXP TBFR = − 0.056 + 1.177 (DXA TBFR), R2 = 0.948, RMSE = 0.007]. Over 8 weeks, DXA TBW and DXA TBLW steadily increased, DXA TBFW steadily increased followed by saturation or declination, difference of DXA TBFW between 2 diet groups steadily increased. In conclusion, our study verified that DXA (iNSiGHT VET DXA, OsteoSys, Korea) is accurate and precise enough to measure body composition of rats. Additionally, we confirmed the possibility that DXA could be used for the long-term follow-up studies.
Absorptiometry, Photon ; Animals ; Body Composition ; Diet ; Diet, High-Fat ; Follow-Up Studies ; Humans ; Male ; Obesity ; Rats