The phosphorylated 43-kDa transactive response DNA-binding protein (TDP-43) was identified as a major disease protein in sporadic amyotrophic lateral sclerosis (ALS) and frontotemporal lobar degeneration. We present a case with progressive muscle weakness who was diagnosed with sporadic ALS. On postmortem examination, TDP-43 immunoreactive neuronal cytoplasmic inclusions were noted in motor cortex, hippocampus and anterior horns of spinal cord, which was compatible with ALS-TDP, stage 4. This is the first documented autopsy-confirmed ALS case with ALS-TDP pathology in Korea.

This study was performed to evaluate the effect of cyclic precalcification treatment on the improvement of bioactivity of Ti-6Al-4V mini-screws. The cutted plate-shaped specimens of 10 mm × 10 mm dimensions, and a mini-screw with a diameter of 1.6 mm × 6.0 mm in length were used. Anodic oxidation treatment was carried out in a glycerol electrolyte solution containing 20 wt% H2O and 1.5 wt% NH 4F. Voltage of 20 V with current density of 20 mA/cm2 was applied for 1 hour to form a nanotube TiO2 layer. Afterwards, to improve the bioactivity, specimens were immersed in 0.5 vol% silica aqueous solution at 37 ℃ for 5 minutes, and then cyclic precalcification treatment with 0.05 M NH 4H2PO4and 0.01 M Ca(OH)2 solution at 90 ℃ was repeated with 20 times. Based on surface treatment the experimental groups were divided into three groups, namely untreated group (UT), anodized and heat-treated group (AH), and anodized, silica-treated, cyclic precalcified and heat-treated group (ASPH). There were TiO2 nanotubes completely self-aligned and formed in a dense structure on the surface after anodic oxidation treatment. A fine granular cluster layer of hydroxyapatite and octacalcium phosphate were formed on the surface after the cyclic precalcification treatment. As a result of immersion test in the simulated body fluid (SBF), bioactivity was confirmed to be improved by the precipitation of protrusions appearing at the initial stage of formation of hydroxyapatite.

Point-of-care ultrasound (POCUS) is a useful tool that is widely used in the emergency and intensive care areas. In Korea, insurance coverage of ultrasound examination has been gradually expanding in accordance with measures to enhance Korean National Insurance Coverage since 2017 to 2021, and which will continue until 2021. Full coverage of health insurance for POCUS in the emergency and critical care areas was implemented in July 2019. The National Health Insurance Act classified POCUS as a single or multiple-targeted ultrasound examination (STU vs. MTU). STU scans are conducted of one organ at a time, while MTU includes scanning of multiple organs simultaneously to determine each clinical situation. POCUS can be performed even if a diagnostic ultrasound examination is conducted, based on the physician's decision. However, the Health Insurance Review and Assessment Service plans to monitor the prescription status of whether the POCUS and diagnostic ultrasound examinations are prescribed simultaneously and repeatedly. Additionally, MTU is allowed only in cases of trauma, cardiac arrest, shock, chest pain, and dyspnea and should be performed by a qualified physician. Although physicians should scan all parts of the chest, heart, and abdomen when they prescribe MTU, they are not required to record all findings in the medical record. Therefore, appropriate prescription, application, and recording of POCUS are needed to enhance the quality of patient care and avoid unnecessary cut of medical budget spending. The present article provides background and clinical guidance for POCUS based on the implementation of full health insurance coverage for POCUS that began in July 2019 in Korea.
Abdomen ; Budgets ; Chest Pain ; Critical Care ; Dyspnea ; Emergencies ; Heart ; Heart Arrest ; Insurance Coverage ; Insurance ; Insurance, Health ; Korea ; Medical Records ; National Health Programs ; Patient Care ; Point-of-Care Systems ; Prescriptions ; Shock ; Thorax ; Ultrasonography

Point-of-care ultrasound (POCUS) is a useful tool that is widely used in the emergency and intensive care areas. In Korea, insurance coverage of ultrasound examination has been gradually expanding in accordance with measures to enhance Korean National Insurance Coverage since 2017 to 2021, and which will continue until 2021. Full coverage of health insurance for POCUS in the emergency and critical care areas was implemented in July 2019. The National Health Insurance Act classified POCUS as a single or multiple-targeted ultrasound examination (STU vs. MTU). STU scans are conducted of one organ at a time, while MTU includes scanning of multiple organs simultaneously to determine each clinical situation. POCUS can be performed even if a diagnostic ultrasound examination is conducted, based on the physician's decision. However, the Health Insurance Review and Assessment Service plans to monitor the prescription status of whether the POCUS and diagnostic ultrasound examinations are prescribed simultaneously and repeatedly. Additionally, MTU is allowed only in cases of trauma, cardiac arrest, shock, chest pain, and dyspnea and should be performed by a qualified physician. Although physicians should scan all parts of the chest, heart, and abdomen when they prescribe MTU, they are not required to record all findings in the medical record. Therefore, appropriate prescription, application, and recording of POCUS are needed to enhance the quality of patient care and avoid unnecessary cut of medical budget spending. The present article provides background and clinical guidance for POCUS based on the implementation of full health insurance coverage for POCUS that began in July 2019 in Korea.

The prolonged neglect of the posterior teeth missing area may cause mesial drift, extrusion, unexpected movement of the adjacent teeth and alveolar bone loss with occlusion collapse. Therefore it is recommended to treat that area by the prosthesis as soon as possible after tooth missing. However, if orthodontic treatment is applied to move the remained teeth, it can create improved biomechanical dentoalveolar environment. The use of the third molars in teeth missing area provides advantages as optimizing of prosthesis size. However, crown shape, location, soundness of the third molar and possible of eruption failure should be considered. In this case report, two patients closed a second teeth missing site and reduced the size of the first and second teeth missing area for an implant by protraction of impacted third molars. This case reports the considerations for closing or reducing the posterior teeth space with protracting the third molars by comparing two patients.

This study compared the effectiveness two-finger chest compression technique (TFCC) performed using the right vs. left hand and the index-middle vs. middle-ring fingers. Four different finger/hand combinations were tested randomly in 30 healthcare providers performing TFCC (Test 1: the right index-middle fingers; Test 2: the left index-middle fingers; Test 3: the right middle-ring fingers; Test 4: the left middle-ring fingers) using two cross-over trials. The "patient" was a 3-month-old-infant-sized manikin. Each experiment consisted of cardiopulmonary resuscitation (CPR) consisting of 2 minutes of 30:2 compression: ventilation performed by one rescuer on a manikin lying on the floor as if in cardiac arrest. Ventilations were performed using the mouth-to-mouth method. Compression and ventilation data were collected during the tests. The mean compression depth (MCD) was significantly greater in TFCC performed with the index-middle fingers than with the middle-ring fingers regardless of the hand (95% confidence intervals; right hand: 37.8-40.2 vs. 35.2-38.6 mm, P = 0.002; left hand: 36.9-39.2 vs. 35.5-38.1 mm, P = 0.003). A deeper MCD was achieved with the index-middle fingers of the right versus the left hand (P = 0.004). The ratio of sufficiently deep compressions showed the same patterns. There were no significant differences in the other data. The best performance of TFCC in simulated 30:2 compression: ventilation CPR performed by one rescuer on an infant in cardiac arrest lying on the floor was obtained using the index-middle fingers of the right hand. Clinical Trial Registry at the Clinical Research Information Service (KCT0001515).
Adult ; Cardiopulmonary Resuscitation/*methods ; Cross-Over Studies ; Female ; *Fingers ; Hand ; Heart Arrest/*therapy ; Humans ; Infant ; Male ; Manikins ; Models, Cardiovascular ; Thorax/physiology ; Young Adult

PURPOSE: This study compared the effects of counting chest compressions verbally and silently on the performance of cardiopulmonary resuscitation (CPR). METHODS: Forty-six medical students were enrolled in this study. After the participants performed a two-min CPR (Test 1), during which they counted each compression silently, they were divided randomly into Groups A and B. After a 30-min rest, the participants took Test 2. In Test 2, Group A performed two-min CPR, during which the participants counted the number of chest compressions verbally (Test 2A), and in Group B, CPR was performed using the same methods as detailed for Test 1 (i.e., with silent enumeration; Test 2B). Each student counted the number of chest compressions aloud from one to 30 in Test 2A. RESULTS: No significant differences were observed for either test (Tests 1 and 2) between Groups A and B. Although the mean compression rate (MCR) was increased significantly from 107.2+/-15.4 to 116.3+/-15.9/min between Tests 1 and 2B in Group B (p<0.01), a similar result was also obtained in Group A. In the individual interviews conducted with the Group A participants, all members reported having difficulty breathing while counting the number of chest compressions verbally when compared with silent enumeration. CONCLUSION: Tallying the numbers of chest compressions verbally did not significantly alter the performance of CPR.
Cardiopulmonary Resuscitation* ; Humans ; Manikins* ; Pilot Projects* ; Prospective Studies* ; Respiration ; Students, Medical ; Thorax* ; Voice

PURPOSE: One-handed chest compression (OHCC) technique is performed by one hand. Therefore chest compression (CC) depth might decrease rapidly. This study will evaluate the patterns of CC depth decaying in performing OHCC and assess the effects of alternating the hand which performs CC on the patterns of CC depth decaying. METHODS: This study was designed as a prospective randomized manikin simulation trial. Students of medical college participated. First, 10 students performed OHCC (chest compression:ventilation=30:2) in a pediatric manikin lying on a hard floor for 5 minutes (baseline study). After the baseline study, 32 students were recruited and randomized to group A and B. Group A performed OHCC with hand shift every other cycle (test 1). Group B performed OHCC with hand shift when they feel fatigue (test 2). The compression data were collected using the CPRmeter. The mean compression depths (MCD) were calculated at one minute intervals using the Q-CPR review software. The heart rates were monitored and the fatigue scales were collected every 1 minute. RESULTS: The MCD values were decreased significantly after 1 minute in the baseline study (p<0.05). However they were not changed in test 1 and decreased significantly after 4 minutes in test 2 (p<0.05). The heart rate and the fatigue scales were increased significantly with time in all tests (p<0.05). CONCLUSION: When OHCC was performed without shifting the hand which performed CC, the MCD decreased significantly after 1 minute. However, we could delay the time of decreasing MCD by shifting the hand which performed CC.
Cardiopulmonary Resuscitation ; Deception ; Fatigue* ; Hand* ; Heart Arrest ; Heart Massage ; Heart Rate ; Humans ; Manikins* ; Pilot Projects* ; Prospective Studies* ; Thorax* ; Weights and Measures