Regarding to preserve the cadaver, formaldehyde has been used as a major preservative. However, the usage of formaldehyde has been considered by its harmful effects such as the disturbing ordor, toxicities and limitations to use. Therefore we studied the effect of decomposition-inhibition which is a natural product, grapefruit seed extract (GSE). Concerning the preservative activity, we sacrificed 8 week old male SD rat and collected liver. Using liver tissues, we treated GSE as a time dependant manner under 37degrees, 80+/-5% humidity conditions. To confirm GSE effects, we applied light and electron microscopic analysis. In results, we observed GSE attenuated the morphological changes and putrefaction of liver tissues more than 3 days. Herein, we introduced the potential substitute of formaldehyde to preserve the cadaver as well as animal tissues.
Animals ; Cadaver ; Citrus paradisi ; Electrons ; Formaldehyde ; Humans ; Humidity ; Light ; Liver ; Male ; Rats ; Seeds

BACKGROUND: A predominant accumulation of adipose tissue in abdominal region confers increased risk of cardiovascular disease. The best technology available for measurement of regional fat distribution is computed tomography. However, computed tomography is limited its use for clinical purposes by cost. The aim of this study is to identify the best simple anthropometric index of abdominal visceral fat accumulation. METHODS: To quantify the relationship between anthropometric indices of abdominal obesity(waist circumference, waist to hip ratio, waist to height ratio, body mass index, abdominal sagittal diameter) and abdominal(total, visceral, subcutaneous) fat areas measured by computed tomography, correlation and multiple regression analyses have been conducted. RESULTS: No significant difference for waist circumference, body mass index and sagittal diameter between men and women have been found. Mean value of waist to hip ratio is larger in women, but waist to height ratio is larger in men. The mean abdominal total fat area and mean subcutaneous fat area are higher in women. Interestingly, men, despite lower total fat area, have higher mean abdominal visceral area. Thus, the mean visceral fat to subcutaneous fat ratio is much higher in men. Abdominal sagittal diameter shows the highest correlation(men: 0.69, women: 0.76) with abdominal visceral fat area in both genders. Stepwise regression analyses have been performed to determine the best simple anthropometric index of abdominal visceral fat accumulation. In men, the significant indices are abdominal sagittal diameter, body mass index, and waist to height ratio. In women, abdominal sagittal diameter is the only significant index. CONCLUSION: Abdominal sagittal diameter, in comparison with the waist circumference, waist to hip ratio, waist to height ratio and body mass index, is the best predictor of the amount of abdominal visceral fat.
Adipose Tissue ; Body Mass Index ; Cardiovascular Diseases ; Female ; Hip ; Humans ; Intra-Abdominal Fat* ; Male ; Obesity ; Subcutaneous Fat ; Waist Circumference ; Waist-Hip Ratio

In case of bezoar removal, pharmacotherapy has been performed within restrictive patients as well as therapeutic endoscopy has been restricted as to the size of bezoar and its hardness. In patients with huge and hard bezoars, that is unable to remove through endoscopy they need surgical removal. But in case of geriatric patient management, we can't overlook the complication of general anethesia and post operative wound infection. Thus we describe two case of geriatric patient that endoscopically removed bezoar through the medium of dissolved by Coca-Cola direct injection and lavage. We injected Coca-Cola directly to bezoar through the spray catheter and then Coca-Cola lavage daily two liters for three days. We could easily destroy dissolved huge bezoars by using of biopsy forcep and snare and than get rid of them endoscopically by use of basket. In case of geriatric patient management of huge gastric bezoar it is considered another choice for bezoar removal.
Bezoars* ; Biopsy ; Catheters ; Drug Therapy ; Endoscopy ; Hardness ; Humans ; SNARE Proteins ; Surgical Instruments ; Therapeutic Irrigation ; Wound Infection

Homocysteine has been reported as an independent risk factor of intravascular thrombosis and atherosclerosis by its participation in vascular endothelial cell dysfunction, platelet activation and thrombus formation. The serum homocysteine concentration is influenced by not only heredity, but also by environmental factors, and it interacts with the former reported risk factors of atherosclerosis. We report here on a case of a young patient with hyperhomocysteinemia that manifested by deep vein thrombosis and pulmonary embolism.
Atherosclerosis ; Endothelial Cells ; Heredity ; Homocysteine ; Humans ; Hyperhomocysteinemia* ; Platelet Activation ; Pulmonary Embolism* ; Risk Factors ; Thrombosis ; Venous Thrombosis*

HLA-matched platelet transfusion is required for patients with platelet refractoriness due to HLA alloimmunity. From 2013 to 2019, the Korean Red Cross has recruited 4,080 donors for HLA-matched platelets. The patient’s HLA information should be submitted to the Korean Red Cross in accordance with the WHO HLA serologic specificities. When HLA-matched platelets are requested, the Korean Red Cross selects the appropriate donors based on Duquesnoy’s matching grade classification (1977) and CREGs defined by Takemoto, Fuller, and Rodey (2007) and then contacts them to request blood donations. Platelets of HLA-matched donors are collected by apheresis and supplied to the hospital. To make this process more efficient, the Korean Red Cross introduced a systemic standard work procedure using a computer program for blood donor management and HLA matching. Owing to the extensive polymorphism of the HLA types, expansion of the donor pool would be required to supply HLA-matched platelets sufficiently. As the number of registered donors for HLA-matched platelets is limited, it should only be ordered when the indication criteria for its use are met. The Korean Red Cross is planning to study genotype-based matching strategies for patients with rare HLA types and receive patients’ laboratory test results from medical institutions to evaluate the effectiveness of HLA-matched platelet transfusions.

HLA-matched platelet transfusion is required for patients with platelet refractoriness due to HLA alloimmunity. From 2013 to 2019, the Korean Red Cross has recruited 4,080 donors for HLA-matched platelets. The patient’s HLA information should be submitted to the Korean Red Cross in accordance with the WHO HLA serologic specificities. When HLA-matched platelets are requested, the Korean Red Cross selects the appropriate donors based on Duquesnoy’s matching grade classification (1977) and CREGs defined by Takemoto, Fuller, and Rodey (2007) and then contacts them to request blood donations. Platelets of HLA-matched donors are collected by apheresis and supplied to the hospital. To make this process more efficient, the Korean Red Cross introduced a systemic standard work procedure using a computer program for blood donor management and HLA matching. Owing to the extensive polymorphism of the HLA types, expansion of the donor pool would be required to supply HLA-matched platelets sufficiently. As the number of registered donors for HLA-matched platelets is limited, it should only be ordered when the indication criteria for its use are met. The Korean Red Cross is planning to study genotype-based matching strategies for patients with rare HLA types and receive patients’ laboratory test results from medical institutions to evaluate the effectiveness of HLA-matched platelet transfusions.

PURPOSE: This study was conducted to see the effect of alcohol ingestion on clinical features of acute drug intoxicated patients. METHODS: We prospectively investigated drug intoxicated patients who visited the emergency department 6 hours after acute poisoning from January 2004 to December 2007. Patients were classified into two groups according to serum alcohol levels: an alcohol group (serum alcohol level>10 mg/dl) and a non-alcohol group. The type of toxic material, age, sex, duration of time to arrive to the emergency department (ED) after poisoning, mean arterial pressure, respiratory rate, base excess level, AST level, serum creatinine level, cause of poisoning, suicide attempt, past psychiatric history, discharge against medical advice rate, and admission rate were checked. The initial and final Poisoning Severity Score (PSS), the Glasgow coma scale, the length of stay in the intensive care unit (ICU), the usage of a mechanical ventilator, and death rate were also checked. RESULTS: The study enrolled 222 intoxicated patients of which 75 fell into the non-alcohol group and 147 into the alcohol group. Alcohol ingestion of acute poisoning in males was higher than in females. The AST level and discharge against medical advice rates in the alcohol group were higher than the non-alcohol group. The base excess level, length of stay in ICU, past psychiatric history rate, and admission rates in the non-alcohol group were higher than the alcohol group. The PSS were not correlated with alcohol consumption between the two groups. CONCLUSION: Alcohol ingestion is not associated with PSS. However, alcohol ingestion is commonly found in acute drug intoxicated patients. The discharge against medical advice rate in the alcohol group was higher than the non-alcohol group.
Alcohol Drinking ; Arterial Pressure ; Creatinine ; Eating ; Emergencies ; Female ; Glasgow Coma Scale ; Humans ; Intensive Care Units ; Length of Stay ; Male ; Prospective Studies ; Respiratory Rate ; Severity of Illness Index ; Suicide ; Ventilators, Mechanical

Giardia lamblia infection, giardiasis, is the leading waterborne diarrhea-causing disease. It is common in most countries of the world, including South Korea and Japan. Giardia lamblia can cause asymptomatic infection but also acute abdominal discomfort with diarrhea. In addition, it may lead to chronic diarrhea associated with villous atrophy and impaired epithelial barrier in the small intestine. In the present case, a 45-year-old woman presented with lower abdominal discomfort in the absence of diarrhea. Colonoscopy showed diffuse mucosal edema, erythema, and erosions with exudate in the cecum and ascending colon. Colonoscopic biopsy and stool examination revealed trophozoites of Giardia lamblia. Colitis resolved after metronidazole therapy. Our case suggests that giardiasis should be included in the differential diagnosis of colitis, even if the patient does not present with diarrhea.
Asymptomatic Infections ; Atrophy ; Biopsy ; Cecum ; Colitis* ; Colon, Ascending ; Colonoscopy ; Diagnosis, Differential ; Diarrhea ; Edema ; Erythema ; Exudates and Transudates ; Female ; Giardia lamblia* ; Giardia* ; Giardiasis ; Humans ; Intestine, Small ; Japan ; Korea ; Metronidazole ; Middle Aged ; Trophozoites

PURPOSE: Although vitamin D deficiency is more commonly found in cancer patient than in non-cancer patients, there have been little data regarding the prevalence of vitamin D deficiency in cancer patients at the very end of life. We examined vitamin D deficiency in terminally ill cancer patients and related factors. METHODS: This study was based on a retrospective chart review of 133 patients in a hospice ward. We collected data regarding age, sex, serum 25-hydroxyvitamin D level, cancer type, physical performance, current medications and various laboratory findings. We investigated factors related to serum vitamin D levels after multivariate adjustment for potential confounders. Serum 25-hydroxyvitamin D<20 ng/mL was considered deficient and <10 ng/mL severely deficient. RESULTS: Ninety-five percent of the patients were serum vitamin D deficient. Severe vitamin D deficiency was more common in male patients, non-lung cancer patients, H2 blocker users and non-anticonvulsant users. Elevated levels of serum alanine aminotransferase (ALT) were also associated with low serum vitamin D levels. Multiple regression analysis showed that severe vitamin D deficiency was associated with male gender (aOR 3.82, 95% CI: 1.50~9.72, P=0.005), H2 blocker users (aOR 3.94, 95% CI: 1.61~9.65, P=0.003) and elevated serum ALT levels (aOR 4.52, 95% CI: 1.35~15.19, P=0.015). CONCLUSION: Vitamin D deficiency was highly prevalent among terminally ill cancer patients. Severe vitamin D deficiency was more common in male patients, H2 blocker users, and patients with elevated ALT levels.
Alanine Transaminase ; Hospices* ; Humans ; Male ; Prevalence ; Retrospective Studies ; Terminally Ill ; Vitamin D ; Vitamin D Deficiency*

BACKGROUND: Incidents of suicide attempts and acute poisonings in the elderly population is rising. This study com- pared elderly and younger patients to investigate the influence of age on the clinical nature of acute poisoning. METHODS: We retrospectively investigated 147 patients with acute poisoning who visited the emergency department within 6 hours of exposure. Patients were divided into two groups, young adult(20-40 yrs) and elderly(> or =55 yrs). Information on type of toxic material, age, sex, duration of time to arrive to the emergency department(ED) after poisoning, cause of poisoning, usage of activated charcoal and gastric lavage, previous suicide attempts, and past psy- chiatric history were collected. And, the mean arterial pressure, respiratory rate, base excess, aspartate aminotransfe- rase(AST), serum creatinine, rate of discharge against medical advice, intensive care unit(ICU) admission rate, discharge rate, duration in ICU, usage of mechanical ventilator, and death rate were analyzed. Initial and final Poisoning Severity Scores(PSS) of each patient were calculated. RESULTS: The mean age of the young adult group and the elderly group were 30.6+/-6.1 yrs and 66.6+/-8.2 yrs, respectively. Cause of poisoning was accidental more often in the elderly group than in the young adult group. AST and creatinine levels were higher and base excess was lower in the elderly group. ICU admission rate, duration in ICU, usage of mechanical ventilator, death rate, and initial and final PSS were all higher in the elderly group as well. CONCLUSION: This study showed that the PSS and death rate from acute poisoning were higher in the elderly group than in the young adult group.
Aged ; Arterial Pressure ; Aspartic Acid ; Charcoal ; Creatinine ; Emergencies ; Gastric Lavage ; Humans ; Critical Care ; Respiratory Rate ; Retrospective Studies ; Suicide ; Ventilators, Mechanical ; Young Adult