Heat stress disorders or heat-related illnesses are a kind of physiological damage that occurs when the body cannot dissipate enough heat due to its thermoregulatory dysfunction. This paper aims to summarize the latest information on the diagnosis and treatment of heat-related illnesses. Heat stress disorders come in a variety of forms including heat edema, heat rash, heat cramps, heat syncope, heat tetany, severe heat exhaustion, and life-threatening heatstroke. Major risk factors may include excessive exercise, continuous exposure to high temperatures or humid environments, lack of acclimation, excessive clothing or protective equipment, obesity, and dehydration. Additional risk factors may include the patientʼs existing medical condition, environmental and personal factors, and the use of various drugs. Mild heat-related illnesses can be treated only by supportive care such as moving patients to a cool place and laying them in a supine position while elevating their legs and loosening their clothes. However, in the case of heatstroke, quickly lowering the body temperature is an essential in reducing the mortality rate. The most effective cooling method is to immerse the entire body in ice cold water.

Heat stress disorders or heat-related illnesses are a kind of physiological damage that occurs when the body cannot dissipate enough heat due to its thermoregulatory dysfunction. This paper aims to summarize the latest information on the diagnosis and treatment of heat-related illnesses. Heat stress disorders come in a variety of forms including heat edema, heat rash, heat cramps, heat syncope, heat tetany, severe heat exhaustion, and life-threatening heatstroke. Major risk factors may include excessive exercise, continuous exposure to high temperatures or humid environments, lack of acclimation, excessive clothing or protective equipment, obesity, and dehydration. Additional risk factors may include the patientʼs existing medical condition, environmental and personal factors, and the use of various drugs. Mild heat-related illnesses can be treated only by supportive care such as moving patients to a cool place and laying them in a supine position while elevating their legs and loosening their clothes. However, in the case of heatstroke, quickly lowering the body temperature is an essential in reducing the mortality rate. The most effective cooling method is to immerse the entire body in ice cold water.

OBJECTIVE: It has been suggested that hysterectomy has a disturbing influence on bowel function, mainly constipation. We performed a prospective study to assess the changes of ano-rectal physiology after hysterectomy. METHODS: Fourteen consecutive patients were assessed before and two months after hysterectomy. A detail questionnaire was devised to allow assessment of bowel function and ano-rectal pressure test and balloon expulsion test were performed before and after hysterectomy. The parameters measured in ano-rectal pressure test included the minimal sensible volume, ano-rectal resting pressure, maximal squeezing pressure, recto-anal inhibitory reflex and balloon expulsion test. Data analysis was carried out by paired t-test. Statistical significance was inferred when the p value was<0.05. RESULTS: Among the fourteen patients, the straining in defecation was found in three patients after operation, other defication habits were not significantly changed after hysterectomy(P>0.05). There were no significant changes in ano-rectal pressure test after hysterectomy. The disturbance of balloon expulsion capacity was increased in four patients after hysterectomy(29%). CONCLUSION: Our results demonstrate that hysterectomy does not cause a decrease in ano-rectal pressure and rectal sensitivity, but has an adverse effect on rectal expulsion capacity in a some of patients.
Constipation ; Defecation ; Humans ; Hysterectomy* ; Physiology ; Prospective Studies ; Surveys and Questionnaire ; Reflex ; Statistics as Topic

Humans ; Malocclusion ; Mandibular Condyle ; Mouth ; Prognosis ; Retrospective Studies ; Temporomandibular Joint ; Temporomandibular Joint Disorders

PURPOSE: Oxygen is indispensable for survival and aerobic metabolism in all mammalian cells. Inadequate oxygen triggers a multifaceted cellular response negatively impacting important physiological functions which are observed in clinical diseases such as stroke, drowning, cardiac arrest, hazardous gas poisoning, myocardial infarction and vascular dementia. In this study, we investigated the neuroprotective effect of a synthetic delta-opioid agonist, [D-Ala2, D-Leu5] enkephalin (DADLE), and its role in ischemic neuronal injury. METHODS: This experiment was conducted in vitro using a primary culture of rat cortical neurons. Ischemia induction was performed using a hypoxic chamber. To test the degree of neuronal viability, as protected by delta-opioid stimulation with DADLE under ischemia, we used three independent approaches including a lactate dehydrogenase assay, MTT assay, and an immunofluorescent staining assay for viable cells. In addition, the gene expressions of caspase-3 and heat shock protein 70 were analyzed using real-time PCR. RESULTS: Incubation of the cortical neurons with DADLE protected them from ischemia-induced cytotoxicity, as observed by all three independent viability assays. Also, we found that its neuroprotective effect might be related with suppression of the caspase-3 gene. CONCLUSION: The results of this study suggested that DADLE exhibits a neuroprotective effect against ischemia-induced neuronal cell death.
Animals ; Caspase 3 ; Cell Death ; Dementia, Vascular ; Drowning ; Enkephalin, Leucine-2-Alanine ; Enkephalins ; Gas Poisoning ; Gene Expression ; Heart Arrest ; HSP70 Heat-Shock Proteins ; Ischemia ; L-Lactate Dehydrogenase ; Myocardial Infarction ; Neurons ; Neuroprotective Agents ; Oxygen ; Rats ; Stroke

PURPOSE: Oxygen is indispensable for survival and aerobic metabolism in all mammalian cells. Inadequate oxygen triggers a multifaceted cellular response negatively impacting important physiological functions which are observed in clinical diseases such as stroke, drowning, cardiac arrest, hazardous gas poisoning, myocardial infarction and vascular dementia. In this study, we investigated the neuroprotective effect of a synthetic delta-opioid agonist, [D-Ala2, D-Leu5] enkephalin (DADLE), and its role in ischemic neuronal injury. METHODS: This experiment was conducted in vitro using a primary culture of rat cortical neurons. Ischemia induction was performed using a hypoxic chamber. To test the degree of neuronal viability, as protected by delta-opioid stimulation with DADLE under ischemia, we used three independent approaches including a lactate dehydrogenase assay, MTT assay, and an immunofluorescent staining assay for viable cells. In addition, the gene expressions of caspase-3 and heat shock protein 70 were analyzed using real-time PCR. RESULTS: Incubation of the cortical neurons with DADLE protected them from ischemia-induced cytotoxicity, as observed by all three independent viability assays. Also, we found that its neuroprotective effect might be related with suppression of the caspase-3 gene. CONCLUSION: The results of this study suggested that DADLE exhibits a neuroprotective effect against ischemia-induced neuronal cell death.
Animals ; Caspase 3 ; Cell Death ; Dementia, Vascular ; Drowning ; Enkephalin, Leucine-2-Alanine ; Enkephalins ; Gas Poisoning ; Gene Expression ; Heart Arrest ; HSP70 Heat-Shock Proteins ; Ischemia ; L-Lactate Dehydrogenase ; Myocardial Infarction ; Neurons ; Neuroprotective Agents ; Oxygen ; Rats ; Stroke

BACKGROUND AND OBJECTIVES: With the present methods for assessing speech, there are procedures that make effective diagnostics possible for voice disorders. One such procedure is cepstrum. Spectrum is produced by Fourier transformation of sound waves, and if Fourier transformation is performed again about the spectrum, cepstrum is produced. This study compared cepstrum to jitter, shimmer, and noise-to-harmonic ratio (NHR) for assessment of its usefulness. Cepstrum was measured by Cepstral Peak Prominence (CPP) calculated by the Hillenbrand method and Cepstral Mean Values (CMV) calculated using the Computerized Speech Laboratory software. SUBJECTS AND METHOD: We included in the study 30 patients with vocal nodule and unilateral vocal cord palsy who were diagnosed in Kangbuk Samsung Hospital between March 2010 and May 2011, and 30 normal controls. Phonation of sustained vowel /a/ sample and running speech was subjected to acoustic analysis using CMV and CPP. Then we compared the correlation of cepstrum with other acoustic methods. RESULTS: The measured values of CPP-a were 14.16, 17.25, 20.00 and the age adjusted CPP-s values were 11.21, 12.85, 15.00 for vocal cord palsy, vocal nodule and normal group, respectively. There was significant correlation with perceptions of dysphonia (p<0.001), but in CMV-a, CMV-s, there was no significant correlation. When jitter, shimmer, and NHR were compared with cepstrum, the result showed negative correlation among the three groups but CPP values showed significant difference (p<0.001). CONCLUSION: In the assessment of voice disorders, cepstrum may be used as a reliable method for comparing other complementary analysis tools. For the acoustic analysis of voice by cepstrum, however, CPP has more reliable correlations with dysphonia than CMV.
Acoustics ; Dysphonia ; Fourier Analysis ; Hoarseness ; Humans ; Phonation ; Running ; Sound ; Vocal Cord Paralysis ; Voice ; Voice Disorders

Hypoglycemia is caused by poor oral intake, excessive exercise, alcohol abuse and inaccurate use of a hypoglycemic agent or insulin in patients that have history of diabetes mellitus (DM), especially in the elderly. Severe hypoglycemia has a variety of different symptoms or signs from focal neurologic deficits to severe coma, or death. It can be difficult to differentiate hypoglycemia-induced symptoms or signs, and stroke or cardiovascular disease in acute setting. Transient hypoglycemic hemiparesis is an infrequent case in the emergency department (ED), which is frequently misdiagnosed for stroke. When patients with decreased mental status or hemiparesis are admitted to the ED, a routine blood sugar test is essential. Hypoglycemic hemiparesis if unrecognized can result in permanent neurological damage. Therefore, it is important to detect hypoglycemia early and treat it appropriately.
Aged ; Alcoholism ; Blood Glucose ; Cardiovascular Diseases ; Coma ; Diabetes Mellitus ; Emergencies ; Humans ; Hypoglycemia ; Insulin ; Neurologic Manifestations ; Paresis ; Stroke

Objective: This study was undertaken to assess the appropriateness of transfer of patients from a long-term care hospital to the emergency department (ED). Methods: We conducted a retrospective study in a Wide Regional Emergency Center in Gyeongsangnam-do between January 2019 and December 2019. The patients were divided into groups (direct visit, transferred from other hospitals, and transferred from long-term care hospitals [LTCHs]). The baseline characteristics, Korean Triage and Acuity Scale (KTAS), vital signs, length of stay, ED disposition, cost, clinical outcome, and instances of application of the “Act on decisions on life-sustaining treatment” were collected. Results: A total of 30,142 patients were enrolled during the study period. Twenty-one thousand, nine hundred and sixty-five patients were in the direct visit group, 7,057 patients were transferred from other hospitals, and 1,120 patients were transferred from LTCHs. Hospital admission was higher in cases of transfer from other hospitals and LTCHs (LTCHs, 63.8%; transferred from other hospitals, 64.1%, direct visit, 30.1%; P<0.001). Re-transfer and mortality in the ED were much higher (re-transfer: LTCHs, 11.0%; transferred from other hospitals 3.8%, direct visit 1.9%; P<0.001 and mortality in ED: 2.9%, 0.8%, 1.4%; respectively P<0.001). In the LCTH group after admission, mortality was higher (mortality: 16.2%, 5.4%, 7.1% for LTCH transfers and direct respectively; P<0.001). The implementation rate of the “Act on decisions on life-sustaining treatment”, the well-dying law, was higher in the LTCHs (26.6%, 12.5%, and 11.4% LTCH transfers, and direct respectively; P<0.001). Conclusion In the LTCH group, re-transfer, mortality, and the implementation rate of the “Act on decisions on life-sustaining treatment” were higher than in the other groups.