PURPOSE: Early assessment of injury severity is important in management of major trauma patients. In general, hypotensive major trauma patients show more severe outcomes from injuries compared with normotensive major trauma patients. In this study, we analyzed the clinical features of severe trauma patients with initial hypotension and attempted to determine the prognostic factors of mortality in these patients. METHODS: A retrospective study was conducted within our hospital. Review of trauma registry data identified 679 major trauma patients (Injury severity score, ISS>15). From January 2011 to December 2013, all major trauma patients with initial systolic blood pressure lower than 90 mmHg were included (N=77). The patients were divided into two groups - those who survived and those who expired - and the differences in initial and final values were compared between the two groups. RESULTS: Out of a total of 77 patients, 55 patients survived and 22 patients died. The data showed almost no difference in heart rate between the two groups. The expired group showed low Glasgow Coma Scale (GCS) score, systolic blood pressure, revised trauma score, initial pH, and follow-up pH, as well as higher age, ISS, initial lactate, prothrombin time (PT), international normalized ration (INR), and follow-up lactate, compared with the survived group. In multivariate logistic analysis, age (p=0.034, OR 1.071), GCS (p=0.006, OR 0.61), initial base excess (p=0.042, OR 0.57), and follow-up base excess (p=0.041, OR 0.799) were independently associated with mortality. CONCLUSION: The patient's age, initial GCS, initial base excess and follow-up values of base excess were good prognostic factors for mortality in the expired major trauma patients with initial hypotension.
Blood Pressure ; Emergency Service, Hospital* ; Follow-Up Studies ; Glasgow Coma Scale ; Heart Rate ; Humans ; Hydrogen-Ion Concentration ; Hypotension* ; Lactic Acid ; Mortality* ; Multiple Trauma ; Prothrombin Time ; Retrospective Studies

We have successfully applied the nested PCR to detect Cylindrocarpon destructans, a major pathogen causing root rot disease from ginseng seedlings in our former study. The PCR assay, in this study, was used to detect the pathogen from soils. The nested PCR using internal transcribed spacer (ITS) 1, 4 primer set and Dest 1, 4 primer set maintained the specificity in soils containing various microorganisms. For a soil DNA extraction method targeting chlamydospores, when several cell wall disrupting methods were tested, the combination of lyophilization and grinding with glass beads, which broke almost all the chlamydospores, was the strongest. The DNA extraction method which was completed based on the above was simple and time-saving because of exclusion of unnecessary stages, and efficient to apply in soils. As three ginseng fields whose histories were known were analyzed, the PCR assay resulted as our expectation derived from the field information. The direct PCR method will be utilized as a reliable and rapid tool for detecting and monitoring C. destructans in ginseng fields.
Cell Wall ; DNA ; Freeze Drying ; Glass ; Panax ; Polymerase Chain Reaction ; Seedlings ; Sensitivity and Specificity ; Soil

The purpose of this retrospective study was to describe cases of feline intermediate- to high-grade alimentary lymphoma regarding signalment, clinical presentation, laboratory findings, response to therapy (modified 25-week University of Wisconsin–Madison [UW-25] vs. COP [cyclophosphamide, vincristine, prednisone]), toxicosis, and outcomes and to identify prognostic factors. Sixteen cats were treated with chemotherapy protocols. Response rates and survival did not differ statistically between the two protocols. The progression-free interval (PFI) and median survival time (MST) in cats achieving a response to therapy were longer than in those with no response [NR] (complete remission [CR] vs. partial remission [PR] vs. NR; PFI, 124 vs. 49 vs. 12 days, p < 0.001; MST, 361 vs. 118 vs. 16 days, p < 0.001). Clinical stage was another prognostic factor for PFI and MST. The PFI and MST in cats in stage I were longer than in those in other stages (PFI, 107 days vs. 30 days; MST, 193 days vs. 54 days). Hematologic and gastrointestinal toxicosis was mostly low grade. In comparing the modified UW-25 protocol with the COP protocol, there was not much difference in the number of neutropenic episodes and grade levels.

The purpose of this retrospective study was to describe cases of feline intermediate- to high-grade alimentary lymphoma regarding signalment, clinical presentation, laboratory findings, response to therapy (modified 25-week University of Wisconsin–Madison [UW-25] vs. COP [cyclophosphamide, vincristine, prednisone]), toxicosis, and outcomes and to identify prognostic factors. Sixteen cats were treated with chemotherapy protocols. Response rates and survival did not differ statistically between the two protocols. The progression-free interval (PFI) and median survival time (MST) in cats achieving a response to therapy were longer than in those with no response [NR] (complete remission [CR] vs. partial remission [PR] vs. NR; PFI, 124 vs. 49 vs. 12 days, p < 0.001; MST, 361 vs. 118 vs. 16 days, p < 0.001). Clinical stage was another prognostic factor for PFI and MST. The PFI and MST in cats in stage I were longer than in those in other stages (PFI, 107 days vs. 30 days; MST, 193 days vs. 54 days). Hematologic and gastrointestinal toxicosis was mostly low grade. In comparing the modified UW-25 protocol with the COP protocol, there was not much difference in the number of neutropenic episodes and grade levels.

Background: Disseminating public knowledge on malignant melanoma through YouTube is an important way to bridge the gap between physicians and patients. However, videos recorded on this topic in Korea are yet to be evaluated. Objective: We aimed to evaluate the quality of YouTube videos on malignant melanoma recorded in Korea. We also investigated whether there was a difference in the quality of videos made by medical professionals (subdivided into dermatologists and non-dermatologists) and non-medical personnel. Methods: We included all videos recorded in Korean by searching YouTube using the keywords “melanoma” or “malignant melanoma”. The search was performed on March 22, 2021. The inclusion criterion was videos in Korean language that contained medical information about malignant melanoma. The characteristics and content information were collected for each video. Video quality (DISCERN, Global Quality Scale [GQS], Journal of the American Medical Association [JAMA] benchmark criteria) was analyzed. Results: Eighty-five videos met the inclusion criterion for the analysis. Fifty-six (66%) and 29 videos (34%) were made by medical and non-medical personnel, respectively. The videos made by medical professionals significantly contained more of the following information than those made by non-medical personnel: clinical information (p＜ 0.001), symptoms and signs (p=0.001), risk factors (p＜0.05), diagnosis (p＜0.001). Videos made by medical professionals, videos with a length of more than 5 minutes, or videos with more than 10,000 views had significantly higher quality scores (DISCERN, GQS, JAMA). Conclusion Considering that YouTube is being used as a portal for medical information, the participation of medical professionals is essential for providing more accurate information.

Breast reconstruction using TRAM flap after mastectomy has been widely adopted and regarded as a gold standard method. In patients with the abdominal midline scar, insufficient blood circulation to regions contralateral to the pedicle disables inclusion of them in the TRAM flap design. So modifications including Double- pedicled TRAM, Super-charged, Turbo-charged, Bipedicled free TRAM et al. have been attempted to resolve the problem of circulatory interruption by midline scar. The authors designed a new bipedicled free TRAM flap to avoid limitations like epigastric buldging, significant abdominal weakness and complexity of flap insetting. The two donor arteries(right and left deep inferior epigastric arteries) are anastomosed to the proximal and distal ends of divided internal mammary arteries using the reverse flow. Vein anastomoses were performed in the same manner through the divided venae comitantes. Two patients having infraumbilical midline scar underwent breast reconstruction using author`s new flap. Flaps survived without fat necrosis or partial flap loss in both patients and their results in aesthetic aspects were very satisfactory. Compared to previous method for breast reconstruction of patients having infraumbilical midline scar, author's new method is useful and effective in terms of the aesthetic and technical aspect.
Blood Circulation ; Breast* ; Cicatrix* ; Fat Necrosis ; Female ; Humans ; Mammaplasty* ; Mammary Arteries ; Mastectomy ; Tissue Donors ; Veins

A 58-year old male patient, with a history of gastrectomy, came to our department for recently aggravated glossodynia. A delicate physical examination revealed gait ataxia and a positive Rhomberg test. He was diagnosed as having vitamin B12 deficiency using a combination of the laboratory results, such as macrocytic anemia. It was thought that the tongue pain might have been a main clinical manifestation of vitamin B12 deficiency.
Anemia, Macrocytic ; Gait Ataxia ; Gastrectomy ; Glossalgia* ; Humans ; Male ; Middle Aged ; Physical Examination ; Tongue ; Vitamin B 12 Deficiency* ; Vitamin B 12* ; Vitamins*

OBJECTIVE: To investigate the effect of extracorporeal shock wave therapy (ESWT) on painful stump neuroma. METHODS: Thirty patients with stump neuroma at the distal end of an amputation site were assigned randomly to the ESWT group (n=15) and the transcutaneous electrical nerve stimulation (TENS)+desensitization+pharmacological treatment group (n=15). For 3 weeks, the ESWT group received a weekly session involving 1,500 pulses at 0.10 mJ/mm2, while the control group was treated 10 times each, 40 minutes per day with TENS and desensitization treatment, and daily medication for 3 weeks. ESWT stimulation was given by focusing on the area at the neuroma site clearly identified by ultrasound. RESULTS: The changes in the McGill pain questionnaire were 38.8+/-9.0 prior to treatment and 11.8+/-3.1 following the treatment. The corresponding values for the control group were 37.2+/-7.7 and 28.5+/-10.3. The changes between groups were significantly different (p=0.035). The change in visual analog scale prior to and after treatment was 7.0+/-1.5 and 2.8+/-0.8 in the ESWT group, respectively, and 7.2+/-1.4 and 5.8+/-2.0 in the control group. These changes between the groups were also significantly different (p=0.010). The outcome in the pain rating scale also showed significant differences between groups (p<0.001). Changes in neuroma size and pain pressure threshold (lb/cm2) were not significantly different between groups (p>0.05). CONCLUSION: The study findings imply that ESWT for stump neuroma is superior to conventional therapy.
Amputation ; Amputation Stumps ; Humans ; Neuroma* ; Pain Measurement ; Shock* ; Transcutaneous Electric Nerve Stimulation ; Ultrasonography ; Visual Analog Scale

BACKGROUND: Asthma can be described as the hypersensitivity of the airway to various stimuli. Injury to tracheal epithelial cells could be the reason for tracheal hypersensitivity in asthma or upper respiratory infection. This study is based on the hypothesis that the dysfunction of the airway in asthma is caused by epithelial cell injury. METHODS: After isolating guinea-pig tracheal preparations, in order to examine the role of airway epithelium in response to smooth muscle, we measured the contractile responses to acetylcholine, carbachol, and histamine on the isolated epithelium-denuded or epithelium-intact guinea-pig tracheal preparations. When tracheal tones were stabilized, each contractile agent was added cumulatively to the organ baths to obtain concentration-response curves, and ED50 and ED95 were calculated. RESULTS: In both groups, tracheal tones increased in response to contractile agents, in concentration- dependent manners. In comparing both groups, the contractility of denuded trachea was increased by 10 7 and 10 6 M in acetylcholine, and by 10 6 M in histamine significantly. In denuded trachea, ED50 and ED95 increased significantly in response to both acetylcholine and histamine. However, they did not increase in carbachol. CONCLUSIONS: The removal of the epithelium increased the contractile responses to acetylcholine and histamine.
Acetylcholine ; Asthma ; Baths ; Carbachol ; Epithelial Cells ; Epithelium ; Histamine ; Hypersensitivity ; Muscle, Smooth* ; Trachea

PURPOSE: Raman spectroscopy is a vibrational spectroscopic technique, which is capable of providing details on the chemical composition, molecular structure and molecular interactions in cells and tissues. The primary objective of this study was to explore Raman spectroscopy for the detection of spectral changes between normal and cancer tissue in the stomach. METHODS: Tissue specimens were obtained from the resected stomach of advanced gastric cancer patients. The normal gastric and cancer tissues were harvested from the middle, lower portion of the stomach and from the tumor mass, respectively. 19 sets (antrum, body and cancer) of spectral data, with clearly defined histopathological findings, were selected in this study. FT-Raman spectroscopy (Bruker Inc., Karsruhe, Germany) was used for tissue Raman studies, with excitation at 1, 064 nm. The Raman spectra from the gastric tissue specimens were obtained with a 20 minute signal acquisition time. RESULTS: In the range 700~1, 900 cm-1, the Raman spectra of gastric antral tissue were dominated by a number of vibrational modes of biomolecules, such as proteins, lipids and nucleic acids. The Raman spectrum pattern of gastric body tissue was similar to that of the antrum, suggesting the structure and composition between the gastric antrum and body are much the same. The Raman spectra differed significantly between the normal and malignant cancer tissues, with cancers showing higher percentage signals for protein, lipid and nucleic acid compared to normal tissue (P<0.05). Difference were observed in the shapes of the Raman spectra between the normal and cancer tissues, particularly in the spectral ranges 1, 250~1, 255, 1, 330~1, 340 and 1, 440~1, 450 cm-1, which contain signals relating to protein and lipid conformations and CH2 bending mode of nucleic acids. CONCLUSION: This study demonstrates the ability of Raman spectroscopy to detect biochemical changes in malignant gastric tissue, and may become a useful adjunct to pathological diagnosis allowing guided biopsies and assessment of adequacy of resection margins.
Biopsy ; Diagnosis ; Humans ; Molecular Structure ; Nucleic Acids ; Pyloric Antrum ; Spectrum Analysis ; Spectrum Analysis, Raman* ; Stomach Neoplasms ; Stomach*