No abstract available.
Humans ; Hypersensitivity* ; Skin*

Dyslipidemia stands as a significant risk factor for stroke, on par with the impact of hypertension, diabetes, and smoking. While the role of dyslipidemia is firmly established in the context of coronary artery disease, its influence on strokes remains somewhat enigmatic. This complexity likely arises from the diverse mechanisms underpinning strokes, which encompass a heterogeneous spectrum (hemorrhagic and ischemic; large artery atherosclerosis, small vessel occlusion, cardioembolism, and etc.). The extent to which lipid-lowering treatments affect stroke outcomes may vary depending on the specific stroke subtype. For instance, in cases of large artery atherosclerosis (LAA), the optimal target level of low-density lipoprotein cholesterol (LDL-C) is relatively clear. However, when dealing with other stroke subtypes like small vessel occlusion or cardioembolism, the appropriate LDL-C target remains uncertain. Furthermore, reperfusion therapy has emerged as the foremost treatment for acute ischemic stroke. Nevertheless, the precise relationship between LDL-C levels and outcomes in patients undergoing reperfusion therapy remains shrouded in uncertainty. Consequently, we have undertaken an in-depth exploration of the existing evidence supporting the utilization of lipid-lowering medications such as statins, ezetimibe, and proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors. Our objective is to elucidate their role in secondary stroke prevention and the management of dyslipidemia across the various stroke subtypes.

PURPOSE: Amniotic membrane (AM) contains various proteinase inhibitors and when used as a graft, it could enhance healing process by blocking insult of inflammatory cells and inhibiting proteolytic damage. Thus we evaluated whether applying of amniotic membrane extract as eyedrops could get the same effect as amniotic membrane patching. METHODS: Alkali wounds were inflicted on the central corneas of rabbits by applying a round filter paper, 6.0 mm in diameter, soaked in 1N NaOH for 30 seconds. A total of 16 rabbits were divided into four groups: (1) applied with amniotic membrane extract; (2) applied with amniotic membrane extract and Healon(R); (3) applied with methylcellulose; and (4) control. Each material was applied for 1 week. During follow-ups, epithelial defects, corneal thickness and its opacity were measured. RESULTS: The epithelial healing was faster and the corneal thickness was thinner in amniotic membrane extract applied groups than in non-applied. Corneal opacity was much less in AM extract applied groups. CONCLUSIONS: AM extract as eyedrops promotes wound healing and it could be an effective method for treating various keratitis due to its convenience and good effect.
Alkalies* ; Amnion* ; Burns* ; Cornea ; Corneal Opacity ; Follow-Up Studies ; Keratitis* ; Methylcellulose ; Ophthalmic Solutions ; Rabbits ; Transplants ; Wound Healing ; Wounds and Injuries

No abstract available.
Cardiomyopathies* ; Peripartum Period*

Disseminated intravascular coagulation (DIC) is a major complication in sepsis patients. We compared the performance of five DIC diagnostic criteria, focusing on the prediction of mortality. One hundred patients with severe sepsis or septic shock admitted to intensive care unit (ICU) were enrolled. Routine DIC laboratory tests were performed over the first 4 days after admission. The overall ICU and 28-day mortality in DIC patients diagnosed from five criteria (International Society on Thrombosis and Haemostasis [ISTH], the Japanese Association for Acute Medicine [JAAM], the revised JAAM [R-JAAM], the Japanese Ministry of Health and Welfare [JMHW] and the Korean Society on Thrombosis and Hemostasis [KSTH]) were compared. Both KSTH and JMHW criteria showed superior performance than ISTH, JAAM and R-JAAM criteria in the prediction of overall ICU mortality in DIC patients (odds ratio 3.828 and 5.181, P = 0.018 and 0.006, 95% confidence interval 1.256–11.667 and 1.622–16.554, respectively) when applied at day 1 after admission, and survival analysis demonstrated significant prognostic impact of KSTH and JMHW criteria on the prediction of 28-day mortality (P = 0.007 and 0.049, respectively) when applied at day 1 after admission. In conclusion, both KSTH and JMHW criteria would be more useful than other three criteria in predicting prognosis in DIC patients with severe sepsis or septic shock.
Asian Continental Ancestry Group ; Dacarbazine ; Diagnosis ; Disseminated Intravascular Coagulation* ; Hemostasis ; Humans ; Intensive Care Units ; Mortality* ; Prognosis ; Sepsis* ; Shock, Septic ; Thrombosis

No abstract available.
Ascorbic Acid* ; Pyuria* ; Vitamins*

The goal in facial paralysis treatment is to achieve the normal appearance of the face as well as to reconstruct the natural symmetrical smile. In cases of facial paralysis, a widely accepted procedure is the two stage method, which combines neurovascular free muscle transfer with cross face nerve grafting. Although the results are promising, the two operations of this method, which are about 1 year apart, impose an economic burden on the patients and require a lengthy period before results are obtained. In order to overcome these drawbacks, one stage method, using latissimus dorsi neurovascuular free muscle flap was introduced. Between January 2000 and January 2004, fifteen patients with long standing facial paralysis were treated in the Korea University Anam Hospital. The segmental latissimus dorsi with long nerve and pedicle was transferred to the paralyzed side of the face. The first postoperative movement of the transferred muscle was reported at 8.9 months, faster than that of the two stage method. During the next 24 months, a constant increase in the power of muscle contraction was observed. The fifteen cases were evaluated within an average of 31.7 months following the surgery and satisfactory results including muscle contraction were obtained in eleven of the cases but muscle contraction was not found in three cases.
Facial Paralysis* ; Free Tissue Flaps* ; Humans ; Korea ; Muscle Contraction ; Superficial Back Muscles* ; Transplants

Leiomyoma is the most common benign tumor of the esophagus, but it still occurs rarely as compared with the incidence of carcinoma in this area. Most of leiomyomas may manifest itself with unusual and inconsistent symptoms, and found incidentally during endoscopic or radiographic examination. Those who menifested symptoms are included as dysphagia and vague pain mostly. We experienced recently two cases with esophageal leiomyoma who underwent successful surgical resection and endoscopic enucleation, respectively.
Deglutition Disorders ; Esophagus* ; Incidence ; Leiomyoma*

PURPOSE: Emergency department (ED) overcrowding is a common occurrence, and requires performance of appropriate triage to determine the priority for patient treatments. Undertriage, defined as inappropriate assignment of a low level of severity during triage, delays the initiation of treatment and may lead to deterioration of severely ill or injured patients. The aim of this observational study was to evaluate the clinical characteristics of undertriage patients and their risk exposure to a worsening prognosis. METHODS: Subjects were ED patients admitted to a university affiliated hospital from Jan 1, 2010 to Dec 31, 2010, and they were triaged according to the modified Canadian Triage and Acuity Scale. Patients who were initially categorized as non-emergency cases (scale 4 or 5) but later recategorized as emergency cases (scale 1 or 2) were defined as the undertriage group. Triage patients who did not receive a change of severity categorization were assigned to a low-acuity group for non-emergency cases, and a high-acuity group for emergency cases. The clinical characteristics and worsening prognosis of the undertriage group were compared with low- and high-acuity groups. Worsening prognosis included cardiac arrest and the admission to the intensive care unit. RESULTS: Patients in the undertriage group were 0.9% of the total study participants. The undertriage group predominantly included elderly males with head and neck injuries, or hemato-oncology diseases. Worsening prognosis was less likely in the undertriage group than in the high-acuity group, and more likely than in the low-acuity group. CONCLUSION: Undertriage was not common. However, worsening prognosis was very high in the undertriage group as compared to the low-acuity group. Prudential concern is required to avoid undertriage with the elderly, and patients with head and neck injuries, or hemato-oncology diseases.
Aged ; Emergencies ; Head ; Heart Arrest ; Humans ; Critical Care ; Male ; Neck Injuries ; Prognosis ; Triage

PURPOSE: To descirbe a series of patients in which Thyroid Associated Orbitopathy (TAO) occurred after periocular surgery. METHODS: A retrospective case review of patients who developed TAO in close temporal association with periocular surgical interventions and presented at the orbital clinic from 1997 to 2004. History of previous thyroid abnormality and the lack of TAO signs and symptoms before surgery were reviewed and analyzed. RESULTS: Nine patients that developed TAO in association with periocular surgery were identified. All were women with an average age of 59.3years. (range: 45-75 years). The patients divided into two groups. Group 1 consisted of four patients who had previously been diagnosed with Graves' hyperthyroidism (GH). They ranged in age from 48 to 75 years (average: 58.8 years). The diagnosis of GH had been made an average of 50.5 months (range: 12-96 months) before presentation with TAO. Group 2 consisted of five patients who had no previous history of thyroid abnormality. They ranged in age from 45 to 74 years (average: 60.2 years). No patients had any signs or symptoms of TAO before their recent presentation. CONCLUSIONS: Periocular surgery may lead to local inflammatory events that may contribute to the instigation of TAO in predisposed individuals.
Risk Factors ; Retrospective Studies ; Postoperative Complications ; Ophthalmologic Surgical Procedures/*adverse effects ; Middle Aged ; Humans ; Graves Ophthalmopathy/*etiology ; Follow-Up Studies ; Female ; Aged