BACKGROUND: Although diagnostic peritoneal lavage (DPL) is a well-established, reliably objective method of diagnosis of intraperitoneal injury, it is too sensitive to be used as a absolute indicator for emergency laparotomy. Recently, Otomo et al, have devised a new DPL criteria specifically designed and modified the classics criteria to aid in diagnosis of intestinal injury. So the author studied the difference of diagnostic sensitivity, specificity, and accuracy between the new and classic criteria for intestinal injury. METHODS: The author reviewed retrospectively one hundred fifteen patients underwent DPL from January 1993 to August 1999. The author adopted the classic criteria positive for intestinal injury when the lavage fluid was white blood cell(WBC) > or = 500/mm3 and newly developed supplementary criteria positive when RBC > or = 100,000/mm3, the positive-negative borderline was adjusted to WBC > or = RBC/150, and when RBC <100,000/mm3, to WBC > or = 500/mm3. And analyzed the difference of sensitivity, specificity, and accuracy each other. RESULTS: Among 115 patients, the sensitivity, specificity, and accuracy for intestinal injury were 96.4%, 87.4%, and 89.6% for the new criteria, and 100%, 42.5%, and 56.5% for the classic criteria. After exclusion of 10 patients in whom-DPL was performed within 3 hours or after 18 hours from the time of injury, the sensitivity, specificity and accuracy for intestinal injury were 96.4%, 97.4%, and 97.1% for the new criteria, and 100%, 46.8%, and 61% for the classic criteria. When analyzed the time interval from injury to DPL in the new criteria, 105 patients that DPL was performed between 3 to 18 hours had 2 false-positive, while 115 patients regardless of DPL time 11 false-positive. CONCLUSIONS : The author concluded that the new criteria of DPL effluent performed between 3 to 18 hours from abdominal blunt trauma would be more specific and accurate indicator of intestinal perforation than the classic criteria. And this new criteria will be used as a reliable indicator for emergency laparotomy for that patients.
Diagnosis ; Emergencies ; Humans ; Intestinal Perforation ; Laparotomy ; Peritoneal Lavage* ; Retrospective Studies ; Sensitivity and Specificity ; Therapeutic Irrigation

Purpose: This study investigated customers' perception of a hygiene grade certification system for restaurants and this study also determined way to promote the application of the hygiene grade certification. Methods: A total of 315 customer responses were used for the data analysis. Statistical analyses were conducted using the SPSS program (ver. 23.0) for frequency analysis, χ2-tests, t-tests, analysis of variance, and Importance-Performance Analysis (IPA). Results: The composition of the respondents was 43.8% males and 56.2% females. The 73.3% lived with their families while 26.7% lived alone. Among those surveyed, 84.5% dine out at least once a week and 66.8% dine out during weekends evening. In addition, the most preferred types of restaurants were Korean restaurants (37.5%), delivery restaurants (14.6%), and Western restaurants (8.9%). Information about restaurant was most frequently obtained through Internet searches (54.0%). The average expenditure of eating-out per person was 15,483 Korean won, and the overall satisfaction averaged 3.58 out of 5 points. According to the results of IPA, the restaurant selection attributes that were priorities for improvement were the foods' taste and restroom cleanliness. In addition, 30.5% of respondents recognized the hygiene grade certification system for restaurants. The intention of dining at restaurants with a hygiene grade certification in the future was on average 4.02 out of 5 points. A total of 56.8% of respondents were willing to pay more for a restaurant with a hygiene grade certification. The average percentage of additional price was 6.02%. Conclusion In order to apply and quickly disseminate the hygiene grade certification system all over the Korea, the study results suggest that relevant policy should be provided by the Korean government for certified restaurants along with the relevant education and promotion of the system to customers.

Purpose: This study was conducted to segment the delivery food market and to develop customized products and services. Methods: This study analyzed 636 responses collected from customers who ordered delivery food. Statistical analyses were conducted using the SPSS program (ver. 25.0) for frequency analysis, χ2-test, one-way analysis of variance, factor analysis, and cluster analysis. Results: Four factors were extracted by exploratory factor analysis (safety-orientation, convenience-orientation, taste-orientation, and economy-orientation) to explain the consumers’ food-related lifestyles. The results of cluster analysis indicated that the ‘low-interest group’, ‘convenience and economy-oriented group’, and ‘gourmet and economy-oriented group’ should be regarded as the target segments. Characteristic analysis of each cluster showed that low-interest group had higher rates of married (67.1%) and living with family (85.4%) than other clusters. The convenience and the economy-oriented group had higher rates of living alone (28.9%) than others. The gourmet and the economy-oriented group had a higher percentage of unmarried (62.0%) than the others. In addition, the average age of convenience and economy-oriented group (32.3 years) and gourmet and economy-oriented group (32.5 years) were significantly lower than the safety seeker (40.0 years) (p < 0.001). Difference analysis of the consumption practice according to the cluster, revealed significant differences in the order frequency (p < 0.001), main day to order (p < 0.05), source of information about delivery food (p < 0.001), order method (p < 0.001), and co-consumer (p < 0.01). In addition, the convenience and the economy-oriented group had significantly higher overall satisfaction than the others (p < 0.001). Conclusion These findings suggest that customer segmentation based on a food-related lifestyle can be used to build a successful marketing strategy. Therefore, restaurant managers and delivery platform operators should consider developing products and services according to the segmentation to maximize customer satisfaction.

The study was the clinical analysis of 509 patients with pure ocular injuries who visited to Chonnam University Hospital Emergency center from July 1, 1996 to June 30, 1997 retrospectively. Clinical data survey including sex and age distribution, causes of trauma, injury site, ocular disease, and surgical intervention was done. Most of ocular injury patients were male. 3rd and 4th decade who were socially active were nearly 50%. Direct and indirect injury from foreign body was the most common cause of ocular injuries followed by fist blow, traffic accident, falling down, and sport injury. Cornea was the most common ocular injury site (209 patients, 41.1%). The incidence of the traumatic ocular disease showed corneal erosion (117 patients, 22.9%) and then eyeball perforation, traumatic hyphema etc. by frequency of order. Eyeball perforation was the most common ocular injury which needed a emergency surgical intervention. As a results, emergency physicians have to pay attention to the cornea in case of any type of ocular injuries and eyeball perforation which caused by direct and indirect injury from foreign body.
Accidents, Traffic ; Age Distribution ; Cornea ; Emergencies ; Foreign Bodies ; Humans ; Hyphema ; Incidence ; Jeollanam-do ; Male ; Retrospective Studies ; Sports

Purpose: To identify the differences in perception of and adherence to the COVID-19 social distancing behavior guidelines among health care workers, patients, and the general public and to use them to prevent the spread of COVID-19. Methods: From October 16 2020 to November 30, 2020, a survey was conducted among 85 health care workers, 85 patients, and 82 general public regarding the perception of and adherence to the COVID-19 social distancing behavior guidelines. Results: Patients scored significantly higher than the general public in the adherence to the COVID-19 social distancing behavior guideline, and there was no difference between health care workers and general public, and patients and health care workers. In the multivariate analysis, the factors that influence the adherence of the COVID-19 social distancing behavior guide were found in women and the perception of the COVID-19 social distancing behavior guideline. Conclusion In order to promote the implementation of the COVID-19 social distancing behavior guideline, it is necessary to increase the perception of the COVID-19 social distancing behavior guideline and provide additional education in men. It is necessary to investigate the reason behind why men have low adherence to the COVID-19 social distancing behavior guideline.

The objective of this study was to determine the incidence and distribution of root fusion as well as its sexlinkage in maxillary and mandibular molars. One hundred fifty patients who had eight maxillary and mandibular molars (third molars excluded) were consecutively selected for the study subjects. The subjects provided a total of 1200 molars, i.e., 600 maxillary and 600 mandibular molars. A decision about root fusion was made on the radiographic examination. If a molar had one root and/or roots fused at any part in the root surface, it was considered as having root fusion. The results showed that : (1) 14.1 % of the maxillary molars and 5.8 % of the mandibular molars had a fused root, (2) the prevalence of root fusion in the male was 33 % and 56.4 % in the female, (3) 60 % in the male and 48.8 % in the female had bilaterally paired root fusion, (4) the root fusion was most frequently observed in the maxillary second molar position, but none in the mandibular first position in this study. Within limitations of this study, it can be concluded that, in management of molars with a furcation problem, treatment options such as hemisection and root amputation should be chosen after careful evaluation of root fusion. Further studies are needed to investigate a possible relationship between root fusion and periodontal disease progression.
Amputation ; Female ; Humans ; Incidence ; Male ; Molar* ; Periodontal Diseases ; Prevalence*

In aging societies, incidences of neurodegenerative diseases such as Alzheimer’s disease and Parkinson’s disease are increasing. Neurodegenerative diseases are bringing main challenges to the healthcare system in today’s world. Analyzing characteristic imaging patterns of patients with neurodegenerative diseases is important. Since objective and reliable imaging assessments and precise analyses can lead to early diagnosis of neurodegenerative diseases, imaging patterns are being increasingly investigated. Artificial intelligence (AI) analyzing brain MRI has been applied to neurodegenerative diseases, providing added value in early diagnosis. MRI-based AI software has been developed and studied worldwide, with some AI-based software already being used in actual clinical care. Currently, there are MRI-based volumetry and segmentation software available. There is also an unmet demand for the application of AI in neurodegenerative diseases. Here, we review current status and unmet needs for application of AI in neurodegenerative diseases. We also discuss current limitations of AI, suggestion for AI-based software, and how it can be clinically applied in the future.

Purpose: When performing laparoscopic spleen-preserving distal pancreatectomy (LSPDP), sometimes, anatomically challenging patients are encountered, where the pancreatic tail is deep in the splenic hilum. The purpose of this study was to discuss the experience with the surgical technique of leaving the deep pancreatic tail of the splenic hilum in these patients. Methods: Eleven patients who underwent LSPDP with remnant pancreatic tails between November 2019 and August 2021 at Samsung Medical Center in Seoul, Korea were included in the study. Their short-term postoperative outcomes were analyzed retrospectively. Results: The mean operative time was 168.6 ± 26.0 minutes, the estimated blood loss was 172.7 ± 95.8 mL, and the postoperative length of stay was 6.1 ± 1.0 days. All 11 lesions were in the body or tail of the pancreas and included 2 intraductal papillary mucinous neoplasms, 6 neuroendocrine tumors, 2 cystic neoplasms, and 1 patient with chronic pancreatitis. In 10 of the 11 patients, only the pancreatic tail was left inside the distal portion of the splenic hilum of the branching splenic vessel, and there was a collection of intraabdominal fluid, which was naturally resolved. One patient with a remnant pancreatic tail above the hilar vessels was readmitted due to a postoperative pancreatic fistula with fever and underwent internal drainage. Conclusion In spleen preservation, leaving a small pancreatic tail inside the splenic hilum is feasible and more beneficial to the patient than performing splenectomy in anatomically challenging patients.

BACKGROUND: Although cardiopulmonary resuscitation(CPR) is a very effective therapy in cardiac arrest, it is hard to prove the true effectiveness of CPR. Several studies about out-of-hospital and emergency department CPR exist, but only a few reports about in-hospital CPR are available. This study was designed to investigate in-hospital cardiac arrest, to analyze the result of CPR, and to evaluate the problems associated with in-hospital CPR. METHODS: A clinical analysis of 71 cases of in-hospital CPR announcement from January 2000 to August 2000 was performed. The initial rhythm on cardiac arrest, return of spontaneous circulation(ROSC), and the survivals were analyzed in the case of the 46 true cardiac arrest patients. RESULTS: During 8 months, there were 71 cases of in-hospital CPR announcement. Among them, there were 46 cases of true cardiac arrest and 25 cases of non-cardiac arrest. Of the 46 true cardiac-arrest cases, 27(58.7%) experienced ROSC, 15(32.6) survived for over 24 hours, and 7(15.2%) survived to be discharged. The initial rhythms on cardiac arrest were 30 cases(65.2%) of asystole, 14(30.4%) of PEA(pulseless electrical activity), and 2(4.3%) of ventricular fibrillation, with ROSC being 17 cases(56.7%), 9(64.3%) and 1(50.0%) cases and discharged survivors being 4 cases(13.3%), 3(21.4%) and 0(0.0%) cases, respectively. CONCLUSION: Extraordinarily high proportions of asystole and PEA were seen in the initial rhythm of cardiac arrest, and those were associated with high survival rates. Although further study is needed to evaluate the course leading to this high proportion of asystole and PEA, this result suggests that if the EMS system in the hospital is activated promptly and systematically, a better outcome will be achieved in case of cardiac arrest with asystole and PEA.
Cardiopulmonary Resuscitation* ; Emergency Service, Hospital ; Heart Arrest ; Humans ; Peas ; Survival Rate ; Survivors ; Tertiary Care Centers* ; Ventricular Fibrillation

BACKGROUND: Spinal zaprinast, phospodiesterase inhibitor, has been shown to have an antinociception through an increase of cGMP. The aim of this study was to examine the role of spinal adrenergic and cholinergic receptors on the antinociceptive action of intrathecal zaprinast. METHODS: Rats were implanted with lumbar intrathecal catheters. After formalin injection, formalin-induced nociceptive behavior (flinching response) was observed for 60 min. After observing the effect of intrathecal zaprinast, antagonism of intrathecal prazosin, yohimbine, atropine and mecamylamine for the effect of zaprinast were evaluated. RESULTS: Intrathecal zaprinast produced a dose-dependent suppression of formalin-induced flinches in both phases of the formalin test. Intrathecal prazosin reversed the antinociception of zaprinast in phase 2, but not phase 1. Intrathecal yohimbine reversed the antinociception of zaprinast in both phases. Neither atropine nor mecamylamine reversed the antinocicetive action of zaprinast. CONCLUSIONS: Intrathecal zaprinast is against the nociceptive state evoked by formalin stimulus. Alpha 2 or alpha 1 adrenergic receptor, but not cholinergic receptors, may be related to the action of zaprinast in the spinal cord.
Animals ; Atropine ; Catheters ; Formaldehyde* ; Mecamylamine ; Pain Measurement* ; Prazosin ; Rats* ; Receptors, Adrenergic, alpha-1 ; Receptors, Cholinergic* ; Spinal Cord ; Yohimbine