The survival rate of commotio cordis is low, and there is often associated neurological disability if return of spontaneous circulation (ROSC) can be achieved. We report a case of commotio cordis treated with therapeutic hypothermia (TH) that demonstrated a favorable outcome. A 16-year-old female was transferred to our emergency department (ED) for collapse after being struck in the chest with a dodgeball. She has no history of heart problems. She was brought to our ED with pulseless ventricular tachycardia (VT), and ROSC was achieved with defibrillation. She was comatose at our ED and was treated with TH at a target temperature of 33degrees C for 24 hours. After transfer to the intensive care unit, pulseless VT occurred, and defibrillation was performed twice. She recovered to baseline neurologic status with the exception of some memory difficulties.
Adolescent ; Coma ; Commotio Cordis* ; Emergency Service, Hospital ; Female ; Heart ; Humans ; Hypothermia* ; Intensive Care Units ; Memory ; Survival Rate ; Tachycardia ; Tachycardia, Ventricular* ; Thoracic Injuries ; Thorax

The deep vein thrombosis had been described as the reaction of vascular inflammatory change by John Hunter in 1773, and Virchow described the pathophysiology of etiologic factors for the first time in 1856. Deep Vein thrombosis and pulmonary embolism is common disease in the North American and European countries. It was reported that deep Vein thrombosis and pulmonary embolism were associated with 300,000 to 600,000 hospitalizations for each year and that as many as 50,000 individuals die each year as a result of pulmonary embolism in the United States. In Korea, deep vein thrombosis is uncommon, complicating pulmonary embolism & renal thromboembolism are also rare, and many cases had not specific history & precipitating factor. The report is for one case of deep vein thrombosis associated with pulmonary & renal thromboembolism, who was 34-years-old, admitted to Masan Koryo hospital because of pain and edema in left lower extremity, had not specific history & precipitating factor. The thrombosis(or thromboembolism) involed his left lung & kidney, and the patient present with severe swelling of affected limb and oliguria. He underwent leg elevation under absolute bed rest and anticoagulant therapy. The significant improvement was done under medical treatment. We report one case of deep vein thrombosis with a brief of literatures.
Bed Rest ; Edema ; Extremities ; Hospitalization ; Humans ; Kidney ; Korea ; Leg ; Lower Extremity ; Lung ; Oliguria ; Precipitating Factors ; Pulmonary Embolism ; Thromboembolism* ; United States ; Venous Thrombosis*

This study evaluated the efficacy of a new, single-dose otic solution combining florfenicol, terbinafine, and mometasone furoate for the treatment of canine otitis externa (OE) in vitro and in vivo. Forty-one client-owned dogs with OE were included in the study and divided into a treatment group that received the test solution and a negative control group that received a normal saline solution. On day 0, the dogs were treated either with the test or the control solution and evaluated over 30 days. Clinical efficacy was evaluated by clinical signs and cytological organism counts. In vitro antimicrobial susceptibility was evaluated by the minimum inhibitory concentration (MIC). After treatment with the test solution, clinical signs continuously decreased and cytological scores were significantly reduced. The results of MIC testing showed that the test solution was potent against the common pathogenic causes of canine OE. In this study, the most common causative pathogens were Staphylococcus pseudintermedius, Pseudomonas spp. and Malassezia pachydermatis. No issues related to safety were identified. Based on these results, this new ototopical drug can be used as first line treatment for canine OE.

Tracheal ultrasonography was performed to measure the width of the tracheal ring shadow and to assess the clinical relevance of these measurements for identifying tracheal collapse. The first tracheal ring width (FTRW) and thoracic inlet tracheal ring width (TITRW) were measured on both expiration and inspiration. The mean of the FTRW width (129 dogs) was greater in expiration (10.97 +/- 1.02 mm, p = 0.001) than that in inspiration (9.86 +/- 1.03 mm). For 51 normal dogs, the mean of the TITRW width was greater in expiration (9.05 +/- 1.52 mm, p = 0.001) than in inspiration (8.02 +/- 1.43 mm). For 78 tracheal collapse dogs, the mean of the TITRW width was greater in expiration (15.89 +/- 1.01 mm, p = 0.001) than in inspiration (14.85 +/- 1.17 mm). The TITRW/FTRW ratio of the normal dogs was higher (p = 0.001) in expiration (0.81 +/- 0.09) than that in inspiration (0.79 +/- 0.10). When compared between the normal and tracheal collapse dogs, the TITRW/FTRW ratio was also increased (p = 0.001) both in expiration (1.54 +/- 0.09) and inspiration (1.47 +/- 0.08), respectively. Based on these results, the cutoff level of the TITRW/FTRW ratio was statistically analyzed according to the receiver operating characteristic curve and it could be set at 1.16 in expiration and at 1.13 in inspiration. We have demonstrated that tracheal ultrasonography is a useful technique for the evaluation of tracheal collapse and it can be a supportive tool together with the radiographic findings for making the correct diagnosis.
Animals ; Dog Diseases/diagnosis/pathology/*ultrasonography ; Dogs ; Female ; Male ; Radiography, Thoracic/*veterinary ; Sensitivity and Specificity ; Trachea/*pathology/radiography ; Tracheal Stenosis/diagnosis/pathology/veterinary

No study has examined the effectiveness of backboards and air deflation for achieving adequate chest compression (CC) depth on air mattresses with the typical configurations seen in intensive care units. To determine this efficacy, we measured mattress compression depth (MCD, mm) on these surfaces using dual accelerometers. Eight cardiopulmonary resuscitation providers performed CCs on manikins lying on 4 different surfaces using a visual feedback system. The surfaces were as follows: A, a bed frame; B, a deflated air mattress placed on top of a foam mattress laid on a bed frame; C, a typical air mattress configuration with an inflated air mattress placed on a foam mattress laid on a bed frame; and D, C with a backboard. Deflation of the air mattress decreased MCD significantly (B; 14.74 +/- 1.36 vs C; 30.16 +/- 3.96, P < 0.001). The use of a backboard also decreased MCD (C; 30.16 +/- 3.96 vs D; 25.46 +/- 2.89, P = 0.002). However, deflation of the air mattress decreased MCD more than use of a backboard (B; 14.74 +/- 1.36 vs D; 25.46 +/- 2.89, P = 0.002). The use of a both a backboard and a deflated air mattress in this configuration reduces MCD and thus helps achieve accurate CC depth during cardiopulmonary resuscitation.
Beds ; Cardiopulmonary Resuscitation/*instrumentation/methods ; *Compressive Strength ; Equipment Design ; Heart Massage/*instrumentation/methods ; Humans ; Intensive Care Units ; Manikins ; Prospective Studies

A dog (5.6 kg, 4-year-old, castrated male, Miniature pinscher) with diffuse symmetric alopecia on the chest and excessive scales was referred to Veterinary Medical Teaching Hospital of Chungnam National University, Korea. On physical examination, diffuse alopecia on ventral aspect of the neck and caudomedial thighs, and severe scales were presented. Dermatologic tests of lesions revealed bacterial infections. Histopathologically, atrophy of hair bulb was observed in the severely alopecic lesion of caudomedial thighs. ACTH stimulation test was performed to differentiate the endocrine disorder related to generalized alopecia. The pre-ACTH serum testosterone and progesterone concentrations were above normal ranges and the post-ACTH serum testosterone concentration was high. The pre- and post-ACTH serum estradiol and cortisol concentrations were within normal ranges. Canine pattern alopecia was diagnosed based on history, physical examination, hormonal assay and dermatohistopathologic examination. After 3 months of melatonin administration, multifocal alopecia on the trunk was improved and general hair regrowth was identified.
Adrenocorticotropic Hormone ; Alopecia ; Alopecia Areata ; Animals ; Atrophy ; Bacterial Infections ; Dogs ; Estradiol ; Hair ; Hospitals, Teaching ; Humans ; Hydrocortisone ; Korea ; Male ; Melatonin ; Neck ; Physical Examination ; Preschool Child ; Progesterone ; Reference Values ; Testosterone ; Thigh ; Thorax ; Weights and Measures

BACKGROUND: Recruitment and homing cells into graft materials from host tissue is crucial for bone regeneration. METHODS: Highly porous, multi-level structural, hydroxyapatite bone void filler (HA-BVF) have been investigated to restore critical size bone defects. The aim was to investigate a feasibility of bone regeneration of synthetic HA-BVF compared to commercial xenograft (Bio-Oss). HA-BVF of 0.7 mm in average diameter was prepared via template coating method. Groups of animals (n = 6) were divided into two with normal (Sham) or induced osteoporotic conditions (Ovx). Subsequently, subdivided into three treated with HA-BVF as an experiment or Bio-Oss as a positive control or no treatment as a negative control (defect). The new bone formation was analyzed by micro-CT and histology. RESULTS: At 4 weeks post-surgery, new bone formation was initiated from all groups. At 8 weeks post-surgery, new bone formation in the HA-BVF groups was greater than Bio-Oss groups. Extraordinarily greater bone regeneration within the Ovx-HA group than Sham-Bio-Oss or Ovx-Bio-Oss group (p<0.05). CONCLUSION: This study suggests that the immediate wicking property of HA-BVF from host tissue activates a natural healing cascade without the addition of exogeneous factors or progenitor cells. HA-BVF may be an effective alternative for repairing bone defects under both normal and osteoporotic bone conditions.
Animals ; Bone Regeneration* ; Capillary Action* ; Durapatite ; Heterografts ; Methods ; Models, Animal* ; Osteogenesis ; Osteoporosis ; Rats* ; Stem Cells ; Transplants*

The survival rate of commotio cordis is low, and there is often associated neurological disability if return of spontaneous circulation (ROSC) can be achieved. We report a case of commotio cordis treated with therapeutic hypothermia (TH) that demonstrated a favorable outcome. A 16-year-old female was transferred to our emergency department (ED) for collapse after being struck in the chest with a dodgeball. She has no history of heart problems. She was brought to our ED with pulseless ventricular tachycardia (VT), and ROSC was achieved with defibrillation. She was comatose at our ED and was treated with TH at a target temperature of 33degrees C for 24 hours. After transfer to the intensive care unit, pulseless VT occurred, and defibrillation was performed twice. She recovered to baseline neurologic status with the exception of some memory difficulties.
Adolescent ; Coma ; Commotio Cordis ; Emergency Service, Hospital ; Female ; Heart ; Humans ; Hypothermia ; Intensive Care Units ; Memory ; Survival Rate ; Tachycardia ; Tachycardia, Ventricular ; Thoracic Injuries ; Thorax

A 14-year-old, spayed female, poodle was presented with dysuria and hematuria. A mass that appeared hypoechoic on ultrasound and hypoattenuating on computed tomography (CT) extended from the bladder neck to the urethra. Magnetic resonance imaging (MRI) showed the mass invading the muscular layer of the bladder, urethra, and prostate with distinct margins. Transitional cell carcinoma (TCC) was confirmed with the CADET-BRAF test. This study describes the CT and MRI features of suspected TCC lesions involving the bladder, prostate, and urethra. MRI showed superior soft tissue contrast resolution, enabling evaluation of invasion of the muscular layer of the bladder and urethra.

BACKGROUND/AIMS: Peptic ulcer bleeding can be treated by endoscopic laser, argon plasma coagulation, heater probe, or electrocoagulation. However, techinical difficulties and significant rebleeding rate after such endoscopic hemostasis, offer some beneficial effect of Alto Shooter(TM) as an adjuvant therapy in active peptic ulcer bleeding. METHODS: Twenty-three patients with active peptic ulcer bleeding were randomized to Alto Shooter(TM) & argon plasma coagulation therapy (ALTO+APC) or argon plasma coagulation therapy alone (APC). Forrest classifications were used to compare the effect of bleeding control. RESULTS: The Forrest classifications in two groups before treatment were Ib (6 patients), IIa (11 patients) in "ALTO+APC", Ib (2 patients) and IIa (4 patients) in "APC". The Forrest classifications of two groups at follow-up endoscopy were Ia (1 patient), Ib (1 patient), IIc (14 patients), III (1 patient) in "ALTO+APC" and IIc (6 patients) in "APC". There was no significant difference in hemostatic effect between "ALTO+APC" (p=0.001) and "APC" (p=0.001) groups. CONCLUSIONS: Alto Shooter(TM) offers no advantage over conventional endoscopic argon plasma coagulation therapy in controlling active peptic ulcer bleeding. Therefore routine addition of Alto ShooterTM treatment may not be recommended after initial successful endoscopic argon plasma coagulation therapy in active peptic ulcer bleeding.
Argon Plasma Coagulation ; Classification ; Electrocoagulation ; Endoscopy ; Follow-Up Studies ; Hemorrhage* ; Hemostasis, Endoscopic ; Humans ; Peptic Ulcer* ; Sodium*