BACKGROUNDS/AIMS: The aim of this study was to compare operative versus non-operative management of patients with liver injury and to ascertain the differences of the clinical features. METHODS: From April 2000 to July 2012, 191 patients were admitted to Seoul St. Mary's Hospital and St. Vincent's Hospital for liver injuries. Of these, 148 patients were included in this study. All patients were diagnosed using computed tomography (CT). The liver injury was graded in accordance with the American Association for the Surgery of Trauma liver injury scoring scale. Patients were divided into two groups: those who underwent surgery and those treated with non-operative management (NOM). There was a comparison between these two groups concerning the clinical characteristics, grade of liver injury, hemodynamic stability, laboratory findings, and mortality. RESULTS: According to the 148 patient records evaluated, 108 (72.9%) patients were treated with NOM, and 40 (27.1%) underwent surgery. Patients treated with NOM had significantly fewer severe injuries as rated using the Revised Traumatic Injury Scale, Injury Severity Score, and Glasgow Coma Scale. Grade of liver injury and number of patients with extravasation of contrast dye on CT and hemoperitoneum were higher in the operative group than in the NOM group. There were significant differences between the two groups for: heart rate, respiratory rate, systolic blood pressure, and mean hemoglobin levels at admission and after 4 hours. The operative group experienced a significantly higher mortality than the NOM group. CONCLUSIONS: The results of our study suggest that hemodynamic stability and the following should be considered for deciding the treatment for liver injuries: grade of liver injury, amount of blood loss, and injury scales scores.
Abdominal Injuries ; Blood Pressure ; Glasgow Coma Scale ; Heart Rate ; Hemodynamics ; Hemoperitoneum ; Humans ; Injury Severity Score ; Liver* ; Mortality ; Respiratory Rate ; Seoul ; Weights and Measures

PURPOSE: To evaluate functional results and complications after minimally invasive plate osteosynthesis through an anterior approach for distal tibial fractures, including pilon fracture. MATERIALS AND METHODS: Between March 2007 and December 2008, thirteen patients with fractures of the distal tibia were treated with minimally invasive plate osteosynthesis through an anterior approach, and were followed for a mean of 16.2 months (range, 12-30 months). Fractures according to the AO/OTA classification were six 43A, four 43B and three 43C. We analyzed functional results by bone union, postoperative complications, and the Olerud and Molander ankle scoring system. RESULTS: All fractures were united after a mean of 15.7 weeks (range, 12 to 24 weeks) except one case. There were 2 cases of superficial wound infection, one case of fibular shortening and metal failure, and two cases of tibialis anterior tendon adhesion. The average functional score was 79 points (range, 35-95 points) and results were four excellent, six good and three fair. CONCLUSION: Minimally invasive plate osteosynthesis through an anterior approach may be used for distal tibial fracture with medial soft tissue injury, and has an advantage in that the metaphyseal and distal articular fracture are fixed at the same time through a single incision However, it should be approached with caution because of the risk of complications due to the anterior approach, such as iatrogenic injury of the tibialis anterior tendon.
Animals ; Ankle ; Humans ; Imidazoles ; Nitro Compounds ; Postoperative Complications ; Soft Tissue Injuries ; Tendons ; Tibia ; Tibial Fractures ; Wound Infection

BACKGROUND: NSAIDs induce gut damage and bacterial translocation throughout the entire gastrointestinal tract. The aim of the present study was to examine whether mastic, a natural resinous exudate obtained from the Pistacia lentiscus treetrees, can reduce diclofenac induce gut damage and bacterial translocation in rats. METHODS: 32 SD rats were divided into four groups; a control group, diclofenac group, diclofenac with 0.3 cc/kg mastic group and diclofenac with 1.0 cc/kg mastic group. Mastic oils were administered 3 hours before diclofenac administration (100 mg/kg orally x2 days). Intestinal permeability, enteric aerobic bacterial counts in the distal ileum and cecum, intestinal adhesion, lipid peroxidation of distal ileum, and bacterial translocation to mesenteric lymph nodes, liver, spleen, kidney and heart were measured, respectively RESULTS: Diclofenac caused marked increase in intestinal permeability, enteric bacterial numbers in distal ileum and cecum, intestinal adhesion, lipid peroxidation of the distal ileum, and bacterial translocation to mesenteric lymph nodes, liver, spleen, kidney and heart of which event were reduced with Mostic coadminist. Howere mastic oil showed significant profect effects in 1.0 cc/kg dose. CONCLUSIONS: Mastic was proven to have beneficial effects on preventing NSAID induced gut injury and bacterial translocation in a rat model.
Animals ; Anti-Inflammatory Agents ; Anti-Inflammatory Agents, Non-Steroidal ; Bacterial Load ; Bacterial Translocation* ; Cecum ; Diclofenac ; Exudates and Transudates ; Gastrointestinal Tract ; Heart ; Ileum ; Intestines ; Kidney ; Lipid Peroxidation ; Liver ; Lymph Nodes ; Models, Animal* ; Oils ; Permeability ; Pistacia ; Rats* ; Spleen

OBJECTIVE: Pelvic inflammatory disease has been inclining over the years and high prevalence rates in teenagers is an upcoming issue. Our study is to research and analyze the PID patients of a certain region to give a better perspect of the disease for adequate prevention and management. METHODS: From March 1998 to December 2001, we underwent retrospective studies on medical records of 130 admitted PID patients in po-hang Dong-guk university hospital. RESULTS: Our of all gynecologic patients, 14.4% were PID patients. 17.7% of these were teenagers and patients who were in there twenties consumed up to 50.8%. The disease mostly occured within 8 days of the first menstruational day. Common etiology of the disease was unmarried state, using IUD as a contraceptive and previous artificial abortion. CONCLUSION: PID patients who are in their teens or twenties represented 68.5% of all PID patients. PID in younger ages keeps increasing and seems to be a trend. Secondary treatment of the disease is undoubtfully important, but primary prevention such as sexual education and birth control must also be considered.
Adolescent ; Contraception ; Education ; Female ; Gyeongsangbuk-do* ; Humans ; Medical Records ; Pelvic Inflammatory Disease* ; Prevalence ; Primary Prevention ; Retrospective Studies ; Single Person

In the era of COVID-19 outbreak, various efforts are undertaken to develop a quick, easy, inexpensive, and accurate way for diagnosis. Although many commercial diagnostic kits are available, detailed scientific evaluation is lacking, making the public vulnerable to fear of false-positive results.Moreover, current tissue sampling method from respiratory tract requires personal contact of medical staff with a potential asymptomatic SARSCOV-2 carrier and calls for safe and less invasive sampling method. Here, we have developed a convenient detection protocol for SARS-COV-2 based on a non-invasive saliva self-sampling method by extending our previous studies on development of a laboratory-safe and low-cost detection protocol based on qRT-PCR. We tested and compared various self-sampling methods of self-pharyngeal swab and self-saliva sampling from non-carrier volunteers. We found that the self-saliva sampling procedure gave expected negative results from all of the non-carrier volunteers within 2 hours, indicating cost-effectiveness, speed and reliability of the saliva-based method. For an automated assessment of the sampling quality and degree of positivity for COVID-19, we developed scalable formulae based on a logistic classification model using both cycle threshold and melting temperature from the qRT-PCR results. Our newly developed protocol will allow easy sampling and spatial-separation between patient and experimenter for guaranteed safety. Furthermore, our newly established risk assessment formula can be applied to a large-scale diagnosis in health institutions and agencies around the world.

Chronic myeloid leukemia (CML) is a clonal myeloproliferative disorder of the primitive hematopoietic stem cells. CML is characterized by the overproduction of myeloid cells, which results in marked splenomegaly and leukocytosis. CML presented by multiple chloromas is extremely rare. Multiple chloromas in the skin and brain are quite rare as the initial presentation of CML. These rare manifestation should alert clinicians to include CML in the differential diagnosis of patients presenting with multiple non-pruritic skin nodules or neurologic symptoms. Dasatinib has promising therapeutic potential for managing intracranial leukemic disease. Here, we report the case of a patient who visited the hospital with multiple chloroma which is unusual presentation of CML, and treated with dasatinib successfully.
Brain ; Diagnosis, Differential ; Hematopoietic Stem Cells ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive* ; Leukocytosis ; Myeloid Cells ; Myeloproliferative Disorders ; Neurologic Manifestations ; Sarcoma, Myeloid* ; Skin ; Splenomegaly ; Dasatinib

Umbilical cord blood is an attractive source of hematopoietic stem cells in allogeneic hematopoietic stem cell transplantation. Umbilical cord blood transplantation has merits of rapid availability and low risk of severe acute graft versus host disease. Umbilical cord blood should be an important source of stem cell transplantation for patients who have no suitable human leukocyte antigen-matched bone marrow, or peripheral stem cell donor. Transplantation of umbilical cord blood is limited by insufficient cell doses. This had led to the alternative concept of attempting to increase the number of cell doses using two cord blood units from different donor. We report a case of double-unit cord blood transplantation for 55-year-old male with primary refractory acute myeloid leukemia.
Bone Marrow ; Fetal Blood* ; Graft vs Host Disease ; Hematopoietic Stem Cell Transplantation ; Hematopoietic Stem Cells ; Humans ; Leukemia, Myeloid, Acute* ; Leukocytes ; Male ; Middle Aged ; Stem Cell Transplantation ; Stem Cells ; Tissue Donors

PURPOSE: OPB-31121 is an oral STAT3 inhibitor with a good preclinical antitumor activity. This phase I dose-escalation study of OPB-31121 was conducted to determine maximum-tolerated dose (MTD), safety, pharmacokinetics, and preliminary antitumor efficacy in patients with advanced solid tumors. MATERIALS AND METHODS: Patients received OPB-31121 once daily for 28 days of each cycle followed by 2 weeks rest. A standard 3+3 design was used for dose-escalation. Safety and response were evaluated by the National Cancer Institute-Common Terminology Criteria for Adverse Events (NCI-CTCAE) ver. 3.0 and Response Evaluation Criteria in Solid Tumor (RECIST) ver. 1.0, respectively. RESULTS: Twenty-five patients were treated with OPB-31121 at five dose levels: 100 mg (n=4), 200 mg (n=3), 400 mg (n=3), 600 mg (n=7), and 800 mg (n=8). Seven patients discontinued treatment during cycle 1 for various reasons other than study drug-related adverse events. Among 18 patients who were evaluable for dose-limiting toxicity (DLT), three DLTs were observed: one DLT (grade 3 vomiting) at 600 mg and two DLTs (grade 3 vomiting, grade 3 diarrhea) at 800 mg. The MTD was determined as 800 mg/day. Common adverse events were gastrointestinal adverse event including nausea (84%), vomiting (80%), and diarrhea (72%). Pharmacokinetics did not demonstrate dose-proportionality of OPB-31121. Eight patients had stable disease and 10 patients had disease progression. Two patients (1 colon cancer, 1 rectal cancer) showed tumor shrinkage. One gastric cancer patient continued treatment up to cycle 13 before disease progression. CONCLUSION: This study demonstrates feasibility of STAT3 inhibition in patients with advanced solid tumor. OPB-31121, at the MTD of 800 mg/day, was safe and relatively well tolerated, and has a preliminary antitumor activity.
Colonic Neoplasms ; Diarrhea ; Disease Progression ; Humans ; Nausea ; Pharmacokinetics ; Stomach Neoplasms ; Vomiting

OBJECTIVE: Ovarian cancer is common a gynecologic malignancy and leading cause of death in women being diagnosed with advanced disease. This study was undertaken to investigate the roles of the proteins related to G1 cell cycle in ovarian carcinogenesis. METHODS: The expression of cyclin Dl, p16, RB and PCNA in DMBA (7, 12-dimethylbenzanthracene)-induced ovarian cancer of rats was analyzed by immuno-histochemistry and Western blot. RESULTS: 1. Twenty-nine tumors were induced in 32 ovaries from 16 rats (90.6%) in the experimental group. The average weight of tumor was 3.35+/-0.73 gm and the average size was 1.84+/-0.17 cm in greatest dimension. The histologic types were adenocarcinomas (n=20), squamous cell carcinomas (n=3), sarcoma (n=4) and combined types (n=3). 2. With respect to the cyclin D1 and PCNA labelling index, ovarian cancers showed significantly higher index than normal ovarian surface epithelium. There were no differences among the cancer types. In Western blot analysis, the expression of cyclin Dl in ovarian cancers was higher than that in normal ovarian surface epithelium. 3. With respect to the p16 and RB labelling index, ovarian cancers showed significantly lower index than normal ovarian surface epithelium. There were no differences among the cancer types. In Western blot analysis, the expression of cyclin Dl in ovarian cancers were lower than that in normal ovarian surface epithelium. 4. Positive correlation was shown among cyclin D1, PCNA. RB was negatively correlated with cyclin D1, PCNA. The p16 had no correlation with cyclin D1, PCNA. CONCLUSION: These results suggest that the deregulation of cyclin Dl, p16, RB and PCNA occur in DMBA induced rat ovarian carcinogenesis and result in tumor progression. Further studies are needed to investigate the role and function of cyclin Dl-p16-RB pathway in human ovarian cancer with this animal model.
9,10-Dimethyl-1,2-benzanthracene* ; Adenocarcinoma ; Animals ; Blotting, Western ; Carcinogenesis* ; Carcinoma, Squamous Cell ; Cause of Death ; Cell Cycle ; Cyclin D1* ; Cyclins* ; Epithelium ; Female ; Humans ; Models, Animal ; Ovarian Neoplasms ; Ovary ; Proliferating Cell Nuclear Antigen* ; Rats* ; Sarcoma