PURPOSE: To calculate the injury rate of skiers and snowboarders, to document the risk factors affecting injury, and to investigate the characteristics of the cause, kind and region of injury. METHODS: A questionnaire survey was conducted at 4 major Kangwon - province ski resorts during the 2004 - 2005 winter season with 373 skiers and snowboarders. The statistical SPSS was used to analyze data that included chi-square, fisher's exact test, and multiple logistic regression. The mean mark of the safety rule by separating the skiers and snowboarders was compared between the two groups. RESULTS: The injury and wound experience rates of the snowboarders (46.5%, 34.2% respectively) were higher than those of the skiers (33.2%, 25.5% respectively). The proportion of injury and wound for the skiers was 76.7% and for the snowboarders was 73.6%. The occurrence of injuries was higher among those with ski career of 5 to 9 years (p=0.012), those with a higher level of ski skills (p=0.002), those who used the higher slope (p=0.002) and those who skied 15 to 19 times(p=0.004). Based on the results of logistic regression analysis, the significant risk factors for skiers were career, level, slope and visit number. Leg injuries accounted for 40.9% of total injuries among skiers, which was followed by arm injuries (35.9%) and head injuries (15.4%)(p=0.033). CONCLUSIONS: The study therefore emphasizes safety training for individual skiers and overall conditions of ski resorts.
Arm Injuries ; Craniocerebral Trauma ; Gangwon-do ; Health Resorts ; Leg Injuries ; Logistic Models ; Risk Factors ; Seasons ; Skiing* ; Wounds and Injuries ; Surveys and Questionnaires

OBJECTIVE: The purpose of this study was to report our preliminary experience with endovascular treatment (EVT) for life-threatening bleeding from branches of the external carotid artery (ECA) in patients with traumatic maxillofacial fractures. MATERIALS AND METHODS: A total of 12 patients seen between March 2010 and December 2014 were included in this study. All subjects met the following criteria: 1) presence of maxillofacial fracture; 2) continuous blood loss from oronasal bleeding; and 3) EVT to stop bleeding. Various clinical factors were recorded for each patient and the correlations between those factors and clinical outcome (Glasgow Outcome Scale, GOS) were evaluated. RESULTS: Four patients were injured in traffic accidents, five in falls, and three by assaults. Mean initial Glasgow Coma Scale (GCS) was 6.9 ± 2.1 and the lowest hemoglobin measured was mean 6.3 ± 0.9 g/dL. GOS at discharge was 4 in five patients, 3 in three patients, and 1 (death) in four patients. GOS on follow-up (mean 13.7 months) was 5 in two patients, 4 in three patients, and 3 in three patients. Initial GCS (p = 0.016), lowest systolic blood pressure (p = 0.011), and lowest body temperature (p = 0.012) showed a significant positive correlation with good clinical outcomes. The number of units of red blood cells transfused (p = 0.030), the number of units of fresh frozen plasma transfused (p = 0.013), and the time from arrival to groin puncture (p < 0.001) showed significant negative correlation with good clinical outcomes. CONCLUSION: It might be suggested that rapid transition to EVT could be preferable to struggling with other rescue strategies to stop life-threatening bleeding from branches of the ECA in patients with traumatic maxillofacial fractures.
Accidental Falls ; Accidents, Traffic ; Blood Pressure ; Body Temperature ; Carotid Artery, External* ; Endovascular Procedures ; Erythrocytes ; Facial Bones ; Follow-Up Studies ; Glasgow Coma Scale ; Groin ; Hemorrhage* ; Humans ; Maxillary Artery ; Maxillary Fractures ; Plasma ; Punctures

OBJECTIVE: The purpose of this study was to report our preliminary experience with endovascular treatment (EVT) for life-threatening bleeding from branches of the external carotid artery (ECA) in patients with traumatic maxillofacial fractures. MATERIALS AND METHODS: A total of 12 patients seen between March 2010 and December 2014 were included in this study. All subjects met the following criteria: 1) presence of maxillofacial fracture; 2) continuous blood loss from oronasal bleeding; and 3) EVT to stop bleeding. Various clinical factors were recorded for each patient and the correlations between those factors and clinical outcome (Glasgow Outcome Scale, GOS) were evaluated. RESULTS: Four patients were injured in traffic accidents, five in falls, and three by assaults. Mean initial Glasgow Coma Scale (GCS) was 6.9 ± 2.1 and the lowest hemoglobin measured was mean 6.3 ± 0.9 g/dL. GOS at discharge was 4 in five patients, 3 in three patients, and 1 (death) in four patients. GOS on follow-up (mean 13.7 months) was 5 in two patients, 4 in three patients, and 3 in three patients. Initial GCS (p = 0.016), lowest systolic blood pressure (p = 0.011), and lowest body temperature (p = 0.012) showed a significant positive correlation with good clinical outcomes. The number of units of red blood cells transfused (p = 0.030), the number of units of fresh frozen plasma transfused (p = 0.013), and the time from arrival to groin puncture (p < 0.001) showed significant negative correlation with good clinical outcomes. CONCLUSION: It might be suggested that rapid transition to EVT could be preferable to struggling with other rescue strategies to stop life-threatening bleeding from branches of the ECA in patients with traumatic maxillofacial fractures.
Accidental Falls ; Accidents, Traffic ; Blood Pressure ; Body Temperature ; Carotid Artery, External* ; Endovascular Procedures ; Erythrocytes ; Facial Bones ; Follow-Up Studies ; Glasgow Coma Scale ; Groin ; Hemorrhage* ; Humans ; Maxillary Artery ; Maxillary Fractures ; Plasma ; Punctures

BACKGROUND: With the approval of topical retapamulin ointment in 2011, it was officially required to conduct a post-marketing surveillance (PMS) study to obtain further data of its safety profile and effectiveness, in accordance with the requirement of the Korean Ministry of Food and Drug Safety (MFDS). OBJECTIVE: This study had prospectively designed to monitor safety and tolerability with the effectiveness of topical retapamulin in clinical practices. METHODS: Open label, multi-center, non-interventional observational study was done from May 2011 to October 2015. All subjects had bacterial skin infections of locally approved prescribing information accordingly. The study mainly focused on safety issues in the local target population (3,612 eligible subjects). And, drug effectiveness was also evaluated by physicians. RESULTS: The incidence of adverse events (AEs) and adverse drug reactions (ADRs) were 2.53% and 0.97%, respectively. In terms of the incidence of unexpected AEs and ADRs, 1.45% and 0.33%, and for the incidence of serious AEs, 0.28%, whereas no serious ADRs reported. And, the effectiveness of topical retapamulin rate was 96.1% (1,697 of total 1,765 subjects). CONCLUSION: Topical retapamulin is to be well-tolerated and effective in patients with bacterial skin infections of locally approved prescribing information.
Anti-Bacterial Agents ; Drug-Related Side Effects and Adverse Reactions ; Health Services Needs and Demand ; Humans ; Incidence ; Observational Study ; Prospective Studies ; Skin ; Skin Diseases

PURPOSE: The empirical use of a chemotherapy regimen shows different results in individual breast cancer patient treatment. Recent studies showed the effectiveness of the adenosine triphosphate-based chemotherapy response assay (ATP-CRA). However, little is known about the correlation between chemosensitivity and breast cancer molecular subtypes. Therefore, we investigated whether the result of ATP-CRA is associated with a molecular subtype of breast cancer. METHODS: Two hundred eighty-seven patients diagnosed with breast cancer and receiving ATP-CRA at Mokdong Hospital, Ewha Womans University between September 2007 and December 2010 were enrolled in this study. Hormone receptor status, HER2/neu expression, and results of chemosensitivity tests of the patients was analyzed. RESULTS: In all of four subtypes, the combination of two agents showed significant higher mean cell death rate than a single agent. Within the breast cancer cell lines in this study, the range of chemosensitivity response was very wide and varied for each patient. For this reason, the molecular subtype of breast cancer is inconclusive in choosing an effective chemotherapeutic agent and in vitro chemosensitivity test, prior to therapy, could be a useful method for planning chemotherapy for each patient. CONCLUSION: Chemosensitivity response to anticancer agents was found to vary depending on the individual breast cancer patients. The molecular subtype of breast cancer is inconclusive to choose the effective chemotherapeutic agent and the in vitro chemosensitivity test, prior to therapy, could be more useful for planning chemotherapy for each patient.
Adenosine ; Adenosine Triphosphate ; Antineoplastic Agents ; Breast ; Breast Neoplasms ; Cell Death ; Cell Line ; Chemotherapy, Adjuvant ; Female ; Humans

Objective: RapidRhino is widely used in emergency departments (EDs) to treat epistaxis, and we have used RapidRhino plus epinephrine empirically. In this study, we evaluated the effectiveness of RapidRhino plus epinephrine compared to RapidRhino with saline. Methods: This prospective randomized study was performed on patients with epistaxis who visited our ED between October 2021 and January 2023. Patients were randomized to RapidRhino plus epinephrine or RapidRhino groups by drawing numbers. Subgroup analyses were performed on patients who received or did not receive anticoagulants or antiplatelets. Results: The overall success rates for RapidRhino with saline and RapidRhino with epinephrine were both high (92% and 94%, respectively), but the 10-minute success rates of RapidRhino with saline and RapidRhino with epinephrine were 57.4% and 78%.0%, respectively, which was a significant difference (P=0.001). In patients administered anticoagulants, initial success rate of RapidRhino with epinephrine was higher than that of RapidRhino with saline (83.3% and 62.9%, respectively, P=0.046), and these results were confirmed by adjusted logistic regression analyses-for all patients (adjusted odds ratio [aOR]=2.42; 95% confidence interval [CI], 1.28-4.58) and for patients treated with anticoagulants (aOR=6.31; 95% CI, 1.17-34.17). Conclusion RapidRhino with epinephrine may be more effective at controlling hemorrhage than RapidRhino. The combined administration of RapidRhino and epinephrine might reduce the time spent in emergency departments by epistaxis patients.

We experienced a case of neurological deterioration after decompressive suboccipital craniectomy (DSC) in a patient with a brainstem-compressing thrombosed giant aneurysm of the vertebral artery (VA). A 60-year-old male harboring a thrombosed giant aneurysm (about 4 cm) of the right vertebral artery presented with quadriparesis. We treated the aneurysm by endovascular coil trapping of the right VA and expected the aneurysm to shrink slowly. After 7 days, however, he suffered aggravated symptoms as his aneurysm increased in size due to internal thrombosis. The medulla compression was aggravated, and so we performed DSC with C1 laminectomy. After the third post-operative day, unfortunately, his neurologic symptoms were more aggravated than in the pre-DSC state. Despite of conservative treatment, neurological symptoms did not improve, and microsurgical aneurysmectomy was performed for the medulla decompression. Unfortunately, the post-operative recovery was not as good as anticipated. DSC should not be used to release the brainstem when treating a brainstem-compressing thrombosed giant aneurysm of the VA.
Aneurysm* ; Brain Stem ; Decompression ; Decompressive Craniectomy ; Humans ; Intracranial Aneurysm ; Laminectomy ; Male ; Middle Aged ; Neurologic Manifestations ; Quadriplegia ; Thrombosis ; Vertebral Artery*

PURPOSE: A chemotherapy response assay test is performed to evaluate the degree of tumor growth inhibition by a chemotherapeutic agent. Several studies have been done on its usefulness; however, to the best of our knowledge, only a few studies concerning the relationship between chemotherapy response assay test results and breast cancer patients' prognoses have been conducted. Thus, we performed this study to analyze this relationship. METHODS: Among breast cancer patients who underwent curative surgery and neoadjuvant or adjuvant chemotherapy between August 2004 and December 2009, 102 were enrolled in this study. Chemotherapeutic regimens for patients were doxorubicin plus taxane or doxorubicin plus cyclophosphamide followed by taxane. We divided these patients into two groups (sensitive group [n=19] and resistant group [n=83]) and analyzed the relationship between chemosensitivity results and patient prognosis. RESULTS: The sensitive group was associated with poor disease-free survival (DFS) (p=0.003) and overall survival (OS) (p<0.001). No significant differences were observed in tumor histology (p=0.548), tumor size (p=0.479), number of metastatic lymph nodes (p=0.326), histologic grade (p=0.077), or nuclear grade (p=0.216) between the two groups. However, in respect to molecular subtype, the HER2-positive type and triple negative breast cancer were more frequently observed in the sensitive group (p=0.001). In a univariate and multivariate analysis for DFS, doxorubicin sensitivity was significantly associated with a poor prognosis (p<0.05). CONCLUSION: Better chemosensitivity results are associated with a poor prognosis in breast cancer patients who have undergone anthracycline- and taxane-based chemotherapy, however, examination of additional cases and the use of a longer study period are needed.
Breast ; Breast Neoplasms ; Bridged Compounds ; Chemotherapy, Adjuvant ; Cyclophosphamide ; Disease-Free Survival ; Doxorubicin ; Humans ; Lymph Nodes ; Multivariate Analysis ; Prognosis ; Taxoids

PURPOSE: Endoscopic thyroidectomy has brought lots of advantages to the patients since its first introduction. The aim of this study is to evaluate the functional and cosmetic satisfaction of patients receiving endoscopic thyroidectomy with patients receiving conventional thyroidectomy. METHODS: From October 2009 to January 2010, 98 patients underwent with conventional (n=69) or endoscopic (n=22) thyroidectomy. Of these patients 91 who had responded to a questionnaire distributed during the visit outpatient clinic visit. The questionnaire responses were analyzed to compare the satisfaction and postoperative results of these patients. RESULTS: The patient mean age was 45.5±10.1 years and the male to female ratio was 1:8.1. Perceived cosmetic satisfaction was significantly greater in patients who received conventional thyroidectomy than in those who received endoscopic thyroidectomy (P=0.03). Otherwise, there were no significant differences concerning functional problems. The conventional surgery was significantly longer than the endoscopic surgery (P=0.001). However, there were no significant differences in estimated blood loss, postoperative hospital stayand complication rates (P>0.05). CONCLUSION: Endoscopic thyroidectomy might bring satisfactory cosmetic result compared to conventional thyroidectomy. However, further studies are necessary.
Ambulatory Care Facilities ; Female ; Humans ; Male ; Patient Satisfaction* ; Postoperative Hemorrhage ; Thyroidectomy*

BACKGROUND: Native low-density lipoprotein (nLDL) was one of the modifiable risk factors contributed directly to cardiovascular diseases development. We investigated that nLDL stimulation induced NADPH oxidase activation and superoxide production that was an important factor on human aortic smooth muscle cells (hAoSMC) proliferation. METHODS: Superoxide generation was recorded with fluorescent-staining of dihydroethidine or by measuring lucigenin-induced chemiluminescence for 5 minutes. We examined cell proliferation with 4[-3-(4-iodophenyl)-2-(4-nitrophenyl)-2H-5-tetrazolio]-1,3-benzene disulfonate (WST-1) reagent and analyzed the change of gene expression by northern blot analysis. RESULTS: nLDL stimulation increased superoxide anion production in hAoSMC that confirmed through dihydroethidine staining and lucigenin-induced chemiluminescence methods. nLDL-induced proliferation abolished with preincubation of superoxide scavengers or NADPH oxidase inhibitor. NADPH as a substrate of NADPH oxidase increased superoxide generation in both nLDL-stimulated and unstimulated cell homogenate, which was completely blocked at the diphenylene iodinium (DPI)- or apocynin-pretreated hAoSMC homogenates. Furthermore, superoxide generation was only observed at the fraction of cellular precipitate, but not in soluble fraction. Expression of p22phox in mRNA level increased with nLDL treatment as early as 30 minutes and transfection of anti-sense oligonucleotide of p22phox completely abolished nLDL-induced proliferation of hAoSMC. CONCLUSIONS: The above results have shown that nLDL-induced proliferation in hAoSMC depends on superoxide production through NADPH oxidase activation.
Blotting, Northern ; Cardiovascular Diseases ; Cell Proliferation ; Dicarbethoxydihydrocollidine ; Gene Expression ; Humans ; Lipoproteins ; Luminescence ; Muscle, Smooth ; Myocytes, Smooth Muscle ; NADP ; NADPH Oxidase ; Risk Factors ; RNA, Messenger ; Superoxides ; Transfection