BACKGROUND: We postulate that a delay in the implementation of hepatic arterial embolization for traumatic liver injury patients will negatively affect patient prognosis. Our work also seeks to identify factors related to the mortality rate among traumatic liver injury patients. METHODS: From January 2008 to April 2014, patients who had been admitted to the emergency room, were subsequently diagnosed with traumatic liver injury, and later underwent hepatic arterial embolization were included in this retrospective study. RESULTS: Of the 149 patients that underwent hepatic arterial embolization, 86 had the procedure due to traumatic liver injury. Excluding the 3 patients that were admitted to the hospital before procedure, the remaining 83 patients were used as subjects for the study. The average time between emergency room arrival and incidence of procedure was 164 min for the survival group and 132 min for the non-survival group; this was not statistically significant (p = 0.170). The average time to intervention was 182 min for the hemodynamically stable group, and 149 min for the hemodynamically unstable group, the latter having a significantly shorter wait time (p = 0.047). Of the factors related to the mortality rate, the odds ratio of the Glasgow Coma Score (GCS) was 18.48 (p < 0.001), and that of albumin level was 0.368 (p = 0.006). CONCLUSIONS: In analyzing the correlation between mortality rate and the time from patient admission to arrival for hepatic arterial embolization, there was no statistical significance observed. Of the factors related to the mortality rate, GCS and albumin level may be used as prognostic factors in traumatic liver injury.
Coma ; Embolization, Therapeutic ; Emergency Service, Hospital ; Humans ; Incidence ; Liver* ; Mortality* ; Odds Ratio ; Patient Admission ; Prognosis ; Retrospective Studies ; Time Factors

Despite efforts to control the spread of malaria, the disease persists in certain parts of the world. Moreover, there has been a resurgence of the disease recently. Another protozoan disease, babesiosis is a disease of animals; Humans are infected only incidentally, and when they are infected, they develop a nonspecific febrile illness. Babesia organism enters red blood cells and resembles malaria parasites, thus posing a problem in the differential diagnosis. We encountered an imported case of mixed infection of malaria and babesia. The patient was a 20-year old Korean male who had been in Saong-dume near Gabon for 3 months. We treated him with chloroquine with the diagnosis of Plasmodium malariae infection, but fever recurred after 2 weeks of the treatment. The second peripheral blood smear findings revealed specific ring forms of Babesia spp, so we changed to quinine and clindamycin. The treatment was successful and the patient was well after 4 months of follow-up period.
Animals ; Babesia* ; Babesiosis ; Chloroquine ; Clindamycin ; Coinfection* ; Diagnosis ; Diagnosis, Differential ; Erythrocytes ; Fever ; Follow-Up Studies ; Gabon ; Humans ; Malaria* ; Male ; Parasites ; Plasmodium malariae ; Quinine ; Young Adult

Fibroblast growth factor(FGF) is a mitogen and a potent antigenic factor. It is also known as a differentiation factor for neuroectodermal-derived cell. It has been observed to be expressed in more than 90% of m-RNA of human meningiomas and gliomas. Progesterone receptor(PR) is well known surface receptor of meningioma and its number is greater than that of estrogen receptor. It is one os the known prognostic factors of meningioma. Meningiomas themselves are regarded as benign tumors in general, however some types show aggressive features. In the present study, authors examined the expression of FGF-1 and PR in meningioma tissues using immunohistochemical techniques with monoclonal antibody against human FGF-1 and PR. FGF-1 was detected in 25 of 35 classic meningiomas and in 7 of 9 aggressive ones. PR is expressed in 5 cases of classic and 2 cases of aggressive meningiomas. These results suggest FGF-1 may be involved in aggressive progression of meningioma. There was no significant difference of aggressiveness and expression of FGFR-1 and PR between classic and aggressive meningiomas, including their subtypes.
Estrogens ; Fibroblast Growth Factor 1 ; Fibroblast Growth Factors* ; Fibroblasts* ; Glioma ; Humans ; Meningioma* ; Progesterone*

OBJECTIVES: The aim of the present study is to explore the effect of fluoxetine on transcription, translation and activity of tryptophan hydroxylase (TPH), and intracellular level of serotonin. METHODS: The expression level of the TPH mRNA and the protein, the TPH enzyme activity, and the intracellular level of serotonin were explored at the fluoxetine-treated RBL-2H3 cells. Real-time RT-PCR and immunoblotting analysis confirmed changes in the expression of TPH mRNA and protein. The activity of TPH was measured using [3H]tryptophan. The intracellular level of serotonin was measured by HPLC. RESULTS: The TPH activity was gradually increased on time from 24hr to 72hr. The real-time RT-PCR also revealed that the TPH mRNA was increased at 12, 24 and 72hr in the fluoxetine-treated RBL-2H3 cells. The immunoblotting analysis also revealed that the TPH protein was decreased at 72hr in the fluoxetine-treated RBL-2H3 cells. The intracellular level of serotonin was increased at 48hr after treatment of fluoxetine. CONCLUSION: Fluoxetine induced the increases of the TPH mRNA, the TPH enzyme activity and intracellular level of serotonin, and the decrease of the TPH protein expression at the RBL- 2H3 cells.
Chromatography, High Pressure Liquid ; Fluoxetine ; Immunoblotting ; RNA, Messenger ; Serotonin ; Tryptophan Hydroxylase* ; Tryptophan*

OBJECTIVE: Self-report is being used in most of studies investigating the therapeutic effect of smoking cessation clinics of public health centers in Korea instead of cotinine or other chemical markers of nicotine exposure. This study was conducted to evaluate the agreement between self-report and urinary cotinine test after smoking cessation program. METHODS: The study subjects were 333 adult male who visited public health center and participated in 12-week scheduled smoking cessation program. Questionnaires including demographic data and information about cigarette use, blood test, and urinary cotinine test were performed to all subjects during initial evaluation. At the end of the program, smoking status of subjects was assessed by an oral self-report and additional blood and urinary cotinine tests were done to the subjects who agreed. RESULTS: 52 participants who gave both self-report on smoking status and urine sample were included in the final analysis. The overall percentage agreement was 67.3%, and the overall Kappa index was 0.367. The sensitivity, specificity, positive predictive value, and negative predictive value of self-report in detecting smoking state were 46.43%, 91.67%, 86.67%, and 59.46%, respectively. CONCLUSION: The agreement between self-report and urinary cotinine test in detecting smoking status after smoking cessation program was relatively low on account of participants who failed to quit smoking but reported their smoking status incorrectly. Therefore, the use of objective measures such as urine cotinine should be considered in evaluation of successful smoking cessation.
Adult ; Cotinine ; Hematologic Tests ; Humans ; Korea ; Male ; Nicotine ; Public Health ; Surveys and Questionnaires ; Sensitivity and Specificity ; Smoke ; Smoking ; Smoking Cessation ; Tobacco Products

No abstract available.
Ultrasonography*

PURPOSE: A stylet aids intubation as a glottis by changing and maintaining the bending inside the endotracheal tube and is used as an auxiliary device in intubation. The aim of this experimental study is to evaluate resistance differences among endotracheal tube sizes and the usefulness of lubricant for stylet removal. METHODS: Depending on endotracheal tube size and lubricant use status, the subjects were divided into the control (n=10, each 7 tube sizes), lidocaine gel (n=70), and saline groups (n=70). Using a tensile strength meter, the work and the peak withdrawal force consumed for retracting a stylet were measured. RESULTS: When the work dependent on the endotracheal tube size and stylet coating was compared, significantly less work was consumed for 6.0-, 6.5-, 7.0-, 8.0-, 8.5 mm stylet group coated with lidocaine gel (p=0.029, p=0.002, p=0.001, p=0.001, p<0.001, p<0.001) or 6.0-, 6.5-, 8.0-, 8.5 mm stylets coated with saline compared to the control group (p=0.002, p<0.001, p<0.001, and p<0.001). In comparison of the peak withdrawal force dependent on the endotracheal tube size and stylet coating, significantly less peak withdrawal force was consumed for the 6.0- or 8.0- mm stylet group coated with lidocaine gel (p=0.004, p<0.001) or 6.0-, 6.5-, 7.5-, or 8.0 mm stylets coated with saline compared to the control group (p=0.025, p=0.001, p=0.008, and p=0.001). CONCLUSION: We found that the effectiveness of lubricant resulted in various sized tubes. Less work was consumed for five tube sizes (6.0-, 6.5-, 7.0-, 8.0-, 8.5 mm) in lidocaine gel groups and four tube sizes (6.0-, 6.5-, 8.0-, 8.5 mm) in saline groups. Less peak withdrawal force was consumed for two tube sizes (6.0-, 8.0 mm) in lidocaine gel groups and four tube sizes (6.0-, 6.5-, 7.5-, 8.0 mm) in saline groups.
Device Removal ; Friction ; Glottis ; Intubation ; Intubation, Intratracheal ; Lidocaine ; Lubricants ; Tensile Strength

PURPOSE: Use of emergency rooms (ERs) has increased considerably in Korea. This increase has caused over-crowding and has increased the burden on ER services, created a lack of continuous service provided by ERs, and raised costs. The objective of this study was to examine the characteristics of ER use for urgent and non-urgent cases in 2009-2011. METHODS: In this multivariate analysis, we included data collected from the 2009-2011 Korea Medical Expenditure Panel Survey to assess independent factors associated with ER use in non-urgent settings. We consecutively included patients > or =19 years who had completed the survey until 2011. RESULTS: Among the 10,428 respondents, 19.1% of patients had used ERs. Patients who had used EDs were less likely to have attended graduate school (high school: odds ratio [OR], 0.78 [0.63-0.98]; university: OR, 0.69 [0.54-0.89]) or have chronic disease (OR: 0.68 [0.60-0.78]). In addition, patients who did not have a usual source of care (OR, 0.78 [0.70-0.87]) or those who did not have private insurance (OR, 0.86 [0.74-0.99]) were less likely to use ERs. In the 1,994 cases of ER use, however, the any factors were not affected in the non-urgent ER use group. CONCLUSION: The number of patients who used ERs has increased, and there were no significant differences in ER use between non-urgent and urgent patients. ERs may have been used for non-urgent cases owing to other reasons. Further studies on the reasons for non-urgent ER use and development of urgent patient criteria are required.
Adult* ; Chronic Disease ; Surveys and Questionnaires ; Emergency Medical Services* ; Emergency Service, Hospital ; Health Care Surveys ; Health Expenditures* ; Humans ; Insurance ; Korea ; Multivariate Analysis ; Odds Ratio

BACKGROUND: We postulate that a delay in the implementation of hepatic arterial embolization for traumatic liver injury patients will negatively affect patient prognosis. Our work also seeks to identify factors related to the mortality rate among traumatic liver injury patients. METHODS: From January 2008 to April 2014, patients who had been admitted to the emergency room, were subsequently diagnosed with traumatic liver injury, and later underwent hepatic arterial embolization were included in this retrospective study. RESULTS: Of the 149 patients that underwent hepatic arterial embolization, 86 had the procedure due to traumatic liver injury. Excluding the 3 patients that were admitted to the hospital before procedure, the remaining 83 patients were used as subjects for the study. The average time between emergency room arrival and incidence of procedure was 164 min for the survival group and 132 min for the non-survival group; this was not statistically significant (p = 0.170). The average time to intervention was 182 min for the hemodynamically stable group, and 149 min for the hemodynamically unstable group, the latter having a significantly shorter wait time (p = 0.047). Of the factors related to the mortality rate, the odds ratio of the Glasgow Coma Score (GCS) was 18.48 (p < 0.001), and that of albumin level was 0.368 (p = 0.006). CONCLUSIONS: In analyzing the correlation between mortality rate and the time from patient admission to arrival for hepatic arterial embolization, there was no statistical significance observed. Of the factors related to the mortality rate, GCS and albumin level may be used as prognostic factors in traumatic liver injury.
Coma ; Embolization, Therapeutic ; Emergency Service, Hospital ; Humans ; Incidence ; Liver ; Mortality ; Odds Ratio ; Patient Admission ; Prognosis ; Retrospective Studies ; Time Factors