No abstract available.
Butterflies

Purpose: The occurrence of trauma-related delirium following postoperative abdominal surgery is associated with a poor prognosis. The purpose of this study was to identify predictive risk factors for trauma-related delirium. Methods: Trauma patient data from a regional trauma center were retrospectively collected from August 2015 to December 2016. The primary inclusion criteria were patients diagnosed with traumarelated delirium following abdominal trauma surgery. Head trauma patients and those under 18 years of age were excluded from this study. A multivariate logistic regression analysis was performed to identify the risk factors associated with trauma-related delirium. Results: Of the 255 trauma patients who met the inclusion criteria, 32 (12.5%) were diagnosed with delirium. The mean values for the age of the patients, Injury Severity Score, Glasgow Coma Scale score, and length of intensive care unit stay were 52.1 ± 17.8 years, 16.9, 14, and 7.1 days, respectively. Among the measured parameters, age [odds ratio (OR), 1.03; 95% confidence interval (CI), 1.01-1.06; p = 0.022)], sex (OR, 0.125; 0.03-0.55; p = 0.006), hemoglobin level (OR, 0.875; CI, 0.68-0.98; p = 0.03), length of stay in the intensive care unit (OR, 1.12; CI, 1.03-1.22; p = 0.01), and having an abdominal operation (OR, 2.92; CI, 1.10-7.23; p = 0.011) showed strong correlations with trauma-related delirium. Conclusion This study showed that abdominal surgery was strongly associated with delirium in patients with traumatic abdominal injury. Thus, changes in consciousness should be carefully monitored following surgery.

PURPOSE: This study aimed to investigate the clinical and socioenvironmental characteristics of sudden cardiorespiratory arrest after venipuncture in children. METHODS: We conducted a retrospective email-based survey of all members of the Korean Pediatric Society. The questionnaire included items on patient demographics, socioenvironmental circumstances of the venipuncture, type of cardiorespiratory arrest, symptoms and signs, treatment, prognosis, and presumed cause of the arrest. RESULTS: Fourteen patients were identified. Of these, 13 were young children (< 2 years old), and 1 was 14 years old. All patients had been previously healthy and had no specific risk factors for sudden cardiorespiratory arrest. Most cases (n=11, 79%) were defined as cardiac or cardiorespiratory arrest, while the remaining cases (n=3, 21%) were defined as respiratory arrest. Aspiration (n=3), acute myocarditis (n=2), and laryngeal chemoreflex (n=1) were presumed as the causes; however, the exact causes were unclear. The overall prognosis was poor (death, n=7; morbidity, n=5; full recovery, n=2). The medical institutions faced severe backlash because of these incidents (out-of-court settlement, n=5; medical lawsuit, n=5; continuous harassment, n=3). CONCLUSION: Cardiorespiratory arrest after venipuncture is unpredictable and the probable cause of most cases is a vasovagal reaction. Medical personnel must be aware of the risk of unexpected cardiorespiratory arrest during routine intravenous procedures.
Cardiopulmonary Resuscitation ; Child* ; Demography ; Heart Arrest ; Humans ; Myocarditis ; Phlebotomy* ; Prognosis ; Retrospective Studies ; Risk Factors

PURPOSE: This study aimed to investigate the incidence and risk factors of early postoperative small bowel obstruction (EPSBO) after laparotomy for trauma patients. METHODS: From 2009 to 2016, consecutive patients who had undergone laparotomy for trauma were retrospectively evaluated. EPSBO was defined as the presence of signs and symptoms of obstruction between postoperative days 7 and 30, or obstruction occurring anytime within 30 days and lasting more 7 days. RESULTS: Among 297 patients who met the inclusion criteria, 72 (24.2%) developed EPSBO. The length of hospital stay was significantly longer in patients with EPSBO than in those without EPSBO (median [interquartile range], 34 [21–48] days 24 [14–38] days, P < 0.001). Multivariate logistic analysis identified male sex (adjusted odds ratio [AOR], 3.026; P = 0.008), intraoperative crystalloid (AOR, 1.130; P = 0.031), and Abbreviated Injury Scale (AIS) score for mesenteric injury (AOR, 1.397; P < 0.001) as independent risk factors for EPSBO. The incidence of adhesive small bowel adhesion after 30 days postoperatively did not significantly differ between the 2 groups (with EPSBO, 5.6% without EPSBO, 5.3%; P = 0.571). Most of the patients with EPSBO were recovered by conservative treatment (95.8%). CONCLUSION: After laparotomy for trauma patients, the incidence of EPSBO was 24.2% in our study. EPSBO was associated with a longer hospital stay. Male sex, use of intraoperative crystalloid, and AIS score for mesenteric injury were significant independent risk factors for EPSBO. Patients with these risk factors should be followed-up more carefully.
Abbreviated Injury Scale ; Abdominal Injuries ; Adhesives ; Humans ; Ileus ; Incidence ; Laparotomy ; Length of Stay ; Male ; Odds Ratio ; Retrospective Studies ; Risk Factors

PURPOSE: In this study, the effect arthroscopic adhesiolysis and the need for additional quadricepsplasty were evaluated by reviewing the patients 'data. MATERIALS AND METHODS: From July 1996 to January 2002, 18 patients received operation for the stiff knee. The patients were classified into 2 groups according to treatment method - Group 1: arthroscopic adhesiolysis and Group 2: arthroscopic adhesiolysis plus Judet quadricepsplasty. The Judet quadricepsplasty was performed when maximal knee flexion was not achieved over 90 degree even after arthroscopic adhesiolysis. We reviewed primary causes and the duration of contracture of stiff knee. Preoperative, postoperative, and final range of motion was evaluated. RESULTS: Preoperative, postoperative, and final range of motion was evaluated. In group 1, the average range of motion was 34 degree preoperatively, 107 degree intraoperatively, and 103 degree at the last follow-up. In group 2, the average range of motion, 26 degree preoperatively, 67 degree (after arthroscopic adhesiolysis)-115 degree(after quadricepsplasty) intraoperatively, and 112 degree at the last follow-up. CONCLUSION: Arthroscopic adhesiolysis has an effect in releasing intrarticular adhesion. Additional quadricepsplasty should be considered when the duration of contracture is over 12 months and primary causes of stiff knee is distal femur fracture which causes damages in the quadriceps muscle.
Contracture ; Femur ; Follow-Up Studies ; Humans ; Knee* ; Quadriceps Muscle ; Range of Motion, Articular

Purpose: The occurrence of trauma-related delirium following postoperative abdominal surgery is associated with a poor prognosis. The purpose of this study was to identify predictive risk factors for trauma-related delirium. Methods: Trauma patient data from a regional trauma center were retrospectively collected from August 2015 to December 2016. The primary inclusion criteria were patients diagnosed with traumarelated delirium following abdominal trauma surgery. Head trauma patients and those under 18 years of age were excluded from this study. A multivariate logistic regression analysis was performed to identify the risk factors associated with trauma-related delirium. Results: Of the 255 trauma patients who met the inclusion criteria, 32 (12.5%) were diagnosed with delirium. The mean values for the age of the patients, Injury Severity Score, Glasgow Coma Scale score, and length of intensive care unit stay were 52.1 ± 17.8 years, 16.9, 14, and 7.1 days, respectively. Among the measured parameters, age [odds ratio (OR), 1.03; 95% confidence interval (CI), 1.01-1.06; p = 0.022)], sex (OR, 0.125; 0.03-0.55; p = 0.006), hemoglobin level (OR, 0.875; CI, 0.68-0.98; p = 0.03), length of stay in the intensive care unit (OR, 1.12; CI, 1.03-1.22; p = 0.01), and having an abdominal operation (OR, 2.92; CI, 1.10-7.23; p = 0.011) showed strong correlations with trauma-related delirium. Conclusion This study showed that abdominal surgery was strongly associated with delirium in patients with traumatic abdominal injury. Thus, changes in consciousness should be carefully monitored following surgery.

BACKGROUND: This investigation was to perform the epidemiological surveillance and genetic analysis on respiratory viral agents from children with acute respiratory infections in Gwangju. MATERIALS AND METHODS: For this study, 3,695 specimens obtained from patients with acute respiratory infections were collected by collaboration with pediatric hospitals in Gwangju between 2005 and 2007. Specimens were screened for 8 respiratory viruses including influenza viruses (IFV), human rhinoviruses (HRV), human coronaviruses (HCoV), adenoviruses (ADV), parainfluenza viruses (PIV), human enteroviruses (HEV), respiratory synthitial viruses (RSV) and human bocaviruses (HBoV). Respiratory viruses were detected using multiplex (RT) PCR with viral specific primers. RESULTS: Out of 3,695 specimens, the ratio of virus detection was 24.9% (919). Overall, HRV (35.5%) and IFV (34.9%) were the most common viruses found, followed by HBoV (14.8%), HCoV (10.6%), RSV (3.7%), ADV (3.4%), PIV (3.2%) and HEV (3.0%). In addition, multiple infections were detected in 80 patients (8.7%). When the prevalence was analyzed according to season, HBoV, IFV and HCoV showed two epidemic points in late spring and early winter. ADV, HRV, RSV PIV and HEV, however, were all found to have only one epidemic point, with RSV being most common during winter and the others being most prominent during spring. CONCLUSIONS: Through this epidemiological surveillance, the respiratory viruses prevalent in children in Gwangju area were investigated. We strongly recommend the development of nationwide policy for the management of prevalent respiratory virus that includes long term collection of data and samples, vaccine development and prevention education of the misuse of antibiotics.
Adenoviridae ; Anti-Bacterial Agents ; Child ; Cooperative Behavior ; Coronavirus ; Enterovirus ; Hospitals, Pediatric ; Human bocavirus ; Humans ; Orthomyxoviridae ; Paramyxoviridae Infections ; Polymerase Chain Reaction ; Prevalence ; Respiratory Tract Infections ; Rhinovirus ; Seasons ; Viruses

BACKGROUND: This investigation was to perform the epidemiological surveillance and genetic analysis on respiratory viral agents from children with acute respiratory infections in Gwangju. MATERIALS AND METHODS: For this study, 3,695 specimens obtained from patients with acute respiratory infections were collected by collaboration with pediatric hospitals in Gwangju between 2005 and 2007. Specimens were screened for 8 respiratory viruses including influenza viruses (IFV), human rhinoviruses (HRV), human coronaviruses (HCoV), adenoviruses (ADV), parainfluenza viruses (PIV), human enteroviruses (HEV), respiratory synthitial viruses (RSV) and human bocaviruses (HBoV). Respiratory viruses were detected using multiplex (RT) PCR with viral specific primers. RESULTS: Out of 3,695 specimens, the ratio of virus detection was 24.9% (919). Overall, HRV (35.5%) and IFV (34.9%) were the most common viruses found, followed by HBoV (14.8%), HCoV (10.6%), RSV (3.7%), ADV (3.4%), PIV (3.2%) and HEV (3.0%). In addition, multiple infections were detected in 80 patients (8.7%). When the prevalence was analyzed according to season, HBoV, IFV and HCoV showed two epidemic points in late spring and early winter. ADV, HRV, RSV PIV and HEV, however, were all found to have only one epidemic point, with RSV being most common during winter and the others being most prominent during spring. CONCLUSIONS: Through this epidemiological surveillance, the respiratory viruses prevalent in children in Gwangju area were investigated. We strongly recommend the development of nationwide policy for the management of prevalent respiratory virus that includes long term collection of data and samples, vaccine development and prevention education of the misuse of antibiotics.
Adenoviridae ; Anti-Bacterial Agents ; Child ; Cooperative Behavior ; Coronavirus ; Enterovirus ; Hospitals, Pediatric ; Human bocavirus ; Humans ; Orthomyxoviridae ; Paramyxoviridae Infections ; Polymerase Chain Reaction ; Prevalence ; Respiratory Tract Infections ; Rhinovirus ; Seasons ; Viruses

PURPOSE: Though it is a general and common method to temporarily stop breast feeding and use whole milk instead for neonatal breast milk jaundice, it may cause some difficulties in continuing breast feeding after the recovery. We study the effect of continuing breast feeding on the treatment of breast milk jaundice and the success of breast feeding afterwards. METHODS: We retrospectively analyzed the medical records of 59 neonates who were admitted to Cheil general hospital from Jan 2008 to Aug 2012 for phototherapy due to breast milk jaundice. Subjects were divided into two groups, one with continuing breast feeding (35 cases) during treatment and the other with stopping breast feeding (24 cases). We examined and compared the changes in the level of serum total bilirubin between two groups, as well as the difficulties the mothers might had in continuing or restarting breast feeding after the discharge. RESULTS: There was no significant difference in times of treatment (until reaching the level of serum total bilirubin <13 mg/dL) between two groups (P=0.066). However, the group with temporary stop of breast feeding had difficulties such as nipple confusion and breast engorgement compared to breast feeding group (P=0.001). In long-term follow up, the breast feeding duration (P=0.017) and the rate of exclusive breast feeding for 6 months (P=0.024) were also significantly higher in breast feeding group. CONCLUSIONS: We suggest that continuing breast feeding while treating breast milk jaundice is helpful both for successfully continuing breast feeding and preventing problems after discontinuing breast feeding.
Bilirubin ; Breast Feeding* ; Breast* ; Follow-Up Studies ; Hospitals, General ; Humans ; Infant, Newborn ; Jaundice* ; Medical Records ; Methods ; Milk ; Milk, Human* ; Mothers ; Nipples ; Phototherapy ; Retrospective Studies

Mucosal-associated invariant T (MAIT) cells and natural killer T (NKT) cells are known to play important roles in autoimmunity, infectious diseases and cancers. However, little is known about the roles of these invariant T cells in multiple trauma. The purposes of this study were to examine MAIT and NKT cell levels in patients with multiple trauma and to investigate potential relationships between these cell levels and clinical parameters. The study cohort was composed of 14 patients with multiple trauma and 22 non-injured healthy controls (HCs). Circulating MAIT and NKT cell levels in the peripheral blood were measured by flow cytometry. The severity of injury was categorised according to the scoring systems, such as Acute Physiology and Chronic Health Evaluation (APACHE) II score, Simplified Acute Physiology Score (SAPS) II, and Injury Severity Score (ISS). Circulating MAIT and NKT cell numbers were significantly lower in multiple trauma patients than in HCs. Linear regression analysis showed that circulating MAIT cell numbers were significantly correlated with age, APACHE II, SAPS II, ISS category, hemoglobin, and platelet count. NKT cell numbers in the peripheral blood were found to be significantly correlated with APACHE II, SAPS II, and ISS category. This study shows numerical deficiencies of circulating MAIT cells and NKT cells in multiple trauma. In addition, these invariant T cell deficiencies were found to be associated with disease severity. These findings provide important information for predicting the prognosis of multiple trauma.
APACHE ; Autoimmunity ; Cell Count ; Cohort Studies ; Communicable Diseases ; Flow Cytometry ; Humans ; Injury Severity Score ; Linear Models ; Multiple Trauma* ; Natural Killer T-Cells* ; Physiology ; Platelet Count ; Prognosis ; T-Lymphocytes*