Objective: This study evaluated the accuracy of the pre-hospital shock index multiplied by the AVPU scale (PSIAVPU) as a predictor of massive transfusion (MT) and traumatic coagulopathy. Methods: This research was a retrospective single-center study that included patients consecutively presenting to a trauma center between 2017 and 2020. The predictive value of the PSIAVPU for MT, in-hospital mortality, and traumatic coagulopathy was measured using the area under the curve (AUC) of the receiver operating characteristic curve. The AUC of the PSIAVPU was compared with the Reverse Shock Index multiplied by the Glasgow Coma Scale (rSIG) measured at the trauma center presentation. Results: One thousand seven hundred and ninety-two patients were included, of which 163 patients (9.09%) received MT and 195 patients (10.88%) died during their hospital stay. Traumatic coagulopathy was observed in 245 patients. The AUC values for the PSIAVPU in terms of predicting MT, hospital mortality, and traumatic coagulopathy were 0.755, 0.752, and 0.736, respectively. Conclusion In patients with trauma, the predictive power of the PSIAVPU was higher than that of the prehospital shock index and was comparable to that of the rSIG. The PSIAVPU is a useful indicator that can be used easily and quickly for trauma patients at the prehospital stage.

OBJECTIVES: The effectiveness of social distancing during the coronavirus disease 2019 (COVID-19) pandemic has been evaluated using the magnitude of changes in population mobility. This study aimed to investigate a direct indicator—namely, the number of close contacts per patient with confirmed COVID-19. METHODS: From week 7, 2020 to week 43, 2021, population movement changes were calculated from the data of two Korean telecommunication companies and Google in accordance with social distancing stringency levels. Data on confirmed cases and their close contacts among residents of Gyeonggi Province, Korea were combined at each stage. Pearson correlation analysis was conducted to compare the movement data with the change in the number of contacts for each confirmed case calculated by stratification according to age group. The reference value of the population movement data was set using the value before mid-February 2020, considering each data’s characteristics. RESULTS: In the age group of 18 or younger, the number of close contacts per confirmed case decreased or increased when the stringency level was strengthened or relaxed, respectively. In adults, the correlation was relatively low, with no correlation between the change in the number of close contacts per confirmed case and the change in population movement after the commencement of vaccination for adults. CONCLUSIONS The effectiveness of governmental social distancing policies against COVID-19 can be evaluated using the number of close contacts per confirmed case as a direct indicator, especially for each age group. Such an analysis can facilitate policy changes for specific groups.

In November 2021, 14 international travel-related severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) B.1.1.529 (omicron) variant of concern (VOC) patients were detected in South Korea. Epidemiologic investigation revealed community transmission of the omicron VOC. A total of 80 SARS-CoV-2 omicron VOC-positive patients were identified until December 10, 2021 and 66 of them reported no relation to the international travel.There may be more transmissions with this VOC in Korea than reported.

The aim of this study was to evaluate the compomer cement and resin cement as an orthodontic band cement on zirconia crown.A total of 30 specimens were prepared. Preformed stainless steel crowns and zirconia crowns of upper right second primary molar were used. Orthodontic bands were cemented on stainless steel crowns (Group I, n = 10) and zirconia crowns (Group II, n = 10) with compomer cement. The other bands were cemented on zirconia crowns with resin cement (Group III, n = 10). The tensile loads were applied to band to measure the bond strength.The mean of bond strengths of group I, II and III were 0.79 MPa, 1.09 MPa and 1.56 MPa respectively. Bond strength of group II is significantly higher than group I. There was no significant difference between group II and III.Compomer cement and resin cement containing functional monomers showed favorable bond strength of orthodontic bands.
Crowns ; Molar ; Resin Cements ; Stainless Steel

OBJECTIVE: To preliminarily evaluate technical feasibility of a dual-echo ultrashort echo time (UTE) subtraction MR imaging by using concurrent dephasing and excitation (CODE) sequence for visualization of iron-oxide enhancement in focal inflammatory pulmonary lesions. MATERIALS AND METHODS: A UTE pulmonary MR imaging before and after the injection of clinically usable superparamagnetic iron-oxide nanoparticles, ferumoxytol, was conducted using CODE sequence with dual echo times of 0.14 ms for the first echo and 4.15 ms for the second echo on 3T scanner in two rabbits concurrently having granulomatous lung disease and lung cancer in separate lobes. A mean ratio of standardized signal intensity (SI) was calculated for comparison of granulomatous lesion and cancer at first echo, second echo, and subtracted images. Lesions were pathologically evaluated with Prussian blue and immunohistochemistry staining. RESULTS: Post-contrast subtracted CODE images visualized exclusive enhancement of iron oxide in granulomatous disease, but not in the cancer (mean ratio of SI, 2.15 ± 0.68 for granulomatous lesion versus 1.00 ± 0.07 for cancer; p value = 0.002). Prussian blue and corresponding anti-rabbit macrophage IgG-staining suggested an intracellular uptake of iron-oxide nanoparticles in macrophages of granulomatous lesions. CONCLUSION: Dual-echo UTE subtraction MR imaging using CODE sequence depicts an exclusive positive enhancement of iron-oxide nanoparticle in rabbits in focal granulomatous inflammatory lesions.
Ferrosoferric Oxide ; Granuloma ; Immunohistochemistry ; Iron ; Lung Diseases ; Lung Neoplasms ; Macrophages ; Magnetic Resonance Imaging ; Nanoparticles ; Rabbits

Replication-independent incorporation of variant histone H3.3 has a profound impact on chromatin function and numerous cellular processes, including the differentiation of muscle cells. The histone chaperone HIRA and H3.3 have essential roles in MyoD regulation during myoblast differentiation. However, the precise mechanism that determines the onset of H3.3 deposition in response to differentiation signals is unclear. Here we show that HIRA is phosphorylated by Akt kinase, an important signaling modulator in muscle cells. By generating a phosphospecific antibody, we found that a significant amount of HIRA was phosphorylated in myoblasts. The phosphorylation level of HIRA and the occupancy of phosphorylated protein on muscle genes gradually decreased during cellular differentiation. Remarkably, the forced expression of the phosphomimic form of HIRA resulted in reduced H3.3 deposition and suppressed the activation of muscle genes in myotubes. Our data show that HIRA phosphorylation limits the expression of myogenic genes, while the dephosphorylation of HIRA is required for proficient H3.3 deposition and gene activation, demonstrating that the phosphorylation switch is exploited to modulate HIRA/H3.3-mediated muscle gene regulation during myogenesis.
Antibodies, Phospho-Specific ; Chromatin ; Histones* ; Muscle Cells* ; Muscle Development ; Muscle Fibers, Skeletal ; Myoblasts ; Phosphorylation* ; Phosphotransferases ; Transcriptional Activation

The objective of this study was to report on a new surgical technique, hybrid laparoscopic myomectomy that integrates the advantages of transumbilical laparoendoscopic single-site surgery and those of isobaric laparoscopy, and the initial experience with 14 cases. All of the procedures were performed by a single surgeon who has over 18 years of experience in laparoscopic surgery and 4 years of experience in laparoendoscopic single-site surgery. All cases of hybrid laparoscopic myomectomy were completed safely and effectively without conversion to conventional laparoscopic procedure. The median operative time was 75 minutes (range, 30 to 100 minutes). No postoperative complication was observed. The findings show that hybrid laparoscopic myomectomy is a safe and feasible surgical technique, and therefore can be a feasible, minimally invasive alternative to either abdominal or laparoendoscopic single-site surgery myomectomy.
Laparoscopy ; Leiomyoma ; Operative Time ; Postoperative Complications

PURPOSE: An emerging trend in Asian higher education is English-medium instruction (EMI), which uses English as the primary instructional language. EMI prepares domestic students for international leadership; however, students report difficulty in learning, and educators have raised questions concerning the effectiveness of EMI. The flipped learning model (FLM), in which lecture and homework activities for a course are reversed, was applied to an English-medium course offered by a college of nursing in Korea. The aims of this study were to: 1) revise an existing English-medium nursing course using the FLM; 2) explore students' learning experiences and their acceptance of the FLM; and 3) identify key factors in the success of FLM. METHODS: We used a descriptive, cross-sectional, mixed-methods design and the participants were students at one nursing school in Korea. A series of course development meetings with faculties from the nursing school and the center for teaching and learning were used to develop the course format and content. We conducted course evaluations using the Flipped Course Evaluation Questionnaire with open-ended questions and focus group interviews. RESULTS: Students (N=75) in a 15-week nursing course responded to a survey after completing the course. Among them, seven students participated in one of two focus groups. Overall, students accepted and favored the flipped learning strategy, and indicated that the method enhanced lecture content and their understanding of it. Factors associated with effective instruction included structured monitoring systems and motivational environments. CONCLUSION: The FLM requires sufficient preparation to facilitate student motivation and maximize learning outcomes.
Cross-Sectional Studies ; Curriculum ; *Education, Nursing, Baccalaureate ; Female ; Focus Groups ; Humans ; Interviews as Topic ; Male ; *Models, Educational ; Republic of Korea ; Students, Nursing/psychology ; Surveys and Questionnaires ; Young Adult

Laparoscopic fundoplication is a treatment option for gastroesophageal reflux disease refractory to medical treatment. When deciding whether or not to undergo surgery, patients with refractory gastroesophageal reflux disease and esophageal motility disorder need to fully understand the operative procedure, postoperative complications, and residual symptoms such as dysphagia, globus sensation, and recurrence of reflux. Herein, we report a case of a patient diagnosed with gastroesophageal reflux disease and aperistalsis who underwent Nissen (total, 360degrees) fundoplication after lack of response to medical treatment and subsequently underwent pneumatic dilatation due to unrelieved postoperative dysphagia and globus sensation.
Deglutition Disorders* ; Dilatation* ; Esophageal Motility Disorders ; Fundoplication ; Gastroesophageal Reflux ; Humans ; Postoperative Complications ; Recurrence ; Sensation ; Surgical Procedures, Operative

Background The benefit of statin use after acute ST-segment elevation myocardial infarction (STEMI) has been well established, however, the influence of the timing of statin administration has not been elucidated. The objective of this study focused on early clinical outcomes after percutaneous coronary intervention (PCI). Methods This analysis of the Korea Working Group on Myocardial Infarction registry (KorMI) study included 3,584 STEMI patients (mean age, 63 ±13 years;male, 2,684, 74.9%) undergoing PCI from January 2008 to June 2009. Rates of major adverse cardiac events (MACE:all-cause death, recurrent MI, and target lesion revascularization) were compared among patients grouped according to statin therapy timing:I, both during and after hospitalization (n=2,653, 74%);II, only during hospita-lization (n=309, 8.6%);III, only after discharge (n=157, 4.4%);and IV, no statin therapy (n=465, 13%). Mean follow-up duration was 234 ± 113 days. Results Multivariate factors of statin use during hospitalization included prior statin use, multiple diseased vessels, final thrombolysis in myocardial infarction flow grade III, and low-density lipoprotein cholesterol level. At 6-month follow-up, groups III and IV had the highest MACE rates (2.3%, 3.9%, 5.1%, and 4.9%for groups I-IV, respectively, P=0.004). After adjusting for confounders, groups II-IV had a higher MACE risk than group I [hazard ratio (HR):3.20, 95%confidence interval (95%CI):1.31-7.86, P=0.011;HR:3.84, 95%CI:1.47-10.02, P=0.006;and HR:3.17, 95%CI:1.59-6.40, P=0.001;respectively]. Conclusions This study, based on the national registry database, shows early and continuous statin therapy improvs early outcomes of STEMI patients after PCI in real-world clinical prac-tice.