Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) with submucosal saline injection are well-established methods for excising nonpolypoid early neoplastic lesions of the gastrointestinal tract in humans. In EMR and ESD, this submucosal injection forms a bulla that lifts the lesion, provides a safety cushion during resection, and reduces the risk of perforation. Commonly used solutions include normal saline (NS), 10% glycerol, and 0.4% sodium hyaluronate (SH). Among these, 0.4% SH is the most preferred solution in humans due to its slow absorption. While the usefulness of EMR and ESD in humans has been well-documented, information on its application in veterinary medicine remains limited. This study aimed to compare the usefulness and safety of 0.4% SH with 10% glycerol and NS as a gastric submucosal injection solution in rabbits with goals of providing a veterinary perspective on the application of submucosal injection solutions and highlighting the clinical relevance for endoscopic procedures in animals. A conventional gastrotomy was performed to expose the gastric lumen, followed by a submucosal injection. In macroscopic evaluations of mucosal elevation using a digital caliper, 0.4% SH showed a statistically significant elevation effect compared with NS, unlike 10% glycerol. Histomorphometric analysis further revealed that 0.4% SH maintained submucosal space expansion for the longest duration. In addition, histopathological analysis showed no tissue damage except for hemorrhage across all of the submucosal injection groups. In conclusion, 0.4% SH is considered the most preferable submucosal injection material in veterinary medicine, particularly for its usefulness and safety. Based on the results of this study, minimally invasive techniques such as EMR and ESD are expected to be applicable in animals. This study provides the first veterinary-specific evaluation of 0.4% SH as a submucosal injection solution in endoscopic resection (ER), demonstrating its potential benefits in minimally invasive endoscopic procedures. The findings suggest that 0.4% SH may enhance the safety and efficacy of ER, making it a preferable choice for submucosal injection in this context in veterinary medicine.

PURPOSE: Trauma is a leading cause of death, even in previously healthy and disease-free individuals, and the mortality rate is very high in neck trauma patients. On the other hand, there have been few studies related to neck injuries. This study examined the characteristics and treatment results of trauma-related neck injuries using the data from Korean National Emergency Department Information System. METHODS: Neck trauma patients were classified using the 6th Korean Standard Disease Classification system. The patients' demographic factors, number of surgeries, and clinical results were investigated. Statistical analysis was conducted using SPSS to evaluate the annual differences in the demographic factors; mortality according to the site of injury and type of surgery; and mechanisms of injury. RESULTS: From 2011 to 2014, 2,458 neck trauma patients were treated in hospitals in South Korea. The number of patients admitted to regional and local emergency medical centers was 883 (35.9%) and 1,502 (61.1%), respectively. No significant annual differences were observed in age, sex ratio, location of treatment center, mortality, and injury site (vascular, tracheal, or esophageal). In addition, no significant differences in the cause of injury, performed surgery (%), and mortality according to the injured organ were observed. CONCLUSION: This study revealed no annual changes in neck injury patients or differences in mortality according to injured organs. This study can be used as a basis for national research on organ-specific injuries, and may help predict the demand for future support projects for the establishment of regional trauma centers.
Cause of Death ; Classification ; Demography ; Emergencies* ; Emergency Service, Hospital* ; Hand ; Humans ; Information Systems* ; Korea ; Mortality ; Neck Injuries ; Neck* ; Sex Ratio ; Trauma Centers ; Wounds and Injuries

OBJECTIVE: To evaluate the efficacy of taxane and platinum-based chemotherapy guided by extreme drug resistance assay (EDRA) in patients with epithelial ovarian cancer. METHODS: Thirty-nine patients were enrolled, who were diagnosed as epithelial ovarian cancer, tubal cancer or primary peritoneal carcinoma and received both debulking surgery and EDRA in Asan Medical Center between August 2004 and August 2006. Another thirty-nine patients were enrolled, who did not receive EDRA as control. Paclitaxel 175 mg/m2 and carboplatin AUC 5 were administered as primary combination chemotherapy to both EDRA group and the control group. In the EDRA group, paclitaxel was replaced by docetaxel 75 mg/m2 if a patient showed extreme drug resistance (EDR) to paclitaxel and not to docetaxel. Carboplatin was replaced by cisplatin 75 mg/m2 if a patient showed EDR to carboplatin and not to cisplatin. If only one drug showed low drug resistance (LDR), it was allowed to add another drug which showed LDR such as gemcitabine 1,000 mg/m2. CT scan was performed every three cycles and CA-125 was checked at each cycle. RESULTS: There was no significant difference in overall response rate between EDRA group and the control group (84.5% vs. 71.8%, p=0.107). However, 93.8% of patients in EDRA group did not show EDR to at least one drug and its response rate was significantly higher than that of the control group (93.3% vs. 71.8%, p=0.023). CONCLUSION: we could choose a combination of taxane and platinum which did not show EDR and could obtain a good response in the patients with ovarian cancer.
Area Under Curve ; Biological Assay ; Bridged Compounds ; Carboplatin ; Cisplatin ; Deoxycytidine ; Drug Resistance ; Drug Therapy, Combination ; Humans ; Neoplasms, Glandular and Epithelial ; Ovarian Neoplasms ; Paclitaxel ; Platinum ; Taxoids