PURPOSE: To compare the effects of empirical and modified hemostatic resuscitation for liver blast injury combined with seawater immersion. METHODS: Thirty rabbits were subjected to liver blast injury combined with seawater immersion, and were then divided into 3 groups randomly (n = 10 each): group A (no treatment after immersion), group B (empirical resuscitation with 20 mL hydroxyethyl starch, 50 mg tranexamic acid, 25 IU prothrombin complex concentrate and 50 mg/kg body weight fibrinogen concentrate), and group C (modified resuscitation with additional 10 IU prothrombin complex concentrate and 20 mg/kg body weight fibrinogen concentrate based on group B). Blood samples were gathered at specified moments for assessment of thromboelastography, routine coagulation test, and biochemistry. Mean arterial pressure, heart rate, and survival rate were also documented at each time point. The Kolmogorov-Smirnov test was used to examine the normality of data distribution. Multigroup comparisons were conducted with one-way ANOVA. RESULTS: Liver blast injury combined with seawater immersion resulted in severe coagulo-fibrinolytic derangement as indicated by prolonged prothrombin time (s) (11.53 ± 0.98 vs. 7.61 ± 0.28, p＜0.001), activated partial thromboplastin time (APTT) (s) (33.48 ± 6.66 vs. 18.23 ± 0.89, p＜0.001), reaction time (R) (min) (5.85 ± 0.96 vs. 2.47 ± 0.53, p＜0.001), decreased maximum amplitude (MA) (mm) (53.20 ± 5.99 vs. 74.92 ± 5.76, p＜0.001) and fibrinogen concentration (g/L) (1.19 ± 0.29 vs. 1.89 ± 0.32, p = 0.003), and increased D-dimer concentration (mg/L) (0.38 ± 0.32 vs. 0.05 ± 0.03, p = 0.005). Both empirical and modified hemostatic resuscitation could improve the coagulo-fibrinolytic states and organ function, as indicated by shortened APTT and R values, decreased D-dimer concentration, increased fibrinogen concentration and MA values, lower concentration of blood urea nitrogen and creatine kinase-MB in group B and group C rabbits in comparison to that observed in group A. Further analysis found that the R values (min) (4.67 ± 0.84 vs. 3.66 ± 0.98, p = 0.038), APTT (s) (23.16 ± 2.75 vs. 18.94 ± 1.05, p = 0.001), MA (mm) (60.10 ± 4.74 vs. 70.21 ± 3.01, p < 0.001), and fibrinogen concentration (g/L) (1.68 ± 0.21 vs. 1.94 ± 0.16, p = 0.013) were remarkably improved in group C than in group B at 2 h and 4 h after injury. In addition, the concentration of blood urea nitrogen (mmol/L) (24.11 ± 1.96 vs. 21.00 ± 3.78, p = 0.047) and creatine kinase-MB (U/L) (85.50 ± 13.60 vs. 69.74 ± 8.56, p = 0.013) were lower in group C than in group B at 6 h after injury. The survival rates in group B and group C were significantly higher than those in group A at 4 h and 6 h after injury (p < 0.001), however, there were no statistical differences in survival rates between group B and group C at each time point. CONCLUSIONS Modified hemostatic resuscitation could improve the coagulation parameters and organ function better than empirical hemostatic resuscitation.
Animals ; Rabbits ; Resuscitation/methods* ; Liver/injuries* ; Seawater ; Blast Injuries/therapy* ; Fibrinogen/administration & dosage* ; Male ; Tranexamic Acid/administration & dosage* ; Immersion ; Hydroxyethyl Starch Derivatives/administration & dosage*

OBJECTIVES: The metabolomics technique of LC-MS/MS combined with data analysis was used to detect changes and differences in metabolic profiles in the vitreous humor of early rat carcasses found in water, and to explore the feasibility of its use for early postmortem submersion interval (PMSI) estimation and the cause of death determination. METHODS: The experimental model was established in natural lake water with 100 SD rats were randomly divided into a drowning group (n=50) and a postmortem (CO₂ suffocation) immediately submersion group (n=50). Vitreous humor was extracted from 10 rats in each group at 0, 6, 12, 18 and 24 h postmortem for metabolomics analyses, of which 8 were used as the training set to build the model, and 2 were used as test set. PCA and PLS multivariate statistical analysis were performed to explore the differences in metabolic profiles among PMSI and causes of death in the training set samples. Then random forest (RF) algorithm was used to screen several biomarkers to establish a model. RESULTS: PCA and PLS analysis showed that the metabolic profiles had time regularity, but no differences were found among different causes of death. Thirteen small molecule biomarkers with good temporal correlation were selected by RF algorithm. A simple PMSI estimation model was constructed based on this indicator set, and the data of the test samples showed the mean absolute error (MAE) of the model was 0.847 h. CONCLUSIONS The 13 metabolic markers screened in the vitreous humor of rat corpses in water had good correlations with the early PMSI. The simplified PMSI estimation model constructed by RF can be used to estimate the PMSI. Additionally, the metabolic profiles of vitreous humor cannot be used for early identification of cause of death in water carcasses.
Animals ; Biomarkers/metabolism* ; Cadaver ; Chromatography, Liquid ; Immersion ; Postmortem Changes ; Rats ; Rats, Sprague-Dawley ; Tandem Mass Spectrometry ; Vitreous Body/metabolism* ; Water/metabolism*

PURPOSE: This study evaluated color stability of Dentca 3D-printed denture teeth, in comparison to color stabilities of four conventional types of denture teeth, upon being immersed in various colorants.MATERIALS AND METHODS: Four types of conventional prefabricated denture teeth (Surpass, GC, Artic 6, Heraeus Kulzer, Premium 6, Heraeus Kulzer, Preference, Candulor), 3D-printed denture teeth (Dentca); and Z250 (Filtek Z250, 3M ESPE) were prepared for testing. The samples were immersed in erythrosine 3%, coffee, cola, and distilled water (DW) at 37℃. Color change (ΔE) was measured by spectrophotometer before immersion and at 7, 14, and 21 days after immersion. One-way analysis of variance was performed along with Tukey's honestly significant difference multiple comparisons test (P<.05).RESULTS: No great difference was observed between the color change of Dentca denture teeth and that of conventional denture teeth in most cases (P>.05). The color change of Dentca denture teeth immersed in erythrosine 3% was greater than that of Surpass (ΔE = 0.67 ± 0.25) after 1 week; Artic 6 (ΔE = 1.44 ± 0.38) and Premium 6 (ΔE = 1.69 ± 0.35) after 2 weeks; and Surpass (ΔE = 1.79 ± 0.49), Artic 6 (ΔE = 2.07 ± 0.21), Premium 6 (ΔE = 2.03 ± 0.75), and Preference (ΔE = 2.01 ± 0.75) after 3 weeks (P<.05).CONCLUSION: A color change was observed in Dentca denture teeth when immersed in some colorants; however, the maximum value of ΔE for Dentca denture teeth was within the clinically acceptable range.
Coffee ; Cola ; Dentures ; Erythrosine ; Immersion ; Printing, Three-Dimensional ; Tooth ; Water

Postmortem interval （PMI） estimation is one of the most important and difficult academic tasks in forensic sciences. Due to the influence of the corpse itself and the water environment, corpses in water have unique corruption phenomenon and laws. Based on the experience of traditional PMI studies of corpses on land, forensic practitioners across the world have proposed a variety of practical methods for estimating postmortem submersion interval （PMSI）. This paper summarizes the literatures related to PMSI in recent years, and introduces methods to infer PMSI according to the phenomenon of corpses, the development of insects, the succession pattern of aquatic organisms, and the changes of other physical and chemical indexes of corpses, in order to provide some reference for the study of PMSI of corpses in water.
Animals ; Autopsy ; Cadaver ; Forensic Medicine ; Immersion ; Postmortem Changes

PURPOSE: To review the clinical features and natural courses of cold urticaria (ColdU) in a tropical country. METHODS: A retrospective chart review was performed of patients who visited Siriraj Urticaria Clinic, Siriraj Hospital, Bangkok, Thailand, and were diagnosed with ColdU between 2007 and 2018. Data on provocation and threshold tests, clinical courses, and laboratory work-up were analyzed and compared with data reported by studies in temperate countries. RESULTS: Of 1,063 chronic urticaria patients, 27 (2.5%) were diagnosed with ColdU, with a mean age of symptom onset of 34.8 years. Half of the patients had a history of atopy, and 1 (3.7%) had a history of anaphylaxis. All patients were positive to 1 of 3 provocation tests: an ice cube test; TempTest 4.0; or a tray filled with ice, salt and water. Thirteen patients underwent the ice cube test, and all had positive results. TempTest was performed on 15 patients, 8 of whom had positive results, with a mean critical temperature threshold (CTT) of 21.0°C. All of the 7 patients who had a negative TempTest result later produced positive results to the immersion of their hand and forearm in a tray filled with ice, salt, and water. All patients were treated with H1-antihistamines, the vast majority (96.3%) being non-sedating H1-antihistamines. Some (14.8%) needed to be administered oral corticosteroids, ciclosporin, or omalizumab. Six patients (22.2%) were in remission. A Kaplan-Meier survival curve demonstrated 5-year and 10-year remission rates of 13.8% and 42.6%, respectively. CONCLUSIONS: The rate of anaphylaxis in patients with ColdU in a tropical country was lower than those reported by other studies conducted intemperate climates. On the other hand, the number of female patients, mean age at symptom onset, atopy rate, rate of concomitant chronic spontaneous urticaria and mean CTT were higher.
Adrenal Cortex Hormones ; Anaphylaxis ; Climate ; Cyclosporine ; Female ; Forearm ; Hand ; Humans ; Ice ; Immersion ; Omalizumab ; Retrospective Studies ; Thailand ; Tropical Climate ; Urticaria ; Water

BACKGROUND: In this study, four types of effervescent vitamins marketed in Korea were analyzed for their acidity and vitamin content. For this purpose, bovine teeth were immersed in vitamin, and surface microhardness and appearance were measured before and after immersion to evaluate tooth demineralization and erosion.METHODS: Bovine permanent incisors with sound surface enamel were cut to 5×5 mm size, embedded in acrylic resin, and polished using a polishing machine with Sic-paper. The prepared samples were analyzed for pH, vitamin content, and surface hardness before and after immersion using a surface microhardness meter. Demineralization of surface dental enamel was observed using a scanning electron microscope.RESULTS: The average pH of the four effervescent vitamins was less than 5.5; the pH of the positive control Oronamin C was the lowest at 2.76, while that of the negative control Samdasoo was the highest at 6.86. The vitamin content was highest in Berocca and lowest in the DM company Multivitamin. On surface microhardness analysis, surface hardness values of all enamel samples were found to be decreased significantly after 1 and 10 minutes of immersion (p<0.05). After 10 minutes of immersion, there was a significant difference in the decrease in hardness between the experimental groups (p<0.05). Scanning electron microscopy observation showed that dental enamel demineralization after 10 minutes of immersion was the most severe in Oronamin C except for Samdasoo, followed by DM company Multivitamin and VitaHEIM. Immersion in BeroNew and Berocca resulted in similar effects.CONCLUSION: There is a risk of tooth erosion due to decreased tooth surface microhardness when using the four types of effervescent vitamins and vitamin carbonated beverages with pH below 5.5. Therefore, high pH vitamin supplements are recommended to prevent tooth erosion.
Carbonated Beverages ; Dental Enamel ; Hardness ; Hydrogen-Ion Concentration ; Immersion ; Incisor ; Korea ; Microscopy, Electron, Scanning ; Tablets ; Tooth ; Tooth Demineralization ; Tooth Erosion ; Vitamins

PURPOSE: The purpose of this study is to identify the educational effect among nursing students who performed the patient role in women's health nursing simulations.METHODS: In this exploratory qualitative study, a sample of 31 third- and fourth-grade nursing students who participated in scenario-based patient roles in clinical performance examination of the women's health nursing simulation practice training. Data were collected through focus group interviews. Qualitative data were analyzed using qualitative content analysis.RESULTS: Three themes emerged from the data analysis. Participants experienced an enhancement of patient-centered nursing competence, deep learning immersion and display of self-regulated learning. The difficulty of performing the patient role contributed additional effects such as the difficulty to perform the patient role in the psychological training environment.CONCLUSION: It is recommended to utilize nursing students as patients in simulation practice training. On the other hand, the psychological training environment can cause difficulties in performing patient roles, a burden on the role of the patient, and involves the interruption of the role.
Clinical Competence ; Education ; Education, Nursing ; Focus Groups ; Hand ; Humans ; Immersion ; Learning ; Mental Competency ; Nursing ; Patient Simulation ; Patient-Centered Care ; Statistics as Topic ; Students, Nursing ; Women's Health

OBJECTIVES: This study aims to compare the fluoride-release between different fluorine varnish under in vitro experimental conditions.METHODS: In this study, 5 fluoride varnish products distributed in Korea were selected. V-varnish™ (Vericom, Korea: VV), CavityShield™ (3M ESPE, USA: CS), Clinpro™ White varnish™ (3M ESPE, USA: CP), MI Varnish™ (GC, Japan: MI), and Fluor Protector (Ivoclar Vivadent, Liechtenstein: FP). For the in vitro study, 10 mg of each fluoride varnish was thinly applied to the same area of the specimen. The specimen was then immersed in 3 ml of distilled water at consistent intervals to confirm fluoride release. Nine specimens per group were used. Fluoride ion electrodes were used to measure the fluoride concentration of the solution. The Kruskal-Wallis nonparametric test was performed to compare between each experimental group, and the Wilcoxon signed-rank nonparametric test was performed to compare experimental groups over time. The significance level for a Type I error was set at 0.05. All statistical analyses were performed using SPSS 25.0 (IBM Co., Armonk, NY, USA).RESULTS: In vitro experiments showed that the amount of fluoride released from MI was higher than the other groups during the first 12 hours after application. However, the amount of fluoride released from CP and CS was higher than MI as the immersion time increased over 12 and 20 hours, respectively. The fluoride release from FP was the lowest at all measurement points.CONCLUSIONS: The results of this study showed that the remaining fluoride effect from rosin type fluoride varnishes was higher than liquid type fluoride varnishes. There were differences in the residual fluoride concentrations despite each fluoride varnish having the same fluoride content.
Dental Caries ; Electrodes ; Fluorides ; Fluorides, Topical ; Fluorine ; Immersion ; In Vitro Techniques ; Japan ; Korea ; Liechtenstein ; Paint ; Water

OBJECTIVES: We investigated the effects of commercial plum beverage on the dentin surface that could be exposed to caries, gliopathy, and abrasion to investigate the inhibitory effects of dentin corrosion.METHODS: The experimental beverages were Jeju Samdasoo (Group 1, negative control), Coca-Cola (Group 2, positive control), Chorok Maesil (Group 3), and Chorok Maesil with 3% calcium lactate added (Group 4). The specimens were prepared and divided into 4 groups of 12 each. The pH of the experimental beverages was measured using a pH meter, and specimen surface hardness was assessed according to the Vickers hardness number (VHN). The specimens were immersed in the experimental beverage for 1, 3, 5, 10, and 15 minutes. Then, we obtained the average VHN by measuring surface microhardness. Measures of surface microhardness were compared using the paired t-test before and after 15 minutes of immersion in each of the four beverages. Between-group differences in surface microhardness were compared using one-way analysis of variance and the Tukey test after the analysis.RESULTS: After 15 minutes of immersion in the experimental beverages, there was no significant difference in surface microhardness in group 1 (P>0.05). There were significant differences in groups 2, 3, and 4 (P < 0.05). The difference in surface microhardness before and after immersion for 15 minutes was highest in group 3 (−18.1±2.55), followed by group 2 (−13.0±3.53) and group 4 (−7.79±4.47). In group 1, the difference was −1.52±4.30. Moreover, there was a significant difference in each group (P < 0.05). After 10 minutes of immersion, surface microhardness tended to rapidly decrease.CONCLUSIONS: Patients who regularly ingest a commercially available plum drink with low pH should be provided dietary guidance on the risk of dental erosion. Calcium additives should be considered when producing plum beverage products.
Beverages ; Calcium ; Corrosion ; Dentin ; Hardness ; Humans ; Hydrogen-Ion Concentration ; Immersion ; Lactic Acid ; Prunus domestica ; Tooth

The aim of this study was to examine the bioactivity and osseointegration of Ti-6Al-4V alloy implant which was modified by an anodic oxidation and a cyclic precalcification treatments. After blasting treatment using HAp (Hydroxyapatitie; HAp) powder which is resorbable blasting media (RBM) on the surface of Ti-6Al-4V alloy implants, the anodic oxidation treatment and the cyclic precalcification treatment were conducted to form nanotube TiO2 layer and HAp precipitation respectively. The surface morphology of the surface-treated Ti-6Al-4V alloy implant was investigated after immersion in the simulated body fluid(SBF) for 3 days to investigate the bioactivity. To investigate the effect of surface treatment on bonding between the implant and bone, RBM treated implant and RBM-anodization-cyclic precalcification(RACP) treated implant were placed on the distal side of both tibia diaphysis of rats, and then the removal torque of the implant was measured after 4 weeks. On the surface of RACP treated group, bone-like apatite precipitation was observed after immersion in SBF for 3 days. The removal torque was significantly higher in the RACP treated group than in the RBM treated group. The interfacial fracture between the implant and the new bone was observed in the RBM treated group, but both the cohesive fracture at the new bone and the interfacial fractures between the implant and the new bone were observed in the RACP treated group.
Alloys ; Animals ; Diaphyses ; Immersion ; Nanotubes ; Osseointegration ; Rats ; Tibia ; Torque