Hand injuries due to high-pressure paint gun devices are rare but may lead to serious outcomes. The authors describe a case of a high-pressure injury of the thumb that was managed promptly and later reconstructed successfully with minimal functional deficit. A 39-year-old man with a high-pressure paint gun injury of the right thumb was referred. Though the external wound was small, X-ray and computed tomography images showed extensive spread of paint inside. The paint was removed through a wide skin incision. After 6 weeks, the surgical wound had completely healed, except for a defect around the interphalangeal joint with bone exposure. A reverse thenar perforator-based island flap based on the princeps pollicis artery was elevated and moved to the defect. After defect reconstruction, the patient recovered pinch and grasp function through physiotherapy. High-pressure paint gun injuries of the thumb can lead to significant functional deficits of the hand. A small skin lesion may cause the actual extent of damage to be underestimated, as extensive penetration of paint can cause severe damage to the soft tissues. Thus, immediate surgical removal of the paint and coverage of the remnant wounds with an appropriate flap are necessary.

Background: Keloid scars occur idiopathically, and the ear is a common site of keloid scar formation after ear-piercing. Management is always challenging because of the high likelihood of recurrence. When treating a large keloid scar, surgical debulking is inevitable. Among various surgical options, the fillet flap is useful for very large scars with broad stalks that cannot be removed by simple excision and primary closure. Methods: From April 2016 to June 2021, scar revision with a fillet flap was performed on 24 auricular keloid scars. The operation was performed to debulk the scar as much as possible, while retaining a thin envelope of scar tissue. The patients were observed for 1 year postoperatively. Oral tranilast (a transforming growth factor-β suppressor) was administered to reduce the risk of recurrence during follow-up. When recurrence was observed, triamcinolone was injected into the scar. Results: All 24 cases were successfully treated without major problems such as flap loss. The postoperative contour and volume of the scars were appropriate when recurrence did not occur. During the follow-up period, there were nine cases of keloid recurrence, and the mean number of triamcinolone injections was 2.7. One patient experienced a second recurrence 10 months after the first recurrence and needed two more injections. Conclusion The fillet flap is an appropriate option for removing a large keloid scar with a broad stalk. Although it does not guarantee that recurrence will not take place, it provides a small and flat scar into which triamcinolone can be injected if the keloid scar recurs.

The use of thermogenic dietary supplements has led to growing concerns about potential adverse health effects. A 19-year-old female patient experienced recurrent blurred vision after consuming thermogenic dietary supplements for 5 weeks and eating only one meal per day. Initial brain imaging showed a lesion at the corpus callosum, which disappeared after a month, and her symptoms resolved within 2 days. The potential risks associated with using thermogenic dietary supplements in combination with intermittent fasting need to be carefully considered.

Microplastics are environmental pollutants that prevail in the oceans, remote islands, and polar regions. Exposure to microplastics presents a major emerging threat to the ecosystems due to their potential adverse effects. Herein, we reviewed the literature to provide an up-to-date synopsis of the current understanding of the sources, compositions, and adverse effects of microplastics in humans and the environment. Most studies on microplastics have focused on developing standardized methods for monitoring the occurrence, distribution, and movement of microplastics in the environment, as well as developing microplastic substitutes; however, although humans are exposed to microplastics via various routes, research on the adverse effects of microplastics in humans remains limited. Little is known about the impact of microplastics on human health and the toxic effects that may vary depending on the type, size, shape, and concentration of microplastics. Therefore, more research is needed to understand the cellular and molecular mechanisms of microplastic toxicity and related pathologies.

BACKGROUND: Therapeutic strategies that can promote platelet production are in demand to enhance clinical outcomes of bone marrow transplantation (BMT). Our research group has studied human tonsil-derived mesenchymal stem cells (TMSCs) and their effectiveness in promoting bone marrow (BM) engraftment. Here, we analyzed the effects of T-MSCs on platelet production and hemostasis. METHODS: Donor BM cells (BMCs) were isolated from C57BL/6 mice and transplanted with or without T-MSCs to BALB/c recipient mice. Mice were sacrificed and blood cells were counted using an Auto Hematology Analyzer. Femur sections were stained with CD41 antibody to analyze megakaryocytes in the BM. Growth factor secretion from MSCs was analyzed using the Quantibody Array. Effects of T-MSC conditioned medium (CM) on megakaryopoiesis were investigated using the MegaCult assay. In a mouse model of BMT, T-MSC CM was injected with or without anti-placental growth factor (a-PlGF) blocking antibody, and blood cell numbers and coagulation were analyzed. RESULTS: T-MSC co-transplantation increased percent survival of BMT mice. Platelet numbers were significantly lower in the BMC-only group, whereas T-MSC co-transplantation restored circulating platelets to levels similar to those of the control group. Significantly reduced numbers of CD41 ? megakaryocytes in Bu-Cy and BMC groups were increased by T-MSC co-transplantation. PlGF secretion from T-MSCs were detected and enhanced megakaryopoiesis, platelet production, and coagulation by T-MCS CM were disrupted in the presence of the a-PlGF blocking antibody. CONCLUSION We demonstrated the effectiveness of T-MSC co-transplantation in promoting platelet production and coagulation after BMT. These findings highlight the potential therapeutic relevance of T-MSCs for preventing thrombocytopenia after BMT.

Purpose: Microbiota manipulation through selected probiotics may be a promising tool to prevent cancer development as well as onset, to improve clinical efficacy for cancer treatments. The purpose of this study was to evaluate change in microbiota composition after-probiotics supplementation and assessed the efficacy of probiotics in improving quality of life (QOL) in postoperative cancer patients. Methods: Stool samples were collected from 30 cancer patients from February to October 2020 before (group I) and after (group II) 8 weeks of probiotics supplementation. We performed 16S ribosomal RNA gene sequencing to evaluate differences in gut microbiota between groups by comparing gut microbiota diversity, overall composition, and taxonomic signature abundance. The health-related QOL was evaluated through the EORTC Quality of life Questionnaire Core 30 questionnaire. Results: Statistically significant differences were noted in group II; increase of Shannon and Simpson index (P = 0.004 and P = 0.001), decrease of Bacteroidetes and Fusobacteria at the phylum level (P = 0.032 and P = 0.014, retrospectively), increased of beneficial bacteria such as Weissella (0.096% vs. 0.361%, P < 0.004), Lactococcus (0.023% vs. 0.16%, P < 0.001), and Catenibacterium (0.0% vs. 0.005%, P < 0.042) at the genus level. There was a significant improvement in sleep disturbance (P = 0.039) in group II. Conclusion Gut microbiota in cancer patients can be manipulated by specific probiotic strains, result in an altered microbiota. Microbiota modulation by probiotics can be considered as part of a supplement that helps to increase gut microbiota diversity and improve QOL in cancer patients after surgery.

Purpose: The purpose of this study was to investigate the age-related clinical features, risk factors, and prognoses of bacterial keratitis in Daejeon and Chungcheong provinces and the patterns and trends of fluoroquinolone antibiotic susceptibility. Methods: Medical records of 433 patients (433 eyes) who visited one of the five university hospitals in Daejeon and Chungcheong provinces and were diagnosed as culture-positive bacterial keratitis between January 2000 to December 2018 were reviewed retrospectively. The patients were divided into younger and older groups based on an age of 60 years. Predisposing factors, prognostic factors, treatment method, causative organisms, and susceptibility to fluoroquinolone were analyzed. Results: Two hundred seventy three males (63.0%) and 160 females (37.0%) were included. The most common risk factors in the younger group were contact lens wear (27.5%) and trauma and foreign body (27.0%). The most common risk factors in the older group were trauma and foreign body (30.5%). Staphylococcus species was the most common causative Gram-positive bacteria, regardless of age, and Pseudomonas species was the most common among Gram-negative bacteria. The older group tended to have more severe keratitis required more surgical treatment and had a worse visual outcome than the younger group (p < 0.05). As of 2011, the resistance to fluoroquinolone did not differ significantly between the groups (p > 0.05). Conclusions Bacterial keratitis in Daejeon and Chungcheong provinces indicated more severe clinical aspects and worse prognoses in older patients showing similar results from previous studies. Caution regarding trauma and foreign bodies and managing previous ocular disease is necessary for all age groups. Education regarding adequate contact lens care and hygiene is required for younger (<60 years) patients.

Purpose: The purpose of this study was to investigate the age-related clinical features, risk factors, and prognoses of bacterial keratitis in Daejeon and Chungcheong provinces and the patterns and trends of fluoroquinolone antibiotic susceptibility. Methods: Medical records of 433 patients (433 eyes) who visited one of the five university hospitals in Daejeon and Chungcheong provinces and were diagnosed as culture-positive bacterial keratitis between January 2000 to December 2018 were reviewed retrospectively. The patients were divided into younger and older groups based on an age of 60 years. Predisposing factors, prognostic factors, treatment method, causative organisms, and susceptibility to fluoroquinolone were analyzed. Results: Two hundred seventy three males (63.0%) and 160 females (37.0%) were included. The most common risk factors in the younger group were contact lens wear (27.5%) and trauma and foreign body (27.0%). The most common risk factors in the older group were trauma and foreign body (30.5%). Staphylococcus species was the most common causative Gram-positive bacteria, regardless of age, and Pseudomonas species was the most common among Gram-negative bacteria. The older group tended to have more severe keratitis required more surgical treatment and had a worse visual outcome than the younger group (p < 0.05). As of 2011, the resistance to fluoroquinolone did not differ significantly between the groups (p > 0.05). Conclusions Bacterial keratitis in Daejeon and Chungcheong provinces indicated more severe clinical aspects and worse prognoses in older patients showing similar results from previous studies. Caution regarding trauma and foreign bodies and managing previous ocular disease is necessary for all age groups. Education regarding adequate contact lens care and hygiene is required for younger (<60 years) patients.

Lateral ankle sprain is the most common ankle injuries. Patients who fail conservative treatments are candidates for modified Broström operation (MBO). Traditionally, the primary surgical treatment performed is the open MBO. Recently, there has been an evolution in the arthroscopic treatment of lateral ankle injury. Several reports reveal biomechanically equivalent results of arthroscopic vs . open MBO when using matched cadaver pairs. Also there was no difference in the clinical or radiologic outcomes between the arthroscopic and open MBO in randomized controlled trial. Therefore, arthroscopic MBO is reasonable and good alternative treatment for lateral ankle injury. Actually new techniques of arthroscopic treatment for ankle injury is introduced about arthroscopic syndesmotic repair and arthroscopic deltoid repair. Arthroscopic techniques for ankle injuries seem to develop further in the future.
Ankle Injuries ; Ankle* ; Arthroscopy ; Cadaver ; Humans

The definition of osteochondral lesion of the talus (OLT) is any defect involving both the articular surface and the subchondral bone of the talus. Many of these lesions are associated with acute ankle injury. Although many classification schemes for OLT have been proposed, Berndt and Harty's 4-staging classification is most commonly used. Stage 4 lesions and symptomatic lesions under grade 3 are usually recommended to surgical treatment. The treatment approach for athletes should be more elaborate due to the need for an early return to play. Several different types of treatment are described for OLTs in athletes, including bone marrow stimulation, osteochondral autograft transfer system, and autogenous chondrocyte implantation. Osteochondral autograft transfer system shows good clinical outcome and has the advantages that could be applied to large defect and recurred lesions, however, it has some disadvantages in terms of the complications related with the donor site and the difficult approach to the medial lesions. Although autogenous chondrocyte implantation has been extensively applied for treating OLTs with successful clinical outcomes, it has some limitations that apply to athletes in terms of the 2-stage and complicated procedure and the insurance issues. Bone marrow stimulation being a simple and cost-effective procedure associated with a low complication rate and low postoperative pain has faster return to play and is recommended the first-line treatment for the OLTs of athletes.
Ankle Injuries ; Athletes* ; Autografts ; Bone Marrow ; Chondrocytes ; Classification ; Humans ; Insurance ; Pain, Postoperative ; Return to Sport ; Talus* ; Tissue Donors