Background: During the early stages of the COVID-19 pandemic, many residents of longterm care facilities (LTCFs) in various countries were infected with COVID-19, leading to high mortality. This study aimed to identify risk factors associated with severe disease progression and mortality among LTCF residents to mitigate the impact of COVID-19 on this vulnerable population. Methods: We analyzed risk factors for severe disease and mortality in 224,983 patients with COVID-19 aged 50 years or older, focusing specifically on 4,442 LTCF residents. Results: Logistic regression analysis showed that, among all patients aged 50 and older, severe progression was associated with LTCF residence (OR: 1.29, 95% CI: 1.15-1.44), older age, male sex, higher Charlson Comorbidity Index (CCI), and having received fewer than three doses of COVID-19 vaccine. Mortality within 30 days was associated with LTCF residence (OR: 2.04, 95% CI: 1.86-2.24), older age, male sex, higher CCI, under-vaccination, and receipt of medical aid. Among LTCF residents, male sex and lack of COVID-19 vaccination (OR: 4.37, 95% CI: 2.77-6.91) were significantly associated with increased risk of severe progression.Mortality among LTCF residents was associated with older age, male sex, absence of vaccination (OR: 6.18, 95% CI: 4.40-8.68), no hospitalization or emergency room visit within 30 days after diagnosis, and an LTCF stay of longer than one year (OR: 1.51, 95% CI: 1.09-2.09). A higher number of medical staff in LTCF was significantly associated with lower mortality (OR:0.71, 95% CI: 0.55-0.91). Conclusion LTCF residents shared similar risk factors for severe COVID-19 progression and mortality as the general population. Timely medical intervention for LTCF residents may help reduce severe outcomes and prevent death.

Purpose: We investigated the factors that affect the occurrence of sinusoidal obstruction syndrome (SOS) and the effect of SOS on the patient’s perioperative outcomes through histological review of liver resection specimens from patients who underwent chemotherapy. Methods: From December 2007 to December 2020, liver specimens from patients who underwent liver resection for colorectal liver metastasis after neoadjuvant chemotherapy were analyzed regarding liver damage in the nontumorous lesion. Through pathological review, patients with grade 1–3 sinusoidal dilatation were categorized into the SOS (+) group, compared to a control group (grade 0, SOS [–]). Results: Of 286 patients, 175 were included. Preoperative factors were similar between the groups. Although not statistically significant, the SOS (+) group had a shorter chemotherapy-free interval before resection (7.96 weeks vs. 10.0 weeks, P = 0.069). The SOS (+) group had higher intraoperative blood loss (889.1 ± 1,126.6 mL vs. 555.3 ± 566.7 mL, P = 0.012) and transfusion rates (46.6% vs. 25.3%, P = 0.003). SOS correlated with increased liver surgery-specific complications (40.9% vs. 26.4, P = 0.043). Patients with SOS experienced adverse effects on intrahepatic recurrent-free survival and overall survival (5-year survival, 46.0% vs. 33.9%; P = 0.014). Conclusion SOS development during liver surgery is associated with increased intraoperative blood loss, transfusion volume, and liver surgery-specific complications and has a higher risk of early recurrence and decreased overall survival.Thus, it is crucial to exercise caution during liver surgery in these patients.

Purpose: We investigated the factors that affect the occurrence of sinusoidal obstruction syndrome (SOS) and the effect of SOS on the patient’s perioperative outcomes through histological review of liver resection specimens from patients who underwent chemotherapy. Methods: From December 2007 to December 2020, liver specimens from patients who underwent liver resection for colorectal liver metastasis after neoadjuvant chemotherapy were analyzed regarding liver damage in the nontumorous lesion. Through pathological review, patients with grade 1–3 sinusoidal dilatation were categorized into the SOS (+) group, compared to a control group (grade 0, SOS [–]). Results: Of 286 patients, 175 were included. Preoperative factors were similar between the groups. Although not statistically significant, the SOS (+) group had a shorter chemotherapy-free interval before resection (7.96 weeks vs. 10.0 weeks, P = 0.069). The SOS (+) group had higher intraoperative blood loss (889.1 ± 1,126.6 mL vs. 555.3 ± 566.7 mL, P = 0.012) and transfusion rates (46.6% vs. 25.3%, P = 0.003). SOS correlated with increased liver surgery-specific complications (40.9% vs. 26.4, P = 0.043). Patients with SOS experienced adverse effects on intrahepatic recurrent-free survival and overall survival (5-year survival, 46.0% vs. 33.9%; P = 0.014). Conclusion SOS development during liver surgery is associated with increased intraoperative blood loss, transfusion volume, and liver surgery-specific complications and has a higher risk of early recurrence and decreased overall survival.Thus, it is crucial to exercise caution during liver surgery in these patients.

Purpose: We investigated the factors that affect the occurrence of sinusoidal obstruction syndrome (SOS) and the effect of SOS on the patient’s perioperative outcomes through histological review of liver resection specimens from patients who underwent chemotherapy. Methods: From December 2007 to December 2020, liver specimens from patients who underwent liver resection for colorectal liver metastasis after neoadjuvant chemotherapy were analyzed regarding liver damage in the nontumorous lesion. Through pathological review, patients with grade 1–3 sinusoidal dilatation were categorized into the SOS (+) group, compared to a control group (grade 0, SOS [–]). Results: Of 286 patients, 175 were included. Preoperative factors were similar between the groups. Although not statistically significant, the SOS (+) group had a shorter chemotherapy-free interval before resection (7.96 weeks vs. 10.0 weeks, P = 0.069). The SOS (+) group had higher intraoperative blood loss (889.1 ± 1,126.6 mL vs. 555.3 ± 566.7 mL, P = 0.012) and transfusion rates (46.6% vs. 25.3%, P = 0.003). SOS correlated with increased liver surgery-specific complications (40.9% vs. 26.4, P = 0.043). Patients with SOS experienced adverse effects on intrahepatic recurrent-free survival and overall survival (5-year survival, 46.0% vs. 33.9%; P = 0.014). Conclusion SOS development during liver surgery is associated with increased intraoperative blood loss, transfusion volume, and liver surgery-specific complications and has a higher risk of early recurrence and decreased overall survival.Thus, it is crucial to exercise caution during liver surgery in these patients.

Objective: We aimed to evaluate the efficacy of EmboTrap II in terms of first-pass recanalization and to determine whether it could yield favorable outcomes. Materials and Methods: In this multicenter, prospective study, we consecutively enrolled patients who underwent mechanical thrombectomy using EmboTrap II as a front-line device. The primary outcome was the first pass effect (FPE) rate defined by modified Thrombolysis In Cerebral Infarction (mTICI) grade 2c or 3 by the first pass of EmboTrap II. In addition, modified FPE (mFPE; mTICI grade 2b–3 by the first pass of EmboTrap II), successful recanalization (final mTICI grade 2b–3), and clinical outcomes were assessed. We also analyzed the effect of FPE on a modified Rankin Scale (mRS) score of 0–2 at 3 months. Results: Two hundred-ten patients (mean age ± standard deviation, 73.3 ± 11.4 years; male, 55.7%) were included. Ninetynine patients (47.1%) had FPE, and mFPE was achieved in 150 (71.4%) patients. Successful recanalization was achieved in 191 (91.0%) patients. Among them, 164 (85.9%) patients underwent successful recanalization by exclusively using EmboTrap II. The time from groin puncture to FPE was 25.0 minutes (interquartile range, 17.0–35.0 minutes). Procedure-related complications were observed in seven (3.3%) patients. Symptomatic intracranial hemorrhage developed in 14 (6.7%) patients. One hundred twenty-three (58.9% of 209 completely followed) patients had an mRS score of 0–2. Sixteen (7.7% of 209) patients died during the follow-up period. Patients who had successful recanalization with FPE were four times more likely to have an mRS score of 0–2 than those who had successful recanalization without FPE (adjusted odds ratio, 4.13;95% confidence interval, 1.59–10.8; p = 0.004). Conclusion Mechanical thrombectomy using the front-line EmboTrap II is effective and safe. In particular, FPE rates were high. Achieving FPE was important for an mRS score of 0–2, even in patients with successful recanalization.

The purpose of this study was to investigate the characteristics of intrusion in primary dentition and to evaluate factors influencing complications of primary and permanent dentition during long-term follow-up period.61 patients (84 teeth) were selected in this study. Medical records of 61 patients were reviewed and age, gender, cause of injury, site of injury, severity of traumatic injury, other injuries associated with trauma, treatment method, and complications of primary and permanent dentition were examined. Collected data were statistically evaluated using Chi-square test and Fisher's exact test.Intrusion in primary anterior teeth was predominant in boys over girls and fall was the most common cause of trauma. It was most common at home and occurred most in the primary maxillary central incisors. Severity had an effect on the incidence of sequelae in permanent successors (p = 0.014). The incidence of complications was significantly lower in patients with soft tissue injuries than in patients with other periodontal injuries (p = 0.000).
Dentition, Permanent ; Female ; Follow-Up Studies ; Humans ; Incidence ; Incisor ; Medical Records ; Methods ; Prognosis ; Soft Tissue Injuries ; Tooth Abnormalities ; Tooth Injuries ; Tooth ; Tooth, Deciduous

PURPOSE: We have summarized the experience of our institution related to what treatment has been performed in patients with pancreatic fistula and their outcome.METHODS: Seventy-eight pancreatico-enteric anastomosis failure (PEAF) patients of 403 pancreaticoduodenectomy (PD) were included for this retrospective study. PEAF was defined by the presence of rich amylase (over 10,000 IU/L) in drainage fluid at postoperative day 5 to 7 and radiographic demonstration of the anastomotic breakdown and associated local fluid collection. The management was analyzed by observation group (O group), intervention (I group) and surgery group (S group).RESULTS: Preoperative clinical status of the PEAF group and non-PEAF group was similar. Bile duct cancer was the highest risk subgroup of the PEAF (P=0.001) and the pancreatic adenocarcinoma showed the least risk for the PEAF (P<0.001). Among the 78 PEAF patients, 50 were managed as a conservative treatment, 15 patients were received radiologic intervention and 13 patients performed rescue surgery. Among these three subgroups, there was no statistical significance in the patient's demographics, clinical status, surgical factors and disease nature. However, mortality was significantly higher in the S group (P<0.001). The mortality cases were developed one and six patients in O and S group, respectively. Surgical procedures in S group were completion total pancreatectomy with or without splenectomy (n=12) and pancreatectomy preserving spleen in four (28.6%). Pancreaticogastrostomy repair and Roux-en-Y pancreaticojejunostomy reconstruction were performed each case, respectively.CONCLUSION: Proper drainage catheter indwelling during the PD or postoperative radiological intervention can effectively manage the PEAF without surgical interventional treatment.
Adenocarcinoma ; Amylases ; Bile Duct Neoplasms ; Catheters ; Demography ; Drainage ; Humans ; Mortality ; Pancreatectomy ; Pancreatic Fistula ; Pancreaticoduodenectomy ; Pancreaticojejunostomy ; Retrospective Studies ; Spleen ; Splenectomy

PURPOSE: Abnormalities in hemostasis and coagulation have been suggested in chronic renal failure (CRF). In this study, we compared processes of thrombus formation between rats with CRF and those with normal kidney function. MATERIALS AND METHODS: CRF was induced by 5/6 ablation/infarction of the kidneys in Sprague-Dawley rats, and surviving rats after 4 weeks were used. Ferric chloride (FeCl3)-induced thrombosis in the carotid artery was induced to assess thrombus formation. Whole blood clot formation was evaluated using rotational thromboelastometry (ROTEM). Platelet aggregation was assessed with impedance platelet aggregometry. RESULTS: FeCl3-induced thrombus formation was initiated faster in the CRF group than in the control group (13.2±1.1 sec vs. 17.8±1.0 sec, p=0.027). On histological examination, the maximal diameters of thrombi were larger in the CRF group than in the control group (394.2±201.1 µm vs. 114.0±145.1 µm, p=0.039). In extrinsic pathway ROTEM, the CRF group showed faster clot initiation (clotting time, 59.0±7.3 sec vs. 72.8±5.0 sec, p=0.032) and increased clot growth kinetics (α angle, 84.8±0.2° vs. 82.0±0.6°, p=0.008), compared to the control group. Maximal platelet aggregation rate was higher in the CRF group than in the control group (58.2±0.2% vs. 44.6±1.2%, p=0.006). CONCLUSION: Our study demonstrated that thrombogenicity is increased in rats with CRF. An activated extrinsic coagulation pathway may play an important role in increasing thrombogenicity in CRF.
Animals ; Blood Platelets ; Carotid Arteries ; Electric Impedance ; Hemostasis ; Kidney ; Kidney Failure, Chronic* ; Kinetics ; Models, Animal* ; Platelet Aggregation ; Rats* ; Rats, Sprague-Dawley ; Thrombelastography ; Thrombosis

In essential thrombocythemia (ET), cerebral infarction with large cerebral artery occlusion has rarely been reported. A 53-year-old male was admitted with left sided weakness. Brain magnetic resonance images revealed right internal carotid artery (ICA) territory infarction and proximal ICA occlusion. The blood laboratory examination demonstrated continuously increased platelet count (above 617,000/µL). Increased megakaroycytes and JAK2 V617F mutation were confirmed in the bone marrow biopsy. We should consider the possibility of ET in patient with large artery thrombosis and thrombocythemia.
Arteries ; Biopsy ; Bone Marrow ; Brain ; Carotid Artery, Internal* ; Cerebral Arteries ; Cerebral Infarction ; Humans ; Infarction ; Janus Kinase 2 ; Male ; Middle Aged ; Platelet Count ; Stroke* ; Thrombocythemia, Essential* ; Thrombocytosis ; Thrombosis

No abstract available.
Glycogen Storage Disease Type V* ; Glycogen Storage Disease* ; Glycogen* ; Humans ; Rhabdomyolysis* ; Seizures*