Complications of fluid overload during hysteroscopic surgery: cardiomyopathy and epistaxis - A case report -

Background@#Hysteroscopic surgery has been used in various gynecological fields. However, massive fluid overload can occur as a complication due to persistent infusion of media for uterine cavity distension. We present the case of a woman who developed cardiomyopathy with pulmonary edema and epistaxis during hysteroscopic surgery.Case: A 76-year-old female underwent hysteroscopic septectomy. She manifested abrupt, active nasal bleeding and regurgitation in the intravenous line. Heart rate, SpO2, and PETCO2 decreased from 55 beats/min to 29 beats/min, from 100% to 56%, and from 31 mmHg to 9 mmHg, respectively. After the operation, brain CT showed bilateral prominent superior ophthalmic vein dilation. Echocardiography showed left ventricle apical ballooning and global hypokinesia. The patient recovered after two days of conservative management, with no sequelae. @*Conclusions@#Although hysteroscopic surgery is a simple procedure, careful monitoring is necessary to prevent complications from absorption of fluid distending media during the procedure.

Prediction Model for Massive Transfusion in Placenta Previa during Cesarean Section

0.05). The area under the receiver operating characteristics curve (AUC) was 0.922 [95% confidence interval (CI) 0.89–0.95]. In external validation, the discrimination was good, with an AUC value of 0.833 (95% CI 0.70–0.92) for this model. Nomogram calibration plots indicated good agreement between the predicted and observed outcomes, exhibiting close approximation between the predicted and observed probability.CONCLUSION: We constructed a scoring model for predicting massive transfusion during cesarean section in women with placenta previa. This model may help in determining the need to prepare an appropriate amount of blood products and the optimal timing of blood transfusion.

Factors affecting practice of infectious wastes management of dental professionals / 대한구강보건학회지

OBJECTIVES: This study aimed to evaluate the relationship between oral health professionals' knowledge, attitude, and practice with regard to infectious waste management and to identify related factors influencing it. METHODS: The study comprised of 219 oral health professionals from select dental clinics and public health centers recruited between August 25, 2016 and September 5, 2016, who agreed to participate in the study with full understanding of the study objectives. A self-reported questionnaire was administered, which consisted of 22 items on knowledge of infectious waste management, 9 items on attitude, and 16 items on practice. Data were analyzed using Pearson's correlation coefficient and stepwise multiple regression analyses. RESULTS: The age, knowledge, and clinical attitude of oral health professionals significantly correlated with waste management practice. Specifically, infectious waste management practice improved with increasing age, a greater level of knowledge, and a more positive clinical attitude. Additionally, the standardized regression coefficient demonstrated that, of these three factors, clinical attitude more strongly correlated with effective waste management practice, followed by age and level of knowledge. CONCLUSIONS: These results indicated that oral health professionals had a low level of knowledge regarding infectious waste management, and a more positive clinical attitude resulted in better practices. Therefore, the development of detailed and active education guidelines and strategies are needed to enhance the attitude, knowledge, and practice of oral health professionals with regard to infectious waste management.

Revealing Weapon Impacts on Clothes Using Reaction Reagents for Amino Acids / 대한법의학회지

If we analogize any external physical force applied to victims of crimes involving violence, it would be possible to not only presume the mutual action between victims and suspects but also deduce more facts related to the cases. Therefore, in this study, defining the phenomenon of amino acid compounds in sweat spreading into clothes as impact marks, experiments using ninhydrin, 1,8-dizafluoren-9-one (DFO), 1,2-indanedione-zinc (1,2-IND-Zn) were conducted to determine developmental variations through change over time, which was not performed in previous studies. A 5-week period was set up including first damage as a variation factor, and materials in each action were developed using certain reagents. The level of specimen development depending on the change over time was identified. Thus, no changes were observed at each initial level of development.