Chest Trauma Scoring Systems for Predicting Respiratory Complications in Isolated Rib Fracture.

BACKGROUND: We retrospectively compared chest trauma scoring systems in patients with rib fractures without major extrathoracic injury for predicting respiratory complications. We also evaluated the predictive power according to the presence or absence of pulmonary contusion. MATERIALS AND METHODS: Data from 177 patients with isolated rib fractures were included (December 2013 to April 2018). The primary outcome was respiratory complications (pneumonia, respiratory failure, or empyema). The Abbreviated Injury Scale (AIS), Thoracic Trauma Severity Score (TTSS), Chest Trauma Score (CTS), Rib Fracture Score (RFS), and RibScore were evaluated using univariate and receiver operating characteristic (ROC) analyses to determine their predictive value for pulmonary complications. We divided patients into two groups according to the presence or absence of pulmonary contusion, and constructed ROC curves for both groups. RESULTS: Twenty-eight patients (15.8%) had ≥1 respiratory complication, with significantly higher numbers of standard, segmental, and displaced rib fractures as well as significantly higher TTSS, CTS, RFS, and AIS scores. In all patients, the TTSS (0.723, 95% confidence interval [CI] 0.651-0.788) showed the highest area under the ROC curve (AUROC), followed by the CTS, RFS, AIS, and RibScore. In patients with pulmonary contusion, TTSS also showed the highest AUROC (0.704, 95% CI 0.613-0.784). In patients without pulmonary contusion, RFS showed the highest AUROC (0.759, 95% CI 0.630-0.861). CONCLUSIONS: TTSS was the most useful system for predicting respiratory complications in isolated rib fracture patients with pulmonary contusion. By contrast, RFS was the most useful in patients without pulmonary contusion.

p-Coumaric acid stimulates longitudinal bone growth through increasing the serum production and expression levels of insulin-like growth factor 1 in rats.

The aim of the present study was to examine the effects of p-coumaric acid on the longitudinal growth of the long bone in adolescent male rats. Teatment with p-coumaric acid significantly increased the tibial length and the height of each growth plate zone and the ratio of 5-bromo-2'-deoxyuridine-positive cells relative to total proliferative cells. Expression of insulin-like growth factor 1 and its receptor in the proliferative and hypertrophic zones, and serum levels of growth hormone and insulin-like growth factor 1 were significantly increased as well in the p-coumaric acid-treated group. Via increasing both the serum level of insulin-like growth factor 1 and its expression, p-coumaric acid could promote cell proliferation in growth plate zones. These results suggest that p-coumaric acid has the potential to increase height and may be a feasible alternative to growth hormone therapy.

Reduced orbitofrontal cortical thickness in male adolescents with internet addiction.

BACKGROUND: The orbitofrontal cortex (OFC) has consistently been implicated in the pathology of both drug and behavioral addictions. However, no study to date has examined OFC thickness in internet addiction. In the current study, we investigated the existence of differences in cortical thickness of the OFC in adolescents with internet addiction. On the basis of recently proposed theoretical models of addiction, we predicted a reduction of thickness in the OFC of internet addicted individuals. FINDINGS: Participants were 15 male adolescents diagnosed as having internet addiction and 15 male healthy comparison subjects. Brain magnetic resonance images were acquired on a 3T MRI and group differences in cortical thickness were analyzed using FreeSurfer. Our results confirmed that male adolescents with internet addiction have significantly decreased cortical thickness in the right lateral OFC (p<0.05). CONCLUSION: This finding supports the view that the OFC alterations in adolescents with internet addiction reflect a shared neurobiological marker of addiction-related disorders in general.

Sclerosing angiomatoid nodular transformation of the spleen related to IgG4-associated disease: report of a case.

Sclerosing angiomatoid nodular transformation (SANT) of the spleen is a rare benign vascular mass, with fewer than 100 cases documented. It is generally recognized as a vascular lesion that develops in the red pulp of the spleen; however, its pathogenesis is not clearly defined. We report a case of SANT of the spleen, which presents evidence to support the hypothesis that this disease entity is associated with IgG4-associated disease. Microscopically, the tumor was composed of multiple vascular structures separated by fibrous connective tissue and immunohistochemical examination revealed positive staining for CD31, CD34, factor VIII, and IgG4. Further research based on large number of cases is warranted to clarify the pathogenesis of this tumor.

Associations of ambient manganese exposure with brain gray matter thickness and white matter hyperintensities.

Manganese (Mn) exposure is associated with increased risks of dementia and cerebrovascular disease. However, evidence regarding the impact of ambient Mn exposure on brain imaging markers is scarce. We aimed to investigate the association between ambient Mn exposure and brain imaging markers representing neurodegeneration and cerebrovascular lesions. We recruited a total of 936 adults (442 men and 494 women) without dementia, movement disorders, or stroke from the Republic of Korea. Ambient Mn concentrations were predicted at each participant's residential address using spatial modeling. Neurodegeneration-related brain imaging markers, such as the regional cortical thickness, were estimated using 3 T brain magnetic resonance images. White matter hyperintensity volume (an indicator of cerebrovascular lesions) was also obtained from a certain number of participants (n = 397). Linear regression analyses were conducted after adjusting for potential confounders. A log-transformed ambient Mn concentration was associated with thinner parietal (ß = -0.02 mm; 95% confidence interval [CI], -0.05 to -0.01) and occipital cortices (ß = -0.03 mm; 95% CI, -0.04 to -0.01) after correcting for multiple comparisons. These associations remained statistically significant in men. An increase in the ambient Mn concentration was also associated with a greater volume of deep white matter hyperintensity in men (ß = 772.4 mm3, 95% CI: 36.9 to 1508.0). None of the associations were significant in women. Our findings suggest that ambient Mn exposure may induce cortical atrophy in the general adult population.

Submerged leaves of live indoor foliage plants adsorb H1N1 influenza virus from suspension.

Control of hazardous indoor particles using plants has attracted interest due to the increasing worldwide air pollution and spread of pandemic-causing viruses. However, the interaction between human pathogenic viruses (HPVs) and live plants has not been examined largely due to issues in detecting tiny amounts of infectious viruses in a carrier (such as an aerosol) and the lack of suitable examination methods. In this study, as a novel evaluation method, the effect of submerged leaves of live plants on HPVs in water was examined, using the H1N1 influenza virus as a model. Selected plant foliage of a live plant was immersed in a small bag containing HPV water suspension. In an initial screening test, the activities of 20 different plant species on the virus suspension were evaluated using a rapid virus detection kit. Ten plant species had the capability to decrease virus concentrations in the water suspension within 72 h. Among the experimental plant species, Epipremnum aureum showed the highest virus decreasing characteristics when examined using both the kit and quantitative real time polymerase chain reaction. The capacity of immersed leaf of live E. aureum to decrease viral content was enhanced when the plant-containing pot was electrically grounded to the earth (approximately 70% decrease in virus concentration). The foliage sample analysis showed that virus adsorption to the plant foliage surface could be the major reason for the decrease in the suspension. These results suggest that the proposed method can be applied to select plants to further investigate plant-HPV interactions.

Prediction of respiratory complications by quantifying lung contusion volume using chest computed tomography in patients with chest trauma.

Pulmonary contusion is an important risk factor for respiratory complications in trauma patients. Hence, we aimed to determine the relationship between the ratio of pulmonary contusion volume to the total lung volume and patient outcomes and the predictability of respiratory complications. We retrospectively included 73 patients with a pulmonary contusion on chest computed tomography (CT) from 800 patients with chest trauma admitted to our facility between January 2019 and January 2020. Chest injury severity was expressed as the ratio of pulmonary contusion volume to total lung volume by quantifying pulmonary contusion volume on chest CT. The cut-off value was 80%. Among the 73 patients with pulmonary contusion (77% males, mean age: 45.3 years), 28 patients had pneumonia, and five had acute respiratory distress syndrome. The number of patients in the severe risk group with > 20% of pulmonary contusion volume was 38, among whom 23 had pneumonia. For predicting pneumonia, the area under the receiver operating characteristic curves for the ratio of pulmonary contusion volume was 0.85 (95% confidence interval 0.76-0.95, p = 0.008); the optimal threshold was 70.4%. Quantifying pulmonary contusion volume using initial CT enables identifying patients with chest trauma at high risk of delayed respiratory complications.

Carcinosarcoma of the gallbladder: report of two cases.

Adenocarcinoma is the predominant histological type of carcinoma of the gallbladder, accounting for more than 80% of all gallbladder carcinomas. In contrast, carcinosarcoma of the gallbladder is an extremely atypical subset of gallbladder malignancies. It is characterized by the presence of both epithelial and mesenchymal components. Currently, fewer than 100 cases have been reported in the English literature. Therefore, knowledge and experience regarding this disease are limited. Recently, we experienced two cases of gallbladder carcinosarcoma, which were diagnosed as gallbladder carcinoma based on the preoperative clinical and radiological examinations. Cholecystectomies were performed in both cases, and the malignant tumor cells included carcinomatous and sarcomatous components histologically. The final pathological diagnoses were carcinosarcoma of the gallbladder. We herein report these two cases of gallbladder carcinosarcoma and review the previous pertinent literature.

Primary extragastrointestinal stromal tumor arising in the pancreas: report of a case.

Primary extragastrointestinal stromal tumors (EGISTs) arising in the pancreas are extremely rare, with only ten cases documented to our knowledge. We report a further case of EGIST of the pancreas. The patient was a 55-year-old man who presented with postprandial abdominal discomfort. Abdominal computed tomography and magnetic resonance imaging showed a lobulated heterogenous enhancing mass, 11 cm in diameter, in the abdominal cavity. No regional lymphadenopathy, ascites, or metastasis was seen radiologically. There was no obvious lesion in the stomach or small intestine. The initial diagnosis was a solid pseudopapillary tumor or serous cystic neoplasm. The patient underwent distal pancreatectomy with splenectomy. Microscopically, the tumor consisted of spindle cells arranged in short fascicles. Mitotic figures were seen in 7/50 high-power fields. Immunohistochemical examination revealed strongly positive staining for CD117. Based on these findings, the final pathologic diagnosis was a primary EGIST of the pancreas. This case consolidates the possibility that this rare tumor can involve the pancreas as a primary site and should be included in the differential diagnosis of cystic lesions in this site.

Clinical features and surgical outcome of solid pseudopapillary tumor of the pancreas: 30 consecutive clinical cases.

BACKGROUND/AIM: This study examined the clinical characteristics and surgical outcomes of solid pseudopapillary tumors of the pancreas (SPT). METHODOLOGY: Cases of SPT encountered in our hospital between January 1994 and December 2009 were reviewed retrospectively. The clinicopathological factors in the benign and malignant cases were compared to determine what features of the tumor could suggest malignant potential. RESULTS: Thirty patients with SPT were identified: 26 females and 4 males with a average age of 30.5 years (range 9-66). The median size of the tumors was 6.2cm (range 1.25 to 15.0). Tumors were located in the head (50%), neck (3.3%), body (16.7%) and tail (30%) of the pancreas. Surgical procedures included a local tumor resection (10 cases) or radical resection, such as a pancreaticoduodenectomy (6 cases), central pancreatectomy (1 case) or distal pancreatectomy (13 cases). There was no recurrence after the surgical resection. All patients were alive at a median follow-up of 58 months (range 6 to 187). Among the clinico-pathological factors, the presence of calcification was associated with the malignant potential (OR=16.000, 95% CI=1.451-176.451, p=0.024). CONCLUSIONS: SPT is a less aggressive pancreatic neoplasm that differs from other pancreatic cancers. The prognosis is favorable after a surgical resection. The presence of calcification is a predictive factor for a malignant SPT.

Prevalence of allergic diseases among Korean school-age children: a nationwide cross-sectional questionnaire study.

The purpose of this study was to investigate the nationwide prevalence of childhood asthma, eczema and other allergic diseases in Korean school-age children (8-11 yr old) and to assess the difference between residential areas. Among 6,279 elementary schools, 427 schools were randomly selected according to residential area (metropolitan, provincial, rural, and industrial area) by the cluster sampling method. Parents of students completed a modified Korean version of a questionnaire formulated by the International Study of Asthma and Allergies in Childhood (ISAAC). Among 50,200 subjects, 31,026 (61.8%) responded, and 30,893 (99.6%) were analyzed. The 12-month prevalence of wheeze, flexural rash, and allergic rhinitis symptoms were 4.8%, 15.3%, and 32.9%, respectively. The prevalence of diagnosis of allergic diseases in boys was higher than that in girls, with the exception of eczema. In both boys and girls, the difference of the prevalence of allergic diseases among industrial, metropolitan and provincial areas was not statistically significant, but the differences between rural area and other areas were significant. Our results support the importance of contextual effect associated with residential area as causative agents of allergic diseases among Korean school-age children.

Association between body mass index and asthma symptoms among Korean children: a nation-wide study.

The purpose of this study was to investigate the association between body mass index (BMI) and the prevalence of wheeze using nation-wide cross-sectional study in Korean children. Total 50,200 children from 427 elementary schools were randomly selected according to residential areas (metropolitan, provincial, rural, and industrial areas) by the cluster sampling method. The International Study of Asthma and Allergies in Childhood (ISAAC) questionnaires were used to measure the prevalence of wheeze. Among 31,026 respondents, 25,322 were analyzed. BMI was classified into quartiles based on BMI-for-age percentile. In all residential areas, pets at home and visible mold or moisture were associated with an increased prevalence of wheeze in both genders. However, other living environment factors were not consistently associated among residential areas and gender. Among girls, lowest BMI was negatively associated with prevalence of wheeze and highest BMI was positively associated in all residential areas. In multilevel logistic regression analysis, environmental tobacco smoking exposure, pets at home, visible mold or moisture, and being in the lowest and highest BMI quartile were significantly associated with the prevalence of wheeze in both genders. BMI has become an important risk factor for asthma symptoms among Korean children.

Undifferentiated embryonal sarcoma of the liver presenting as a hemorrhagic cystic tumor in an adult.

BACKGROUND: Undifferentiated embryonal sarcoma (UES) of the liver is a rare, highly malignant neoplasm with a poor prognosis occurring almost exclusively in late childhood (6-10 years of age). Only a few cases have been reported in adults, accounting for less than 1% of all primary liver neoplasms. METHODS: A 47-year-old woman presented with a palpable mass in the left upper abdomen. Magnetic resonance imaging revealed a 12x10 cm cystic mass with hemorrhage in the left lateral segment of the liver. The initial impression was a hemorrhagic cystic tumor of the liver. The patient underwent a left lateral sectionectomy of the liver. Histopathology and immunohistochemistry helped make a diagnosis of UES. RESULTS: The patient recovered uneventfully and received systemic chemotherapy. Radiologic examination for follow-up revealed a metastatic lesion in the lumbar spine (L5). She was subjected to radiotherapy at the lumbar spine. She survived 48 months. CONCLUSION: Although hepatic cyst as UES of the liver is difficult to diagnose because of its rarity in adults and lack of specific findings, it should be considered in a differential diagnosis.

Morphological and Chemical Evaluations of Leaf Surface on Particulate Matter2.5 (PM2.5) Removal in a Botanical Plant-Based Biofilter System.

Particulate matter has been increasing worldwide causing air pollution and serious health hazards. Owing to increased time spent indoors and lifestyle changes, assessing indoor air quality has become crucial. This study investigated the effect of watering and drought and illumination conditions (constant light, light/dark cycle, and constant dark) on particulate matter2.5 (PM2.5) removal and surface characterization of leaf in a botanical plant-based biofilter system. Using Ardisia japonica and Hedera helix as experimental plants in the plant-based biofilter system, PM2.5, volatile organic carbon, and CO2, as the evaluators of indoor air quality, were estimated using a sensor. Morphological and chemical changes of the leaf surface (i.e., roughness and wax) associated with PM2.5 removal were characterized via scanning electron microscopy, Fourier transform infrared spectroscopy, and atomic force microscopy. The highest PM2.5 removal efficiency, stomata closure, high leaf roughness, and wax layer were observed under drought with constant light condition. Consequently, PM2.5 removal was attributed to the combined effect of leaf roughness and wax by adsorption rather than stomatal uptake. These results suggest that operating conditions of indoor plant-based biofilter system such as watering (or drought) and illumination may be applied as a potential strategy for enhancing PM2.5 removal.

Methodology: non-invasive monitoring system based on standing wave ratio for detecting water content variations in plants.

BACKGROUND: Water content variation during plant growth is one of the most important monitoring parameters in plant studies. Conventional parameters (such as dry weight) are unreliable; thus, the development of rapid, accurate methods that will allow the monitoring of water content variation in live plants is necessary. In this study, we aimed to develop a non-invasive, radiofrequency-based monitoring system to rapidly and accurately detect water content variation in live plants. The changes in standing wave ratio (SWR) caused by the presence of stem water and magnetic particles in the stem water flow were used as the basis of plant monitoring systems. RESULTS: The SWR of a coil probe was used to develop a non-invasive monitoring system to detect water content variation in live plants. When water was added to the live experimental plants with or without illumination under drought conditions, noticeable SWR changes at various frequencies were observed. When a fixed frequency (1.611 GHz) was applied to a single experimental plant (Radermachera sinica), a more comprehensive monitoring, such as water content variation within the plant and the effect of illumination on water content, was achieved. CONCLUSIONS: Our study demonstrated that the SWR of a coil probe could be used as a real-time, non-invasive, non-destructive parameter for detecting water content variation and practical vital activity in live plants. Our non-invasive monitoring method based on SWR may also be applied to various plant studies.

Cohort profile: the Environmental-Pollution-Induced Neurological EFfects (EPINEF) study: a multicenter cohort study of Korean adults.

The general population is exposed to numerous environmental pollutants, and it remains unclear which pollutants affect the brain, accelerating brain aging and increasing the risk of dementia. The Environmental-Pollution-Induced Neurological Effects study is a multi-city prospective cohort study aiming to comprehensively investigate the effect of different environmental pollutants on brain structures, neuropsychological function, and the development of dementia in adults. The baseline data of 3,775 healthy elderly people were collected from August 2014 to March 2018. The eligibility criteria were age ≥50 years and no self-reported history of dementia, movement disorders, or stroke. The assessment included demographics and anthropometrics, laboratory test results, and individual levels of exposure to air pollution. A neuroimaging sub-cohort was also recruited with 1,022 participants during the same period, and brain magnetic resonance imaging and neuropsychological tests were conducted. The first follow-up environmental pollutant measurements will start in 2022 and the follow-up for the sub-cohort will be conducted every 3-4 years. We have found that subtle structural changes in the brain may be induced by exposure to airborne pollutants such as particulate matter 10 µm or less in diameter (PM10), particulate matter 2.5 µm or less in diameter (PM2.5) and Mn10, manganese in PM10; Mn2.5, manganese in PM2.5. PM10, PM2.5, and nitrogen dioxide in healthy adults. This study provides a basis for research involving large-scale, long-term neuroimaging assessments in community-based populations.

The effect of body fatness on regional brain imaging markers and cognitive function in healthy elderly mediated by impaired glucose metabolism.

Brain atrophy is related to vascular risk factors and can increase cognitive dysfunction risk. This community-based, cross-sectional study investigated whether glucose metabolic disorders due to body fatness are linked to regional changes in brain structure and a decline in neuropsychological function in cognitively healthy older adults. From 2016 to 2019, 429 participants underwent measurements for cortical thickness and subcortical volume using 3 T magnetic resonance imaging and for cognitive function using the neuropsychological screening battery. The effects of body fatness mediated by impaired glucose metabolism on neuroimaging markers and cognitive function was investigated using partial least square structural equation modeling. Total grey matter volume (ß = -0.020; bias-corrected (BC) 95% confidence interval (CI) = -0.047 to -0.006), frontal (ß = -0.029; BC 95% CI = -0.063 to -0.005) and temporal (ß = -0.022; BC 95% CI = -0.051 to -0.004) lobe cortical thickness, and hippocampal volume (ß = -0.029; BC 95% CI = -0.058 to -0.008) were indirectly related to body fatness. Further, frontal/temporal lobe thinning was associated with recognition memory (ß = -0.005; BC 95% CI = -0.012 to -0.001/ß = -0.005; BC 95% CI = -0.013 to -0.001) and delayed recall for visual information (ß = -0.005; BC 95% CI = -0.013 to -0.001/ß = -0.005; BC 95% CI = -0.013 to -0.001). Additionally, the smaller the hippocampal volume, the lower the score in recognition memory (ß = -0.005; BC 95% CI = -0.012 to -0.001), delayed recall for visual information (ß = -0.005; BC 95% CI = -0.012 to -0.001), and verbal learning (ß = -0.008; BC 95% CI = -0.017 to -0.002). Our findings indicate that impaired glucose metabolism caused by excess body fatness affects memory decline as well as regional grey matter atrophy in elderly individuals with no neurological disease.

Characteristics of exposure and health risk air pollutants in public buses in Korea.

The objective of this study was to estimate the concentrations of indoor air pollutants in unregulated public transport means in Korea and to determine the factors affecting the air quality as well as to assess the harmful effects of indoor air pollutants on the health of passengers. The correlation between particulate matter (PM10) and number of passengers on intra-city buses, express buses, town shuttle buses, or rural buses was insignificant whether it was during rush hours or non-rush hours. In regard to PM10 on express buses, there was no case where the standard limit was exceeded during the winter and summer seasons. In winter, however, the average concentration of PM10 increased by the travel distance. In regard to CO2, there was a statistically significant correlation (p < 0.05) between CO2 concentrations and the number of passengers, owing to human respiration. Unlike the case of PM10, there was a difference between rush hours and non-rush hours. Regarding volatile organic compounds (VOCs) and aldehydes, the values were high among recently manufactured vehicles regardless of bus types. The standard limit was exceeded during the summer season, which seemed to be related to the temperature and humidity in both indoor and outdoor. The results of this study indicate that the excess mortality resulting from PM10 was as high as the safety margin during both non-rush hours and rush hours among all unregulated public transportation means. The excess cancer risk and non-cancer risk of VOCs and aldehydes were as high as the safety margin during both non-rush hours and rush hours.

Evaluation of IAQ Management Using an IoT-Based Indoor Garden.

This study was designed to verify the effectiveness of smart gardens by improving indoor air quality (IAQ) through the installation of an indoor garden with sensor-based Internet-of-Things (IoT) technology that identifies pollutants such as particulate matter. In addition, the study aims to introduce indoor gardens for customized indoor air cleaning using the data and IoT technology. New apartments completed in 2016 were selected and divided into four households with indoor gardens installed and four households without indoor gardens. Real-time data and data on PM2.5, CO2, temperature, and humidity were collected through an IoT-based IAQ monitoring system. In addition, in order to examine the effects on the health of occupants, the results were analyzed based on epidemiological data, prevalence data, current maintenance, and recommendation criteria, and were presented and evaluated as indices. The indices were classified into a comfort index, which reflects the temperature and humidity, an IAQ index, which reflects PM2.5 and CO2, and an IAQ composite index. The IAQ index was divided into five grades from "good" to "hazardous". Using a scale of 1 to 100 points, it was determined as follows: "good (0-20)", "moderate (21-40)", "unhealthy for sensitive group (41-60)", "bad (61-80)", "hazardous (81-100)". It showed an increase in the "good" section after installing the indoor garden, and the "bad" section decreased. Additionally, the comfort index was classified into five grades from "very comfortable" to "very uncomfortable". In the comfort index, the "uncomfortable" section decreased, and the "comfortable" section increased after the indoor garden was installed.

A Comparative Study on the Ferroelectric Performances in Atomic Layer Deposited Hf0.5Zr0.5O2 Thin Films Using Tetrakis(ethylmethylamino) and Tetrakis(dimethylamino) Precursors.

The chemical, physical, and electrical properties of the atomic layer deposited Hf0.5Zr0.5O2 thin films using tetrakis(ethylmethylamino) (TEMA) and tetrakis(dimethylamino) (TDMA) precursors are compared. The ligand of the metal-organic precursors strongly affects the residual C concentration, grain size, and the resulting ferroelectric properties. Depositing Hf0.5Zr0.5O2 films with the TDMA precursors results in lower C concentration and slightly larger grain size. These findings are beneficial to grow more ferroelectric-phase-dominant film, which mitigates its wake-up effect. From the wake-up test of the TDMA-Hf0.5Zr0.5O2 film with a 2.8 MV/cm cycling field, the adverse wake-up effect was well suppressed up to 105 cycles, with a reasonably high double remanent polarization value of ~40 µC/cm2. The film also showed reliable switching up to 109 cycles with the 2.5 MV/cm cycling field without involving the wake-up effect but with the typical fatigue behavior.