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1.
J Vasc Interv Radiol ; 32(3): 343-349, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33272814

RESUMO

PURPOSE: To evaluate the clinical outcomes of fluoroscopic primary posterior urethral realignment (PPUR) for complete posterior urethral disruption (PUD) accompanied by complex pelvic fractures. MATERIALS AND METHODS: Data from 15 male patients (median age, 58 years; range, 32-76 years) with traumatic PUD treated with fluoroscopic PPUR between 2016 and 2019 at a regional trauma center were retrospectively analyzed. The technical success (continuity of the ruptured urethra in PUD by Foley catheter placement) rate of fluoroscopic PPUR, trauma mechanism, concurrent embolization for pelvic arterial hemorrhage, time from the hospital visit to the start of the procedure, procedure time, Foley catheterization duration, and delayed complications were investigated. RESULTS: Fluoroscopic PPUR was technically successful for 13 of 15 (87%) patients. Concurrent embolization for pelvic arterial hemorrhage was performed in 11 of 15 (73%) patients. The mean time between the hospital visit and procedure initiation was 181.6 minutes ± 83.2. The mean procedure time was 66.3 minutes ± 26.6. The mean Foley catheterization duration for 13 patients (technical success group) was 52.3 days ± 39.8 (median, 40 days; range, 21-177 days). Symptomatic urethral stricture developed in 9 of 13 (69.2%) patients after the procedure; 7 underwent visual internal urethrotomy, 4 required regular urethral dilatation, and 2 needed urethral stent insertion. Three of 13 (23%) patients did not have delayed complications during the 1-year follow-up. CONCLUSIONS: PPUR with fluoroscopic guidance appears safe and effective for achieving the continuity of the ruptured urethra in PUD. It enables PPUR without general anesthesia and the lithotomy position in patients with complex pelvic fractures.


Assuntos
Endoscopia , Fraturas Ósseas/etiologia , Ossos Pélvicos/lesões , Radiografia Intervencionista , Uretra/lesões , Ferimentos não Penetrantes/terapia , Adulto , Idoso , Embolização Terapêutica , Endoscopia/efeitos adversos , Fluoroscopia , Fraturas Ósseas/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Ossos Pélvicos/diagnóstico por imagem , Radiografia Intervencionista/efeitos adversos , Estudos Retrospectivos , Resultado do Tratamento , Uretra/diagnóstico por imagem , Ferimentos não Penetrantes/diagnóstico por imagem , Ferimentos não Penetrantes/etiologia
2.
J Vasc Interv Radiol ; 31(10): 1570-1577.e2, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32340865

RESUMO

PURPOSE: To evaluate the benefits and risks of splenic artery embolization (SAE) in patients with American Association for the Surgery of Trauma (AAST) grade V blunt spleen injury (BSI) MATERIALS AND METHODS: Medical records of 88 patients treated with SAE between April 2013 and May 2017 at a regional trauma care center were reviewed retrospectively. The BSI grade according to the AAST spleen injury scale (revised version 2018) was determined by using computed tomography (CT) images. A total of 42 patients (46.6%) had AAST grade V injury and were included in the analysis. Patient demographics, angiographic findings, embolization techniques, and technical and clinical outcomes, including splenic salvage rate and procedure-related complications, were examined. RESULTS: SAE was performed within 2 hours after admission for 78.5% of the patients. All patients underwent selective distal embolization (n = 42). Primary clinical success rate was 80.9% (n = 34), and secondary clinical success rate was 88.1% (n = 37). The clinical failure group consisted of 5 patients. Four patients underwent splenectomy, and 1 patient died due to acute respiratory distress syndrome after embolization. The splenic salvage rate was 85.7% (n = 36). No patient had sepsis at follow-up (median, 247.0 days; interquartile range, 92.0-688.0). Clinical success rates (P = .356) and spleen salvage rates (P = .197) of patients who were hemodynamically stable (n = 19) showed no significant differences from those who were unstable (n = 23). CONCLUSIONS: Distal embolization of grade V BSI is a safe and feasible procedure which is effective for successful spleen salvage.


Assuntos
Traumatismos Abdominais/terapia , Embolização Terapêutica , Baço/irrigação sanguínea , Baço/lesões , Artéria Esplênica , Ferimentos não Penetrantes/terapia , Traumatismos Abdominais/diagnóstico por imagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Registros Eletrônicos de Saúde , Embolização Terapêutica/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , República da Coreia , Estudos Retrospectivos , Fatores de Risco , Baço/diagnóstico por imagem , Artéria Esplênica/diagnóstico por imagem , Fatores de Tempo , Centros de Traumatologia , Resultado do Tratamento , Ferimentos não Penetrantes/diagnóstico por imagem , Adulto Jovem
3.
Planta Med ; 82(4): 330-6, 2016 03.
Artigo em Inglês | MEDLINE | ID: mdl-26848701

RESUMO

This study examined whether treatment with Phyllostachyos Caulis in Taeniam aqueous extract improves longitudinal bone growth in adolescent male rats. Three-week-old male Sprague-Dawley rats were divided into three groups: a control group, a Phyllostachyos Caulis in Taeniam group (200 mg/kg, p.o.), and a recombinant human growth hormone group (20 µg/kg, s.c.). The total tibial length and the height of each growth plate zone were evaluated by radiography and histomorphometry. The total number of proliferative cells and 5-bromo-2'-deoxyuridine-positive cells were counted after 5-bromo-2'-deoxyuridine staining. Serum total osteocalcin levels were assayed using an enzyme-linked immunosorbent assay. The average total tibial length of the Phyllostachyos Caulis in Taeniam group was significantly longer than that of the control group. The heights of the proliferative and hypertrophic zones in the Phyllostachyos Caulis in Taeniam group were increased, and the ratio of 5-bromo-2'-deoxyuridine-positive to total cells in the proliferative zone was also increased. The serum osteocalcin, growth hormone, and insulin-like growth factor-1 levels were significantly increased in the Phyllostachyos Caulis in Taeniam group compared to the control group. Insulin-like growth factor-1 and insulin-like growth factor-1 receptor were highly expressed in the proliferative and hypertrophic zones in the Phyllostachyos Caulis in Taeniam group. The Phyllostachyos Caulis in Taeniam extract increased bone length, promoted cell proliferation, and activated the growth plate zones, which suggested that the extract could play an important role in longitudinal bone growth. Therefore, the Phyllostachyos Caulis in Taeniam extract might be a good alternative medicine to growth hormone therapy.


Assuntos
Bambusa/química , Desenvolvimento Ósseo/efeitos dos fármacos , Extratos Vegetais/farmacologia , Animais , Peso Corporal , Bromodesoxiuridina , Proliferação de Células/efeitos dos fármacos , Condrócitos/citologia , Condrócitos/efeitos dos fármacos , Ingestão de Alimentos , Masculino , Caules de Planta/química , Ratos , Ratos Sprague-Dawley , Tíbia/efeitos dos fármacos , Tíbia/crescimento & desenvolvimento
4.
Behav Brain Funct ; 9: 11, 2013 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-23497383

RESUMO

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.


Assuntos
Comportamento Aditivo/patologia , Internet , Córtex Pré-Frontal/patologia , Adolescente , Estudos de Casos e Controles , Interpretação Estatística de Dados , Humanos , Processamento de Imagem Assistida por Computador , Imageamento por Ressonância Magnética , Masculino , Escalas de Graduação Psiquiátrica , Jogos de Vídeo
5.
Surg Today ; 43(8): 930-6, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23440358

RESUMO

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.


Assuntos
Transformação Celular Neoplásica , Histiocitoma Fibroso Benigno/imunologia , Histiocitoma Fibroso Benigno/patologia , Imunoglobulina G/metabolismo , Baço/imunologia , Baço/patologia , Neoplasias Esplênicas/imunologia , Neoplasias Esplênicas/patologia , Antígenos CD34/metabolismo , Diagnóstico por Imagem , Fator VIII/metabolismo , Feminino , Histiocitoma Fibroso Benigno/irrigação sanguínea , Histiocitoma Fibroso Benigno/diagnóstico , Humanos , Imunoquímica , Pessoa de Meia-Idade , Molécula-1 de Adesão Celular Endotelial a Plaquetas/metabolismo , Neoplasias Esplênicas/irrigação sanguínea , Neoplasias Esplênicas/diagnóstico
6.
Ulus Travma Acil Cerrahi Derg ; 29(6): 669-676, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37278075

RESUMO

BACKGROUND: Splenic arterial embolization (SAE) is an effective intervention for the management of arterial hemorrhage asso-ciated with blunt splenic injury. However, its role and clinical outcomes in pediatric and adolescent patients are unclear. The aim of this study is to assess the role and the clinical outcomes of SAE for blunt splenic injuries in pediatric and adolescent trauma patients. METHODS: A retrospective cohort study was performed in patients aged ≤17 years with blunt splenic injury transferred to a re-gional trauma center in a tertiary referral hospital between November 01, 2015, and September 30, 2020. The final study population consisted of 40 pediatric and adolescent patients with blunt splenic injuries. The patient demographics, mechanisms of injury, details of injuries, angiographic findings, embolization techniques, and technical and clinical outcomes, including spleen salvage rates and pro-cedure-related complications, were examined. RESULTS: Of the 40 pediatric and adolescent patients with blunt splenic injury, 17 underwent SAE (42.53%). The clinical success rate was 88.2% (15/17). No cases of embolization-related complications or clinical failure were observed. Spleen salvage after SAE was achieved in all patients. In addition, no statistically significant differences were observed in clinical outcomes (clinical success and spleen salvage rates) between low-grade (World Society of Emergency Surgery [WSES] spleen trauma classification I or II) and high-grade (WSES classification III or IV) splenic injury groups. CONCLUSION: SAE is a safe and feasible procedure, and is effective for successful spleen salvage of blunt splenic injuries in pediatric and adolescent patients.


Assuntos
Traumatismos Abdominais , Embolização Terapêutica , Ferimentos não Penetrantes , Humanos , Adolescente , Criança , Baço/lesões , Estudos Retrospectivos , Resultado do Tratamento , Artéria Esplênica/lesões , Escala de Gravidade do Ferimento , Embolização Terapêutica/métodos , Ferimentos não Penetrantes/diagnóstico por imagem , Ferimentos não Penetrantes/terapia , Traumatismos Abdominais/terapia
7.
Acute Crit Care ; 38(1): 95-103, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36935538

RESUMO

BACKGROUND: In patients with severe trauma, the diagnosis of acute kidney injury (AKI) is important because it is a predictive factor for poor prognosis and can affect patient care. The diagnosis and staging of AKI are based on change in serum creatinine (SCr) levels from baseline. However, baseline creatinine levels in patients with traumatic injuries are often unknown, making the diagnosis of AKI in trauma patients difficult. This study aimed to enhance the accuracy of AKI diagnosis in trauma patients by presenting an appropriate reference creatinine estimate (RCE). METHODS: We reviewed adult patients with severe trauma requiring intensive care unit admission between 2015 and 2019 (n=3,228) at a single regional trauma center in South Korea. AKI was diagnosed based on the current guideline published by the Kidney Disease: Improving Global Outcomes organization. AKI was determined using the following RCEs: estimated SCr75-modification of diet in renal disease (MDRD), trauma MDRD (TMDRD), admission creatinine level, and first-day creatinine nadir. We assessed inclusivity, prognostic ability, and incrementality using the different RCEs. RESULTS: The incidence of AKI varied from 15% to 46% according to the RCE used. The receiver operating characteristic curve of TMDRD used to predict mortality and the need for renal replacement therapy (RRT) had the highest value and was statistically significant (0.797, P<0.001; 0.890, P=0.002, respectively). In addition, the use of TMDRD resulted in a mortality prognostic ability and the need for RRT was incremental with AKI stage. CONCLUSIONS: In this study, TMDRD was feasible as a RCE, resulting in optimal post-traumatic AKI diagnosis and prognosis.

8.
Diagnostics (Basel) ; 13(21)2023 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-37958288

RESUMO

BACKGROUND: Transcatheter arterial embolization (TAE) is an established approach for controlling hemorrhage in adults with acute abdominal and pelvic trauma. However, its application in pediatric trauma is not well established. This study aimed to evaluate the safety and effectiveness of TAE in a population of pediatric patients with blunt trauma. METHODS: This retrospective study was conducted in pediatric patients (<18 years) who underwent TAE for blunt trauma between February 2014 and July 2022. The patients were categorized into subgroups based on age and body weight. Patient demographics, injury severity, transfusion requirements, and clinical outcomes were analyzed. RESULTS: Exactly 73 patients underwent TAE. Technical success was achieved in all patients (100%), and clinical success was achieved in 83.6%. The mortality and complication rates were 4.1% and 1.4%, respectively. The mean duration of hospitalization was 19.3 days. Subgroup analysis showed that age, body weight, and sex did not significantly affect clinical success. The injury severity score and transfusion requirement were predictors of clinical success, with lower values associated with better outcomes. CONCLUSIONS: TAE is effective and safe for managing blunt pediatric trauma in younger and lighter patients. Injury severity and transfusion requirement are predictors of clinical success.

9.
Clin Exp Emerg Med ; 10(4): 363-381, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38225778

RESUMO

Point-of-care ultrasound (POCUS) is a rapidly developing technology that has the potential to revolutionize emergency and critical care medicine. The use of POCUS can improve patient care by providing real-time clinical information. However, appropriate usage and proper training are crucial to ensure patient safety and reliability. This article discusses the various applications of POCUS in emergency and critical care medicine, the importance of training and education, and the future of POCUS in medicine.

10.
Surg Today ; 42(7): 670-5, 2012 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-22391981

RESUMO

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.


Assuntos
Carcinossarcoma/diagnóstico , Neoplasias da Vesícula Biliar/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Carcinossarcoma/patologia , Carcinossarcoma/cirurgia , Colecistectomia , Feminino , Neoplasias da Vesícula Biliar/patologia , Neoplasias da Vesícula Biliar/cirurgia , Humanos , Imuno-Histoquímica , Neoplasias Hepáticas/patologia , Neoplasias Hepáticas/cirurgia , Excisão de Linfonodo , Masculino , Invasividade Neoplásica
11.
Surg Today ; 42(4): 386-90, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22258729

RESUMO

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.


Assuntos
Neoplasias Gastrointestinais/patologia , Tumores do Estroma Gastrointestinal/patologia , Pâncreas/patologia , Neoplasias Gastrointestinais/cirurgia , Tumores do Estroma Gastrointestinal/cirurgia , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Dor Pós-Operatória , Pâncreas/cirurgia , Pancreatectomia , Proteínas Proto-Oncogênicas c-kit , Esplenectomia , Tomografia Computadorizada por Raios X
12.
Eur J Trauma Emerg Surg ; 48(3): 1929-1938, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33523237

RESUMO

BACKGROUND: While transarterial embolization (TAE) is an effective way to control arterial bleeding associated with pelvic fracture, the clinical outcomes according to door-to-embolization (DTE) time are unclear. This study investigated how DTE time affects outcomes in patients with severe pelvic fracture. METHODS: Using a trauma database between November 1, 2015 and December 31, 2019, trauma patients undergoing TAE were retrospectively reviewed. The final study population included 192 patients treated with TAE. The relationships between DTE time and patients' outcomes were evaluated. Multiple binomial logistic regression analyses, multiple linear regression analyses, and Cox hazard proportional regression analyses were performed to estimate the impacts of DTE time on clinical outcomes. RESULTS: The median DTE time was 150 min (interquartile range, 121-184). The mortality rates in the first 24 h and overall were 3.7% and 14.6%, respectively. DTE time served as an independent risk factor for mortality in the first 24 h (adjusted odds ratio = 2.00, 95% confidence interval [CI] = 1.20-3.34, p = 0.008). In Cox proportional hazards regression analyses, the adjusted hazard ratio of DTE time for mortality at 28 days was 1.24 (95% CI = 1.04-1.47, p = 0.014). In addition, there was a positive relationship between DTE time and requirement for packed red blood cell transfusion during the initial 24 h and a negative relationship between DTE time and ICU-free days to day 28. CONCLUSION: Shorter DTE time was associated with better survival in the first 24 h, as well as other clinical outcomes, in patients with complex pelvic fracture who underwent TAE. Efforts to minimize DTE time are recommended to improve the clinical outcomes in patients with pelvic fracture treated with TAE.


Assuntos
Embolização Terapêutica , Fraturas Ósseas , Ossos Pélvicos , Fraturas Ósseas/complicações , Hemorragia/complicações , Hemorragia/terapia , Humanos , Ossos Pélvicos/lesões , Estudos Retrospectivos , Resultado do Tratamento
13.
J Korean Med Sci ; 26(3): 332-8, 2011 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-21394299

RESUMO

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.


Assuntos
Hipersensibilidade/epidemiologia , População Rural , População Urbana , Criança , Estudos Transversais , Eczema/epidemiologia , Exantema/epidemiologia , Feminino , Humanos , Masculino , República da Coreia/epidemiologia , Sons Respiratórios , Instituições Acadêmicas , Distribuição por Sexo , Inquéritos e Questionários
14.
J Korean Med Sci ; 26(12): 1541-7, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-22147989

RESUMO

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.


Assuntos
Asma/epidemiologia , Índice de Massa Corporal , Exposição Ambiental , Características de Residência , Alérgenos , Composição Corporal , Criança , Estudos Transversais , Feminino , Fungos/imunologia , Humanos , Masculino , Animais de Estimação/imunologia , República da Coreia/epidemiologia , Inquéritos e Questionários , Poluição por Fumaça de Tabaco , Água
15.
Taehan Yongsang Uihakhoe Chi ; 82(4): 923-935, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36238056

RESUMO

Purpose: We aimed to assess the clinical efficacy of transcatheter arterial embolization (TAE) for treating hemothorax caused by chest trauma. Materials and Methods: Between 2015 and 2019, 68 patients (56 male; mean age, 58.2 years) were transferred to our interventional unit for selective TAE to treat thoracic bleeding. We retrospectively investigated their demographics, angiographic findings, embolization techniques, technical and clinical success rates, and complications. Results: Bleeding occurred mostly from the intercostal arteries (50%) and the internal mammary arteries (29.5%). Except one patient, TAE achieved technical success, defined as the immediate cessation of bleeding, in all the other patients. Four patients successfully underwent repeated TAE for delayed bleeding or increasing hematoma after the initial TAE. The clinical success rate, defined as no need for thoracotomy for hemostasis after TAE, was 92.6%. Five patients underwent post-embolization thoracotomy for hemostasis. No patient developed major TAE-related complications, such as cerebral infarction or quadriplegia. Conclusion: TAE is a safe, effective and minimally invasive method for controlling thoracic wall and intrathoracic systemic arterial hemorrhage after thoracic trauma. TAE may be considered for patients with hemothorax without other concomitant injuries which require emergency surgery, or those who undergoing emergency TAE for abdominal or pelvic hemostasis.

16.
Eur J Trauma Emerg Surg ; 47(6): 1661-1669, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32949247

RESUMO

INTRODUCTION: Transarterial embolisation (TAE) is an effective intervention for management of arterial haemorrhage associated with pelvic fracture. However, its effects on survival and clinical outcomes are unclear. METHODS: Trauma patients with survival data between November 2015 and December 2019 were identified using a trauma database. Patients were divided between TAE and non-TAE groups, and a propensity score was developed using multivariate logistic regression. Survival at 28 days was compared between the groups after propensity score matching. RESULTS: Among 881 patients included in this study, 308 (35.0%) were treated with TAE. After propensity score matching, 130 pairs were selected. Survival at 28 days was significantly higher among patients treated with TAE than among those treated without TAE [122 (93.9%) vs. 112 (86.2%); odds ratio = 2.45; 95% CI 1.02-5.86; p = 0.039]. CONCLUSIONS: TAE use was associated with improved survival at 28 days in patients with pelvic fracture and should therefore be considered in the management of severely injured patients with pelvic fracture.


Assuntos
Embolização Terapêutica , Fraturas Ósseas , Ossos Pélvicos , Fraturas Ósseas/terapia , Humanos , Pontuação de Propensão , Estudos Retrospectivos
17.
Plants (Basel) ; 10(12)2021 Dec 14.
Artigo em Inglês | MEDLINE | ID: mdl-34961230

RESUMO

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.

18.
Environ Sci Pollut Res Int ; 27(29): 37087-37098, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32577981

RESUMO

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.


Assuntos
Poluentes Atmosféricos/análise , Poluição do Ar em Ambientes Fechados/análise , Cidades , Monitoramento Ambiental , Humanos , Veículos Automotores , Material Particulado/análise , República da Coreia
19.
J Clin Med ; 10(1)2020 Dec 30.
Artigo em Inglês | MEDLINE | ID: mdl-33396842

RESUMO

It has been recognized that p-Coumaric acid (p-CA) has protective effects as an antioxidant, anti-inflammatory agent. A sensitive and efficient Liquid Chromatography-Mass Spectrometry (LC-MS) method for maximum determination of p-CA in human plasma has been established using Ultra-performance liquid Chromatography-tandem mass Spectrometry (UPLC-MS/MS). This study provides the developed analysis of p-CA extracted from Bambusae Caulis in Taeniam (BC) to examine the improvement of the treatment p-CA, IGF-1 and Osteocalcin level in human children which are important factors on the growth of children's height through Pharmacokinetics/Pharmacodynamics (PK/PD) model. p-CA and internal standard in a plasma sample were detected by the Multiple Reaction Monitoring (MRM) scan mode with positive ion detection. The sample participating in the study was made of 34 subjects (placebo = 18, treatment = 16). The subjects were enrolled to be randomized to the control group and BC group. Randomized subjects took tested treatment twice a day, three capsules with oral administration (258 mg/capsule) each time after a meal. Standard calibration curves (reproducibility) were constructed and the lower limit of quantitation (LLOQ) for p-CA was found to be 0.2 ng/mL on injection of the sample into the UPLC-MS/MS system. Accuracy and precision were evaluated and the intra-accuracy was 99.2-103.8% with precision of 1.0-5.6% and inter-accuracy was 99.6-108.4% and precision of 1.3-6.4% for p-CA. The method has been successfully applied to PK/PD studies of p-CA in human plasma. The p-CA, BC in Taeniam extract increased the level of IGF-1 and Osteocalcin, and changed the height from baseline, which suggested that the p-CA could play an important role in longitudinal bone growth. Therefore, the p-CA extracted from BC in Taeniam might be a good alternative medicine to growth hormone (GH) therapy.

20.
Artigo em Inglês | MEDLINE | ID: mdl-32183085

RESUMO

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.


Assuntos
Poluentes Atmosféricos , Poluição do Ar em Ambientes Fechados , Monitoramento Ambiental , Jardins , Material Particulado
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