Metastatic intestinal adenocarcinoma with osseous metaplasia in two Domestic Korean Shorthair cats

Two Domestic Korean Shorthair cats presented with dyschezia and vomiting. Computed tomography revealed a colonic mass with calcification and lymph node metastasis in case 1, and a small intestinal mass with disseminated mesenteric metastasis and calcification in case 2. Histopathology revealed intestinal adenocarcinoma with osseous metaplasia. Case 1 died two months after surgery from distant metastasis; and case 2 showed no metastasis for five months but presented with anorexia, euthanized seven months after diagnosis. Metastatic intestinal adenocarcinoma with bone formation should be considered as differential diagnosis for calcification on imaging, and lymph node metastasis at diagnosis may indicate poor prognosis.

A nationwide study of the emergency department utilization rates according to season, day of the week, time of the day, region, and type of emergency department

OBJECTIVE: The mismatch in the demand and supply of emergency medical resources has been a constant issue in Korean emergency departments (EDs). This study analyzed the characteristics and actual utilization of medical bed resources in these EDs. METHODS: The emergency department utilization (EDU) rate was calculated using the Emergency Medical Resource Information System (EMRIS) on the available beds in EDs from April 2014 to January 2015. The EDU rate was analyzed according to the season, day of the week, time of day, and ED type. Furthermore, the ratio between the maximum and minimum EDU rates was also compared between the regions. RESULTS: A total of 14,889,750 data points were included. The EDU rate was relatively high during winter and on Sundays, and was highest between 20:00 and 22:00. The ratio between the maximum and minimum EDU rates according to the time of day was highest in Gyeongbuk (5.4) and lowest in Daegu (1.4). Moreover, the EDU rate according to the ED type was highest in the regional emergency medical center (66.7%). CONCLUSION: Significant differences were observed in the EDU rates according to the season, day of the week, time of the day, region, and ED type. Therefore, EMRIS should allocate resources based on the data on both the hospital and regional characteristics.

Alendronate-Anionic Clay Nanohybrid for Enhanced Osteogenic Proliferation and Differentiation

BACKGROUND: Alendronate (AL), a drug for inhibiting osteoclast-mediated bone-resorption, was intercalated into an inorganic drug delivery nanovehicle, layered double hydroxide (LDH), to form a new nanohybrid, AL-LDH, with 1:1 heterostructure along the crystallographic C-axis. Based on the intercalation reaction strategy, the present AL-LDH drug delivery system (DDS) was realized with an enhanced drug efficacy of AL, which was confirmed by the improved proliferation and osteogenic differentiation of osteoblast-like cells (MG63). METHODS: The AL-LDH nanohybrid was synthesized by conventional ion-exchange reaction and characterized by powder X-ray diffraction (PXRD), high-resolution transmission electron microscopy (HR-TEM), and Fourier transform infrared (FT-IR) spectroscopy. Additionally, in vitro efficacy tests, such as cell proliferation and alkaline phosphatase (ALP) activity, were analyzed. RESULTS: The AL was successfully intercalated into LDH via ion-exchange reaction, and thus prepared AL-LDH DDS was X-ray single phasic and chemically well defined. The accumulated AL content in MG63 cells treated with the AL-LDH DDS nanoparticles was determined to be 10.6-fold higher than that within those treated with the intact AL after incubation for 1 hour, suggesting that intercellular permeation of AL was facilitated thanks to the hybridization with drug delivery vehicle, LDH. Furthermore, both in vitro proliferation level and ALP activity of MG63 treated with the present hybrid drug, AL-LDH, were found to be much more enhanced than those treated with the intact AL. This is surely due to the fact that LDH could deliver AL drug very efficiently, although LDH itself does not show any effect on proliferation and osteogenic differentiation of MG63 cells. CONCLUSION: The present AL-LDH could be considered as a promising DDS for improving efficacy of AL.

Performance of Three Scoring Systems in Predicting Massive Transfusion in Patients with Unstable Upper Gastrointestinal Hemorrhage

PURPOSE: After trauma and surgery, upper gastrointestinal bleeding (UGIB) is the most common condition that can require massive transfusion (MT). The present study aimed to analyze and compare the prognostic performance of the Glasgow-Blatchford (GB), pre-endoscopy Rockall (PER), and modified early warning (MEW) scores for predicting MT in patients with unstable UGIB. MATERIALS AND METHODS: This retrospective observational study included patients with UGIB from March 2016 to February 2018. Receiver operating characteristics analysis was performed to examine the prognostic performance of the GB, PER, and MEW scoring systems. Logistic regression analysis was used to identify independent risk factors for MT, after adjusting for relevant covariates. The primary outcome was MT. RESULTS: Of the 484 included patients with unstable UGIB, 19 (3.9%) received an MT. The areas under the curves (AUCs) of the GB, PER, and MEW scores for MT were 0.577 [95% confidence interval (CI), 0.531–0.621], 0.570 (95% CI, 0.525–0.615), and 0.767 (95% CI, 0.727–0.804), respectively. The AUC of the MEW score was significantly different from those of the GB and PER scores. In multivariate analysis, MEW score was independently associated with MT in patients with unstable UGIB (odds ratio, 1.495; 95% CI, 1.100–2.033; p=0.010). CONCLUSION: In unstable UGIB patients, MEW score had the best prognostic performance for MT among three scoring systems.

Assessment Using the ICF-core set for Children and Youth with Cerebral Palsy: A Single Case Study

PURPOSE: This study evaluated the usefulness of International Classification of Functioning, disability and health core set for children and youths with cerebral palsy (ICF-core set for CP) by comparing the Gross Motor Function Measure-88 (GMFM-88), which is the most widely used outcome measure in children with cerebral palsy (ICF-core set for CP). METHODS: One subject (Female, 14) was evaluated by GMFM-88 and ICF-core set for CP. In addition, the concept of GMFM-88 was compared with the concept of the ICF-core set for CP in compliance with ICF linking rules. The numerical values both of the GMFM-88 categories and the ICF-core set for CP's items were compared. RESULTS: The ICF b760 was linked to the GMFM-88 59~61. d415 was linked to 57~58 of GMFM-88. d450 was linked to GMFM-88's 65~72. d455 was linked to GMFM-88 at 77and 80~83. CONCLUSION: The association of the ICF-core set for CP and GMFM-88 was confirmed. In addition, the number of categories of ICF-core set for CP was smaller than the number of items of GMFM-88. In conclusion, the ICF-core set for CP is an evaluation tool that can identify the various features of children. In addition, GMFM-88 was linked to the ICF core set for CP according to the ICF linking rules.