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1.
Yonsei Medical Journal ; : 372-379, 2022.
Article in English | WPRIM | ID: wpr-927129

ABSTRACT

Purpose@#This study aimed to investigate burnout and resilience among emergency physicians (EPs) at university teaching hospitals during the coronavirus disease (COVID-19) pandemic. @*Materials and Methods@#In April to May 2021, a survey was administered to 331 and 309 emergency medicine specialists and residents, respectively, from 31 university teaching hospitals in Korea. Data on the respondents’ age, sex, designation, working area, experience with treating COVID-19 patients, and personal experience with COVID-19 were collected. Based on the participants’ characteristics, quality of life (compassion satisfaction, burnout, and secondary traumatic stress), resilience, emotional content, and self-image were analyzed. @*Results@#A total of 247 responses were analyzed. Compared to specialists, compassion satisfaction and resilience in residents were not good, burnout was severe, and emotional content and self-image were less positive. Experiences with treating COVID-19 patients did not cause any difference in quality of life, resilience, emotional content, and self-image among participant subgroups. Personal COVID-19 experiences were associated with poor compassion satisfaction, resilience, less positive emotional content and self-image, and severe burnout. Compassion satisfaction, secondary traumatic stress, and resilience can definitively affect burnout. @*Conclusion@#The quality of life and resilience of EPs in university teaching hospitals in Korea during the COVID-19 pandemic have been low. Supportive measures to improve resilience can prevent burnout among emergency staff, particularly residents and EPs, with personal experiences related to COVID-19.

2.
Article in English | WPRIM | ID: wpr-892725

ABSTRACT

Background/Aims@#Although prolonged post-operative ileus (PPOI) is an important factor for the prolonged length of post-operative hospital stay, there is still a lack of effective predictive and therapeutic methods for PPOI. Previous studies reported that increased inflammatory markers, such as C-reactive protein (CRP) level and neutrophil to lymphocyte ratio (NLR), are associated with malignancies. The aim of our study is to elucidate the association between peri-operative inflammatory markers and PPOI after gastrectomy for gastric cancer. @*Methods@#We enrolled patients who received gastrectomy for gastric cancer from June 2013 to January 2016 at a single tertiary referral center in Seoul, Korea. We evaluated peri-operative inflammatory markers, including CRP level, NLR, and platelet to lymphocyte ratio (PLR) of enrolled patients. We compared these data between control group and PPOI group. @*Results@#A total of 390 subjects were enrolled in this study, and 132 patients (33.8%) showed PPOI. In univariate analysis, preoperative CRP level and NLR, post-operative day (POD) 1 CRP level, NLR, and PLR, and POD3 CRP level, NLR, and PLR were significantly associated with PPOI. In multivariate analysis, preoperative NLR (P = 0.014), POD1 NLR (P = 0.019), POD3 CRP (P = 0.004), and POD3 NLR (P = 0.008) were independent risk factors for PPOI. @*Conclusions@#Peri-operative inflammatory markers, such as CRP level and NLR, are useful predictive factors for PPOI who received gastrectomy for gastric cancer. Moreover, prophylactic antibiotics and anti-inflammatory drugs can be preventive and therapeutic agents for PPOI.

3.
Article in English | WPRIM | ID: wpr-892719

ABSTRACT

Background/Aims@#The aim of this study is to identify the alteration in intestinal permeability with regard to the development of post-operative ileus (POI).Moreover, we investigated drug repositioning in the treatment of POI. @*Methods@#An experimental POI model was developed using guinea pigs. To measure intestinal permeability, harvested intestinal membranes of the ileum and proximal colon was used in an Ussing chamber. To identify the mechanisms associated with altered permeability, we measured leukocyte count and expression of calprotectin, claudin-1, claudin-2, and mast cell tryptase. We compared control, POI, and drug groups (mosapride [0.3 mg/kg and 1 mg/kg, orally], glutamine [500 mg/kg, orally], or ketotifen [1 mg/kg, orally] with regard to these parameters. @*Results@#Increased permeability after surgery significantly decreased after administration of mosapride, glutamine, or ketotifen. Leukocyte counts increased in the POI group and decreased significantly after administration of mosapride (0.3 mg/kg) in the ileum, and mosapride (0.3 mg/kg and 1 mg/kg), glutamine, or ketotifen in the proximal colon. Increased expression of calprotectin after surgery decreased after administration of mosapride (0.3 mg/kg), glutamine, or ketotifen in the ileum and proximal colon, and mosapride (1 mg/kg) in the ileum. The expression of claudin-1 decreased significantly and that of claudin-2 increased after operation. After administration of glutamine, the expression of both proteins was restored. Finally, mast cell tryptase levels increased in the POI group and decreased significantly after administration of ketotifen. @*Conclusions@#The alteration in intestinal permeability is one of the factors involved in the pathogenesis of POI. We repositioned 3 drugs (mosapride, glutamine, and ketotifen) as novel therapeutic agents for POI.

4.
Immune Network ; : e1-2021.
Article in English | WPRIM | ID: wpr-874614

ABSTRACT

The emergence of a new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has become a significant health concern worldwide. Undoubtedly, a better understanding of the innate and adaptive immune responses against SARS-CoV-2 and its relationship with the coronavirus disease 2019 (COVID-19) pathogenesis will be the sole basis for developing and applying therapeutics. This review will summarize the published results that relate to innate immune responses against infections with human coronaviruses including SARS-CoV-1 and SARS-CoV-2 in both humans and animal models. The topics encompass the innate immune sensing of the virus to the dysregulation of various innate immune cells during infection and disease progression.

5.
Article in English | WPRIM | ID: wpr-900429

ABSTRACT

Background/Aims@#Although prolonged post-operative ileus (PPOI) is an important factor for the prolonged length of post-operative hospital stay, there is still a lack of effective predictive and therapeutic methods for PPOI. Previous studies reported that increased inflammatory markers, such as C-reactive protein (CRP) level and neutrophil to lymphocyte ratio (NLR), are associated with malignancies. The aim of our study is to elucidate the association between peri-operative inflammatory markers and PPOI after gastrectomy for gastric cancer. @*Methods@#We enrolled patients who received gastrectomy for gastric cancer from June 2013 to January 2016 at a single tertiary referral center in Seoul, Korea. We evaluated peri-operative inflammatory markers, including CRP level, NLR, and platelet to lymphocyte ratio (PLR) of enrolled patients. We compared these data between control group and PPOI group. @*Results@#A total of 390 subjects were enrolled in this study, and 132 patients (33.8%) showed PPOI. In univariate analysis, preoperative CRP level and NLR, post-operative day (POD) 1 CRP level, NLR, and PLR, and POD3 CRP level, NLR, and PLR were significantly associated with PPOI. In multivariate analysis, preoperative NLR (P = 0.014), POD1 NLR (P = 0.019), POD3 CRP (P = 0.004), and POD3 NLR (P = 0.008) were independent risk factors for PPOI. @*Conclusions@#Peri-operative inflammatory markers, such as CRP level and NLR, are useful predictive factors for PPOI who received gastrectomy for gastric cancer. Moreover, prophylactic antibiotics and anti-inflammatory drugs can be preventive and therapeutic agents for PPOI.

6.
Article in English | WPRIM | ID: wpr-900423

ABSTRACT

Background/Aims@#The aim of this study is to identify the alteration in intestinal permeability with regard to the development of post-operative ileus (POI).Moreover, we investigated drug repositioning in the treatment of POI. @*Methods@#An experimental POI model was developed using guinea pigs. To measure intestinal permeability, harvested intestinal membranes of the ileum and proximal colon was used in an Ussing chamber. To identify the mechanisms associated with altered permeability, we measured leukocyte count and expression of calprotectin, claudin-1, claudin-2, and mast cell tryptase. We compared control, POI, and drug groups (mosapride [0.3 mg/kg and 1 mg/kg, orally], glutamine [500 mg/kg, orally], or ketotifen [1 mg/kg, orally] with regard to these parameters. @*Results@#Increased permeability after surgery significantly decreased after administration of mosapride, glutamine, or ketotifen. Leukocyte counts increased in the POI group and decreased significantly after administration of mosapride (0.3 mg/kg) in the ileum, and mosapride (0.3 mg/kg and 1 mg/kg), glutamine, or ketotifen in the proximal colon. Increased expression of calprotectin after surgery decreased after administration of mosapride (0.3 mg/kg), glutamine, or ketotifen in the ileum and proximal colon, and mosapride (1 mg/kg) in the ileum. The expression of claudin-1 decreased significantly and that of claudin-2 increased after operation. After administration of glutamine, the expression of both proteins was restored. Finally, mast cell tryptase levels increased in the POI group and decreased significantly after administration of ketotifen. @*Conclusions@#The alteration in intestinal permeability is one of the factors involved in the pathogenesis of POI. We repositioned 3 drugs (mosapride, glutamine, and ketotifen) as novel therapeutic agents for POI.

7.
Article in English | WPRIM | ID: wpr-922116

ABSTRACT

OBJECTIVE@#To determine the effect of Zanthoxylum piperitum extracet (ZPE) on apoptosis and analyze anticancer substances in ZPE, changes in proteins related to apoptosis, and pathological changes in tumors in mouse.@*METHODS@#Fifteen 4-week-old female BALB/c nu/nu mice were divided into 3 groups depending on ZPE dose, with 5 in each group. AGS gastric carcinoma cells (1 × 10@*RESULTS@#High performance liquid chromatography (HPLC) analysis showed that ZPE contained organic sulfur compounds such as alliin and S-allylcysteine. MTT assay results revealed that ZPE (10-85 µ g/mL) could effectively inhibit the growth of AGS gastric cancer cells at higher concentrations (P<0.05, P<0.01). The annexin V & dead cell staining assay and cell cycle arrest assay confirmed a dose-dependent increase in the apoptosis rate and G@*CONCLUSION@#ZPE decreases AGS cell proliferation and induces apoptosis by inhibiting Akt and MDM2 expression.


Subject(s)
Animals , Apoptosis , Cell Line, Tumor , Cell Proliferation , Female , Mice , Mice, Inbred BALB C , Plant Extracts/therapeutic use , Proto-Oncogene Proteins c-akt/metabolism , Signal Transduction , Stomach Neoplasms/drug therapy , Tumor Suppressor Protein p53/metabolism , Zanthoxylum/metabolism
8.
Kosin Medical Journal ; : 100-108, 2021.
Article in English | WPRIM | ID: wpr-918390

ABSTRACT

Objectives@#Given that cardiopulmonary resuscitation (CPR) is an aerosol-generating procedure, it is necessary to use a mechanical ventilator and reduce the number of providers involved in resuscitation for in-hospital cardiac arrest in coronavirus disease (COVID-19) patients or suspected COVID-19 patients. However, no study assessed the effect of changes in inspiratory time on flowrate and airway pressure during CPR. We herein aimed to determine changes in these parameters during CPR and identify appropriate ventilator management for adults during CPR. @*Methods@#We measured changes in tidal volume (Vt), peak inspiratory flow rate (PIFR), peak airway pressure (Ppeak), mean airway pressure (Pmean) according to changes in inspiratory time (0.75 s, 1.0 s and 1.5 s) with or without CPR. Vt of 500 mL was supplied (flowrate: 10 times/min) using a mechanical ventilator. Chest compressions were maintained at constant compression depth (53 ± 2 mm) and speed (102 ± 2/min) using a mechanical chest compression device. @*Results@#Median levels of respiratory physiological parameters during CPR were significantly different according to the inspiratory time (0.75 s vs. 1.5 s): PIFR (80.8 [73.3 – 87.325] vs. 70.5 [67 – 72.4] L/min, P < 0.001), Ppeak (54 [48 – 59] vs. 47 [45 – 49] cmH2O, P < 0.001), and Pmean (3.9 [3.6 – 4.1] vs. 5.7 [5.6 – 5.8] cmH2O, P < 0.001). @*Conclusions@#Changes in PIFR, Ppeak, and Pmean were associated with inspiratory time. PIFR and Ppeak values tended to decrease with increase in inspiratory time, while Pmean showed a contrasting trend. Increased inspiratory time in low-compliance cardiac arrest patients will help in reducing lung injury during adult CPR.

9.
Article | WPRIM | ID: wpr-836055

ABSTRACT

Two trials involving proficiency tests for complete blood counts (CBCs) and blood cell morphology were conducted as part of the 2019 Routine Hematology Program of the Korean Association of External Quality Assessment Service. Three different control samples were subjected to CBC testing, and two blood cell morphology images were posted on the laboratory’s website during each trial. The mean response rates of the 1,791 participating laboratories were 97.2% and 34.9% for CBC and blood cell morphology, respectively. The distribution of equipment for CBC testing was comparable to that in 2018. The coefficient of variation (CV) ranges were 2.9%–4.1%, 1.6%–2.4%, 1.4%–2.8%, 4.7%–5.3%, and 4.8%–7.3% for white blood cell counts, red blood cell counts, hemoglobin, hematocrit, and platelet counts, respectively. The concordance rate ranged from 83.5% to 99.7% in the blood cell morphology tests. In 2019, the number of participating laboratories was higher than that in 2018, and the CVs of CBC results were similar to those in 2018.

10.
Article | WPRIM | ID: wpr-834548

ABSTRACT

Background@#Immunomodulatory therapies targeting the interaction between programmed cell death protein 1 and programmed death-ligand 1 (PD-L1) have become increasingly important in anticancer treatment. Previous research on the subject of this immune response has established an association with tumor aggressiveness and a poor prognosis in certain cancers. Currently, scant information is available on the relationship between PD-L1 expression and gallbladder cancer (GBC). @*Methods@#We investigated the expression of PD-L1 in 101 primary GBC cases to determine the potential association with prognostic impact. PD-L1 expression was immunohistochemically assessed using a single PD-L1 antibody (clone SP263). Correlations with clinicopathological parameters, overall survival (OS), or progression- free survival (PFS) were analyzed. @*Results@#PD-L1 expression in tumor cells at cutoff levels of 1%, 10%, and 50% was present in 18.8%, 13.8%, and 7.9% of cases. Our study showed that positive PD-L1 expression at any cutoff was significantly correlated with poorly differentiated histologic grade and the presence of lymphovascular invasion (p < .05). PD-L1 expression at cutoff levels of 10% and 50% was significantly positive in patients with perineural invasion, higher T categories, and higher pathologic stages (p < .05). Additionally, there was a significant association noted between PD-L1 expression at a cutoff level of 50% and worse OS or PFS (p = .049 for OS, p = .028 for PFS). Other poor prognostic factors included histologic grade, T category, N category, pathologic stage, lymphovascular invasion, perineural invasion, growth pattern, and margin of resection (p < .05). @*Conclusions@#The expression of PD-L1 in GBC varies according to cutoff level but is valuably associated with poor prognostic parameters and survival. Our study indicates that the overexpression of PD-L1 in GBC had a negative prognostic impact.

11.
Article | WPRIM | ID: wpr-834542

ABSTRACT

Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma), is one of the specific type of low-grade B-cell lymphoma not infrequently found worldwide. It typically involves mucosal sites such as stomach and conjunctiva; however, primary hepatic MALT lymphoma has been extremely rarely reported. We describe a case of hepatic MALT lymphoma in a 70-year-old male patient who underwent left hepatectomy due to the incidentally detected liver masses at a medical checkup. The resected specimen revealed multinodular masses consisting of small-to-intermediate-sized lymphoid cells with serpentine pattern and focal lymphoepithelial lesions. The tumor cells were diffusely positive for CD20 and Bcl-2 but negative for CD3, CD10, CD5, CD23, CD43, and cyclinD1. The Ki-67 labeling index was 10% and immunoglobulin heavy chain gene rearrangement study confirmed monoclonal proliferation. In this paper, we discuss several unique clinicopathologic characteristics which will be helpful to the differential diagnosis of hepatic MALT lymphoma.

12.
Article | WPRIM | ID: wpr-831196

ABSTRACT

Pseudohypoaldosteronism type 1 (PHA1) is a rare salt-wasting disorder caused byresistance to mineralocorticoid action. PHA1 is of two types with different levelsof disease severity and phenotype as follows: systemic type with an autosomalrecessiveinheritance (caused by mutations of the epithelial sodium channel)and renal type with an autosomal dominant inheritance (caused by mutations inthe mineralocorticoid receptor). The clinical manifestations of PHA1 vary widely;however,PHA1 commonly involves hyponatremia, hyperkalemia, metabolicacidosis and elevated levels of renin and aldosterone. The earliest signs of bothtype of PAH1 also comprise insufficiency weight gain due to chronic dehydrationand failure to thrive during infancy. Here, we report a case of renal PAH1 in a28-day-old male infant harboring a novel heterozygous mutation in NR3C2 gene(c.1341_1345dupAAACC in exon 2), showing only failure to thrive without thecharacteristic of dehydration.

13.
Article in English | WPRIM | ID: wpr-891571

ABSTRACT

Purpose@#The Korea Medical Licensing Exam (KMLE) typically contains a large number of items. The purpose of this study was to investigate whether there is a difference in the cut score between evaluating all items of the exam and evaluating only some items when conducting standard-setting. @*Methods@#We divided the item sets that appeared on 3 recent KMLEs for the past 3 years into 4 subsets of each year of 25% each based on their item content categories, discrimination index, and difficulty index. The entire panel of 15 members assessed all the items (360 items, 100%) of the year 2017. In split-half set 1, each item set contained 184 (51%) items of year 2018 and each set from split-half set 2 contained 182 (51%) items of the year 2019 using the same method. We used the modified Angoff, modified Ebel, and Hofstee methods in the standard-setting process. @*Results@#Less than a 1% cut score difference was observed when the same method was used to stratify item subsets containing 25%, 51%, or 100% of the entire set. When rating fewer items, higher rater reliability was observed. @*Conclusion@#When the entire item set was divided into equivalent subsets, assessing the exam using a portion of the item set (90 out of 360 items) yielded similar cut scores to those derived using the entire item set. There was a higher correlation between panelists’ individual assessments and the overall assessments.

14.
Article in English | WPRIM | ID: wpr-899275

ABSTRACT

Purpose@#The Korea Medical Licensing Exam (KMLE) typically contains a large number of items. The purpose of this study was to investigate whether there is a difference in the cut score between evaluating all items of the exam and evaluating only some items when conducting standard-setting. @*Methods@#We divided the item sets that appeared on 3 recent KMLEs for the past 3 years into 4 subsets of each year of 25% each based on their item content categories, discrimination index, and difficulty index. The entire panel of 15 members assessed all the items (360 items, 100%) of the year 2017. In split-half set 1, each item set contained 184 (51%) items of year 2018 and each set from split-half set 2 contained 182 (51%) items of the year 2019 using the same method. We used the modified Angoff, modified Ebel, and Hofstee methods in the standard-setting process. @*Results@#Less than a 1% cut score difference was observed when the same method was used to stratify item subsets containing 25%, 51%, or 100% of the entire set. When rating fewer items, higher rater reliability was observed. @*Conclusion@#When the entire item set was divided into equivalent subsets, assessing the exam using a portion of the item set (90 out of 360 items) yielded similar cut scores to those derived using the entire item set. There was a higher correlation between panelists’ individual assessments and the overall assessments.

15.
Article in Korean | WPRIM | ID: wpr-913294

ABSTRACT

Atopic dermatitis (AD) is a chronically relapsing inflammatory disorder of the skin. It is characterized by severe pruritus, sleep disturbance, and poor quality of life. In addition, AD frequently occurs in childhood and is considered the first manifestation of atopic march, which progresses into respiratory allergic diseases, such as asthma and allergic rhinitis, as the patient grow older. In this regard, the early diagnosis and active treatment of AD are required to lower the severity of disease and to prevent the development of atopic march. The proper management of AD includes avoidance of aggravating factors, barrier repair by skin care, and control of inflammation and infection with appropriate medications. Among them, identification and elimination of environmental risk factors responsible for worsening skin symptoms are essential. They include temperature, humidity, food and inhalant allergens, microorganisms, air pollutants, ultraviolet radiation, water hardness, and so forth. In particular, there is growing concern about indoor environment because time spent indoors and exposure to various kinds of pollutants is increasing with modernization and industrialization. In this review, we summarize the hazardous effect of temperature, humidity, cigarette smoke, volatile organic compounds, formaldehyde, and phthalates on the development or aggravation of AD. Current epidemiological studies and animal experiments suggest possible contributions of various indoor environmental factors to the development and aggravation of AD. However, further studies are needed to demonstrate a causal relationship between indoor environmental factors and AD.

16.
Article in Korean | WPRIM | ID: wpr-764758

ABSTRACT

PURPOSE: To find progression and prognosis of pancreatitis developed in massive burn patients through retrospective analysis. METHODS: A retrospective study was conducted on 32 patients with abnormal increase of serum lipase level among 2523 acute burn patients admitted to our burn center from January 1, 2017 to June 30, 2018. Pancreatitis in this study was defined as a serum lipase concentration level that is higher than 180 IU/L which is three times more than the normal level (less than 60 IU/L). In this study, a retrospective analysis was performed on patients with serum lipase level higher than 300 IU/L to better understand causality of burns and pancreatitis. RESULTS: 32 patients (1.27%) had serum lipase level higher than 180 IU/L among 2523 acute burn subjects. And 13 patients (0.52%) of these 32 patients had serum lipase level elevated more than 300 IU/L. The study indicated serum lipase level was increased around 7 days after the injury. It returned to normal level early as after 1 to 2 weeks and late as after 4 to 6 weeks of injury. The serum amylase level was increased as similar modality as to the serum lipase level increase. The serum bilirubin, AST, ALT, LD, and GGT were also observed to be elevated when serum lipase was more than 1000 IU/L. CONCLUSION: The pancreatitis developed in burn patients are mostly as mild symptom. It could due to the ischemic injury and can easily be treated by a temporary fasting, TPN, and Gabexate intravenous injection.


Subject(s)
Amylases , Bilirubin , Burn Units , Burns , Fasting , Gabexate , Humans , Injections, Intravenous , Lipase , Pancreatitis , Prognosis , Retrospective Studies
17.
Article in Korean | WPRIM | ID: wpr-741144

ABSTRACT

Two trials were conducted with proficiency tests for complete blood cell count (CBC) and blood cell morphology as part of the 2018 Routine Hematology Program of the Korean Association of External Quality Assessment Service. Three different control samples were sent for CBC testing and two blood cell morphology pictures were posted on the laboratory website during each trial. The mean response rates of the 1,719 participating laboratories were 97.4% and 37.2% for CBC and blood cell morphology, respectively. The distribution of equipment for CBC testing was comparable to that of the previous year. The coefficient of variation (CV) ranges were determined as 3.5%–4.1%, 1.9%–2.7%, 1.4%–2.8%, 4.5%–5.3%, and 5.4%–6.9% for white blood cell counts, red blood cell counts, hemoglobin, hematocrit, and platelet counts, respectively. The concordance rate ranged from 83.0% to 97.5% in blood cell morphology tests. We observed a continuous increase in the number of participating laboratories and a trend towards a decrease in the CVs of platelet counts compared to those in 2016. Values of the other assessed parameters were similar to those of the previous year.


Subject(s)
Blood Cell Count , Blood Cells , Erythrocyte Count , Hematocrit , Hematology , Laboratory Proficiency Testing , Leukocyte Count , Platelet Count
18.
Article in English | WPRIM | ID: wpr-762797

ABSTRACT

BACKGROUND: Absorbable plates are widely used in open reduction and internal fixation surgeries for facial bone fractures. Absorbable plates are made of polyglycolic acid (PGA), polylactic acid (PLA), polydioxane (PDS), or various combinations of these polymers. The degradation patterns of absorbable plates made from different polymers and clinical courses of patients treated with such plates have not been fully identified. This study aimed to confirm the clinical courses of facial bone fracture patients using absorbable plates and compare the degradation patterns of the plates. METHODS: A retrospective chart review was conducted for 47 cases in 46 patients who underwent open reduction and internal fixation surgery using absorbable plates to repair facial bone fractures. All surgeries used either PLA/PGA composite-based or poly-L-lactic acid (PLLA)/hydroxyapatite (HA) composite-based absorbable plates and screws. Clinical courses were confirmed and comparisons were conducted based on direct observation. RESULTS: There were no naturally occurring foreign body reactions. Post-traumatic inflammatory responses occurred in eight patients (nine cases), in which six recovered naturally with conservative treatment. The absorbable plates were removed from two patients. PLA/PGA composite-based absorbable plates degraded into fragments with non-uniform, sharp surfaces whereas PLLA/HA composite-based absorbable plates degraded into a soft powder. CONCLUSION: PLA/PGA composite-based and PLLA/HA composite-based absorbable plates showed no naturally occurring foreign body reactions and showed different degradation patterns. The absorbable plate used for facial bone fracture surgery needs to be selected in consideration of its degradation patterns.


Subject(s)
Absorbable Implants , Bone Plates , Facial Bones , Foreign Bodies , Humans , Hydroxyapatites , Polyglycolic Acid , Polymers , Retrospective Studies
20.
Article in Korean | WPRIM | ID: wpr-916473

ABSTRACT

PURPOSE@#Acute carbon monoxide (CO) poisoning is one of the most common types of poisoning and a major health problem worldwide. Treatment options are limited to normobaric oxygen therapy, administered using a non-rebreather face mask or hyperbaric oxygen. Compared to conventional oxygen therapy, high-flow nasal cannula oxygen (HFNC) creates a positive pressure effect through high-flow rates. The purpose of this human pilot study is to determine the effects of HFNC on the rate of CO clearance from the blood, in patients with mild to moderate CO poisoning.@*METHODS@#CO-poisoned patients were administered 100% oxygen from HFNC (flow of 60 L/min). The fraction of COHb (fCOHb) was measured at 30-min intervals until it decreased to under 10%, and the half-life time of fCOHb (fCOHb t(1/2)) was subsequently determined.@*RESULTS@#At the time of ED arrival, a total of 10 patients had fCOHb levels ≥10%, with 4 patients ranging between 10% and 50%. The mean rate of fCOHb elimination patterns exhibits logarithmic growth curves that initially increase quickly with time (HFNC equation, Y=0.3388*X+11.67). The mean fCOHbt1/2 in the HFNC group was determined to be 48.5±12.4 minutes.@*CONCLUSION@#In patients with mild to moderate CO poisoning, oxygen delivered via high flow nasal cannula is a safe and comfortable method to treat acute CO toxicity, and is effective in reducing the COHb half-life. Our results indicate HFNC to be a promising alternative method of delivering oxygen for CO toxicity. Validating the effectiveness of this method will require larger studies with clinical outcomes.

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