Analysis of Factors Influencing the Severity of Cultivator-Related Trauma patients and Correlation between these Factors

PURPOSE: Rural areas of Korea are already aged societies, and the victims of trauma in these areas are increasingly associated with an elderly demographic and farm equipment use. In addition, rural medical services are often not well supported. The purpose of this study was to evaluate the factors that influence the severity and prognosis of cultivator-related trauma, and the correlations between these factors. METHODS: We retrospectively analyzed patients who visited the Chonnam National University Hospital emergence center due to cultivator-related trauma, from January 2006 to December 2010. The injury severity of these patients was analyzed according to the injury severity score (ISS), the revised trauma score (RTS), the new injury severity score (NISS) and the trauma score and injury severity score (TRISS). RESULTS: A total of 376 cases, 322 male and 54 female, of cultivator-related trauma were reviewed. Patient ages ranged from 25 to 85 years (median, 57 years). Patients were divided into two age groups, those older than 65-years of age and those younger than 65. The primary causes of traumatic injury were falling down (57.2%), and vehicle overturning (16.5%). The site most frequently injured was the chest (35.1%). Rate of acute complication was 29.8% and operation was required in 41% of cases. The average ISS was 9.0 (median range [quartile], 4-16). ISS, NISS, RTS and TRISS were statistically correlated with the mechanism of injury, site of injury, and mortality and complication rates. In particular, TRISS was significantly lower in cultivator-related trauma for those older than 65-years of age. CONCLUSION: Among the severity indexes in assessing cultivator-related trauma, TRISS is helpful in assigning severity and predictable index in older, rural patients. However, this result is not representative of all possible cultivator-related traumas. A new statistical model is necessary to accurately analyze the severity and mortality in cases of cultivator-related trauma.

The Effect of Anti-Sperm Antibodies on Conventional IVF and Intracytoplasmic Sperm Injection (ICSI) / 대한불임학회지

The purpose of this study was to examine the effects of anti-sperm antibody (ASA) on the fertilization processes using conventional IVF and ICSI procedure in human and hamster oocytes. In human IVF, we have observed restricted fertilization with sperm testing positive for ASA. (23~90% IgA, 60-97 % IgG). However, if ICSI was perform in the next IVF cycle with the same patients, we could successfully fertilize the oocytes (37%; p<0.001), thus achieving pregnancy and delivery. When the sperm were cocultured in medium containing ASA, there were binding of ASA to sperm surface. In addition, the mean rate of the acrosomal reaction in an in vitro acrosome reaction test was lower for Ab-bound sperm (43.5%) than for Ab-free sperm group (51.3%, p<0.05). We used human sperm and hamster oocytes to confirm the negative effects of the ASA on fertilization. The sperm and/or oocytes have been expose to medium containing ASA before IVF and ICSI. In this experiment, the ASA was bound to the oocyte and sperm surface. The following results were obtain by using various combinations of ASA free or ASA bound sperm with ASA free or ASA bound oocytes for IVF. When ASA free sperm were inseminate with ASA free and ASA bound hamster oocytes, the fertilization rates are 89.6% and 74.3% respectively. However, when ASA bound human sperm were use the results were 62.5% and 55.6% respectively. These shows the fertilization rate was significantly decreased in both ASA bound and ASA free oocytes when using ASA bound sperm. No difference found when ASA are present on the oocyte surface. When the hamster oocytes was treated by ICSI with ASA free or ASA bound human spermatozoa, no significant difference was found. These results showed that ICSI is the most promising method for couples who fertilization was not possible by conventional IVF because of ASA.

Self - Expanding EsophaCoilTM Esophageal Prosthesis for Malignant Esophageal Stenosis / 대한소화기내시경학회지

Endoscopic endoprosthesis is well established as a cheap, fast and durable procedure for palliation of malignant dysphagia. But the placement of conventional endoprosthesis is difficult and is associated with significant complications such as hemorrhage, perforation and dysfunction of the prosthesis. Recently, self -expand- able metal prosthesis have also been utilized for malignant esophageal stenosis, and palliation of this modality seems to be more effective than other modalities. However the main problems with these metal stents are tumor ingrowth leading to reobstruction, migration, and eophageal trauma by the distal, hard skirt of the stent. EsophaCoil stent is a simple coil with close loops made from a single flat wire of nickel titanium alloy. The radial force of this material is much stronger than stainless steel, expansion time is faster and the stent is able to dilate even extremely resistant strictures. This new metalic stent seems to have several advantages over the current commnerically available ones. We report our experiences with this EsophaCoil stent and review of literature.