Factors associated with injury severity among users of powered mobility devices

Objective@#To examine the features of powered mobility device-related injuries and identify the predictors of injury severity in such settings. @*Methods@#Emergency Department-based Injury In-depth Surveillance data from 2011 to 2018 were used in this retrospective study. Participants were assigned to the mild/moderate and severe groups based on their excess mortality ratio–adjusted injury severity score and their general injury-related factors and injury outcome-related factors were compared. @*Results@#Of 407 patients, 298 (79.2%) were assigned to the mild/moderate group and 109 (26.8%) to the severe group. The severe group included a higher percentage of patients aged 70 years or older (43.0% vs. 59.6%, P=0.003), injuries incurred in the daytime (72.6% vs. 82.4%, P=0.044), injuries from traffic accidents and falls (P=0.042), head injuries (38.6% vs. 80.7%, P<0.001), torso injuries (16.8% vs. 32.1%, P=0.001), overall hospital admission (28.5% vs. 82.6%, P<0.001), intensive care unit admission (1.7% vs. 37.6%, P<0.001), death after admission (1.4% vs. 10.3%, P=0.034), and total mortality (0.7% vs. 9.2%, P<0.001). The odds ratios (ORs) for injury severity were as follows: age 70 years or older (OR, 2.124; 95% confidence interval [CI], 1.239–3.642), head injury (OR, 10.441; 95% CI, 5.465–19.950), and torso injury (OR, 4.858; 95% CI, 2.495–9.458). @*Conclusion@#The proportions of patients aged 70 years or older, head and torso injuries, injuries from traffic accidents and falls, and injuries in the daytime were higher in the severe group. Our results highlight the need for measures to address these factors to lower the incidence of severe injuries.

Factors associated with injury severity among users of powered mobility devices

Objective@#To examine the features of powered mobility device-related injuries and identify the predictors of injury severity in such settings. @*Methods@#Emergency Department-based Injury In-depth Surveillance data from 2011 to 2018 were used in this retrospective study. Participants were assigned to the mild/moderate and severe groups based on their excess mortality ratio–adjusted injury severity score and their general injury-related factors and injury outcome-related factors were compared. @*Results@#Of 407 patients, 298 (79.2%) were assigned to the mild/moderate group and 109 (26.8%) to the severe group. The severe group included a higher percentage of patients aged 70 years or older (43.0% vs. 59.6%, P=0.003), injuries incurred in the daytime (72.6% vs. 82.4%, P=0.044), injuries from traffic accidents and falls (P=0.042), head injuries (38.6% vs. 80.7%, P<0.001), torso injuries (16.8% vs. 32.1%, P=0.001), overall hospital admission (28.5% vs. 82.6%, P<0.001), intensive care unit admission (1.7% vs. 37.6%, P<0.001), death after admission (1.4% vs. 10.3%, P=0.034), and total mortality (0.7% vs. 9.2%, P<0.001). The odds ratios (ORs) for injury severity were as follows: age 70 years or older (OR, 2.124; 95% confidence interval [CI], 1.239–3.642), head injury (OR, 10.441; 95% CI, 5.465–19.950), and torso injury (OR, 4.858; 95% CI, 2.495–9.458). @*Conclusion@#The proportions of patients aged 70 years or older, head and torso injuries, injuries from traffic accidents and falls, and injuries in the daytime were higher in the severe group. Our results highlight the need for measures to address these factors to lower the incidence of severe injuries.

Impact of Heart Rate Reduction with Maximal Tolerable Dose of Bisoprolol on Left Ventricular Reverse Remodeling

BACKGROUND: We aimed to evaluate effect of heart rate (HR) reduction on left ventricular reverse remodeling (LVRR) in Korean patients with heart failure with reduced ejection fraction (HFrEF). METHODS: Ambulatory patients with HFrEF, who had paired echocardiograms, N-terminal prohormone brain natriuretic peptide (NT-proBNP), and global assessment score (GAS) at baseline and 6-month (n = 157), were followed up on preset treatment schedule with bisoprolol. RESULTS: The LVRR occurred in 49 patients (32%) at 6-month. In multivariable analysis, independent predictors associated with LVRR were use of anti-aldosterone agent (odds ratio [OR], 4.18; 95% confidence interval [CI], 1.80–9.71), young age (OR, 0.96; 95% CI, 0.92–0.99), high baseline HR (OR, 3.76; 95% CI, 1.40–10.10), and favorable baseline GAS (OR, 1.73; 95% CI, 1.06–2.81). Beneficial effect of bisoprolol, in terms of LVRR, NT-proBNP, and GAS, was remarkable in the high HR group (baseline HR ≥ 75 beats per minute [bpm]), which showed a large HR reduction. CONCLUSION: High baseline HR (≥ 75 bpm) showed an association with LVRR and improvement of NT-proBNP and GAS in patients with HFrEF. This seems to be due to a large HR reduction after treatments with bisoprolol. Trial registry at www.ClinicalTrials.gov, NCT00749034.

Optimal Parameters for Sutures Tied to a Post during Anterior Cruciate Ligament Reconstruction: Thread Numbers, Knot Numbers, Suture Techniques and Stitch Numbers: An Experimental Laboratory Study Using Porcine Tendon / 대한스포츠의학회지

We evaluated the conditions required for sutures tied to a post for tibial fixation during anterior cruciate ligament (ACL) reconstruction. Harvested porcine tendon was used as a graft material and nonabsorbable suture was used for sutures. Samples were tested for ultimate tensile load and elongation according to thread numbers, knot numbers, suture techniques and stitch numbers. As thread numbers were increased, ultimate tensile load was increased and elongation was decreased. However, more than 4 strands of threads provided the sufficient ultimate tensile load more than 454 N of normal ACL for daily activities. As knot numbers were increased, ultimate tensile load was increased, but elongation was decreased. In terms of failure mode, unraveling occurred 100% in 3 and 4 knots, 81.2% in 5 knots, 54.5% in 6 knots, and 0% in 7 knots. Suture techniques and stitch numbers didn't significantly affect the ultimate tensile load and the elongation. For sutures tied to a post for tibial fixation in ACL reconstruction, more than 4 threads, more than 7 knots, and more than 4 stitches provide adequate ultimate tensile load and elongation.

A Case of Chronic Pyothorax-Associated Lymphoma / 대한내과학회지

Pyothorax-associated lymphoma is a distinct type of malignant lymphoma composed of lymphocytes, mostly of a B-cell nature. It occurs in patients with a long history of pyothorax and is strongly associated with Epstein-Barr virus infection. We experienced a case of pyothorax-associated lymphoma in a 66-year-old male. The patient had chronic pyothorax after tuberculous pleurisy was treated about 37 years earlier and was hospitalized for a recently occurring chest wall mass. A core needle biopsy of the chest wall mass led to a diagnosis of diffuse large B-cell lymphoma. Pyothorax-associated lymphoma is rare in Korea, but should be considered in patients with chronic pyothorax and a recently occurring pleural mass.

A Case of Chronic Pyothorax-Associated Lymphoma / 대한내과학회지

Pyothorax-associated lymphoma is a distinct type of malignant lymphoma composed of lymphocytes, mostly of a B-cell nature. It occurs in patients with a long history of pyothorax and is strongly associated with Epstein-Barr virus infection. We experienced a case of pyothorax-associated lymphoma in a 66-year-old male. The patient had chronic pyothorax after tuberculous pleurisy was treated about 37 years earlier and was hospitalized for a recently occurring chest wall mass. A core needle biopsy of the chest wall mass led to a diagnosis of diffuse large B-cell lymphoma. Pyothorax-associated lymphoma is rare in Korea, but should be considered in patients with chronic pyothorax and a recently occurring pleural mass.

Two Cases of Unusual Infectious Peritonitis Mimicking Peritoneal Carcinomatosis of Early Gastric Cancer / 대한소화기내시경학회지

Endoscopic mucosal resection is an organ-saving and minimally invasive treatment modality for early gastric cancer that is mucosa-confined, differentiated, and less than 2 cm in size. On pre-treatment cancer staging work-ups, unusual, benign, infiltrative peritoneal lesions can mimic metastasis of early gastric cancer, and thus lead to loss of an opportunity for the lesion to be properly treated by endoscopy. In the present cases, we report two unusual cases of infectious peritonitis, i.e., tuberculosis and paragonimiasis, which have been occurring sporadically in Korea. The two infectious lesions were confirmed by peritoneal biopsy and the gastric cancers were subsequently removed by endoscopic mucosectomy. These two cases remind us of 1) following indications for endoscopic mucosectomy, 2) the need for peritoneal biopsy for undetermined peritoneal lesions while avoiding laparoscopic gastrectomy, and 3) the coincidental occurrence of unusual infectious peritonitis with gastric cancer in our geographic region.

A Case of Mycobacterium abscessus Lung Disease in a Patient with H1N1 Influenza Pneumonia / 결핵및호흡기질환

Novel influenza A (H1N1) virus is a common pathogen of febrile respiratory infection recently. Here, we report the case of a 63-year-old male patient who presented with 3 days' ongoing cough and fever. He was diagnosed with novel influenza A (H1N1) pneumonia by real-time reverse-transcriptase-polymerase-chain-reaction (rRT-PCR). During treatment for novel influenza A (H1N1), his symptoms and radiologic findings improved initially, but multiple lung nodules developed subsequently and found on chest x-ray (on the 5th hospital day). Mycobacterium abscessus was isolated repeatedly from sputum and bronchoalveolar lavage fluid. To our knowledge, this is the first reported case of Mycobacterium abscessus lung disease in a patient with H1N1 influenza pneumonia.

A Case of Mycobacterium abscessus Lung Disease in a Patient with H1N1 Influenza Pneumonia / 결핵및호흡기질환

Novel influenza A (H1N1) virus is a common pathogen of febrile respiratory infection recently. Here, we report the case of a 63-year-old male patient who presented with 3 days' ongoing cough and fever. He was diagnosed with novel influenza A (H1N1) pneumonia by real-time reverse-transcriptase-polymerase-chain-reaction (rRT-PCR). During treatment for novel influenza A (H1N1), his symptoms and radiologic findings improved initially, but multiple lung nodules developed subsequently and found on chest x-ray (on the 5th hospital day). Mycobacterium abscessus was isolated repeatedly from sputum and bronchoalveolar lavage fluid. To our knowledge, this is the first reported case of Mycobacterium abscessus lung disease in a patient with H1N1 influenza pneumonia.