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Indications and findings of flexible bronchoscopy in trauma field in Korea: a case series

  • Dongsub Noh
    • Journal of Trauma and Injury
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    • v.36 no.3
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    • pp.206-209
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    • 2023
  • Purpose: Since its implementation, flexible fiberoptic bronchoscopy (FBS) has played an important role in the diagnosis and treatment of tracheobronchial tree and pulmonary disease. Although FBS is often performed by endoscopists, it has also been performed by surgeons, albeit rarely. This study investigated FBS from the surgeon's perspective. Methods: This retrospective study included patients who underwent FBS performed by a single thoracic surgeon between March 2017 and December 2021. Accordingly, the epidemiology, purpose, results, and complications of FBS were analyzed. Results: A total of 47 patients received FBS, whereas 13 patients underwent repeat FBS. Their mean age was 60.7 years. The main organs injured involved the chest (n=22), brain (n=9), abdominal organ (n=7), cervical spine (n=4), extremities (n=4), and face (n=1). The average Injury Severity Score was 22.5. Indications for FBS included atelectasis or haziness on chest x-ray (n=34), pneumonia (n=17), difficult ventilator management (n=7), percutaneous dilatory tracheostomy (n=3), blood aspiration (n=2), foreign body removal (n=2), and intubation due to a difficult airway (n=1). The findings of FBS were mucous plugs (n=36), blood and blood clots (n=16), percutaneous dilatory tracheostomy (n=3), foreign bodies (n=2), granulation tissue at the tracheostomy site (n=2), tracheostomy tube malposition (n=1), bronchus spasm (n=1), difficult airway intubation (n=1), and negative findings (n=5). None of the patients developed complications. Conclusions: FBS is an important modality in the trauma field that allows for the possibility of diagnosis and therapy. With sufficient practice, surgeons may safely perform FBS at the bedside with relative ease.

Effect of digital therapies on balance and gait in children with cerebral palsy: A systematic review (디지털 치료제가 뇌성마비 아동의 균형 및 보행에 미치는 효과: 체계적 고찰)

  • Jung-Hyun Kim
    • Journal of Korean Physical Therapy Science
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    • v.30 no.4
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    • pp.92-110
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    • 2023
  • Background: Digital therapeutics are software medical devices that provide evidence-based treatments to prevent, manage, and treat disease. Digital therapies have recently been shown to be effective in motivating children with cerebral palsy as a tool in neuropsychological therapy. Digital therapies improve postural control, balance and gait in children with cerebral palsy. Therefore, this study aims to investigate the effects of digital therapies on balance and gait in children with cerebral palsy and to provide guidelines for prescribing digital therapies for children with cerebral palsy. Design: A Systematic Review Methods: This study searched for English-language articles published in medical journals from January 2000 to July 2023 using PubMed and MEDLINE based on the year of initiation of the digital therapy. The search terms used in the study were 'digital technology' OR 'digital therapeutic' OR 'mobile application' OR 'mobile health' OR 'virtual reality' OR 'game' AND 'cerebral palsy', 'balance' 'gait' as the main keywords. The final article was assigned an evidence level and a Physiotherapy Evidence Database (PEDro) score to assess the quality of clinical trials studies. Results: The digital therapies applied to improve balance and gait in children with cerebral palsy are game-based virtual reality training and the Nintendo Wii Fit program. Both digital therapy interventions had a significant effect on improving balance in children with cerebral palsy, and virtual reality training significantly improved balance and gait. However, there were no significant improvements in balance and gait within two weeks of treatment, regardless of the type of digital intervention. Conclusion: The study suggests that this data will be important in building the evidence base for the effectiveness of digital therapies on balance and gait in children with cerebral palsy and in advancing clinical protocols.

Development of Long-Term Hospitalization Prediction Model for Minor Automobile Accident Patients (자동차 사고 경상환자의 장기입원 예측 모델 개발)

  • DoegGyu Lee;DongHyun Nam;Sung-Phil Heo
    • Journal of Korea Society of Industrial Information Systems
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    • v.28 no.6
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    • pp.11-20
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    • 2023
  • The cost of medical treatment for motor vehicle accidents is increasing every year. In this study, we created a model to predict long-term hospitalization(more than 18 days) among minor patients, which is the main item of increasing traffic accident medical expenses, using five algorithms such as decision tree, and analyzed the factors affecting long-term hospitalization. As a result, the accuracy of the prediction models ranged from 91.377 to 91.451, and there was no significant difference between each model, but the random forest and XGBoost models had the highest accuracy of 91.451. There were significant differences between models in the importance of explanatory variables, such as hospital location, name of disease, and type of hospital, between the long-stay and non-long-stay groups. Model validation was tested by comparing the average accuracy of each model cross-validated(10 times) on the training data with the accuracy of the validation data. To test of the explanatory variables, the chi-square test was used for categorical variables.

Updates on the Immune Cell Basis of Hepatic Ischemia-Reperfusion Injury

  • Mi Jeong Heo;Ji Ho Suh;Kyle L. Poulsen;Cynthia Ju;Kang Ho Kim
    • Molecules and Cells
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    • v.46 no.9
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    • pp.527-534
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    • 2023
  • Liver ischemia-reperfusion injury (IRI) is the main cause of organ dysfunction and failure after liver surgeries including organ transplantation. The mechanism of liver IRI is complex and numerous signals are involved but cellular metabolic disturbances, oxidative stress, and inflammation are considered the major contributors to liver IRI. In addition, the activation of inflammatory signals exacerbates liver IRI by recruiting macrophages, dendritic cells, and neutrophils, and activating NK cells, NKT cells, and cytotoxic T cells. Technological advances enable us to understand the role of specific immune cells during liver IRI. Accordingly, therapeutic strategies to prevent or treat liver IRI have been proposed but no definitive and effective therapies exist yet. This review summarizes the current update on the immune cell functions and discusses therapeutic potentials in liver IRI. A better understanding of this complex and highly dynamic process may allow for the development of innovative therapeutic approaches and optimize patient outcomes.

Kalkitoxin attenuates calcification of vascular smooth muscle cells via RUNX-2 signaling pathways

  • Saroj K Shrestha;Se-Woong Kim;Yunjo Soh
    • Journal of Veterinary Science
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    • v.24 no.5
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    • pp.69.1-69.11
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    • 2023
  • Background: Kalkitoxin (KT) is an active lipopeptide isolated from the cyanobacterium Lyngbya majuscula found in the bed of the coral reef. Although KT suppresses cell division and inflammation, KT's mechanism of action in vascular smooth muscle cells (VSMCs) is unidentified. Therefore, our main aim was to investigate the impact of KT on vascular calcification for the treatment of cardiovascular disease. Objectives: Using diverse calcification media, we studied the effect of KT on VSMC calcification and the underlying mechanism of this effect. Methods: VSMC was isolated from the 6 weeks ICR mice. Then VSMCs were treated with different concentrations of KT to check the cell viability. Alizarin red and von Kossa staining were carried out to examine the calcium deposition on VSMC. Thoracic aorta of 6 weeks mice were taken and treated with different concentrations of KT, and H and E staining was performed. Real-time polymerase chain reaction and western blot were performed to examine KT's effect on VSMC mineralization. Calcium deposition on VSMC was examined with a calcium deposition quantification kit. Results: Calcium deposition, Alizarin red, and von Kossa staining revealed that KT reduced inorganic phosphate-induced calcification phenotypes. KT also reduced Ca++-induced calcification by inhibiting genes that regulate osteoblast differentiation, such as runtrelated transcription factor 2 (RUNX-2), SMAD family member 4, osterix, collagen 1α, and osteopontin. Also, KT repressed Ca2+-induced bone morphogenetic protein 2, RUNX-2, collagen 1α, osteoprotegerin, and smooth muscle actin protein expression. Likewise, Alizarin red and von Kossa staining showed that KT markedly decreased the calcification of ex vivo ring formation in the mouse thoracic aorta. Conclusions: This experiment demonstrated that KT decreases vascular calcification and may be developed as a new therapeutic treatment for vascular calcification and arteriosclerosis.

Comparison of bone subtraction CT angiography with standard CT angiography for evaluating circle of Willis in normal dogs

  • Soyon An;Gunha Hwang;Rakhoon Kim;Tae Sung Hwang;Hee Chun Lee
    • Journal of Veterinary Science
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    • v.24 no.5
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    • pp.65.1-65.9
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    • 2023
  • Background: Bone subtraction computed tomography angiography (BSCTA) is a useful alternative technique for improving visualization of vessels surrounded by skull bone. However, no studies have compared computed tomography angiography (CTA) and BSCTA for improving the visibility of canine cerebral blood vessels. Objectives: To evaluate the potential benefit of BSCTA for better delineation of brain arteries of the circle of Willis (CoW) in dogs by comparing BSCTA with non-subtraction computed tomography angiography (NSCTA). Methods: Brain CTA was performed for nine healthy beagle dogs using a bolus tracking method with saline flushing. A total dose of 600 mgI/kg of contrast agent with an iodine content of 370 mgI/mL was injected at a rate of 4 ml/s. Bone removal was achieved automatically by subtracting non-enhanced computed tomography (CT) data from contrast CT data. Five main intracranial arteries of the CoW were analyzed and graded on a scale of five for qualitative evaluation. Results: Scores of basilar artery, middle cerebral artery, and rostral cerebral artery in the BSCTA group were significantly higher than those in the NSCTA group (p = 0.001, p = 0.020, and p < 0.0001, respectively). Scores of rostral cerebellar artery (RcA) and caudal cerebral artery (CCA) did not differ significantly between the two groups. However, scores of RcA and CCA in the BSCTA group were higher than those in the NSCTA group. Conclusions: BSCTA improved visualization of intracranial arteries of the CoW with close contact to bone. Thus, it should be recommended as a routine scan method in dogs suspected of having brain vessel disease.

Development of a Deep Learning-Based Automated Analysis System for Facial Vitiligo Treatment Evaluation (안면 백반증 치료 평가를 위한 딥러닝 기반 자동화 분석 시스템 개발)

  • Sena Lee;Yeon-Woo Heo;Solam Lee;Sung Bin Park
    • Journal of Biomedical Engineering Research
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    • v.45 no.2
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    • pp.95-100
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    • 2024
  • Vitiligo is a condition characterized by the destruction or dysfunction of melanin-producing cells in the skin, resulting in a loss of skin pigmentation. Facial vitiligo, specifically affecting the face, significantly impacts patients' appearance, thereby diminishing their quality of life. Evaluating the efficacy of facial vitiligo treatment typically relies on subjective assessments, such as the Facial Vitiligo Area Scoring Index (F-VASI), which can be time-consuming and subjective due to its reliance on clinical observations like lesion shape and distribution. Various machine learning and deep learning methods have been proposed for segmenting vitiligo areas in facial images, showing promising results. However, these methods often struggle to accurately segment vitiligo lesions irregularly distributed across the face. Therefore, our study introduces a framework aimed at improving the segmentation of vitiligo lesions on the face and providing an evaluation of vitiligo lesions. Our framework for facial vitiligo segmentation and lesion evaluation consists of three main steps. Firstly, we perform face detection to minimize background areas and identify the face area of interest using high-quality ultraviolet photographs. Secondly, we extract facial area masks and vitiligo lesion masks using a semantic segmentation network-based approach with the generated dataset. Thirdly, we automatically calculate the vitiligo area relative to the facial area. We evaluated the performance of facial and vitiligo lesion segmentation using an independent test dataset that was not included in the training and validation, showing excellent results. The framework proposed in this study can serve as a useful tool for evaluating the diagnosis and treatment efficacy of vitiligo.

P-hydroxybenzoic acid positively affect the Fusarium oxysporum to stimulate root rot in Panax notoginseng

  • Jing Zhao;Zhandi Wang;Rong Jiao;Qionglian Wan;Lianchun Wang;Liangxing Li;Yali Yang;Shahzad Munir
    • Journal of Ginseng Research
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    • v.48 no.2
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    • pp.229-235
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    • 2024
  • Background: Plant health is directly related to the change in native microbial diversity and changes in soil health have been implicated as one of the main cause of root rot. However, scarce information is present regarding allelopathic relationship of Panax notoginseng root exudates and pathogenic fungi Fusarium oxysporum in a continuous cropping system. Methods: We analyzed P. notoginseng root exudate in the planting soil for three successive years to determine phenolic acid concentration using GC-MS and HPLC followed by effect on the microbial community assembly. Antioxidant enzymes were checked in the roots to confirm possible resistance in P. notoginseng. Results: Total 29 allelochemicals in the planting soil extract was found with highest concentration (10.54 %) of p-hydroxybenzoic acid. The HPLC showing a year-by-year decrease in p-hydroxybenzoic acid content in soil of different planting years, and an increase in population of F. oxysporum. Moreover, community analysis displayed negative correlation with 2.22 mmol. L-1 of p-hydroxybenzoic acid correspond to an 18.1 % population of F. oxysporum. Furthermore, in vitro plate assay indicates that medium dose of p-hydroxybenzoic acid (2.5-5 mmol. L-1) can stimulate the growth of F. oxysporum colonies and the production of macroconidia, as well as cell wall-degrading enzymes. We found that 2-3 mmol. L-1 of p-hydroxybenzoic acid significantly increased the population of F. oxysporum. Conclusion: In conclusion, our study suggested that p-hydroxybenzoic acid have negative effect on the root system and modified the rhizosphere microbiome so that the host plant became more susceptible to root rot disease.

Risk Factors Associated with Medication Adherence in HIV/AIDS Patients (한국인 HIV/AIDS 환자의 복약순응도에 미치는 위험 인자 연구)

  • Kyung Sun Oh;Jin-soo Lee;Euna Han
    • Korean Journal of Clinical Pharmacy
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    • v.33 no.4
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    • pp.254-260
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    • 2023
  • Background: Adherence to antiretroviral treatment (ART) is crucial for maintaining the HIV-RNA suppression in patients living with HIV/AIDS. This study aims to analyze the risk factors contributing to low medication adherence among individuals with HIV/AIDS by analyzing data from the Korean HIV/AIDS cohort study. Methods: The dependent variable is ART medication adherence. The depressive symptom and anxiety scores were collected as main independence variables. Covariates included gender, age, transmission route, alcohol and smoking information, and antiviral treatment regimen details. To predict the relationship between ordinal dependent variables and independent variables, an ordered logistic regression analysis was conducted, and odds ratios (OR) were calculated. Results: The results of the ordered logistic regression analysis showed that female was associated with a higher risk of low medication adherence (OR=2.91, 95% CI=1.08, 7.83). Among the subjects who were non-smokers and non-drinkers, the risk of low medication adherence was lower (OR=0.36, 95% CI=0.18, 0.70). Depending on the ART treatment group, individuals taking integrase inhibitor had a lower risk of medication adherence (OR=0.31, 95% CI=0.13, 0.76), and those experiencing depressive symptoms were related with a higher risk of low medication adherence (OR=1.97, 95% CI=1.12, 3.46). Conclusions: The encouragement and emotional support of healthcare professionals are essential for patients living with HIV/AIDS who experience depressive symptoms to maintain ART adherence. Additionally, further research is needed to ensure that HIV/AIDS infected female with concurrent depressive symptoms can achieve appropriate ART therapeutic effect.

Unraveling the Web of Health Misinformation: Exploring the Characteristics, Emotions, and Motivations of Misinformation During the COVID-19 Pandemic

  • Vinit Yadav;Yukti Dhadwal;Rubal Kanozia;Shri Ram Pandey;Ashok Kumar
    • Asian Journal for Public Opinion Research
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    • v.12 no.1
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    • pp.53-74
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    • 2024
  • The proliferation of health misinformation gained momentum amidst the outbreak of the novel coronavirus disease 2019 (COVID-19). People stuck in their homes, without work pressure, regardless of health concerns towards personal, family, or peer groups, consistently demanded information. People became engaged with misinformation while attempting to find health information content. This study used the content analysis method and analyzed 1,154 misinformation stories from four prominent signatories of the International Fact-Checking Network during the pandemic. The study finds the five main categories of misinformation related to the COVID-19 pandemic. These are 1) the severity of the virus, 2) cure, prevention, and treatment, 3) myths and rumors about vaccines, 4) health authorities' guidelines, and 5) personal and social impacts. Various sub-categories supported the content characteristics of these categories. The study also analyzed the emotional valence of health misinformation. It was found that misinformation containing negative sentiments got higher engagement during the pandemic. Positive and neutral sentiment misinformation has less reach. Surprise, fear, and anger/aggressive emotions highly affected people during the pandemic; in general, people and social media users warning people to safeguard themselves from COVID-19 and creating a confusing state were found as the primary motivation behind the propagation of misinformation. The present study offers valuable perspectives on the mechanisms underlying the spread of health-related misinformation amidst the COVID-19 outbreak. It highlights the significance of discerning the accuracy of information and the feelings it conveys in minimizing the adverse effects on the well-being of public health.