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Traumatic brain injury (TBI) is an important public health concern because of the high mortality rate of young people and a high proportion among the trauma. According to studies, patients visiting the emergency department (ED) with TBI comprise 1.4% of all ED patients.
The authors think that the characteristics of patients with TBI will vary according to the age group. Therefore, the purpose of this study is to investigate the clinical and social characteristics of patients with TBI visiting the ED by age group.
Trauma patients who conducted brain CT at the ED of Korean University Hospital (three hospitals) for 3 years from March 2013 to February 2016 were enrolled. Medical records were investigated retrospectively. The GCS scores were estimated at initial ED arrival. The primary outcome was to determine the characteristics of each age groups with gender, severity (by GSC score), trauma mechanism, and admission rate.
A total of 15,567 TBI patients received brain CT evaluation during the investigation period. Based on age, patients in their 50s were the most common (16.5%). Regarding the severity, the ratio of mild was higher in under patients under 9 (99.3%); the ratio of severe was higher for patients in their 20s (4.6%). In almost every age group, the male ratio of TBI was higher, except for females aged 70 or older. Under 19 years of age, the ambulance utilization rate was lower than any other age group. The most common injury mechanism was a collision, the next was a traffic accident, and in under 9, a fall was the most common. 70.1% of patients returned home after treatments.
Identifying the characteristics of patients with TBI visiting ED is fundamental. Therefore, it is necessary to continuously collect basic data on TBI among patients visiting the ED.
Seoul is the third most densely populated area in the world except for the city-state. However, a national disaster plan has not yet been established.
From September 2017, representatives of seven regional emergency medical centers in Seoul met monthly and decided to investigate basic data for the future establishment of surge capacity planning.
Staff, supply, space, and systems for surge capacity were surveyed in seven hospitals. The additional surveyed data were as follows: hospital incident command system and actual operational experience; performance of disaster drill; safety and security plan; estimation of surge capacity in normal operating conditions and extreme operating conditions; alternative therapeutic spaces; back-up plan to call non-duty medical staff; decontamination equipment; contingency plan for stuff shortage; etc.
All the hospitals reported they have hospital incident command systems and held disaster drills every year, however, the two hospitals (28.5%) had no real experience of hospital incident command system activation. Five hospitals (71.4%) did not have a safety and security plan. They replied they can treat average 7.7 emergency patients (Korean Triage and Acute scale (KTAS) ≤ 3), 10 non-emergent patients (KTAS>4), 0.9 surgical patients and 0.7 unstable patients simultaneously in normal operating conditions. In extreme operating conditions, they replied they can treat average 26.4 emergency patients (KTAS ≤ 3), 54.3 non-emergent patients (KTAS>4), 37 surgical patients and 2.3 unstable patients simultaneously. The two hospitals (28.5%) had no alternative therapeutic spaces, no back-up plan to call non-duty medical staff and no contingency plan for stuff shortage. Three hospitals (42.9%) did not have decontamination equipment.
The survey revealed the basic data for surge capacity planning in Seoul. Data from hospitals other than regional emergency medical centers should be collected for the completion of disaster plans.
Spirituality is what gives people meaning and purpose in life, and it has been recognized as a critical factor in patients’ well-being, particularly at the ends of their lives. Studies have demonstrated relationships between spirituality and patient-reported outcomes such as quality of life and mental health. Although a number of studies have suggested that spiritual belief can be associated with mortality, the results are inconsistent. We aimed to determine whether spirituality was related to survival in advanced cancer inpatients in Korea.
For this multicenter study, we recruited adult advanced cancer inpatients who had been admitted to seven palliative care units with estimated survival of <3 months. We measured spirituality at admission using the Korean version of the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-sp), which comprises two subscales: meaning/peace and faith. We calculated a Kaplan-Meier curve for spirituality, dichotomized at the predefined cutoffs and medians for the total scale and each of the two subscales, and performed univariate regression with a Cox proportional hazard model.
We enrolled a total of 204 adults (mean age: 64.5 ± 13.0; 48.5% female) in the study. The most common primary cancer diagnoses were lung (21.6%), colorectal (18.6%), and liver/biliary tract (13.0%). Median survival was 19.5 days (95% confidence interval [CI95%]: 23.5, 30.6). Total FACIT-sp score was not related to survival time (hazard ratio [HR] = 0.981, CI95% = 0.957, 1.007), and neither were the scores for its two subscales, meaning/peace (HR = 0.969, CI95% = 0.932, 1.008) and faith (HR = 0.981, CI95% = 0.938, 1.026).
Significance of results
Spirituality was not related to survival in advanced cancer inpatients in Korea. Plausible mechanisms merit further investigation.
The National Institute of Neurological Disease and Stroke-Canadian Stroke Network (NINDS-CSN) 5-minute neuropsychology protocol consists of only verbal tasks, and is proposed as a brief screening method for vascular cognitive impairment. We evaluated its feasibility within two weeks after stroke and ability to predict the development of post-stroke dementia (PSD) at 3 months after stroke.
We prospectively enrolled subjects with ischemic stroke within seven days of symptom onset who were consecutively admitted to 12 university hospitals. Neuropsychological assessments using the NINDS-CSN 5-minute and 60-minute neuropsychology protocols were administered within two weeks and at 3 months after stroke onset, respectively. PSD was diagnosed with reference to the American Heart Association/American Stroke Association statement, requiring deficits in at least two cognitive domains.
Of 620 patients, 512 (82.6%) were feasible for the NINDS-CSN 5-minute protocol within two weeks after stroke. The incidence of PSD was 16.2% in 308 subjects who had completed follow-up at 3 months after stroke onset. The total score of the NINDS-CSN 5-minute protocol differed significantly between those with and without PSD (4.0 ± 2.7, 7.4 ± 2.7, respectively; p < 0.01). A cut-off value of 6/7 showed reasonable discriminative power (sensitivity 0.82, specificity 0.67, AUC 0.74). The NINDS-CSN 5-minute protocol score was a significant predictor for PSD (adjusted odds ratio 6.32, 95% CI 2.65–15.05).
The NINDS-CSN 5-minute protocol is feasible to evaluate cognitive functions in patients with acute ischemic stroke. It might be a useful screening method for early identification of high-risk groups for PSD.
Echinochloa species are among the most troublesome weeds in rice cultivation, and grow in a broad habitat range in Korea. Although various ecotypes of Echinochloa have been collected as germplasm for future studies, it has been difficult to classify them due to their high level of morphological similarity. This study was thus conducted to develop and investigate the phylogenetic relationships between 77 Echinochloa accessions with the use of 23 simple sequence repeat (SSR) markers and 24 morphological traits. Of 77 Echinochloa accessions, including 57 accessions from Korea and 5 reference species, late watergrass was clearly clustered as a distinctive group from barnyardgrass and other Echinochloa species. In this analysis, we also identified core genetic and morphological markers that can be used for the future identification and classification of Echinochloa species. Five out of 23 SSR makers produced distinctive bands that discriminate late watergrass from barnyardgrass and other Echinochloa species. Four morphological traits of the reproductive organs were the most influential contributors for classifying Echinochloa species. Although there was no clear consensus generated in this study between SSR markers and morphological trait analyses, our results support the potential use of the selected SSR markers and morphological traits in future studies of Echinochloa.
Small and medium-sized enterprises (SMEs) have played a significant role in the process of Korea's successful economic development. This is the result of various governmental policies that have been enacted to foster SMEs. As economic circumstances (both internal and external) have changed, the focus of Korean SME law and policies has shifted from unilateral protection or support of SMEs to reinforcing the economic significance and competitiveness of SMEs. Consequently, the importance of competition policies to SMEs has also grown. The main body of competition law in Korea, the Monopoly Regulation and Fair Trade Act (MRFTA), contains certain exceptions applying to SMEs and provisions for their protection. Other legislations have been enacted to ensure fair transactions for SMEs and franchisees. The MRFTA and related laws aim to create a free competitive market to address the anti-competitive and unfair transactional structures that small firms may be exposed to.
In the process of Korea's rapid and successful economic development, small and medium-sized enterprises (SMEs) have played a major role. This is the result of both specific stipulations in the Constitution, and due to various SME promotion and support policies that have been successfully implemented. But against a backdrop of government-led economic policies that have traditionally prioritized large conglomerate (chaebol) growth, Korean SME policies may be considered relatively lacking, especially when considering the earlier stages of Korea's economic development.
For much of the last few decades, Korean SME policies had been focused on protection policies or on policies in which SMEs played a supplemental role to large conglomerates. More recently, the Korean government has succeeded in amending its policies in response to internal and external changes in national economic circumstances. It has been moving towards reorganizing its legal system to promote and support SMEs so that the economic roles and competitiveness of small firms can be strengthened.
The significance and value of SMEs can vary in different ways, depending on the stage of economic development of the nation involved. SMEs can be considered to have major significance for a rapidly developing country, since promoting them may help build an industrial base, expand employment opportunities, balance development in different regions of the country, and establish a stable social infrastructure.
The RDA Genebank at the National Agrobiodiversity Center (NAAS, RDA, Republic of Korea) has conserved about 182,000 accessions in 1777 species and is working at preserving agricultural genetic resources for the conservation and sustainable utilization of genetic diversity. The detection of genetic variability in conserved resources is important for germplasm management, but the molecular evaluation tools providing genetic information are insufficient for underutilized crops, unlike those for major crops. In this regard, the Korean National Agrobiodiversity Center has been developing microsatellite markers for several underutilized crops. We designed 3640 primer pairs flanking simple sequence repeat (SSR) motifs for 6310 SSR clones in 21 crop species. Polymorphic loci were revealed in each species (7–36), and the mean ratio of polymorphic loci to all the loci tested was 12%. The average allele number was 5.1 (2.8–10.3) and the expected heterozygosity 0.51 (0.31–0.74). Some SSRs were transferable to closely related species, such as within the genera Fagopyrum and Allium. These SSR markers might be used for studying the genetic diversity of conserved underutilized crops.
Liposomal drug delivery products have been already commercialized in tumor therapeutics, which can realize passive tumor targeting via enhanced permeability and retention (EPR) effect resulting from the leaky tumor vasculature. To control drug release out of the liposomes, thermo-sensitive liposomes (TSLs) have been developed so that an abrupt exposure of highly concentrated drugs to tumor tissues was enabled by locally treated thermal stimuli. As interests upon TSL have increased along with ongoing clinical trials, some types of TSLs with different physical properties in pharmacokinetics and the mechanism of drug release have been formulated. However, there are few protocols established with a desirable heat source to maximize the efficacy of different TSLs as treating tumors. In this study, we examined different protocols for the most effective application of different TSLs to tumor therapy. First, we examined if enhancing the accumulation of TSLs within tumor tissues prior to bursting drugs out of TSLs could lead to increasing anti-tumor efficacy. Second, we compared the efficiency of two different heat sources on the use of TSL, a warm water bath (42°C) and high intensity focused ultrasound (HIFU). Our study suggests that the specified protocol be setup for TSLs with different physical properties to optimally function in tumor therapies.
Visual hallucination (VH) is a common psychotic symptom in patients with Parkinson's disease (PD) and may be a significant predictor of cognitive impairment (CI) in such patients.
This study aimed to investigate the pattern of glucose metabolism of VH and the relationship between VH and CI in PD.
We studied 28 PD patients, including 15 with VH (PD-VH) and 13 without VH (PD-NVH). Of the 15 PD-VH patients, 8 patients had cognitive impairment (PD-VHCI) whereas 7 did not (PD-VHNCI). All patients underwent [18F] fluorodeoxyglucose positron emission tomography ([18F] FDG PET) followed by statistical parametric mapping (SPM) analyses.
Compared to the patients with PDNVH, PD-VHNCI patients showed glucose hypometabolism in the inferior and middle temporal cortices, fusiform gyri, and frontal areas, suggesting the involvement of the ventral visual pathway. Compared to the patients with PDNVH, PD-VHCI patients showed glucose hypometabolism in the temporoparietal association cortices with scattered frontal areas.
Dysfunction of ventral visual pathway involving the temporal lobe may play a key role in VH development in PD patients. The evolving distribution from the ventral visual pathway to more extensive posterior cortices in PD-VHCI patients suggests that VH may be a prodromal symptom occurring prior to CI in PD patients.
The liquid phase plasma reduction method has been applied to prepare silver nanoparticles from a solution of silver nitrate (AgNO3) using a bipolar pulsed electrical discharge system. The excited states of atomic silver, hydrogen and oxygen as well as the molecular bands of hydroxyl radicals were detected in the emission spectra. As the discharge duration increased up to 10 min, silver particle peaks produced by surface plasmon absorption were observed around 430 nm. Both the particle size and the particle numbers were observed to increase with the length of the plasma treatment time and with the initial AgNO3 concentration. Spherical nanoparticles of about 5–20 nm in size were obtained with the discharging time of 5 min, whereas aggregates of nanoparticles of about 10–50 nm in size were mainly produced with the discharging time of 20 min. The cationic surfactant of cetyltrimethylammonium bromide (CTAB) added with the CTAB/AgNO3 molar ratio of 30% was shown to inhibit nanoparticle aggregation.
Liquorice is one of the botanicals used frequently as a traditional medicine in the West and in the East. Platelet-derived growth factor (PDGF)-BB is involved in the development of CVD by inducing abnormal proliferation and migration of vascular smooth muscle cells. In our preliminary study, dehydroglyasperin C (DGC), an active compound of liquorice, showed strong antioxidant activity. Since phytochemicals with antioxidant activities showed beneficial effects on chronic inflammatory diseases, the present study aimed to investigate the effects of DGC on PDGF-induced proliferation and migration of human aortic smooth muscle cells (HASMC). Treatment of HASMC with DGC for 24 h significantly decreased PDGF-induced cell number and DNA synthesis in a dose-dependent manner without any cytotoxicity, as demonstrated by the 3-(4,5-dimethyl-thiazol-2-yl)-2,5-diphenyltetrazolium bromide test and thymidine incorporation. Upon cell cycle analysis, DGC blocked the PDGF-induced progression through the G0/G1 to S phase of the cell cycle, and down-regulated the expression of cyclin-dependent kinase (CDK); 2, cyclin E, CDK4 and cyclin D1. Furthermore, DGC significantly attenuated PDGF-stimulated phosphorylation of PDGF receptor-β, phospholipase C-γ1, AKT and extracellular-regulated kinase 1/2, and DGC inhibited cell migration and the dissociation of actin filaments by PDGF. In a rat vascular balloon injury model, DGC suppressed an excessive reduction in luminal diameters and neointimal formation compared with the control group. These results demonstrate the mechanistic basis for the prevention of CVD and the potential therapeutic properties of DGC.
Background: Highly educated participants with normal cognition show lower incidence of Alzheimer's disease (AD) than poorly educated participants, whereas longitudinal studies involving AD have reported that higher education is associated with more rapid cognitive decline. We aimed to evaluate whether highly educated amnestic mild cognitive impairment (aMCI) participants show more rapid cognitive decline than those with lower levels of education.
Methods: A total of 249 aMCI patients enrolled from 31 memory clinics using the standard assessment and diagnostic processes were followed with neuropsychological evaluation (duration 17.2 ± 8.8 months). According to baseline performances on memory tests, participants were divided into early-stage aMCI (−1.5 to −1.0 standard deviation (SD)) and late-stage aMCI (below −1.5 SD) groups. Risk of AD conversion and changes in neuropsychological performances according to the level of education were evaluated.
Results: Sixty-two patients converted to AD over a mean follow-up of 1.43 years. The risk of AD conversion was higher in late-stage aMCI than early-stage aMCI. Cox proportional hazard models showed that aMCI participants, and late-stage aMCI participants in particular, with higher levels of education had a higher risk of AD conversion than those with lower levels of education. Late-stage aMCI participants with higher education showed faster cognitive decline in language, memory, and Clinical Dementia Rating Sum of Boxes (CDR-SOB) scores. On the contrary, early-stage aMCI participants with higher education showed slower cognitive decline in MMSE and CDR-SOB scores.
Conclusions: Our findings suggest that the protective effects of education against cognitive decline remain in early-stage aMCI and disappear in late-stage aMCI.
To compare the characteristics and risk factors for surgical site infections (SSIs) after total hip arthroplasty (THA) and total knee arthroplasty (TKA) in a nationwide survey, using shared case detection and recording systems.
Retrospective cohort study.
Twenty-six hospitals participating in the Korean Nosocomial Infections Surveillance System (KONIS).
From 2006 to 2009, all patients undergoing THA and TKA in KONIS were enrolled.
SSI occurred in 161 (2.35%) of 6,848 cases (3,422 THAs and 3,426 TKAs). Pooled mean SSI rates were 1.69% and 2.82% for THA and TKA, respectively. Of the cases we examined, 42 (26%) were superficial-incisional SSIs and 119 (74%) were “severe” SSIs; of the latter, 24 (15%) were deep-incisional SSIs and 95 (59%) were organ/space SSIs. In multivariate analysis, a duration of preoperative hospital stay of greater than 3 days was a risk factor for total SSI after both THA and TKA. Diabetes mellitus, revision surgery, prolonged duration of surgery (above the 75th percentile), and the need for surgery due to trauma were independent risk factors for total and severe SSI after THA, while male sex and an operating room without artificial ventilation were independent risk factors for total and severe SSI after TKA. A large volume of surgeries (more than 10 procedures per month) protected against total and severe SSI, but only in patients who underwent TKA.
Risk factors for SSI after arthroplasty differ according to the site of the arthroplasty. Therefore, clinicians should take into account the site of arthroplasty in the analysis of SSI and the development of strategies for reducing SSI.
To evaluate the risk factors for surgical site infection (SSI) after gastric surgery in patients in Korea.
A nationwide prospective multicenter study.
Twenty university-affiliated hospitals in Korea.
The Korean Nosocomial Infections Surveillance System (KONIS), a Web-based system, was developed. Patients in 20 Korean hospitals from 2007 to 2009 were prospectively monitored for SSI for up to 30 days after gastric surgery. Demographic data, hospital characteristics, and potential perioperative risk factors were collected and analyzed, using multivariate logistic regression models.
Of the 4,238 case patients monitored, 64.9% (2,752) were male, and mean age (±SD) was 58.8 (±12.3) years. The SSI rates were 2.92, 6.45, and 10.87 per 100 operations for the National Nosocomial Infections Surveillance system risk index categories of 0, 1, and 2 or 3, respectively. The majority (69.4%) of the SSIs observed were organ or space SSIs. The most frequently isolated microorganisms were Staphylococcus aureus and Klebsiella pneumoniae. Male sex (odds ratio [OR], 1.67 [95% confidence interval (CI), 1.09–2.58]), increased operation time (1.20 [1.07–1.34] per 1-hour increase), reoperation (7.27 [3.68–14.38]), combined multiple procedures (1.79 [1.13–2.83]), prophylactic administration of the first antibiotic dose after skin incision (3.00 [1.09–8.23]), and prolonged duration (≥7 days) of surgical antibiotic prophylaxis (SAP; 2.70 [1.26–5.64]) were independently associated with increased risk of SSI.
Male sex, inappropriate SAP, and operation-related variables are independent risk factors for SSI after gastric surgery.
Glyceollins, one family of phytoalexins, are de novo synthesised from daidzein in the soyabean upon exposure to some types of fungus. The efficiency of glyceollin production appears to be influenced by soyabean variety, fungal species, and the degree of physical damage to the soyabean. The compounds have been shown to have strong antioxidant and anti-inflammatory activities, and to inhibit the proliferation and migration of human aortic smooth muscle cells, suggesting their potential to prevent atherosclerosis. It has also been reported that glyceollins have inhibited the growth of prostate and breast cancer cells in xenograft animal models, which is probably due to their anti-oestrogenic activity. In essence, glyceollins deserve further animal and clinical studies to confirm their health benefits.
Epithelial-myoepithelial carcinoma is an uncommon, low-grade carcinoma that generally occurs in the salivary glands. A few cases of epithelial-myoepithelial carcinoma arising in the nasal cavity have been reported. We describe a unique case of aggressive epithelial-myoepithelial carcinoma in the nasal cavity.
A 36-year-old woman presented with a mass in her left nasal cavity. Histopathological evaluation revealed it to be an epithelial-myoepithelial carcinoma with overt nuclear atypia, frequent mitoses and necrosis. The tumour recurred in the contralateral nasal cavity 15 months following primary excision. Medial maxillectomy and radiation therapy were performed. Seven-month follow up revealed extensive bone metastases.
We report a rare case of aggressive epithelial-myoepithelial carcinoma in the nasal cavity, with high-grade histology.
An organic/inorganic hybrid-type nonvolatile memory TFT was proposed as a core device for the future flexible electronics. The structural feature of this memory TFT was that a ferroelectric copolymer and an oxide semiconductor layers were employed as a gate insulator and an active channel, respectively. The memory TFT with the structure of Au/poly(vinylidene fluoride-trifluoroethylene)/Al2O3/ZnO/Ti/Au/Ti/poly(ethylene naphthalate) could be successfully fabricated at the process temperature of below 150°C. It was confirmed that the TFT well operated as a memory device even under the bending situations.
Platelet-derived growth factor (PDGF)-BB can induce abnormal proliferation and migration of vascular smooth muscle cells (VSMC) that are involved in the development of CVD. In our preliminary study, phytoalexin glyceollins (glyceollins I, II and III) isolated from soyabean seeds cultured with Aspergillus sojae showed strong antioxidant and anti-inflammatory activity. Since antioxidants showed beneficial effects on chronic inflammatory diseases, the purpose of the present study was to examine the effects of glyceollins on PDGF-induced proliferation and migration in human aortic smooth muscle cells (HASMC). Incubation of resting HASMC with glyceollins for 24 h significantly diminished PDGF-increased cell number and DNA synthesis in a dose-dependent manner without any cytotoxicity. In addition to blocking of the PDGF-inducible progression through the G0/G1 to the S phase of the cell cycle, glyceollins down-regulated the expression of cyclin-dependent kinase (CDK)2 and cyclin D1, and up-regulated the expression of CDK inhibitors such as p27kip1 and p53.Glyceollins also effectively inhibited reactive oxygen species generation and phosphorylation of PDGF receptor-β, phospholipase Cγ1, Akt and extracellular signal-regulated kinase 1/2 by PDGF stimulation. Furthermore, glyceollins were found to inhibit PDGF-induced dissociation of actin filaments and cell migration. Thus, the results suggest that glyceollins could become a potent therapeutic agent for regulating VSMC-associated vascular disease such as atherosclerosis and restenosis after angioplasty.
The effect of ion beams on the formation of Si nanoclusters from a-SiOx films and their luminescence properties is investigated. a-SiOx films with Si content ranging from 33 to 50 at. % were deposited by Electron Cyclotron Resonance Plasma Enhanced Chemical Vapor Deposition (ECR-PECVD) of SiH4 and O2. Prior to anneal, some samples were implanted with 380 keV Si to a dose ranging from 5.7 × 1014 cm-2 to 5.7 × 1016 cm-2. All films were rapid thermal annealed under flowing Ar environment, and hydrogenated after anneals to passivate defects and to enhance the luminescence of Si nanoclusters. For films with Si content less than 40 at. %, ion beam slightly reduces the photoluminescence (PL) intensity and induces a slight blueshift of the luminescence. For films with Si content greater than 40 at. %, ion beam greatly increases the PL intensity. Based on the effect of the ion beams dose and the ion specie, we propose that ion beams damage greatly promotes nucleation of small Si clusters from the a-SiOx matrix.
The effect of ion beams on the formation of Si nanoclusters from
a-SiOx films and their luminescence
properties is investigated. a-SiOx films with Si
content ranging from 33 to 50 at. % were deposited by Electron Cyclotron
Resonance Plasma Enhanced Chemical Vapor Deposition (ECR-PECVD) of
SiH4 and O2. Prior to anneal, some samples were
implanted with 380 keV Si to a dose ranging from 5.7 × 1014
cm−2 to 5.7 × 1016 cm−2. All films were
rapid thermal annealed under flowing Ar environment, and hydrogenated after
anneals to passivate defects and to enhance the luminescence of Si
nanoclusters. For films with Si content less than 40 at. %, ion beam
slightly reduces the photoluminescence (PL) intensity and induces a slight
blueshift of the luminescence. For films with Si content greater than 40 at.
%, ion beam greatly increases the PL intensity. Based on the effect of the
ion beams dose and the ion specie, we propose that ion beams damage greatly
promotes nucleation of small Si clusters from the