Search

Rupture limited to the lobar bronchus from blunt trauma is especially rare, and the symptoms are light so diagnosis is difficult. In a patient who visited the hospital complaining of shortness of breath after falling down, atelectasis continued in the chest x-ray. Four days after visiting the hospital, a left upper lobar bronchial rupture was diagnosed through a bronchoscopy and 3 dimensional chest computerized tomography. When diagnosis is delayed in the case of a rupture limited to the lobar bronchus, bronchial obstruction can occur from the formation of granulation tissue, so regular monitoring is important. Therefore, when atelectasis continues after blunt trauma, it is important to differentially diagnose a lobar bronchial rupture through tests such as bronchoscopy.

We experienced a case of venous vessel wall entrapment between the introducer needle and the guide wire during an attempt to perform right internal jugular vein (IJV) catheterization. The guide wire was introduced with no resistance but could not be withdrawn. We performed ultrasonography and C-arm fluoroscopy to confirm the entrapment location. We assumed the introducer needle penetrated the posterior vessel wall during the puncture and that only the guide wire entered the vein; an attempt to retract the wire pinched the vein wall between the needle tip and the guide wire. Careful examination with various diagnostic tools to determine the exact cause of entrapment is crucial for reducing catastrophic complications and achieving better outcomes during catheterization procedures.

Purpose: This study reports on limb amputations in diabetic patients according to gender, age, and region based on the data from the Korean Health Insurance Review & Assessment Service. Materials and Methods: The number of amputations was compared by region, age, gender, and year, as well as by femoral region, lower leg, foot, and toe in diabetic patients who received limb amputation. This analysis was performed based on the data from the Korean Health Insurance Review & Assessment Service, between January 2009 and December 2014. Results: The total number of amputations between the study period was 9,155. The number of patients who were treated at hospitals for diabetes in 2009 was 1.9 million, among which, 1,214 patients underwent amputation. In 2014, the incidence of diabetes was 1,747 in 2.58 million individuals. With this rising incidence of diabetes, the amputation of limbs due to diabetes is increasing every year. In particular, the following regions were amputated more often: femoral region, 2.3%; lower legs, 19.6%; feet, 18.1%; and toes 60.0%. Regarding gender differences, males showed a higher amputation rate than females for all body parts. With respect to region, Seoul was the highest with 30.2%, followed by Gyeonggi with 19.9%, and Busan with 8.8%. According to age, older age showed greater diabetic amputation rate. Conclusion: In accordance with the rising incidence of diabetes, the diabetic amputation is also increasing. Here, we showed that toes were amputated with the highest percentage and males had greater amputation rate than females for all body parts. Moreover, amputation rate was highest in older diabetic patients, especially for those in their seventies. Additionally, Seoul was the region with highest amputation rate. [ABSTRACT FROM AUTHOR]

Heavy metals in the mangrove sediments of Chuuk and Kosrae, Federated States of Micronesia were analyzed to examine the pollution levels of heavy metals using enrichment factor (EF) and pollution load index (PLI). The mean concentrations of Cr, Ni, Cu, Zn, As, Cd and Pb in surface mangrove sediments were 642, 125, 46.9, 149, 15.6, 0.14 and 8.55 μg, respectively. Kosrae mangrove sediments showed the highest concentrations of Cr and Ni while Chuuk contains more of other metals such as Cu, Zn, As, Cd and Pb. Compared to those from other mangrove regions of the world, Cr, Ni and As levels in mangrove sediments from Micronesia were at higher levels whereas Cu, Zn, Cd and Pb were at lower to median levels. In core sediment of Chuuk, metal concentrations in the upper part were higher than those in the lower part. Based on the EF and PLI values, As is evaluated as the heaviest contaminant in the surface sediment from Micronesia whilst other metals (Cr, Ni, Cu, Zn, Cd and Pb) are present at slightly lesser levels. [ABSTRACT FROM AUTHOR]

In order to understand phytoplankton and bacterial distribution in tropical coral reef ecosystems in relation to the mangrove community, their biomass and activities were measured in the sea waters of the Chuuk and the Kosrae lagoons located in Micronesia. Chlorophyll a and bacterial abundance showed maximal values in the seawater near the mangrove forests, and then steeply decreased as the distance increased from the mangrove forests, indicating that environmental conditions for these microorganisms changed greatly in lagoon waters. Together with chlorophyll a, abundance of Synechococcus and phototrophic picoeukaryotes and a variety of indicator pigments for dinoflagellates, diatoms, green algae and cryptophytes also showed similar spatial distribution patterns, suggesting that phytoplankton assemblages respond to the environmental gradient by changing community compositions. In addition, primary production and bacterial production were also highest in the bay surrounded by mangrove forest and lowest outside of the lagoon. These results suggest that mangrove waters play an important role in energy production and nutrient cycling in tropical coasts, undoubtedly receiving large inputs of organic matter from shore vegetation such as mangroves. However, the steep decrease of biomass and production of phytoplankton and heterotrophic bacteria within a short distance from the bay to the level of oligotrophic waters indicates that the effect of mangrove waters does not extend far away. [ABSTRACT FROM AUTHOR]

This study analyzed the species composition and density of a macrobenthic community according to variations in the thermal discharge volumes of a nuclear power plant before, during, and after the shutdown of the nuclear power plant during two periods. In this study, 369 macrobenthic fauna species were collected, and their mean density was 1,712 ind. m-2. The number of species and diversity of macrobenthic fauna decreased with distance from the thermal discharge area, regardless of whether the nuclear plant shutdown or not. Many macrobenthic taxa appeared near the thermal discharge area, but polychaetes species were more prominent in outer areas than at the discharge area. The density of macrobenthic fauna decreased with distance from the thermal discharge area during a plant shutdown in the fall of 2011, but increased, except at two sites, near the discharge area in the winter of 2012. Cluster analysis indicated that the spatial distribution of the macrobenthic community changed in areas near the nuclear power plant after a shutdown period; that is, the station group I, in areas near the nuclear power plant, became narrower after the shutdown, but it recovered to previously occupied areas after the nuclear power plant began operating again. Opportunistic species, such as the polychaetes Lumbrineris longifolia (= Scoletoma longifolia) and Mediomastus californiensis, which were present in high densities near thermal discharge areas, decreased after the shutdown but recovered after the plant re-opened. The number of species and diversity of the macrofauna and the density of dominant species showed a significant correlation with temperature, except in winter periods. The results of this study revealed that changes in the amount of thermal discharge before and after the shutdown of a nuclear power plant could exert an influence on the structure of macrobenthic community within the thermal discharge areas depending on the season. [ABSTRACT FROM AUTHOR]

Objective : This study was to evaluate the effectiveness of Bee Venom acupuncture therapy on external epicondylitis. Methods : We divided chronic arthritis of ankle patient into 2 groups; one group combined bee venom acupuncture therapy and acupuncture therapy, another group was only acupuncture therapy. To estimate the effectiveness of treatment that applied for two groups, we used visual analog scale(VAS). We compared the VAS score of two groups statistically. Results : 1. As a result of evaluation by using visual analog scale(VAS), treatment score at final was marked more higher than score before treatment on each groups. 2. treatment at final, acupuncture and bee venom acupuncture therapy group had significant result on visual analog scale(VAS) compared with acupuncture therapy group. Conclusion : Bee Venom acupuncture therapy can be used with acupuncture therapy for highly effective treatment for external epicondylitis.

Background: Simplified acute physiology score 3 (SAPS3) was developed in 2005 to evaluate intensive care unit (ICU) performance and to predict patient mortality or disease severity. The score is usually calculated by doctors, but it requires substantial human resources. And many nurse-lead studies use this scoring system. In the present study, we examined the inter-rater reliability of SAPS3 among nurses in an ICU. Methods: Five ICU nurses who worked in an ICU for a mean length of 7.8 years were educated for 2 hours about SAPS3 score and its components. Each nurse scored 26 patients, and the intraclass correlation coefficient (ICC) of the total scores and each subset were evaluated. Results: The ICC (95% confidence interval) of SAPS3 score was 0.89 (0.82-0.95), that of subset I was 0.90 (0.82-0.95), subset II was 0.54 (0.35-0.73), and subset III was 0.95 (0.91-0.97). The ICC of predicted mortality was 0.91 (0.85-0.96). Conclusions: The ICC of SAPS3 score and predicted mortality among ICU nurses were reliable. According to these ICC values, SAPS3 score is a reliable scale to be used by nurses. The ICC of subset II was lower than those of the other subsets, suggesting that education of SAPS3 should focus on the definition of each subset II component.