The Activities and Roles of Trauma Surgeons in the Treatment of COVID-19 Patients

Trauma surgeons’ roles in a national hospital in Korea changed during the COVID-19 pandemic. In this study, we report on their roles over a 15-month period (March 2020 to May 2021) including the eight months where the hospital was a COVID-19-only hospital. Despite shortages in medical resources including medical personnel, and intensive care unit (ICU) beds, the trauma surgeons helped to control the public health problem by assuming various roles including working in another COVID-19 ICU in Dae-gu, treating trauma patients with COVID-19 or those who needed self-quarantine, being in charge of care for some COVID-19 patients in the ICU (for two months), and performing the role of a rapid response team member for COVID-19 ICU patients. In this report, we emphasize how trauma surgeons, along with intensivists, played an active role in treatment of COVID-19 patients, and helped prevent the collapse of the healthcare system within the hospital during the pandemic

COVID-19 in a Patient Previously Exposed to Toxic Disinfectant from a Humidifier

In August, 2011, the Korean Public Health Surveillance declared an outbreak of pulmonary disease due to the inhalation of humidifier disinfectants (HDs), which led to approximately 20,000 deaths. In March, 2020, the World Health Organization declared coronavirus disease-2019 (COVID-19) a pandemic. In this Case Report, we present a rare case of a patient who inhaled toxic HDs and developed COVID-19. He was young and had a low risk of severe COVID-19, however, he had a critical course to recovery. He was admitted to the intensive care unit and administered high-flow oxygen via a nasal cannula. He received dexamethasone injections each day for 10 days and his condition began to improve on hospital Day 6, although radiographical findings revealed no improvement. He was discharged on hospital Day 26. Despite the patient’s chronic lung disease becoming asymptomatic, HDs could be an important risk factor affecting the clinical course of COVID-19

A Case Series of Trauma Resuscitation in the Intensive Care Unit Bypassing the Emergency Room During the Conversion to a COVID-19 Only Hospital

When a patient with severe trauma is admitted to the emergency room (ER), they are evaluated before transfer to either the intensive care unit (ICU) or operating room. To minimize the time until a definitive treatment can be provided, direct operating room resuscitation can be performed. In this hospital the ER was closed during the hospital’s transition to a coronavirus disease 2019-dedicated hospital, and direct ICU resuscitation for patients with trauma was performed for a short period. To perform effective trauma resuscitation, all ICU beds were reorganized to achieve a modified, experienced nurse: patient ratio (1:2–3) and 2 beds were assigned for trauma ICU resuscitation alone. The equipment for initial resuscitation was installed and ICU nurses received training. Consultations with the hospital administration, nursing, and pharmaceutical departments were completed in advance to avoid formal problems. Conversion of the ICU for direct resuscitation procedures was performed in 4 patients

Prevalence of Bartonella henselae and Bartonella clarridgeiae in cats and dogs in Korea

Blood, saliva, and nail samples were collected from 54 dogs and 151 cats and analyzed for the presence of Bartonella henselae with a novel nested polymerase chain reaction (PCR) method. Bartonella (B.) henselae was detected in feral cat blood (41.8%), saliva (44.1%), and nail (42.7%) samples. B. henselae was also detected in pet cat blood (33.3%), saliva (43.5%), and nail (29.5%) samples and in pet dog blood (16.6%), saliva (18.5%), and nail (29.6%) samples. Nine samples were infected with B. clarridgeiae and 2 were co-infected with B. henselae and B. clarridgeiae of blood samples of dogs. This report is the first to investigate the prevalence of B. henselae and B. clarridgeiae in dogs and cats in Korea, and suggests that dogs and cats may serve as potential Bartonella reservoirs

Thoracic paravertebral block for breast surgery in a pregnant woman -A case report-

Non-obstetrical surgery during the first trimester is stressful to both the mother and the fetus. Anesthesiologists are also stressed, not only because of the effects of surgery itself, but also because of the uncertain influences of anesthesia thrown upon on the fetus. The authors present a case of breast surgery successfully performed on a woman 8 weeks pregnant requiring removal of breast abscess by the application of thoracic paravertebral block without any complications. Thoracic paravertebral block may be a safe anesthetic method for non-obstetric surgery during early pregnancy

Anti-tumor effects of rivoceranib against canine melanoma and mammary gland tumour in vitro and in vivo mouse xenograft models

Background Rivoceranib, a novel tyrosine kinase inhibitor, exhibits anti-tumour effects by selectively blocking vascular endothelial growth factor receptor-2 (VEGFR2) in cancer cells. Recently, the therapeutic effects of rivoceranib on solid tumours have been elucidated in human patients. However, the anti-tumour effects of rivoceranib against canine cancer remain unclear. Here, we investigated the anti-tumour effects of rivoceranib using in vitro and in vivo mouse xenograft models. Methods We performed cell proliferation, cell cycle, and migration assays to determine the effects of rivoceranib on canine solid tumour cell lines in vitro. Furthermore, apoptosis and angiogenesis in tumour tissues were examined using a TUNEL assay and immunohistochemistry methods with an anti-cluster of differentiation-31 antibody, respectively. Additionally, the expression levels of cyclin-D1 and VEGFR2 activity were determined using western blot analysis. Results Rivoceranib treatment showed anti-proliferative effects and mediated cell cycle arrest in the canine melanoma cell line (LMeC) and the mammary gland tumour (MGT) cell line (CHMp). In animal experiments, rivoceranib decreased the average volume of LMeC cells compared to that following control treatment, and similar results were observed in CHMp cells. Histologically, rivoceranib induced apoptosis and exerted an anti-angiogenic effect in tumour tissues. It also downregulated the expression of cyclin-D1 and inhibited VEGFR2 activity. Conclusion Our results show that rivoceranib inhibits proliferation and migration of tumour cells. These findings support the potential application of rivoceranib as a novel chemotherapeutic strategy for canine melanoma and MGTs.This research was supported by Basic Science Research Program to Research Institute for Basic Sciences (RIBS) of Jeju National University through the National Research Foundation of Korea (NRF) funded by the Ministry of Educa‑tion (2019R1A6A1A10072987)

Pharmacokinetic study of meropenem in healthy beagle dogs receiving intermittent hemodialysis

Meropenem, a second carbapenem antimicrobial agent with a broad spectrum of activity, is used to treat sepsis and resistant-bacterial infections in veterinary medicine. The objective of this study was to identify the pharmacokinetics of meropenem in dogs receiving intermittent hemodialysis (IHD) and to determine the proper dosing in renal failure patients receiving IHD. Five healthy beagle dogs were given a single i.v. dose of 24 mg/kg of meropenem and received IHD. The blood flow rate, dialysate flow, and ultrafiltration rate were maintained at 40 mL/min, 300 mL/min, and 40 mL/h, respectively. Blood samples were collected for 24 h from the jugular vein and from the extracorporeal arterial and venous line. Urine samples and dialysate were also collected. The concentrations of meropenem were assayed using HPLC/MS/MS determination. The peak plasma concentration was 116 +/- 37 mu g/mL at 15 min. The systemic clearance was 347 +/- 117 mL/h/kg, and the steady-state volume of distribution was 223 +/- 67 mL/kg. Dialysis clearance was 71.1 +/- 34.3 mL/h/kg, and the extraction ratio by hemodialysis was 0.455 +/- 0.150. The half-life (T-1/2) in dogs with IHD decreased compared with those without IHD, and the reduction in T1/2 was greater in renal failure patients than in normal patients. Sixty-nine percent and 21% of the administered drug were recovered by urine and dialysate in the unchanged form, respectively. In conclusion, additional dosing of 24 mg/kg of meropenem after dialysis could be necessary according to the residual renal function of the patient based on the simulated data.OAIID:RECH_ACHV_DSTSH_NO:T201621129RECH_ACHV_FG:RR00200001ADJUST_YN:EMP_ID:A003050CITE_RATE:1.279FILENAME:Byun_et_al-2016-Journal_of_Veterinary_Pharmacology_and_Therapeutics.pdfDEPT_NM:수의학과EMAIL:[email protected]_YN:YFILEURL:https://srnd.snu.ac.kr/eXrepEIR/fws/file/eb2b2d93-6cb2-4420-a374-90eb43215957/linkCONFIRM:

Tonicity-responsive enhancer-binding protein promotes hepatocellular carcinogenesis, recurrence and metastasis

Objectives: Hepatocellular carcinoma (HCC) is a common cancer with high rate of recurrence and mortality. Diverse aetiological agents and wide heterogeneity in individual tumours impede effective and personalised treatment. Tonicity-responsive enhancer-binding protein (TonEBP) is a transcriptional cofactor for the expression of proinflammatory genes. Although inflammation is intimately associated with the pathogenesis of HCC, the role of TonEBP is unknown. We aimed to identify function of TonEBP in HCC. Design: Tumours with surrounding hepatic tissues were obtained from 296 patients with HCC who received completion resection. TonEBP expression was analysed by quantitative reverse transcription-quantitative real-time PCR (RT-PCR) and immunohfistochemical analyses of tissue microarrays. Mice with TonEBP haplodeficiency, and hepatocyte-specific and myeloid-specific TonEBP deletion were used along with HCC and hepatocyte cell lines. Results: TonEBP expression is higher in tumours than in adjacent non-tumour tissues in 92.6% of patients with HCC regardless of aetiology associated. The TonEBP expression in tumours and adjacent non-tumour tissues predicts recurrence, metastasis and death in multivariate analyses. TonEBP drives the expression of cyclo-oxygenase-2 (COX-2) by stimulating the promoter. In mouse models of HCC, three common sites of TonEBP action in response to diverse aetiological agents leading to tumourigenesis and tumour growth were found: cell injury and inflammation, induction by oxidative stress and stimulation of the COX-2 promoter. Conclusions: TonEBP is a key component of the common pathway in tumourigenesis and tumour progression of HCC in response to diverse aetiological insults. TonEBP is involved in multiple steps along the pathway, rendering it an attractive therapeutic target as well as a prognostic biomarker

The Status of Protein Supply to Patients in the Trauma and Surgical Intensive Care Units and the Effects of Feedback on Protein Supply: A Multicenter Study

Purpose To investigate the status of protein supply by comparing the recommended amount with the delivered amount of protein in patients in the trauma and surgical intensive care units (ICU). Feedback on the protein supply status was presented to each hospital, and we evaluated whether the protein supply had increased to an appropriate level. Methods In this retrospective observational multicenter study, nutritional information on patients in the trauma and surgical ICUs who had received nutritional support intervention was collected on the 1st Wednesday of each month at two-month intervals from August 2020 to June 2021, from nine domestic hospitals in Korea. Every two months, the nutritional status of each hospital was shared with all hospitals, and each nutritional support team received feedback on protein supply status. Results There were 246 patients from nine hospitals included in this study, and data over the study period from six protein days, were analyzed. The mean ratios of delivered calories to calculated required calories were 74.0%, 80.8%, 85.4%, 77.9%, 71.3%, and 82.1% on Protein Days 1, 2, 3, 4, 5, and 6, respectively. The mean ratios of delivered protein to calculated required protein were 73.0%, 77.2%, 78.9%, 79.3%, 69.4%, and 89.6% on Protein Days 1, 2, 3, 4, 5, and 6, respectively. Conclusion Protein supply increased to an appropriate level, feedback on protein supply status may have increased the protein supply ratio and promoted appropriate protein supply and nutritional support for patients in the trauma and surgical ICUs