• Title/Summary/Keyword: 경막하

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A Study on the Main Diagnostic Code according to the Analysis of the Frequency of Fall Patients by Case-Centered Damage External Code (사례 중심의 손상외인코드 별 낙상환자 빈도수 분석에 따른 주진단코드 연구)

  • Eun-Mee Choi;Ye-Ji Park;So-Hyeon Bang;Jin-Hyoung Jeong
    • The Journal of Korea Institute of Information, Electronics, and Communication Technology
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    • v.16 no.6
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    • pp.533-539
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    • 2023
  • This study aimed to analyze patients hospitalized for injuries who fell using the data from 2020 to 2021 at institution A located in Gangneung-si, Gangwon-do, using codes for causes of injury. After classifying 20 codes from W00 to W19, which are external cause codes for fall patients, the most frequently occurring W18, W01, W10, and W13 were analyzed. The external cause of injury code W18 was other falls on the same plane, with the highest frequency of S72 and Z47, S72 being a fracture of the femur, and Z47 being orthopedic follow-up treatment. The external injury code W01 was determined to be a fall on the same plane due to slipping, tripping, and tripping, and like W18, S72, a fracture of the femur, and Z47, orthopedic follow-up treatment, were frequently reported. In W10, intracranial injuries such as concussion and epidural hemorrhage due to a fall on the stairs, S06, were common. Lastly, in W13, 91% of cases occurred in people in their 40s to 70s due to falls from buildings or structures, confirming that they occur frequently in middle-aged people, Z47 had the most frequent orthopedic follow-up treatment, and S72 had a fracture of the femur. It was found to be the second most common. In this way, the frequency of falling patients was analyzed, and the age and main diagnosis code at which most falls occurred were analyzed.

Studies About the Effect of Excitatory Amino Acid Receptor Antagonist on Traumatic Spinal Cord Injury (척수신경손상에 대한 흥분성 아미노산 수용체 길항제의 효과에 대한연구)

  • Kim Jong-Keun
    • The Korean Journal of Pharmacology
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    • v.31 no.1 s.57
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    • pp.1-9
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    • 1995
  • The slow development of histopathological changes and long period required for stabilization of lesions have suggested that secondary injury processes exacerbate the effect of initial mechanical insult after traumatic spinal cord injury (SCI). The importance of glutamate receptors in the normal functions of spinal cord, in concert with the large body of evidence that points to their involvement in neurotoxicity due to both ischemic and traumatic insults to the CNS, suggested a probable role of glutamate receptors in secondary injury process after traumatic SCI. In order to investigate the involvement of excitatory amino acid in the secondary injury process after SCI, this study examined the effect of dextrorphan, a noncompetitive NMDA receptor antagonist, on the recovery of hindlimb function and the residual tissue at injury site following SCI. Locomotor function was assessed using open field test (21 point scale). At 8 weeks spinal cord tissue was examined using quantitative histopathologic technique. Prior to surgery female Long-Evans rats were adapted to the test environment. Rats received laminectomies (T9/T10), and spinal cord contusions (NYU impactor) were produced by a 10 gm weight dropped 25 mm. DXT (15 or 30 mg/kg, i.p.) or saline was injected 15 min before contusion. Behavioral testing resumed 2 days post-injury and continued twice a week for 8 weeks. No differences between DXT and saline groups were found for hindlimb function and sparing tissue at the lesion site. These results suggest that NMDA receptor might not be involved in secondary injury processes after traumatic SCI.

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THE ROLE OF TRANSCRIPTION FACTOR MSX2 AND DLX5 IN CALVARIAL BONE AND SUTURE DEVELOPMENT (두개골 및 두개봉합부 초기발육과정에서의 전사조절인자인 Msx2와 Dlx5의 역할)

  • Song, Min-Ho;Park, Mi-Hyun;Nam, Soon-Hyeun;Kim, Young-Jin;Ryoo, Hyun-Mo;Kim, Hyun-Jung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.30 no.3
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    • pp.391-405
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    • 2003
  • Craniosynostosis, known as a premature fusion of cranial sutures, is a developmental disorder characterized by precocious differentiation and mineralization of osteoblasts in the calvarial sutures. Recent genetic studies have demonstrated that mutation in the homeobox gene Msx2 causes Boston-type human craniosynostosis. Additionally, the phenotype of Dlx5 homozygote mutant mouse presents craniofacial abnormalities including a delayed ossification of calvarial bone. Furthermore transcription of osteocalcin, a mature osteoblast marker, is reciprocally regulated by the homeodomain proteins Msx2 and Dlx5. These facts suggest important roles of osteocalcin, Msx2 and Dlx5 genes in the calvarial bone growth and suture morphogenesis. To elucidate the function of these molecules in the early morphogenesis of mouse cranial sutures, we have first analyzed by in situ hybridization the expression of osteocalcin, Msx2 and Dlx5 genes in the developing parietal bone and sagittal suture of mouse calvaria during the embryonic (E15-E18) stage. Osteocalcin mRNA was found in the periosteum of parietal bones from E15, and gradually more highly expressed with aging. Msx2 mRNA was intensely expressed in the sutural mesenchyme, osteogenic fronts and mildly expressed in the dura mater during the embryonic stage. Dlx5 mRNA was intensely expressed osteogenic fronts and the periostem of parietal bones. To further examine the upstream signaling molecules of transcription factor Msx2 and Dlx5, we have done in vitro experiments in E15.5 mouse calvarial explants. Interestingly, implantation of BMP2-, BMP4-soaked beads onto the osteogenic fronts after 48 hours organ culture induced etopic expressions of Msx2 and Dlx5 genes. On the other hand, overexpression of $TGF{\beta}1$, GDF-6, -7, FGF-2, -4 and Shh did not induce the expression of Msx2 and Dlx5. Taken together. these data indicate that transcription factor Msx2 and Dlx5 play critical roles in the calvarial bone and suture development, and that BMP siganling is involved in the osteogenesis of calvarial bones and the maintenance of cranial sutures through regulating these two transcriotpn factors. Furthermore, different expression patterns between Msx2 and Dlx5 suggest their specific functions in the osteoblast differentiation.

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The Clinical Characteristics According to the Risk Factors of Idiopathic Nonhemolytic Hyperbilirubinemia (신생아 특발성 비용혈성 고빌리루빈혈증의 위험 요인에 따른 임상 양상)

  • Park, Sook-Hyun;Kang, Ji-Hyun;Kwon, Soon-Hak;Kim, Heng-Mi;Kim, Yong-Sun
    • Neonatal Medicine
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    • v.17 no.2
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    • pp.224-231
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    • 2010
  • Purpose: Hospital readmissions have recently increased due to early hospital discharge and increased trends in breast-feeding. Neonatal hyperbilirubinemia can lead to fatal permanent neurological sequelae without appropriate management. Early detection and intervention are critical. We evaluated the clinical features, risk factors, and brain MRI findings of Korean newborns with idiopathic nonhemolytic hyperbilirubinemia to determine the optimal management policy. Methods: A retrospective review of the medical records of 79 newborns with idiopathic nonhemolytic hyperbilirubinemia was performed at the NICU of the Kyungpook National University Hospital from January 2006 to September 2009. All patients were 35 or more weeks of gestation, and their peak level of serum total bilirubin was more than 20 mg/dL. Results: The mean gestational age was $38^{+3}{\pm}1^{+4}$ weeks, and the mean age on admission was 8.8$\pm$4.0 days. The mean body weight (3,105$\pm$479 g) was decreased by 2.8$\pm$6.4 percent compared to the mean birth weight (3,174$\pm$406 g). There were no statistically significant differences for the peak serum bilirubin level or the duration and effects of phototherapy between the patients with and without risk factors, which included: breastfeeding, cephalohematoma, subdural hemorrhage, and/or ABO incompatibility. Patients were grouped according to change of body weight. Group I consisted of patients that gained weight compared to birth weight, and group II of patients that lost weight compared to birth weight. There were significant differences in the peak serum total bilirubin level between the two groups. Thirty nine patients had brain MRI evaluation; 21 patients had bilateral symmetric signal intensity increases in the globus pallidus compared to adjacent corticospinal tract and putamen on T1-weighted images. Conclusion: Bilirubin encephalopathy is preventable with early screening and proper management. Parents require instruction on feeding practices and follow-up to prevent complications from idiopathic nonhemolytic hyperbilirubinemia.

Evaluation on the bone regenerative capacity of hyaluronic acid applied poly (D,L-lactic-co-glycolic acid) membranes in rabbit calvarial defect (Rabbit calvaria를 이용하여 hyaluronic acid (HA)를 처리한 poly (D,L-lactic-co-glycolic acid) 차폐막들의 골 생성능력에 대한 비교 연구)

  • Kim, Nam-Sook;Yun, Kwi-Dug;Vang, Mong-Sook;Yang, Hong-So;Lim, Hyun-Phil;Kang, Sung-Soo;Park, Sang-Won
    • The Journal of Korean Academy of Prosthodontics
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    • v.48 no.2
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    • pp.158-165
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    • 2010
  • Purpose: The objective of the present study was to histologically evaluate durability and bone regeneration capacity of new synthetic membranes in comparison to clinically available collagen membrane. Material and methods: To the skulls of 12 rabbits, we created 4 bone defects of 6 mm in diameter on each of them. Each of defects were covered with at least one of 5 membranes; No membrane, Collagen ($Ossix^{TM}$), PLGA, HA-coated-PLGA and HA-PLGA/PLGA. After 4, 8, 12 weeks, we cut the skulls and dyed with H-E. And then, the histologic observation was done. Results: In current study, the control group which did not use the membrane showed bone regeneration at 12 weeks and covered the bone defect partially. New bones were formed through the underneath of endocranium, and the upper defect was filled with connective tissues and fats. Collagen membrane ($Ossix^{TM}$) showed new bones after 4 weeks, and they were formed through the membrane which maintained until 12 weeks. PLGA, HA-coated-PLGA, HA-PLGA/PLGA showed bone regeneration after 4 weeks and after 8 weeks, they mostly filled defects. At 12 weeks, we could find new bones and previous bones almost look alike and also, they united well. Membranes were unnoticeable after 4 weeks and were absorbed. Conclusion: Bone formation and maturation of PLGA, HA-coated-PLGA and HA-PLGA/PLGA were faster than the control group. They showed no difference on the application of HA and after 4 weeks, they were absorbed.

A clinical study of child bacterial meningitis in Daejeon and Chungcheong area : 2001-2005 (대전·충청 지역의 소아 세균성 수막염에 대한 임상적 연구 : 2001-2005)

  • Lee, Yong Joo;Lee, Soo Jin;Park, Ho Jin;Lee, Young Hyuk;Kang, So Young;Kim, Young Chang;Lee, In Kyu;Lee, Kyung Yeon;Lee, Keon Su;Kim, Won Seop
    • Clinical and Experimental Pediatrics
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    • v.50 no.2
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    • pp.157-162
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    • 2007
  • Purpose : The purpose of this study was to analyze the epidemiology, causative organism, clinical manifestation and prognosis of bacterial meningitis for children after the introduction of Haemophilus influenzae type b (Hib) vaccine in Daejeon and Chungcheong area. Methods : We analyzed retrospectively 53 medical records who had been diagnosed with bacterial meningitis at 10 general or university hospitals in Daejeon and Chungcheong area. All patients aged 1 month-14 years admitted between January 2001 through December 2005. Results : During the 5-year study period, 40 of all cases were positive for bacterial growth. Of the 40 cases that were CSF culture-proven bacterial meningitis, Streptococcus peumoniae was the most common bacteria for 17 (32.1%) of all cases, followed by H. influenzae for 10 (18.9%), Neisseria meningitidis for 3 (5.7%). In this study, the most common clinical manifestation is fever, accompanied by all cases. CSF leukocyte count was more than $100/mm^3$ in 45 (84.1%) cases. CSF glucose concentration was less than 50 mg/dL in 42 (79.2%) cases and protein concentration was more than 45 mg/dL in 49 (92.5%) cases. 45 of all cases made a recovery after treatment and were discharged. Most common complication after treatment is subdural effusion (19.0%) and hearing disturbance (9.4%). Conclusion : The most common organism of culture-proven bacterial meningitis in the children beyond neonatal period was S. pneumoniae. Continued surveillance studies were demanded to know the altered incidence of bacterial meningitis, because we expect the incidence of S. pneumoniae meninigitis will be on the decrease after more active innoculation of pneumococcal protein conjugate vaccine.

Percutaneous Mini-open Reduction for Mason II or III Radial Head and Neck Fracture (요골 두 및 경부 골절의 경피적 도수 정복술)

  • Lee, Jeong-Gil;Koh, Il-Hyun;Kim, Hyung-Sik;Choi, Yun-Rak;Kim, Sung-Jae;Kang, Ho-Jung
    • Clinics in Shoulder and Elbow
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    • v.13 no.2
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    • pp.230-236
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    • 2010
  • Purpose: We wanted to evaluate the result of percutaneous, mini-open reduction for the treatment of Mason II or III radial head and neck fractures. Materials and Methods: 13 patients (8 male, 5 female) with Mason II or III radial head and neck fractures were treated by 1 cm percutaneous mini-open reduction under fluoroscopy. The average age of our subjects was 29 years. Follow up duration was 18 months. Results: Union was noted in all cases. Mean radial neck angulation was decreased from 33.2 degrees to 7.8 degrees. The mean change in angulation between the immediate post-operative and last follow-up was 0.7 degrees. The mean range of motion at the elbow joint was at last follow up, 133.1 degrees in flexion, 7.3 degrees in extension, 80 degrees in pronation and 84.3 degrees in supination. Postoperatively, mean Mayo Elbow Performance Index, American Shoulder and Elbow Surgeons elbow score, and Disabilities of the Arm, Shoulder and Hand score were 96.2, 97 and 1.2. Temporary posterior interosseous nerve palsy (1 case) and minimal cubitus valgus deformity (1 case) were noted. Conclusion: Selected Mason II or III radial head and neck fractures can be treated satisfactorily with percutaneous mini-open reduction.

Korean Clinical Imaging Guidelines for the Appropriate Use of Chest MRI (한국형 흉부 MRI 영상 진단 정당성 권고안)

  • Jiyoung Song;Bo Da Nam;Soon Ho Yoon;Jin Young Yoo;Yeon Joo Jeong;Chang Dong Yeo;Seong Yong Lim;Sung Yong Lee;Hyun Koo Kim;Byoung Hyuck Kim;Kwang Nam Jin;Hwan Seok Yong
    • Journal of the Korean Society of Radiology
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    • v.82 no.3
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    • pp.562-574
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    • 2021
  • MRI has the advantages of having excellent soft-tissue contrast and providing functional information without any harmful ionizing radiation. Although previous technical limitations restricted the use of chest MRI, recent technological advances and expansion of insurance coverage are increasing the demand for chest MRI. Recognizing the need for guidelines on appropriate use of chest MRI in Korean clinical settings, the Korean Society of Radiology has composed a development committee, working committee, and advisory committee to develop Korean chest MRI justification guidelines. Five key questions were selected and recommendations have been made with the evidence-based clinical imaging guideline adaptation methodology. Recommendations are as follows. Chest MRI can be considered in the following circumstances: for patients with incidentally found anterior mediastinal masses to exclude non-neoplastic conditions, for pneumoconiosis patients with lung masses to differentiate progressive massive fibrosis from lung cancer, and when invasion of the chest wall, vertebrae, diaphragm, or major vessels by malignant pleural mesothelioma or non-small cell lung cancer is suspected. Chest MRI without contrast enhancement or with minimal dose low-risk contrast media can be considered for pregnant women with suspected pulmonary embolism. Lastly, chest MRI is recommended for patients with pancoast tumors planned for radical surgery.

Studies on the Physical and Chemical Denatures of Cocoon Bave Sericin throughout Silk Filature Processes (제사과정 전후에서의 견사세리신의 물리화학적 성질변화에 관한 연구)

  • 남중희
    • Journal of Sericultural and Entomological Science
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    • v.16 no.1
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    • pp.21-48
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    • 1974
  • The studies were carried out to disclose the physical and chemical properties of sericin fraction obtained from silk cocoon shells and its characteristics of swelling and solubility. The following results were obtained. 1. The physical and chemical properties of sericin fraction. 1) In contrast to the easy water soluble sericin, the hard soluble sericin contains fewer amino acids include of polar side radical while the hard soluble amino acid sach as alanine and leucine were detected. 2) The easy soluble amino acids were found mainly on the outer part of the fibroin, but the hard soluble amino acids were located in the near parts to the fibroin. 3) The swelling and solubility of the sericin could be hardly assayed by the analysis of the amino acid composition, and could be considered to tee closely related to the compound of the sericin crystal and secondary structure. 4) The X-ray patterns of the cocoon filament were ring shape, but they disappeared by the degumming treatment. 5) The sericin of tussah silkworm (A. pernyi), showed stronger circular patterns in the meridian than the regular silkworm (Bombyx mori). 6) There was no pattern difference between Fraction A and B. 7) X-ray diffraction patterns of the Sericin 1, ll and 111 were similar except interference of 8.85A (side chain spacing). 8) The amino acids above 150 in molecular weight such as Cys. Tyr. Phe. His. and Arg. were not found quantitatively by the 60 minutes-hydrolysis (6N-HCI). 9) The X-ray Pattern of 4.6A had a tendency to disappear with hot-water, ether, and alcohol treatment. 10) The partial hydrolysis of sericin showed a cirucular interference (2A) on the meridian. 11) The sericin pellet after hydrolysis was considered to be peptides composed with specific amino acids. 12) The decomposing temperature of Sericin 111 was higher than that of Sericin I and II. 13) Thermogram of the inner portioned sericin of the cocoon shell had double endothermic peaks at 165$^{\circ}C$, and 245$^{\circ}C$, and its decomposing temperature was higher than that of other portioned sericin. 14) The infrared spectroscopic properties among sericin I, II, III and sericin extracted from each layer portion of the cocoon shell were similar. II. The characteristics of seriein swelling and solubility related with silk processing. 1) Fifteen minutes was required to dehydrate the free moisture of cocoon shells with centrifugal force controlled at 13${\times}$10$^4$ dyne/g at 3,000 R.P.M. B) It took 30 minutes for the sericin to show positive reaction with the Folin-Ciocaltue reagent at room temperature. 3) The measurable wave length of the visible radiation was 500-750m${\mu}$, and the highest absorbance was observed at the wave length of 650m${\mu}$. 4) The colorimetric analysis should be conducted at 650mu for low concentration (10$\mu\textrm{g}$/$m\ell$), and at 500m${\mu}$ for the higher concentration to obtain an exact analysis. 5) The absorbing curves of sericin and egg albumin at different wave lengths were similar, but the absorbance of the former was slightly higher than that of the latter. 6) The quantity of the sericin measured by the colorimetric analysis, turned out to be less than by the Kjeldahl method. 7) Both temperature and duration in the cocoon cooking process has much effect on the swelling and solubility of the cocoon shells, but the temperature was more influential than the duration of the treatment. 8) The factorial relation between the temperature and the duration of treatment of the cocoon cooking to check for siricin swelling and solubility showed that the treatment duration should be gradually increased to reach optimum swelling and solubility of sericin with low temperature(70$^{\circ}C$) . High temperature, however, showed more sharp increase. 9) The more increased temperature in the drying of fresh cocoons, the less the sericin swelling and solubility were obtained. 10) In a specific cooking duration, the heavier the cocoon shell is, the less the swelling and solubility were obtained. 11) It was considered that there are differences in swelling or solubility between the filaments of each cocoon layer. 12) Sericin swelling or solubility in the cocoon filament was decreased by the wax extraction.. 13) The ionic surface active agent accelerated the swelling and solubility of the sericin at the range of pH 6-7. 14) In the same conditions as above, the cation agent was absorbed into the sericin. 15) In case of the increase of Ca ang Mg in the reeling water, its pH value drifted toward the acidity. 16) A buffering action was observed between the sericin and the water hardness constituents in the reeling water. 17) The effect of calcium on the swelling and solubility of the sericin was more moderate than that of magnecium. 18) The solute of the water hardness constituents increased the electric conductivity in the reeling water.

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