• Journal of Korean Neurosurgical Society
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• 제65권5호
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• pp.680-687
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• 2022

Objective : The influence of moderate-to-severe traumatic brain injury (TBI) on acute pulmonary injury is well established, but the association between acute pulmonary injury and mild TBI has not been well studied. Here, we evaluated the histological changes and fluctuations in inflammatory markers in the lungs to determine whether an acute pulmonary inflammatory response occurred after mild TBI. Methods : Mouse models of mild TBI (n=24) were induced via open-head injuries using a stereotaxic impactor. The brain and lungs were examined 6, 24, and 72 hours after injury and compared to sham-operated controls (n=24). Fluoro-Jade B staining and Astra blue and hematoxylin staining were performed to assess cerebral neuronal degeneration and pulmonary histological architecture. Quantitative real-time polymerase chain reaction analysis was done to measure inflammatory cytokines. Results : Increased neuronal degeneration and the mRNA expression of interleukin (IL)-6, tumor necrosis factor (TNF)-α, IL-10, and transforming growth factor (TGF)-β were observed after mild TBI. The IL-6, TNF-α, and TGF-β levels in mice with mild TBI were significantly different compared to those of sham-operated mice 24 hours after injury, and this was more pronounced at 72 hours. Mild TBI induced acute pulmonary interstitial edema with cell infiltration and alveolar morphological changes. In particular, a significant infiltration of mast cells was observed. Among the inflammatory cytokines, TNF-α was significantly increased in the lungs at 6 hours, but there was no significant difference 24 and 72 hours after injury. Conclusion : Mild TBI induced acute pulmonary interstitial inflammation and alveolar structural changes, which are likely to worsen the patient's prognosis.

• Journal of Korean Neurosurgical Society
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• 제55권1호
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• pp.26-31
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• 2014

Objective : Early decompressive craniectomy (DC) has been used as the first stage treatment to prevent secondary injuries in cases of severe traumatic brain injury (TBI). Postoperative management is the major factor that influences outcome. The aim of this study is to investigate the effect of postoperative management, using intracranial pressure (ICP) monitoring and including consecutive DC on the other side, on the two-week mortality in severe TBI patients treated with early DC. Methods : Seventy-eight patients with severe TBI [Glasgow Coma Scale (GCS) score <9] underwent early DC were retrospectively investigated. Among 78 patients with early DC, 53 patients were managed by conventional medical treatments and the other, 25 patients were treated under the guidance of ICP monitoring, placed during early DC. In the ICP monitoring group, consecutive DC on the other side were performed on 11 patients due to a high ICP of greater than 30 mm Hg and failure to respond to any other medical treatments. Results : The two-week mortality rate was significantly different between two groups [50.9% (27 patients) and 24% (6 patients), respectively, p=0.025]. After adjusting for confounding factors, including sex, low GCS score, and pupillary abnormalities, ICP monitoring was associated with a 78% lower likelihood of 2-week mortality (p=0.021). Conclusion : ICP monitoring in conjunction with postoperative treatment, after early DC, is associated with a significantly reduced risk of death.

• 한국방사선학회논문지
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• 제6권2호
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• pp.107-114
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• 2012

사고로 인해 응급실을 내원한 중증외상환자로 등록된 환자 중 혈관조영술을 시행 받고, 동맥 출혈이 진단되어 동맥색전술을 시행 받은 환자를 대상으로 생존군과 사망군을 비교하여 생존의 영향을 미치는 인자와 치료방법으로 혈관조영술 및 색전술의 유용성과 적절한 시행 시점을 연구하였다. 2006년 7월부터 2010년 12월에 경기도에 위치한 H병원 응급실에 중증외상환자로 분류된 환자 중 혈관조영술과 동맥색전술을 시행한 환자 45명을 대상으로 하여 후향적 분석을 실시하였다. 주요 지표로 ISS(Injury Severity Score)와 RTS(Revised Trauma Score), 적혈구 용적률 (Hematocrit)를 삼았다. 다발성 손상의 의한 중증외상환자의 경피적 동맥색전술은 모두 성공적으로 시술되었고, 환자의 사망률과 합병증을 줄이는데 도움을 줄 수 있으며, RTS, ISS, Hematocrit, 쇼크 등이 사망률 조기 인자로써 예측이 가능하였으며 생체활력증후가 안 좋은 환자는 색전술 시행 시점을 가능한 빠르게 진행시켜야 한다.

• 한국임상수의학회지
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• 제20권4호
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• pp.449-457
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• 2003

To investigate the renal effects of enrofloxacin administration on rats induced with dehydration or hyperoxaluria, male rats were treated with enrofloxacin of 50 mg to 500 mg/kg b.w.. The microscopical observations of kidney and urine sediment were carried out in the experimental groups. The result obtained were as follows; The male rats deprived of water for 72 hours and administered with enrofloxacin. As enrofloxacin administration dose was increased, clinical signs such as loss of appetite, depression, weakness, and loss of urine output became more severe. In the histopathological findings, there were hyperemia and hemorrhage in renal cortex, vacuolation and necrosis of renal tubular epithelia, proteinous casts within renal tubules. The male rats were orally administered with sodium oxalate and injected with enrofloxacin for 7days. As enrofloxacin administration dose was increased, clinical signs such as the loss of appetite and water consumption, and weakness became more severe. In the histopathological findings, there are hemorrhage of glomeruli and cortical hyperemia, vacuolation and necrosis of tubular epithelia, proteinous casts in renal tubules. In the microscopical findings of urine sediment, there are calcium oxalate crystal (diamond-like type) and magnesium ammonium phosphate crystals (rhomboid). The male rats were intraperitoneally injected with sodium oxalate and administered with enrofloxacin for 7days. As enrofloxacin administration dose was increased, clinical signs such as the loss of appetite and water consumption, weakness were more severe. In the histopathological findings, there were hyperemia and hemorrhage in both glomeruli and renal cortex. Severe necrosis of renal tubular epithelia, bluish materials within renal tubules were also found. In the microscopical findings of urine sediment, there were many calcium oxalate crystals. The present results suggest that enrofloxacin has some injurious effects in rats having dehydration or hyperoxaluria, and clinically, we should consider these renal injury effects when we use enrofloxacin in patients accompanied renal disease, dehydration and hyperoxaluria conditions.

• Kidney Research and Clinical Practice
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• 제37권4호
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• pp.338-346
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• 2018

Background: The most common cause of acute kidney injury (AKI) in pregnancy is preeclampsia. Serum cystatin C (CysC) is a potential biomarker of early kidney damage as its levels are not disturbed by volume status changes in pregnancy, and serum CysC levels could serve as a replacement for conventionally used creatinine. In this study, we investigated the serum levels of CysC in severe preeclampsia cases and the associations between CysC levels and poor obstetric outcomes. Methods: Our cohort included severe preeclampsia patients with a normal serum creatinine level. Creatinine was measured to calculate estimated glomerular filtration rate (eGFR) based on the Cockcroft and Gault, Modification of Diet in Renal Disease Study (MDRD), and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations, while CysC was measured to calculated eGFR based on a CysC-based equation. We then evaluated the correlations between serum CysC level, eGFR, and obstetric outcomes. Results: Twenty-six patients were evaluated of which 38.5% delivered preterm and 30.8% had low-birth weight babies. Unlike creatinine-based eGFR and CysC-based eGFR, serum CysC demonstrate significant negative correlation with gestational age. Receiver operating characteristic curve analysis indicated that serum CysC is a potential biomarker of preterm delivery with a cut-off serum level of 1.48 mg/L with 80% sensitivity and 75% specificity. Conclusion: GFR estimation using CysC is likely to be inaccurate in pregnancy. However, we found a significant correlation between preterm delivery and serum CysC level. Our results suggest that serum CysC level has the potential to predict preterm delivery in severe preeclampsia patients.

• Journal of Korean Neurosurgical Society
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• 제62권2호
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• pp.232-242
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• 2019

Objective : To investigate the effects of trauma center establishment on the clinical characteristics and outcomes of trauma patients with traumatic brain injury (TBI). Methods : We enrolled 322 patients with severe trauma and TBI from January 2015 to December 2016. Clinical factors, indexes, and outcomes were compared before and after trauma center establishment (September 2015). The outcome was the Glasgow outcome scale classification at 3 months post-trauma. Results : Of the 322 patients, 120 (37.3%) and 202 (62.7%) were admitted before and after trauma center establishment, respectively. The two groups were significantly different in age (p=0.038), the trauma location within the city (p=0.010), the proportion of intensive care unit (ICU) admissions (p=0.001), and the emergency room stay time (p<0.001). Mortality occurred in 37 patients (11.5%). Although the preventable death rate decreased from before to after center establishment (23.1% vs. 12.5%), the difference was not significant. None of the clinical factors, indexes, or outcomes were different from before to after center establishment for patients with severe TBI (Glasgow coma scale score ${\leq}8$). However, the proportion of inter-hospital transfers increased and the time to emergency room arrival was longer in both the entire cohort and patients with severe TBI after versus before trauma center establishment. Conclusion : We confirmed that for patients with severe trauma and TBI, establishing a trauma center increased the proportion of ICU admissions and decreased the emergency room stay time and preventable death rate. However, management strategies for handling the high proportion of inter-hospital transfers and long times to emergency room arrival will be necessary.

• Journal of Preventive Medicine and Public Health
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• 제43권1호
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• pp.84-92
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• 2010

Objectives: To investigate the patterns of unintentional home injuries in Korea. Methods: The study population was 12,382,088 people who utilized National Health Insurance services due to injuries (main diagnosis codes S00 to T28) during 2006. Stratified samples(n=459,501) were randomly selected by sex, age group and severity of injury. A questionnaire was developed based on the International Classification of External Causes of Injury and 18,000 cases surveyed by telephone were analyzed after being projected into population proportionately according to the response rates of their strata. Domestic injury cases were finally included. Results: Domestic injuries (n=3,804) comprised 21.1% of total daily life injuries during 2006. Women were vulnerable to home injuries, with the elderly and those of lower income (medical-aid users) tending to suffer more severe injuries. Injury occurred most often due to a slipping fall (33.9%), overexertion (15.3%), falling (9.5%) and stumbling (9.4%), with severe injury most often resulting from slipping falls, falls and stumbles. Increasing age correlated with domestic injury-related disability. Conclusions: The present findings provide basic information for development of home injury prevention strategies, with focus on the elderly.

• 한국잡초학회지
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• 제7권3호
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• pp.321-328
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• 1987

토양처리(土壤處理) 제초제(除草劑)인 Napropamide와 Pendimethalin을 고추재배(栽培)에 사용(使用)할 때 약해(藥害) 발생요인(發生要因)을 구명(究明)하여 약해(藥害)를 감소(減少)시키는데 필요(必要)한 기초자료(基礎資料)를 조사(調査)하고자 근부침지(根部浸漬)에 따른 고추 품종간(品種間) 생장반응(生長反應)과 토성(土性), 유기물(有機物) 함량(含量), 토양온도(土壤溫度) 및 파종심도(播種深度)에 따른 고추 품종간(品種間) 약해정도(藥害程度)를 비교(比較) 검토(檢討)하였다. 1. Napropamide는 근부침지(根部浸漬)에서 월계관 피만과 오리엔탈 피만의 최상위엽(最上位葉) 생장(生長)이 크게 억제(抑制)되지 않았다. 2. Pendimethalin은 근부침지(根部浸漬)에서 최상위엽(最上位葉) 억제(抑制)가 월계관 피만과 오리엔탈 피만에서 현저히 심했다. 3. Napropamide와 Pendimethalin의 약해(藥害)는 사토(砂土)에서 심하게 나타났으며 특히 피만계통(系統) 품종(品種)에서 더욱 심하였고 양통(壤土)에서 약해(藥害)는 적었다. 4. 유기물(有機物) 함량(含量)이 높을수록 Napropamide와 Pendimethalin의 약해(藥害)는 적은 경향(傾向)이었으며 월계관 피만과 오리엔탈 피만에서는 그 경향(傾向)이 현저하였다. 5 파종심도(播種深度)가 깊으면 Napropamide와 Pendimethalin의 약해(藥害)는 다소(多少) 적은 경향(傾向)이었으며 월계관 피만과 오리엔탈 피만의 고농도(高濃度)에서 그 경향(傾向)은 더욱 뚜렷하였다.

• The Korean Journal of Pain
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• 제21권3호
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• pp.244-247
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• 2008

After a traumatic brachial plexus injury, 80% of patients develop severe pain in the deafferentated arm. This type of pain is considered very resistant to many forms of therapy. When we plan treatments for the patient who suffer from a pain from traumatic brachial plexus injury, clarifying the location of injured nerve is very important. EMG (electromyography), NCV (nerve conduction study), MRI (magnetic resonance imaging) and CT (computed tomography) myelography are recommended diagnostic method for this purpose. Here, we presented a patient who was suspected to have both preganglionic and postganglionic brachial plexus lesion by EMG and NCV study, he showed favorable response after spinal cord stimulation.

• Journal of Korean Neurosurgical Society
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• 제51권2호
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• pp.117-119
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• 2012

The sinking skin flap syndrome is a rare complication after a large craniectomy. It consists of a sunken skin above the bone defect with neurological symptoms such as severe headache, mental changes, focal deficits, or seizures. In patient with sinking skin flap syndrome, cerebral blood flow and cerebral metabolism are decreased by sinking skin flap syndrome, and it may cause the deterioration of autoregulation of brain. We report a case of a patient with sinking skin flap syndrome who suffered from reperfusion injury after cranioplasty with review of pertinent literature.