• Title/Summary/Keyword: Severe injury

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The Effects on Yield, Fruit Characteristics and Growth caused by Low Temperature Treatment of Cucumber (Cucumis sativus L.) Seedling (오이묘의 저온처리가 생육, 과실특성 및 수량에 미치는 영향)

  • Nam, Y.I.;Woo, Y.H.;Hong, K.H.;Lee, K.H.;Suh, G.S.;Kim, J.K.
    • Journal of Practical Agriculture & Fisheries Research
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    • v.10 no.1
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    • pp.77-90
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    • 2008
  • This study was conducted to investigate the influence of chilling temperature and duration at different seeding stages on yield, fruit characteristics and growth of cucumber in a greenhouse. When 20-day-old cucumber were exposed to 0 and 3℃ for 10 hours, 25 and 30% reduction in the main stem elongation rate and 34 and 37% reduction in total leaf area per plant were observed. The reduction in stem elongation and total leaf area was apparently associated with the increases in chilling duration. Exposure of seedlings to 6℃ failed to causes any significant differences in growth as compared to the unchilled plants. Repeated exposure of seedlings to 3℃ chilling for 10 hours per day increased the chilling injury significantly. The seedlings exposed to low temperature for 3 consecutive days exhibited severe injury as compared to the seedlings exposed to chilling treatment only once or twice. Fruit elongation rate was inhibited by approximately 10%, such as 0.59~2.26cm/day, with chilling of 15 hours at 0℃ as compare to 0.61~2.60cm/day in the non-chilled plants. Chilling treatment at 0~3℃ for 10 hours reduced the percentage of marketable fruits by 25~26%. while it increased the percentage of severely bent fruits significantly. Total fruits yield was reduced by 15~25% in cucumber plants when the chilling treatment was given to 20-day-old seedlings and by 22~37% in 30-day-old seedlings. This shows that, Larger seedlings were more sensitive to chilling. Total yield was also influenced by the duration of chilling. Definitely, at 0℃, 5-hour chilling treatment caused 18% of reduction, 10-hour caused 30%, and 15-hour caused 36%, respectively.

Tc-99m DMSA SPECT for Follow-Up of Non-Operative Treatments in Renal Injuries: A Prospective Single-Center Study

  • Sang-Geon Cho;Ki Seong Park;Jahae Kim;Jang Bae Moon;Ho-Chun Song;Taek Won Kang;Seong Hyeon Yu
    • Korean Journal of Radiology
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    • v.24 no.10
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    • pp.1017-1027
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    • 2023
  • Objective: The assessment of cortical integrity following renal injuries with planar Tc-99m dimercaptosuccinic acid (DMSA) scintigraphy depends on measuring relatively decreased cortical uptake (i.e., split renal function [SRF]). We analyzed the additive values of the volumetric and quantitative analyses of the residual cortical integrity using single-photon emission computed tomography (SPECT) compared to the planar scintigraphy. Materials and Methods: This prospective study included 47 patients (male:female, 32:15; age, 47 ± 22 years) who had non-operatively managed renal injuries and underwent DMSA planar and SPECT imaging 3-6 months after the index injury. In addition to planar SRF, SPECT SRF, cortical volume, and absolute cortical uptake were measured for the injured kidney and both kidneys together. The correlations of planar SRF with SPECT SRF and those of SRF with volumetric/quantitative parameters obtained with SPECT were analyzed. The association of SPECT parameters with renal function, grades of renal injuries, and the risk of renal failure was also analyzed. Results: SPECT SRF was significantly lower than planar SRF, with particularly higher biases in severe renal injuries. Planar and SPECT SRF (dichotomized with a cutoff of 45%) showed 19%-36% of discrepancies with volumetric and quantitative DMSA indices (when dichotomized as either high or low). Absolute cortical uptake of the injured kidney best correlated with glomerular filtration rate (GFR) at follow-up (ρ = 0.687, P < 0.001) with significant stepwise decreases by GFR strata (90 and 60 mL/min/1.73 m2). Total renal cortical uptake was significantly lower in patients with moderate-to-high risk of renal failure than those with low risk. However, SRF did not reflect GFR decrease below 60 mL/min/1.73 m2 or the risk of renal failure, regardless of planar or SPECT (count- or volume-based SRF) imaging. Conclusion: Quantitative measurements of renal cortical integrity assessed with DMSA SPECT can provide more clinically relevant and comprehensive information than planar imaging or SRF alone.

Intervention for Chest Trauma and Large Vessel Injury (흉부 및 대혈관 외상의 인터벤션)

  • Hojun Lee;Hoon Kwon;Chang Won Kim;Lee Hwangbo
    • Journal of the Korean Society of Radiology
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    • v.84 no.4
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    • pp.809-823
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    • 2023
  • Trauma is an injury to the body that involves multiple anatomical and pathophysiological changes caused by forces acting from outside the body. The number of patients with trauma is increasing as our society becomes more sophisticated. The importance and demand of traumatology are growing due to the development and spread of treatment and diagnostic technologies. In particular, damage to the large blood vessels of the chest can be life-threatening, and the sequelae are often severe; therefore, diagnostic and therapeutic methods are becoming increasingly important. Trauma to nonaortic vessels of the thorax and aorta results in varying degrees of physical damage depending on the mechanism of the accident and anatomical damage involved. The main damage is hemorrhage from non-aortic vessels of the thorax and aorta, accompanied by hemodynamic instability and coagulation disorders, which can be life-threatening. Immediate diagnosis and rapid therapeutic access can often improve the prognosis. The treatment of trauma can be surgical or interventional, depending on the patient's condition. Among them, interventional procedures are increasingly gaining popularity owing to their convenience, rapidity, and high therapeutic effectiveness, with increasing use in more trauma centers worldwide. Typical interventional procedures for patients with thoracic trauma include embolization for non-aortic injuries and thoracic endovascular aortic repair for aortic injuries. These procedures have many advantages over surgical treatments, such as fewer internal or surgical side effects, and can be performed more quickly than surgical procedures, contributing to improved outcomes for patients with trauma.

Predicting 30-day mortality in severely injured elderly patients with trauma in Korea using machine learning algorithms: a retrospective study

  • Jonghee Han;Su Young Yoon;Junepill Seok;Jin Young Lee;Jin Suk Lee;Jin Bong Ye;Younghoon Sul;Se Heon Kim;Hong Rye Kim
    • Journal of Trauma and Injury
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    • v.37 no.3
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    • pp.201-208
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    • 2024
  • Purpose: The number of elderly patients with trauma is increasing; therefore, precise models are necessary to estimate the mortality risk of elderly patients with trauma for informed clinical decision-making. This study aimed to develop machine learning based predictive models that predict 30-day mortality in severely injured elderly patients with trauma and to compare the predictive performance of various machine learning models. Methods: This study targeted patients aged ≥65 years with an Injury Severity Score of ≥15 who visited the regional trauma center at Chungbuk National University Hospital between 2016 and 2022. Four machine learning models-logistic regression, decision tree, random forest, and eXtreme Gradient Boosting (XGBoost)-were developed to predict 30-day mortality. The models' performance was compared using metrics such as area under the receiver operating characteristic curve (AUC), accuracy, precision, recall, specificity, F1 score, as well as Shapley Additive Explanations (SHAP) values and learning curves. Results: The performance evaluation of the machine learning models for predicting mortality in severely injured elderly patients with trauma showed AUC values for logistic regression, decision tree, random forest, and XGBoost of 0.938, 0.863, 0.919, and 0.934, respectively. Among the four models, XGBoost demonstrated superior accuracy, precision, recall, specificity, and F1 score of 0.91, 0.72, 0.86, 0.92, and 0.78, respectively. Analysis of important features of XGBoost using SHAP revealed associations such as a high Glasgow Coma Scale negatively impacting mortality probability, while higher counts of transfused red blood cells were positively correlated with mortality probability. The learning curves indicated increased generalization and robustness as training examples increased. Conclusions: We showed that machine learning models, especially XGBoost, can be used to predict 30-day mortality in severely injured elderly patients with trauma. Prognostic tools utilizing these models are helpful for physicians to evaluate the risk of mortality in elderly patients with severe trauma.

Time Course Change of Phagocytes and Proinflammatory Activities in BALF in Endotoxin-induced Acute Lung Injury (시간별 내독소 정맥주입으로 유발된 급성폐손상의 변화양상에 대한 고찰)

  • Moon, Seung-Hyug;Oh, Je-Ho;Park, Sung-Woo;NamGung, Eun-Kyung;Ki, Shin-Young;Im, Gun-Il;Jung, Sung-Whan;Kim, Hyeon-Tae;Uh, Soo-Tack;Kim, Yong-Hoon;Park, Choon-Sik;Jin, Byeng-Weon
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.2
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    • pp.360-378
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    • 1997
  • Background : Severe acute lung injury(ALI), also known as the adult respiratory distress syndrome(ARDS), is a heterogenous nature of dynamic and explosive clinical synrome that exacts a mortality of approximately 50%. Endotoxin(ETX) is an abundant component of the outer membrane of gram-negative bacteria capable of inducing severe lung injury in gram-negative sepsis and gram-negative bacterial pneumonia, which are among the most common predisposing causes of ARDS. The influx of PMNs into airway tissue is a pathological hallmark of LPS-induced lung injury. And there is a substantial evidence suggesting that cytokines are important mediators of lung injury in gram-negative sepsis. However, the kinetics of phagocytes and cytokines by an exact time sequence and their respective pathogenic importance remain to be elucidated. This study was performed to investigate the role of phagocytes and proinflammatory cytokines in ETX-induced ALI through a time course of changes in the concentration of protein, $TNF{\alpha}$ and IL-6, and counts of total and its differential cells in BALF. The consecutive histologic findings were also evaluated. Method : The experimental animals, healthy male Sprague-Dawley, weighted $200{\pm}50g$, were divided into control- and ALI- group. ALI was induced by an intravenous administration of ETX, 5mg/kg. Above mentioned all parameters were examined at 0(control), 3, 6, 24, 72 h after administration of ETX. $TNF{\alpha}$ and IL-6 cone. in BALF were measured by a bioassay. Results : The protein concentration and total leukocyte count(TC) in BALF was significantly increased at 3h compared to controls(p < 0.05). The protein conc. was significantly elavated during observation period, but TC was significantly decreased at 72h(p < 0.05 vs. 24h). There was a close relationship between TC and protein cone. in BALF(r = 0.65, p < 0.001). The PMN and monocyte count was well correlated with TC in BALF, and the correlation of PMN(r = 0.97, p < 0.001) appeared to be more meaningful than that of monocyte(r = 0.61, p < 0.001). There was also a significant correlation between protein cone. and PMN or monocyte count in BALF(PMN vs. monocyte : r = 0.55, p < 0.005 vs. r = 0.64, p < 0.001). The count of monocyte was significantly elavated during observation period though a meaningful reduction of PMN count in BALF at 72h, this observation suggested that monocyte may, at least, partipate in the process of lung injury steadly. In this study, there was no relationship between IL-6 and $TNF{\alpha}$ cone., and $TNF{\alpha}$ but not IL-6 was correlated with TC(r = 0.61, p < 0.05) and monocyte(r = 0.67, p < 0.05) in BALF only at 3, 6h after ETX introduced. In particular, the IL-6 cone. increased earlier and rapidly peaked than $TNF{\alpha}$ cone. in BALF. In histologic findings, the cell counts of lung slices were increased from 3 to 72h(p < 0.001 vs. NC). Alveolar wall-thickness was increased from 6 to 24h(p < 0.001 vs. NC). There was a significant correlation between the cell counts of lung slices and alveolar wall-thickness(r= 0.61, p < 0.001). This result suggested that the cellular infiltrations might be followed by the alterations of interstitium, and the edematous change of alveolar wall might be most rapidly recovered to its normal condition in the process of repair. Conclusion : We concluded that although the role of PMN is partly certain in ETX-induced ALI, it is somewhat inadequate to its known major impact on ALL Alveolar macrophage and/or non-immune cells such as pulmonary endothelial or epithelial cells, may be more importantly contributed to the initiation and perpetual progression of ETX-induced ALI. The IL-6 in ETX-induced ALI was independent to $TNF{\alpha}$, measured by a bioassay in BALF. The early rise in IL-6 in BALF implies multiple origins of the IL-6.

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Rhei Rhizoma Mainly Blended Prescriptions According to the Fomula, Manipulation, Related Co-herb in Dongeuibogam (『동의보감(東醫寶鑑)』 중 대황(大黃)이 주약(主藥)으로 배오(配伍)된 방제(方劑)의 제형(劑形), 포제(?製), 약대구성(藥對構成)에 따른 활용(活用))

  • Joh, Hae-In;Kook, Yoon-Bum
    • Herbal Formula Science
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    • v.25 no.4
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    • pp.553-574
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    • 2017
  • The purpose of this study is to find out effects of prescriptions according to the formula, manipulation of Rhei Rhizoma, configuration. The following results were reached through investigations on the prescriptions using Rhei Rhizoma as a main component. Objectives : Analysis of prescriptions According to the formula : Liquid Extract Prescriptions were used widely on three parts to treat fever and damp heat in the interior organs. Powder Prescriptions were taken with hot water, thin porridge, tea etc. to treat damp heat, congestion of phlegm, acute episodes. Liquid Mixed Pill treat congestion of QI, damp heat, phlegm. Honey Mixed Pill treat accumulated fever, distension, acute excessive fever. Paste Pill treat blood stagnation, excessive toxic-fever, epidemic diseases. External Application treat inflammation by injury, swelling due to severe fever by internal damage. Methods : Analysis of prescriptions According to the manipulation of Rhei Rhizoma : Prescriptions including Liquor processed Rhei Rhizoma treat excessive toxic-fever, congestion of phlegm, blocking orifices on the upper side. Steamed Rhei Rhizoma strengthen effects of making evacuate and cooling of heat. Processed Rhei Rhizoma with vinegar strengthen effects of removing blood stagnation by activating blood movement, releasing gathering. Results : Analysis of prescriptions According to the Composition of Rhei Rhizoma : 41% of the total prescriptions were on the area of less than 20%. In case of lower groups show increased frequency of combination with Pharbitidis Semen, Persicae Semen, Scutellariae Radix and manipulation of baking, steaming, roasting. In case of higher groups show increased frequency of treating excess syndrome, critical illness, acute severe illness, and using proccesed Rhei Rhizoma with vinegar. Treatment of damp heat on the liver and gallbladder, disorder of the spleen and stomach is done mostly by prescriptions on the area of less than 30%. Conclusions : Rhei Rhizoma-Coptidis Rhizoma pair treat damp heat, heat toxins in blood, and Constipation caused by excessive heat. Rhei Rhizoma-Glycyrrhizae Radix pair relieve effects of Rhei Rhizoma passing blocked feces, removing the poison, activating blood movement, releasing gathering with the effects of Glycyrrhizae Radix relaxing tension by harmonizing Middle. Rhei Rhizoma-Magnoliae Cortex pair are used to treat damp heat in middle area, excessive heat in the stomach and intestine. Rhei Rhizoma-Pharbitidis Semen pair act on both blood system and QI system treating edema, damp, stagnation, heat toxins, feces. Rhei Rhizoma-Persicae Semen pair treat blood stagnation with fever on blood system.

The Mechanism for Analgesic Effects of Electroacupuncture on Surgical Ankle Sprain Model Classified as Grade 3 in Rats (수술적 방법으로 유도된 3단계 발목염좌에 대한 전침의 진통기전 연구)

  • Yang, Seung-Bum;Choi, Suck-Jun;Lee, Sung-Ho;Kim, Min-Su;Sohn, In-Chul;Kim, Jae-Hyo
    • Korean Journal of Acupuncture
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    • v.30 no.4
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    • pp.220-229
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    • 2013
  • Objectives : Electroacupuncture(EA) has been used effectively in producing analgesia on ankle sprain pain of humans and animals. Currently to examine the underlying mechanisms of the EA-induced analgesia, the effects of EA on weight-bearing forces(WBR) were examined at ankle sprain classified as grade 3 in rats. Methods : The severe ankle sprain classified as grade 3 was induced surgically by ankle ligament injury in the Sprague-Dawley rats. WBR of the affected foot were examined to evaluate effects and mechanism of EA(2 Hz, 1 ms pulse width, 2 mA intensity, for 15 min) which was applied to either SI6, GB34, or GB39 acupoints. The rats were pretreated with naltrexone(10 mg/kg, i.p.) as an opioid receptor antagonist or phentolamine(5 mg/kg, i.p) as an ${\alpha}$-adrenoceptor antagonist at 30 min before EA. Results : The daily repeat EA at either SI6, GB34, or GB39 showed significant analgesic effects on the severe ankle sprain. Particularly, daily EA at GB34 showed more potent analgesic effect than the others. In addition, the naltrexone pretreatment completely blocked the analgesic effect of EA at GB34, indicating the involvement of the endogenous opioid system in mediating the effect of EA at GB34. However, the phentolamine pretreament blocked analgesic effects of EA at either SI6 or GB39, indicating the involvement of ${\alpha}$-adrenoceptors in mediating the effect of EA at either SI6 or GB39. Conclusions : These data suggest that EA-induced analgesia on ankle sprain pain is mediated through either endogenous opioids or ${\alpha}$-adrenoceptors dependant on acupoint specific pattern.

Medical Expenses for Trauma According to the Type of Medical Insurance (외상환자의 보험체계에 따른 진료비 분석)

  • Park, Heeseung;Jung, Yooun Joong;Kim, Young-Hwan;Kim, Tae-Hyun;Km, Min Ae;Kyoung, Kyu Hyouck;Kim, Jung Jae;Hong, Suk-Kyung
    • Journal of Trauma and Injury
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    • v.25 no.4
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    • pp.178-187
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    • 2012
  • Purpose: In Korea, the nation's medical expenses were 12 billion won in 2010. The medical costs for individuals can also be overwhelming. If a patient has sustained severe trauma, his/her insurance company responsible may pay only part of the medical bills. In Korean, there are diverse types of medical insurance, such as health insurance, automobile insurance, and industrial accident compensation insurance. And each insurance system has a different type of payment system. Our study will be essential for establishing the optimal medical expense payment system. Methods: From January to December 2011, we retrospectively reviewed the medical charts of 161 patients who were admitted to our hospital's emergency room after having undergone severe trauma. Of those 161 patients, 125 were retrospectively reviewed. Written permission was obtained from all of the patients. We analysed the demographic characteristics, clinical outcomes, data of the trauma, type of the patient's insurance, and the entire bill when the patient was discharged. Results: Seventy-one patients had health insurance, 48 automobile insurance, and six industrial accident compensation insurance. High-deductible insurance included health insurance and industrial accident compensation insurance, with the deductibles up to 20.6% and 19.1%, respectively. We attempted to analyze the cause of the high deductible rate. In patients with health insurance, medicines, primarily sedatives, pain killers, antibiotics, and fluids. comprised a large proportion. On the other hand, industrial accident compensation insurance deducted for a high-grade hospital room charge. Conclusion: We found that medical expenses were diverse according to the type of insurance. In particular, health insurance forced patients to pay too much of the medical expenses. Therefore, in Korea we should try to identify the insurance problems and improve the wage system.

Esophageal Reconstruction for Hypopharyngeal Stricture After Severe Corrosive Injury (부식성 하인두 협착시 식도재건술)

  • 변정욱;구본일
    • Journal of Chest Surgery
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    • v.30 no.1
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    • pp.48-54
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    • 1997
  • Between 1987 and 1995, eleven patients with severe chronic corrosive stenosis of the hypopharynx and esophagus underwent surgical restoration of digestive continuity at Inje University Seoul Palk Hospital. There were 7 male and 4 female patients aged from 21 to 47 years (mean, 34 years). The caustic material was acid in 6 patients and alkali in 5 patients. The esophagus was reconstructed using the right colon In 9 and left colon in 2. The cervical approach and the side of proximal anastomosis depended on the status of the pyriform slnus of the hypopharynx. In the neck, J-formed incision was made along the sternocleidomastoid muscle. The sternohyoid and thyrohyoid muscles were divided transversely to expose the thyroid cartilage. Hypopharyngeal opening for proximal anastomosis was made by reverse triangular formed resection of the thyroid cartilage after elevation of perichondrium. Immediately after operation, dysphagia and aspiration into trachea were common, so training of swallowing was required. Feeding gastrostomy was usually maintained for 3 months until restoration of swallowing function was confirmed . There was graft necrosis in 3 patients, who were treated with jejunal free graft. Revisional procedures for stenosis of cervical anastomosis in B patients consisted of widening of pharyngocecostomy site in 2 and resection of adhesive band in one. Return of normal swallowing assuring normal nutrition was obtained in 10 of 11 cases.

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Establishment of ethanol-pretreating animal model to study Helicobacter pylori infection (Helicobacter pylori의 in vivo 연구를 위한 ethanol-pretreating animal model의 개발)

  • Lee, Jin-Uk;Kim, Seung-Hee;Park, Tan-Woo;Kim, Okjin
    • Korean Journal of Veterinary Research
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    • v.46 no.4
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    • pp.327-335
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    • 2006
  • A stable and reliable Helicobacter pylori (H. pylori) infection animal model would be necessary for evaluating vaccine efficacy and helpful for understanding the pathological mechanism of the organism. The aim of the present study is to investigate the effect of ethanol treatment prior to H. pylori inoculation on associated gastric mucosal injury and to establish ethanol-pretreating animal model to study H. pylori infection. Male Mongolian gerbils were used for the study. H. pylori was orally inoculated after 12 h fasting. 3 h prior to H. pylori inoculation, a group of gerbils was orally treated with absolute ethanol, 60% and 40% ethanol respectively. Another group of animals was treated either with H. pylori culture media alone or with different concentrations of ethanol plus culture media. Gerbils were killed 4 or 8 weeks after H. pylori inoculation. The colonization of H. pylori was confirmed by both histological examination and rapid urease test. Mucosal damage was evaluated grossly and histologically according to the criteria. The colonization of H. pylori and pathological changes in gastric mucosa of the animals were also observed. Although no significant change to the gastric mucose was observed in the animals treated either with H. pylori culture media alone or with different concentrations of ethanol plus culture media, persistent H. pylori infection was seen in the mucosa and mucosal leucocyte infiltration and severe epithelial damage was observed in the Helicobacter and ethanol + Helicobacter groups after 4 weeks. The gross and histological scores were higher in the ethanol + Helicobacter than in the Helicobacter alone group. As the results, ethanol-pretreatment with 60% concentration induced severe pathogenic changes by H. pylori infection in 5 weeks-old Mongolian gerbils. These results suggested that ethanol-pretreatment before H. pylori inoculation could increase the severity of gastric mucosal inflammation and enhance the colonization of H. pylori. The established ethanol-pretreating animal model would contribute to screen new drugs against H. pylori and be used as an useful tool for various animal experiments with H. pylori strains.