Park, Joseph;Kim, Yong Won;Oh, Se Hyun;Cha, Yong Sung;Cha, Kyoung Chul;Kim, Oh Hyun;Lee, Kang Hyun;Hwang, Sung Oh;Kim, Hyun
Journal of The Korean Society of Clinical Toxicology
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v.12
no.2
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pp.77-84
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2014
Purpose: Carbamate insecticides are potent cholinesterase inhibitors capable of causing severe cholinergic toxicity. Use of carbamate rather than organophosphate insecticides has been increasing. Compared with organophosphate poisoning, relatively few studies have investigated carbamate-associated acute pancreatitis. We investigated general characteristics and pancreatitis of carbamate poisoning and the predictors, among those readily assessed in the emergency department. Methods: We performed a retrospective review of consecutive patients, aged over 18 years, who were admitted between January 2008 and April 2012 to an emergency department (ED) of an academic tertiary care center for treatment of carbamate poisoning. Patients who exhibited poisoning by any other material, except alcohol, were excluded. After application of exclusion criteria, patients were divided according to carbamate-induced pancreatitis and non-pancreatitis groups. Results: A total of 41 patients were included in this study. Among these 41 patients, the prevalence of acute pancreatitis was 36.6% (15 patients). Initial blood chemistry tests showed a statistically higher glucose level in the pancreatitis group, compared with the non-pancreatitis group (222, IQR 189-284 vs. 137, IQR 122-175 mg/dL, P<0.05). Regarding clinical courses and outcomes, a significantly higher proportion of patients developed pneumonia [10 (66.7%) vs. 6 (23.1%), P<0.05] and had a longer hospital stay (7 days, IQR 6-12 vs. 5 days, IQR 2-11, P<0.05), but no difference in mortality, in the pancreatitis group vs. the non-pancreatitis group. In multivariate analysis, the initial glucose was showing significant association with the presentation of carbamate-induced acute pancreatitis (odds ratio 1.018, 95% confidence interval 1.001-1.035, P<0.05). Conclusion: Carbamate-induced acute pancreatitis is common, but not fatal. Initial serum glucose level is associated with acute pancreatitis.
Objective : Cervical surgery in patients with cervical spondylotic myelopathy (CSM) and cerebral palsy (CP) is challenging owing to the complexities of the deformity. We assessed factors affecting postoperative complications and outcomes after CSM surgery in patients with CP. Methods : Thirty-five consecutive patients with CP and CSM who underwent cervical operations between January 2006 and January 2014 were matched to 35 non-cerebral palsy (NCP) control patients. Postoperative complications and radiologic outcomes were compared between the groups. In the CP group, the Japanese Orthopaedic Association score; Oswestry neck disability index; modified Barthel index; and values for the grip and pinch, Box and Block, and Jebsen-Taylor hand function tests were obtained pre- and postoperatively and compared between those with and without postoperative complications. Results : Sixteen patients (16/35%) in the CP group and seven (7/35%) in the NCP group (p=0.021) had postoperative complications. Adjacent segment degeneration (p=0.021), postoperative motor weakness (p=0.037), and revisions (p=0.003) were significantly more frequent in the CP group than in the NCP group; however, instrument-related complications were not significantly higher in the CP group (7/35 vs. 5/35, p=0.280). The number of preoperative fixed cervical deformities were significantly higher in CP with postoperative complications (5/16 vs. 1/19, p=0.037). In the CP group, clinical outcomes were almost similar between those with and without postoperative complications. Conclusion : The occurrence of complications during the follow-up period was high in patients with CP. However, postoperative complications did not significantly affect clinical outcomes.
Heera Yoen;Roh-Eul Yoo;Seung Hong Choi;Eunkyung Kim;Byung-Mo Oh;Dongjin Yang;Inpyeong Hwang;Koung Mi Kang;Tae Jin Yun;Ji-hoon Kim;Chul-Ho Sohn
Korean Journal of Radiology
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v.22
no.1
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pp.118-130
/
2021
Objective: This study aimed to investigate the blood-brain barrier (BBB) disruption in mild traumatic brain injury (mTBI) patients with post-concussion syndrome (PCS) using dynamic contrast-enhanced (DCE) magnetic resonance (MR) imaging and automatic whole brain segmentation. Materials and Methods: Forty-two consecutive mTBI patients with PCS who had undergone post-traumatic MR imaging, including DCE MR imaging, between October 2016 and April 2018, and 29 controls with DCE MR imaging were included in this retrospective study. After performing three-dimensional T1-based brain segmentation with FreeSurfer software (Laboratory for Computational Neuroimaging), the mean Ktrans and vp from DCE MR imaging (derived using the Patlak model and extended Tofts and Kermode model) were analyzed in the bilateral cerebral/cerebellar cortex, bilateral cerebral/cerebellar white matter (WM), and brainstem. Ktrans values of the mTBI patients and controls were calculated using both models to identify the model that better reflected the increased permeability owing to mTBI (tendency toward higher Ktrans values in mTBI patients than in controls). The Mann-Whitney U test and Spearman rank correlation test were performed to compare the mean Ktrans and vp between the two groups and correlate Ktrans and vp with neuropsychological tests for mTBI patients. Results: Increased permeability owing to mTBI was observed in the Patlak model but not in the extended Tofts and Kermode model. In the Patlak model, the mean Ktrans in the bilateral cerebral cortex was significantly higher in mTBI patients than in controls (p = 0.042). The mean vp values in the bilateral cerebellar WM and brainstem were significantly lower in mTBI patients than in controls (p = 0.009 and p = 0.011, respectively). The mean Ktrans of the bilateral cerebral cortex was significantly higher in patients with atypical performance in the auditory continuous performance test (commission errors) than in average or good performers (p = 0.041). Conclusion: BBB disruption, as reflected by the increased Ktrans and decreased vp values from the Patlak model, was observed throughout the bilateral cerebral cortex, bilateral cerebellar WM, and brainstem in mTBI patients with PCS.
Journal of The Korean Association For Science Education
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v.38
no.4
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pp.481-494
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2018
This study investigated elementary students' understanding of Earth revolution and its accompanied apparent motion of constellation in terms of spatial reasoning. We designed a set of multi-tiered constructed response items in which students described their own idea about the reason of consecutive movement of constellations for three months and drew a diagram about relative locations of the Sun, the Earth, and the constellations. Sixty-five sixth grade students from four elementary schools participated in the tests both before and after science classes on the relative movement of Earth and Moon. Their answers to the items were categorized inductively in terms of transforming frames of reference which are observed on the Earth and designed from the Space-based perspective. We analyzed those categories by the levels of spatial reasoning and depicted the change of students' levels between pre/post-tests so that we could get an idea on the preliminary developmental pathway of students' understanding of this topic. The lower anchor description was that constellations move around the Earth with geocentric perspective. Intermediate level descriptions were planar understanding of Earth movement, intuitive idea on constellation movement along with the Earth. Students with intermediate levels did not reach understanding of the apparent motion of constellations. As the upper anchor description students understood the apparent motion of constellations according to the Earth revolution and could transform their frames of reference between Earth-based view and Space-based view. The features as the case of evolutionary learning progressions and critical points of students' development for this topic were discussed.
Background : Perfusion scans are accurate predictors of postoperative lung function. There are few previous studies aimed at predicting the postoperative exercise capacity using the perfusion scanning and those that did reported contradictory results. Method : We prospectively studied the preoperative spirometric, exercise tests and perfusion scans from in 49 consecutive patients who were admitted to Inha University Hospital with surgically resectable lung cancer from Jan. 1998 to Jun. 1999 29 patients who had any condition affecting the lung function and exercise capacity, or refused a surgical resection or a follow-up study were excluded. Spirometric and exercise tests were performed 6 months after operation in 20 patients. Results : The predicted postoperative $FEV_1$, FVC and TLC correlated well with the following corresponding postoperative values : $r_s$ and p value, 0.809 and 0.000 for the $FEV_1$ 0.895 and 0.000 for the FVC ; 0.741 and 0.006 for the TLC, respectively. The measured postoperative exercise values were slightly higher than the postoperative exercise values predicted, $VO_{2max}$ and $Wr_{max}$, were as 112% of $VO_{2max}$ predicted and 119% of $WR_{max}$ predicted. The change in $FEV_1$, FVC and TLC had a weak correlation with the change in $VO_{2max}$ and $WR_{max}$. Conclusion : The perfusion scan was a useful tool for predicting the postoperative exercise capacity. However, they had a tendency to underestimate the exercise capacity, especially in the patients who had a pneumonectomy. A weak correlation between the change in lung function and exercise capacity was observed.
Background: Corticosteroids are known to be significant prognostic parameters in sepsis. Recently, an absolute and relative insufficiency of the corticosteroids system has often been reported to often develop particularly in severe sepsis. Degree of such an adrenal insufficiency not only has prognostic implications but also can be used to guide corticosteroids replacement therapy. The 24-hour urinary cortisol levels as well as serum cortisol concentrations were measured to assess the clinical significance and their relationship with the other parameters of sepsis, and also evaluated the clinical implications of the relative adrenal insufficiency. Methods: 26 consecutive patients with sepsis were enrolled. The basal random serum cortisol, ACTH, ADH, lactate levels and 24-hour urinary free cortisol amount were measured. The rapid ACTH ($250{\mu}g$) stimulation test was also performed. Results: Basal serum cortisol levels were higher in the non-survivors than in the survivors. The 24-hour urinary free cortisol levels were higher in the patients with severe sepsis than in those without. The serum cortisol levels strongly correlated with the serum ADH and lactate levels. The 24-hour urinary free cortisol levels strongly correlated with the serum cortisol and lactate levels. The fractional changes in the cortisol levels after the rapid ACTH stimulation tests correlated with the serum cortisol, ADH, and lactate levels. Conclusion: Both the serum cortisol and 24-hour urinary cortisol were found to be significant prognostic factors in sepsis, and showed a strong correlation with the other parameters. The relative adrenal insufficiency might also be an important clinical parameter.
Lee, Jae Seung;Ji, Hyun Shuk;Hong, Sang Bum;Oh, Yeon-Mok;Lim, Chae-Man;Lee, Sang Do;Koh, Younsuck;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong;Shim, Tae Sun
Tuberculosis and Respiratory Diseases
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v.58
no.5
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pp.452-458
/
2005
Background : In Korea, polymerase chain reaction (PCR) test for M. tuberculosis has been used for the diagnosis of acid-fast bacilli (AFB) smear-negative tuberculosis in order to increase diagnostic sensitivity. However, there have been no data dealing with the clinical utility of PCR in AFB smear-positive patients to differentiate between M. tuberculosis and nontuberculous mycobacteria. Method : We retrospectively analyzed the PCR test results which have been performed in patients who had AFB smear-positive sputum but had ambiguous clinical manifestations of active tuberculosis. PCR test was done using $AMPLICOR^{\hat{a}}$ M. tuberculosis kit. The sensitivity, specificity, and positive and negative predictive values of the PCR test were calculated based on culture and final clinical diagnosis result. Results : Fifty-six consecutive patients (62 PCR tests) were included in the study. Active tuberculosis was diagnosed in 23 patients (41.0%), while 9 patients had NTM infection (16.0%). The sensitivity, specificity, positive- and negative-predictive value of PCR test were 88.8%, 86.8%, 76.1% and 94.3%, respectively, according to the culture result. In comparison, they were 91.3%, 100%, 100%, 94.3%, respectively, according to the final clinical diagnosis. All 15 patients with NTM isolates, including 6 patients who had other lung diseases but expectorated NTM isolate, were negative for PCR test. Conclusion : Even though tuberculosis is still prevalent in Korea, PCR test is useful to differentiate between M. tuberculosis and NTM in patients with AFB-smear positive sputum but with ambiguous clinical manifestations of active tuberculosis.
Jang, Mijung;Kim, Sun Mi;Yun, Bo La;Kim, Sung-Won;Kang, Eun Young;Park, So Yeon;Kim, Jee Hyun;Kim, Yeongmi;Ahn, Hye Shin
Investigative Magnetic Resonance Imaging
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v.18
no.2
/
pp.133-143
/
2014
Purpose : The aim of this study was to determine the magnetic resonance imaging (MRI) features associated with re-excision due to the presence of a positive margin after breast conserving therapy (BCT) in breast cancer patients. Materials and Methods: We reviewed the records of 286 consecutive breast cancer patients who received BCT between January 2006 and December 2007. Among 246 patients who had undergone BCT, 38 (15.4%) underwent immediate further surgery due to positive margin status. We analyzed the MRI findings using ${\chi}^2$ test, Fisher's exact test and t tests. Multivariate logistic regression was conducted for prediction of re-excision. Results: Tumor size (p < 0.001), lesion multiplicity (p = 0.003), and non-mass-like enhancement (NMLE) type on MRI (p < 0.001) were associated with margin involvement in BCT. On preoperative MRI, larger size (${\geq}5cm$) (odds ratio = 2.96), NMLE (odds ratio = 3.81), and multifocal lesions (odds ratio = 2.54) were positively associated with re-excision. In cases involving NMLE, segmental distribution was associated with a greater likelihood of immediate re-excision. Conclusion: Larger size, multiplicity, and NMLE on MRI are significantly associated with re-excision after BCT in breast cancer patients. For NMLE lesions, the segmental distribution pattern was predictive of re-excision.
This paper suggests how to design a ZigBee-chip-based communication module to remotely measure radiation level. The suggested communication module consists of two control processors for the chip as generally required to configure a ZigBee system, and one chip module to configure a ZigBee RF device. The ZigBee-chip-based communication module for remote radiation measurement consists of a wireless communication controller; sensor and high-voltage generator; charger and power supply circuit; wired communication part; and RF circuit and antenna. The wireless communication controller is to control wireless communication for ZigBee and to measure radiation level remotely. The sensor and high-voltage generator generates 500 V in two consecutive series to amplify and filter pulses of radiation detected by G-M Tube. The charger and power supply circuit part is to charge lithium-ion battery and supply power to one-chip processors. The wired communication part serves as a RS-485/422 interface to enable USB interface and wired remote communication for interfacing with PC and debugging. RF circuit and antenna applies an RLC passive component for chip antenna to configure BALUN and antenna impedance matching circuit, allowing wireless communication. After configuring the ZigBee-chip-based communication module, tests were conducted to measure radiation level remotely: data were successfully transmitted in 10-meter and 100-meter distances, measuring radiation level in a remote condition. The communication module allows an environment where radiation level can be remotely measured in an economically beneficial way as it not only consumes less electricity but also costs less. By securing linearity of a radiation measuring device and by minimizing the device itself, it is possible to set up an environment where radiation can be measured in a reliable manner, and radiation level is monitored real-time.
This study was conducted to investigate the herbicidal response and effective control strategy of sulfonylurea(SU)-resistant Scirpus juncoides Roxb. occurred in the paddy fields of Korea. A biotype of Scirpus juncoides Roxb. resistant to SU was identified in the paddy fields treated with SU herbicide-based mixtures for seven consecutive years. The apparent SU resistance observed in Scirpus juncoides Roxb. was completely confirmed in greenhouse tests. The susceptible biotype was almost controlled at the recommended dose of all the tested, but the resistant biotype was survived 20 to 30% even at 10 times higher dose of each the recommended dose of SU herbicides. The $GR_{50}$ values of 4 SU herbicides for the resistant biotype were 53 to 88 times higher than those for the susceptible biotype. The acetolactate synthase(ALS) isolated from the resistant biotype against bensulfuron-methyl and pyrazosulfuron-ethyl was less sensitive than that of the susceptible biotype. The $I_{50}$ values of the resistant biotype against bensulfuron-methyl and pyrazosulfuron-ethyl were 498 and 126 times higher than those for the susceptible biotype. A rapid diagnosis for identifying resistance of Scirpus juncoides Roxb. was possible within at least 3 days after SU herbicides. Three herbicides having different mode of action from SU herbicide, carfentrazone-ethyl, pyrazolate and simetryne exhibited excellent controlling effects on the resistant biotype of Scirpus juncoides Roxb. till 3.5 leaf stage. Among the SU-based herbicides, pyriminobac-methyl+pyrazosulfuroil-ethyl+carfentrazone-ethyl GR and azimsulfuron+carfentrazone-ethyl+pyriminobac-methyl GR were very effective to control resistant biotype of Scirpus juncoides Roxb. without rice injury. The resistant biotype which were not controlled with SU herbicise-based herbicides survived from the fields were effectively controlled by bentazone SL.
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