• Title/Summary/Keyword: GCS

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The Utility of Routine Serial Brain Computed Tomography for Referred Traumatic Brain Injury Patients According to the Severity of Traumatic Brain Injury (전원된 외상성 뇌 손상환자에서 중증도에 따른 일상적인 반복CT의 유용성)

  • Hwang, Jeong In;Cho, Jin Seong;Lee, Seung Chul;Lee, Jeong Hun
    • Journal of Trauma and Injury
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    • v.22 no.2
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    • pp.134-141
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    • 2009
  • Purpose: Patients with traumatic brain injury (TBI) were referred from other hospitals for further management. In addition, patients routinely underwent computed tomography examinations of the head (HCT) in the referral hospitals. The purpose of this study was to evaluate retrospectively the utility of routine HCT scans according to the severity of TBI. Methods: Patients with TBI referred to our hospital between December 2005 and July 2008 were included in this study. We investigated HCT findings, indications for repeat HCT examinations (routine versus a neurological change), and neurosurgical interventions. The head injury severity was divided into three categories according to the Glasgow Coma Scale (GCS) score, including mild, moderate, and severe TBI. The use of neurosurgical interventions between patients who underwent routine HCT scans and patients who underwent HCT scans for a neurological change were compared according to the severity of TBI. Results: A total of 81 patients met the entry criteria for this study. Among these patients, 67%(n=54) of the patients underwent HCT scans on a routine basis, whereas 33%(n=27) of the patients underwent HCT scans for a neurological change. A total of 21 patients showed signs of a worsening condition on the HCT scans. Neurosurgical intervention was required for 23(28.4%) patients. For patients who underwent routine HCT examinations, no patient with mild TBI underwent a neurosurgical intervention. However, one patient with moderate TBI and three(13%) patients with severe TBI underwent neurosurgical interventions. The kappa index, the level of agreement for HCT indications of intervention and referral reasons for intervention, was 0.65 for high hierarchy hospitals and 0.06 for low hierarchy hospitals. Conclusion: Routine serial HCT examinations in the referred hospitals would be useful for patients with severe head injury and for patients from low hierarchy hospitals where no emergency physicians or neurosurgeons are available.

RELATIVE AGE DIFFERENCE BETWEEN THE METAL-POOR GLOBULAR CLUSTERS M53 AND M92

  • CHO, DONG-HWAN;SUNG, HYUN-IL;LEE, SANG-GAK;YOON, TAE SEOG
    • Journal of The Korean Astronomical Society
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    • v.49 no.5
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    • pp.175-192
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    • 2016
  • CCD photometric observations of the globular cluster (GC), M53 (NGC 5024), are performed using the 1.8 m telescope at the Bohyunsan Optical Astronomy Observatory in Korea on the same nights (2002 April and 2003 May) as the observations of the GC M92 (NGC 6341) reported by Cho and Lee using the same instrumental setup. The data for M53 is reduced using the same method as used for M92 by Cho and Lee, including preprocessing, point-spread function fitting photometry, and standardization etc. Therefore, M53 and M92 are on the same photometric system defined by Landolt, and the photometry of M53 and M92 is tied together as closely as possible. After complete photometric reduction, the V versus B − V , V versus V − I, and V versus B − I color-magnitude diagrams (CMDs) of M53 are produced to derive the relative ages of M53 and M92 and derive the various characteristics of its CMDs in future analysis. From the present analysis, the relative ages of M53 and M92 are derived using the Δ(B − V ) method reported by VandenBerg et al. The relative age of M53 is found to be 1.6 ± 0.85 Gyr younger than that of M92 if the absolute age of M92 is taken to be 14 Gyr. This relative age difference between M53 and M92 causes slight differences in the horizontal-branch morphology of these two GCs.

Safety and Efficacy of Transluminal Balloon Angioplasty Using a Compliant Balloon for Severe Cerebral Vasospasm after an Aneurysmal Subarachnoid Hemorrhage

  • Choi, Beam-Jin;Lee, Tae-Hong;Lee, Jae-Il;Ko, Jun-Kyeung;Park, Hwa-Seung;Choi, Chang-Hwa
    • Journal of Korean Neurosurgical Society
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    • v.49 no.3
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    • pp.157-162
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    • 2011
  • Objective : Vasospasm of cerebral vessels remains a major source of morbidity and mortality after an aneurysmal subarachnoid hemorrhage (SAH). The purpose of this study was to evaluate the safety and efficacy of transluminal balloon angioplasty (TBA) for SAH-induced vasospasm. Methods : Eleven patients with an angiographically confirmed significant vasospasm (>50% vessel narrowing and clinical deterioration) were studied. A total of 54 vessel segments with significant vasospasm were treated by TBA. Digital subtraction angiography was used to confirm the presence of vasospasm, and TBA was performed to dilate vasospastic arteries. Medical and angiographic reports were reviewed to determine technical efficacy and for procedural complications. Results : TBA using Hyper-Glide or Hyper-Form balloons (MicroTherapeutics, Irvine, CA) was successfully accomplished in 88.9% vasospastic segments (48 of 54), namely, in the distal internal carotid artery (100%, n=7), the middle cerebral artery (100%), including the M1 (n=10), M2 (n=10), and M3 segments (n=4), in the vertebral artery (100%, n=2), basilar artery (100%, n=1), and in the anterior cerebral artery (ACA), including the A1 (66%), A2 (66%), and A3 segments (100%). Vessel diameters significantly increased after TBA. There were no cases of vessel rupture or thromboembolic complications. GCS at one day after TBA showed an improvement in all patients except one. Conclusion : This study suggests that TBA using Hyper-Glide or Hyper-Form balloons is a safe and effective treatment for subarachnoid hemorrhage-induced cerebral vasospasm.

Time to Recover Consciousness in Patients with Diffuse Axonal Injury : Assessment with Reference to Magnetic Resonance Grading

  • Park, Sung-Jun;Hur, Jin-Woo;Kwon, Ki-Young;Rhee, Jong-Joo;Lee, Jong-Won;Lee, Hyun-Koo
    • Journal of Korean Neurosurgical Society
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    • v.46 no.3
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    • pp.205-209
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    • 2009
  • Objective : This study was conducted to investigate the correlation between the degrees of injury on brain magnetic resonance imaging (MRI) and the time interval to recovery of consciousness in patients with diffuse axonal injury. Methods : From January 2004 to December 2008, 25 patients with diffuse axonal injury were treated at our hospital. We retrospectively investigated the patients' medical records and radiological findings. We divided the patients into three groups according to the grade of MRI finding : grade I, small scattered lesions on the white matter of the cerebral hemisphere; grade II, focal lesions on the corpus callosum; and grade III, additional focal lesions on the brain stem. Result : Seven patients belonged to the grade I group; 10 to the grade II group; and 8 to the grade III group. The mean Glasgow Coma Scale (GCS) score of all patients at the time of admission was 7.28. Recovery of consciousness was observed in 23 of the 25 patients; the remaining two patients never regained consciousness. The time interval to recovery of consciousness (awake status) ranged from 1 day to 125 days (mean 22.1 days) : grade I group patients, within approximately 1 week (mean 3.7 days); grade II group patients, within approximately 2 weeks (mean 12.5 days); and grade III group patients, within approximately 2 months (mean 59.5 days). Conclusion : Our study results suggest a correlation between the mean time interval to recovery of consciousness in patients with diffuse axonal injuries and the degrees of brain injuries seen on MRI. Patients with grade I and II diffuse axonal injuries recovered consciousness within 2 weeks, while patients with grade III injuries required approximately 2 months.

Intraarterial Nimodipine Infusion to Treat Symptomatic Cerebral Vasospasm after Aneurysmal Subarachnoid Hemorrhage

  • Kim, Jong-Hoon;Park, In-Sung;Park, Kyung-Bum;Kang, Dong-Ho;Hwang, Soo-Hyun
    • Journal of Korean Neurosurgical Society
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    • v.46 no.3
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    • pp.239-244
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    • 2009
  • Objective : Cerebral vasospasm leading to cerebral ischemic infarction is a major cause of morbidity and mortality in the patients who suffer with aneurysmal subarachnoid hemorrhage. Despite adequate treatment, some patients deteriorate and they develop symptomatic vasospasm. The objective of the present study was to investigate the efficacy and clinical outcome of intraarterial nimodipine infusion on symptomatic vasospasm that is refractory to hemodynamic therapy. Methods : We retrospectively reviewed the procedure reports, the clinical charts and the transcranial doppler, computed tomography and digital subtraction angiography results for the patients who underwent endovascular treatment for symptomatic cerebral vasospasm due to aneurysmal SAH. During the 36 months between Jan. 2005 and Dec. 2007, 19 patients were identified who had undergone a total of 53 procedures. We assessed the difference in the arterial vessel diameter, the blood flow velocity and the clinical outcome before and after these procedures. Results : Vascular dilatation was observed in 42 of 53 procedures. The velocities of the affected vessels before and after procedures were available in 33 of 53 procedures. Twenty-nine procedures exhibited a mean decrease of 84.1 cm/s. We observed clinical improvement and an improved level of consciousness with an improved GCS score after 23 procedures. Conclusion : Based on our results, the use of intraarterial nimodipine is effective and safe in selected cases of vasospasm following aneurysmal SAH. Prospective, randomized studies are needed to confirm these results.

Effects of Cadmium on Glucose Transport in L6 Myocytes (L6 근육세포에서 포도당 수송능에 미치는 $CdCl_2$의 영향)

  • Kang Donghee;Khil Lee-Yong;park Kwangsik;Lee Byung-Hoon;Moon Chang-Kiu
    • Environmental Analysis Health and Toxicology
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    • v.20 no.1
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    • pp.75-85
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    • 2005
  • This study was aimed to know the effect of cadmium chloride (CdCl₂) on glucose transport in L6 myotube and its action mechanism. CdCl₂ increased the 2-deoxy- (l-3H)-D-glucose (2-DOG) uptake 1.9 and 2.4 fold at 10 and 25 μM respectively. To investigate the stimulating-mechanism of glucose transport induced by CdCl₂, the wortmannin and PD98059 were used as PI3K (phosphatidylinositol 3-kinase) inhibitor and MAPK inhibitor respectively, which did not affect 2-DOG uptake. This fact suggests that CdCl₂ induced 2-DOG uptake may not be concerned to the insulin signalling pathway. Whereas nifedipine, a calcium channel blocker, and trifluoperazine, a calmodulin inhibitor, were found to inhibit the 2-DOG uptake stimulted by CdCl₂. In addition, we also measured the ROS (reactive oxygen species) production and GSH level in L6 myotube to investigate the correlation between the glucose uptake and ROS. CdCl₂(25 μM) increased ROS generation approximately 1.5 fold and changed the cellular GSH level, but GSSG/GSH ratio remained unchanged. CdCl₂ stimulated 2-DOG uptake and ROS generation were inhibited by N-acetylcystein. And BSO pretreatment, a potent inhibitor of γ-GCS, resulted in the dramatic decrease of 2-DOG uptake and also the increase of the sensitivity to cadmium cytotoxicity. The obtained results suggest that CdCl₂-stimulated glucose uptake might be based on the activation of HMP shunt as an antioxidant defense mechanism of the cells.

Effects of Cadmium on Glucose Transport in 3T3- L1 adipocytes (3T3-L1 지방세포주에서 포도당 수송에 미치는 $CdCl_2$의 영향)

  • Kang Donghee;Khil Lee-Yong;park Kwangsik;Lee Byung-Hoon;Moon Chang- Kiu
    • Environmental Analysis Health and Toxicology
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    • v.20 no.1
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    • pp.87-95
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    • 2005
  • Cadmium is well known as a toxic metal and has insulin mimicking effects in rat adipose tissue. This study was undertaken to investigate the effect of CdCl₂ on glucose transport and its mechanism in 3T3 - L1 adipocytes. CdCl₂ exhibits respectively 2.2 and 2.8 fold increases in the 2-deoxyglucose uptake when exposed to 10 and 25 μM of CdCl₂ for 12 hr. To investigate the stimulating mechanism of glucose transport induced by CdCl₂. Wortmannin and PD98059 were used respectively as PI3K inhibitor and MAPK inhibitor, which did not affect 2-DOG uptake. This results suggest that induced 2-deoxy-(l-3H)-D-glucose (2-DOG) uptake by CdCl₂ may not be concerned with the insulin signalling pathway. Whereas nifedipine, a calcium channel blocker inhibited the 2- DOG uptake stimulated by CdCl₂. In addition, we also measured the increased production of Reactive oxygen substances (ROS) and glutathione (GSH) level in 3T3-L1 adipocytes to investigate correlation between the glucose uptake and increased production of ROS with H2DCFDA. CdCl₂ increased production of ROS. Induced 2-DOG uptake and increased production of ROS by CdCl₂ were decreased by N-acetylcystein (NAC). And L-buthionine sulfoximine (BSO) a potent inhibitor of γ-GCS, decreased of 2-DOG uptake. Also NAC and BSO changed the cellular GSH level, but GSH/GSSG ratio remained unchanged at 10, 25 μM of CdCl₂.

Role of Diffusion-Weighted Imaging as a Prognostic Indicator in Acute Hypoxic Encephalopathy (급성 저산소뇌병증의 예후 예측인자로서 확산강조영상의 역할)

  • Kim, Jin-Soo;Noh, Won-Young;Lim, Jae-Sung;Kim, Seon-Jeong;Yun, Chang-Ho;Park, Seong-Ho
    • Annals of Clinical Neurophysiology
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    • v.15 no.2
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    • pp.42-47
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    • 2013
  • Background: Diffusion-weighted image (DWI) might be useful to predict the prognosis of acute hypoxic encephalopathy. The aim of our study was to test whether the early change and extent of DWI abnormalities can be an indicator of the clinical outcome of hypoxic encephalopathy. Methods: Forty-four patients who were diagnosed as hypoxic encephalopathy due to the cardiorespiratory arrest were retrospectively identified. Clinical variables were determined, and the DWI abnormalities were counted by four areas: cortex, subcortical white matter, cerebellum and deep grey matter, and were divided into three groups by the extent of lesions. Prognosis was classified as 'poor' (Glasgow coma scale (GSC) at 30 days after arrest <9 or death) and 'good' (GSC at 30 days after arrest ${\geq}9$). Results: GCS at day 3 (p<0.001), presence of seizure (p=0.01), and presence of lesion (p<0.001) were significantly different in prognosis, but statistically there is no association with the extent of lesions and prognosis (p=0.26). Conclusions: Presence of early DWI changes could predict the clinical outcome of hypoxic encephalopathy after cardiorespiratory arrest.

Comparison of geometrical methods to identify CME 3-D structures

  • Lee, Harim;Moon, Yong-Jae;Na, Hyeonock;Jang, Soojeong
    • The Bulletin of The Korean Astronomical Society
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    • v.39 no.1
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    • pp.73-73
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    • 2014
  • Several geometrical models (e.g., cone and flux rope models) have been suggested to infer 3-D parameters of CMEs using multi-view observations (STEREO/SECCHI) and single-view observations (SOHO/LASCO). To prepare for when only single view observations are available, we have made a test whether the cone model parameters from single-view observations are consistent with those from multi-view ones. For this test, we select 35 CMEs which are identified as CMEs, whose angular widths are larger than 180 degrees, by one spacecraft and as limb CMEs by the other ones. For this we use SOHO/LASCO and STEREO/SECCHI data during the period from 2010 December to 2011 July when two spacecraft were separated by $90{\pm}10$ degrees. In this study, we compare 3-D parameters of these CMEs from three different methods: (1) a triangulation method using the STEREO/SECCHI and SOHO/LASCO data, (2) a Graduated Cylindrical Shell (GCS) flux rope model using the STEREO/SECCHI data, and (3) an ice cream cone model using the SOHO/LASCO data. The parameters used for comparison are radial velocities, angular widths and source location (angle ${\gamma}$ between the propagation direction and the plan of the sky). We find that the radial velocities and the ${\gamma}$-values from three methods are well correlated with one another (CC > 0.8). However, angular widths from the three methods are somewhat different. The correlation coefficients are relatively not good (CC > 0.4). We also find that the correlation coefficients between the locations from the three methods and the active region locations are larger than 0.9, implying that most of the CMEs are radially ejected.

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Clinical Analysis of Blunt Abdominal Trauma in Childhood (소아에서 발생한 복부 둔상의 임상적 고찰)

  • Kim, Young-Yuk;Jeong, Yeon-Jun;Jung, Sung-Hoo;Kim, Jae-Chun
    • Advances in pediatric surgery
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    • v.16 no.2
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    • pp.177-189
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    • 2010
  • Traumatic injury is one of the leading causes of morbidity and mortality in children. This is a clinical review of pediatric blunt abdominal trauma. A retrospective analysis of the 112 children with blunt abdominal trauma aged 15 years or less treated at the Department of Pediatric Surgery, Chonbuk National University Hospital was performed. The analysis included age, sex, injury mechanism, number and site of the injured organ, management and outcomes. The average age of occurrence was 7.6 years, and the peak age was between 6 and 8 years. There was a male preponderance with a male to female ratio of 2.3:1. The most common cause of blunt abdominal trauma was traffic accidents (61.6 %), principally involving pedestrians (79.7 %). The accident prone times were between 8:00 AM and 8:00 PM, the weekends (40.2 %), and the winter respectively. Thirthy-five patients (31.2 %) had multiple intra-abdominal organ injuries and the most common injured organ was the liver. Seventy-four cases (66.1 %) were managed non-operatively and eleven cases (9.8 %) expired. Of the patients who were treated surgically or were to be operated on one patient died before surgery, the remainder died during or after surgery. Risk factors such as number of injured organ, systolic and diastolic blood pressure, and trauma scores by Glasgow coma scale (GCS), Pediatric trauma score (PTS), revised trauma score (RTS), injury severe score (ISS), TRISS were significantly correlated with mortality rate.

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