• Journal of Trauma and Injury
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• v.21 no.2
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• pp.115-119
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• 2008

Purpose: Abrupt abstinence from alcohol in cause of chronic alcohol addiction can trigger alcohol withdrawal syndrome. The authors studied the effect of post-operative alcohol withdrawal syndrome in patients who require intensive care due to trauma. Methods: For the study group, we selected 70 patients who had undergone emergency surgery from May 2003 to March 2007 due to trauma and who had been treated with prophylactic thiamine. Data was collected retrospectively. We excluded those who extended their hospital stay for other than traumatic causes, those who died within 3 days of surgery after trauma, those who transferred to other institutions, and those who received a psychiatric diagnosis. Patient groups were determined by the existence or the non-existence of withdrawal syndrome. Age, sex, injury mechanism, mortality, complications, durations of hospital stay and intensive care, use of mechanical ventilator, and sedative use were investigated. A Chi-square test and The Mann-Whitney method were used for statistical analysis in this study. Results: Twenty-four (24) patients from the 58 who had an ISS of 16 or more showed alcohol withdrawal syndrome, and men were shown to be affected with the syndrome significantly more than women. Although ISS was higher in the group with alcohol withdrawal syndrome, statistically, the difference was not significant (P<0.08). The total hospital stay in the patient group with alcohol withdrawal syndrome was on average 10 days longer. However, the difference was not significant (P<0.054). The duration of intensive care in the patient group with alcohol withdrawal syndrome was significantly longer (P<0.029). The patients with alcohol withdrawal syndrome showed no significant difference in the duration of mechanical ventilator use (P<0.783), or in the duration of sedative use (P<0.284). Respiratory distress, pneumonia, upper airway infection, sepsis, acute renal failure, and mortality in the alcohol withdrawal syndrome group were investigated, but no statistically significant difference were noted. Conclusion: We found that the duration of intensive care in chronic alcohol abusers was longer due to the development of alcohol withdrawal syndrome. We also discovered that, when the patients overcame the symptoms of alcohol withdrawal syndrome after intensive care, no difference was found in the frequency of developing complications, the morbidity, and the mortality. Therefore, we conclude that intensive care in trauma patients who are chronic alcohol abusers decreases the incidence of complications found in patients with post-operative alcohol withdrawal syndrome and does not adversely impact the prognoses for those patients.

• The Journal of Pediatrics of Korean Medicine
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• v.22 no.1
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• pp.69-93
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• 2008

Objectives The purpose of this study is to investigate the effect of KKHS on atopic dermatitis in an in-vivo experiment using an NC/Nga atopic dermatitis mouse, which has histological and clinical similarities to this condition in humans. Methods To investigate the effect of KKHS on atopic dermatitis (AD), we evaluated atopic dermatitis-like skin lesions by clinical skin index and analyzed immunological parameters in peripheral blood mononuclear cells(PBMCs), splenocytes, draining lymph node(DLN) and performed skin histology in ears and dorsal skin of atopic dermatitis of NC/Nga mouse in vivo. Results In vivo, clinical skin severity score was significantly lower in the KKHS group than in the control group. IgE, IL-6, TNF-${\alpha}$, IgM, IgG2a and IgG2b levels in serum decreased remarkably in the KKHS group than in the control group, and the level of IFN-${\gamma}$ production which is secreted from Th1 cell was increased by KKHS. After this experiment we analyzed immunological cells ($CD3^+$, $CD19^+$, $CD4^+$, $CD8^+$, $CD3^+CD69^+$, $CD4^+CD25^+$ and $CD49b^+$) by flow cytometry. It results that the total absolute number of $CD3^+$, $CD19^+$, $CD4^+$ and $CD8^+$ cells were recovered as much as normal state, and the level of $CD3^+CD69^+$ in isolated DLN and PBMCs were significantly decreased, and total absolute number of $Gr-1^+$, $CD11b^+$ and $CD3^+$ in dorsal skin of NC/Nga mouse were decreased by KKHS. We analyzed ear, DLN, and neck-back skin after biopsy and dyeing by hematoxyline/eosin(H&E), toluidine staining (mast cells marker). KKHS were very effective to the histological symptoms which are in dermal and epidermal thickening, hyperkeratosis and inflammatory cell infiltration. Ear thickness was significantly decreased compared with the control group and the size of inflammatory lymphocytes cells (ILC) and plasma cells (PC) in DLN were also decreased. Conclusions KKHS on atopic dermatitis in an in-vivo experiment using an NC/Nga atopic dermatitis mouse was very effectiveness to the atopy dermatitis treatment.

• Journal of Korean Ophthalmic Optics Society
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• v.13 no.3
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• pp.19-28
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• 2008

Purpose: To understand symptoms and signs in soft contact lens wearers the authors evaluate the attribution of the tear test to the contact lens related symptoms and signs. Methods: Sixty-two healthy soft contact lens wearers (23.95${\pm}$4.38 years old, 18.60${\pm}$16.92 months of prior lens wear) were participated in this study. 3 kinds of tear test and McMonnies' questionnaire test were performed for the soft contact lens wearers and subjective symptoms and objective signs were graded using CCLRU scales during the study period. Results: In this surveys, we found ocular dryness, redness and tiredness are the most common frequent and severe symptoms in soft contact lens wearers. Frequency of the ocular dryness, redness and tiredness are associated with grittiness, burning sensation and foreign body sensation respectively, and severity of the photophobia, foreign body sensation are associated with unstable vision and grittiness and which are associated with score of McMonnies' Questionnaire. Conjunctival redness and limbal redness are major signs but those are not need to be clinical care and rarely occurred corneal and conjunctival staining which are associated with tear break-up-time statistically. Conclusions: Dryness, redness and tiredness are primary common symptoms in Korean soft contact lens wearers. The frequency of those symptoms are increased with the period of soft contact lens wear and those are associated with other symptoms but have no relationship with signs.

• Molecules and Cells
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• v.40 no.2
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• pp.133-142
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• 2017

Previous studies have shown that bone marrow mesenchymal stromal cell (MSC) transplantation significantly improves the recovery of neurological function in a rat model of intracerebral hemorrhage. Potential repair mechanisms involve anti-inflammation, anti-apoptosis and angiogenesis. However, few studies have focused on the effects of MSCs on inducible nitric oxide synthase (iNOS) expression and subsequent peroxynitrite formation after hypertensive intracerebral hemorrhage (HICH). In this study, MSCs were transplanted intracerebrally into rats 6 hours after HICH. The modified neurological severity score and the modified limb placing test were used to measure behavioral outcomes. Blood-brain barrier disruption and neuronal loss were measured by zonula occludens-1 (ZO-1) and neuronal nucleus (NeuN) expression, respectively. Concomitant edema formation was evaluated by H&E staining and brain water content. The effect of MSCs treatment on neuroinflammation was analyzed by immunohistochemical analysis or polymerase chain reaction of CD68, Iba1, iNOS expression and subsequent peroxynitrite formation, and by an enzyme-linked immunosorbent assay of pro-inflammatory factors (IL-$1{\beta}$ and TNF-${\alpha}$). The MSCs-treated HICH group showed better performance on behavioral scores and lower brain water content compared to controls. Moreover, the MSC injection increased NeuN and ZO-1 expression measured by immunochemistry/immunofluorescence. Furthermore, MSCs reduced not only levels of CD68, Iba1 and pro-inflammatory factors, but it also inhibited iNOS expression and peroxynitrite formation in perihematomal regions. The results suggest that intracerebral administration of MSCs accelerates neurological function recovery in HICH rats. This may result from the ability of MSCs to suppress inflammation, at least in part, by inhibiting iNOS expression and subsequent peroxynitrite formation.

• Korean Journal of Biological Psychiatry
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• v.25 no.4
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• pp.118-124
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• 2018

Objectives Although impulsivity has long been thought as an important factor influencing suicidal behaviors, it is unknown whether impulsivity increases the risk of dying from suicidal behaviors and what specific component among constructs of impulsivity contributes to the risk of dying among suicide attempters. Methods To elucidate the association between impulsivity and medical lethality of suicide attempt among suicide attempters, we consecutively recruited 46 suicide attempters who visited an emergency room of a general hospital located in a metropolitan area, Seoul, Republic of Korea, due to suicide attempts and consented to participate in this study. Then we assessed medical lethality with the Beck Lethality Scale (LS) and impulsivity with the Korean version of the Barratt Impulsiveness Scale-11-Revised (BIS). Demographic variables were obtained from medical records and structured social work reports for suicide attempters. Results Although total scores of the BIS did not correlate with LS scores, only the scores of self-control, that is one of the Barrett's six theoretical constructs of impulsivity in which the higher score indicates less self-control and more impulsivity, had a significant positive correlation with scores of LS (p = 0.003). The association remained significant after adjusting for variables known to affect suicide lethality such as job status, recent alcohol consumption, diagnosis of depressive disorders, and having a plan for suicide (${\beta}=0.429$, p = 0.009). Conclusions Not impulsivity in general, but poor self-control, in particular, predicts lethal suicidal behaviors among suicide attempters. The degree of self-control should be evaluated when assessing patients with elevated suicide risk, and proper measures should be installed to prevent possible future lethal suicide attempts.

• Mood & Emotion
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• v.16 no.3
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• pp.140-151
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• 2018

Objectives : The purpose of this study was to examine effects of adjunctive aripiprazole versus bupropion, on depressive symptoms of female depression. Methods : Sixty six female patients with major depressive disorders were enrolled from a six-week, randomized prospective open-label multi-center study. Participants were randomized to receive aripiprazole (2.5-10 mg/day) or bupropion (150-300 mg/day). Montgomery Asberg Depression Rating Scale, 17-item Hamilton Depression Rating scale (HAM-D17), Iowa Fatigue Scale, Drug-Induced Extrapyramidal Symptoms Scale, Psychotropic-Related Sexual Dysfunction Questionnaire scores, and Clinical Global Impression-Severity (CGI-S) were obtained at baseline and after one, two, four, and six weeks. Changes on individual items of HAM-D17 were assessed as well as on composite scales (anxiety, insomnia and drive), and on four core subscales that capture core depression symptoms. Results : Overall, both treatments improved depressive symptoms, without causing serious adverse events. There were significant differences in the HAM-D17 total score (p=0.046) and CGI-S (p=0.004), between aripiprazole and bupropion augmentation, favoring aripiprazole over bupropion. Aripiprazole revealed significantly greater effect size in depressed mood (p=0.006), retardation (p=0.005), anxiety psychic (p=0.032), and general somatic symptom (p=0.01). Conclusion : While both treatments were effective, results of this study suggested that aripiprazole may be preferable, in treating general and core symptoms of female depression.

• Journal of Auto-vehicle Safety Association
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• v.10 no.4
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• pp.7-12
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• 2018

Injury mechanisms of lower extremity injuries in motor vehicle accidents are focused on fractures, sprains, and contusions. The purpose of this study is to evaluate the analysis of lower extremity injury mechanism in occupant motor vehicle accident by using Hospital Information System (HIS) and reconstruction program, based on the materials related to motor vehicle accidents. Among patients who visited the emergency department of Wonju Severance Christian Hospital due to motor vehicle accidents from August 2012 to February 2014, we collected data on patients with agreement for taking the damaged vehicle's photos. After obtaining the verbal consent from the patient, we asked about the cause of the accident, information on vehicle involved in the accident, and the location of car repair shop. The photos of the damaged vehicle were taken on the basis of front, rear, left side and right side. Damage to the vehicle was presented using the CDC code by analytical study of photo-images of the damaged vehicle, and a trauma score was used for medical examination of the severity of the patient's injury. Among the 1,699 patients due to motor vehicle crashes, 88 (5.2%) received a diagnosis of lower extremity fracture and 141 (8.3%) were the severe who had ISS over 15. Nevertheless during 19 months for research, it was difficult to build up in-depth database about motor vehicle crashes. It has a limitation on collecting data because not only the system for constructing database about motor vehicle crash is not organized but also the process for demanding materials is not available due to prevention of personal information. For accurate analysis of the relationship between occupant injury and vehicle damage in motor vehicle crashes, build-up of an in-depth database through carrying out various policies for motor vehicle crashes is necessary for sure.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.5
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• pp.275-284
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• 2019

This study was conducted to evaluate the health promotion behavior level, health beliefs, and self-efficacy of individuals preparing for civil service examinations, as well as the main factors that influence their health promotion behavior. The study subjects were 290 individuals who were preparing for civil service examinations in Noryangjin, where there are a lot of private institutions that provide training for the examinations. Data were collected by questionnaire surveys conducted from December 1 to 19, 2017. With the use of SPSS ver. 23, descriptive statistics, t-tests, one-way ANOVA, correlation analysis, and stepwise multiple regression were conducted. On average, the score for health promotion behavior practice was $2.37{\pm}0.45points$, health beliefs $3.13{\pm}0.45points$, and self-efficacy $3.55{\pm}0.74points$. Health promotion behavior was significantly positively correlated with perceived severity and perceived benefits, which are sub factors of health beliefs (r=.60, p<.001; r=.55, p<.001), while it was significantly negatively correlated with perceived barriers, which are a sub factor of health beliefs (r=.32, p<.001). The factors that influenced health promotion behavior were perceived health condition and perceived barriers, and the explanatory power of health promotion behavior was 25.1% (F=13.58, p<.001). In general, respondents studied for the examinations for a long time and were under severe job pressure; accordingly, they need to have quality meals, regular exercise, and regular medical check-ups to enhance health promotion behavior to control their stress.

• Journal of The Korean Society of Clinical Toxicology
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• v.16 no.2
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• pp.131-140
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• 2018

Purpose: The National Emergency Medical Center has been running a project for the storage and delivery of antidotes for acute poisoning patients of the Department of Health and Welfare, Korea. This study analyzed the results of this project over the past two years. Methods: The requests received by the National Emergency Medical Center and the data on the delivery process were analyzed. Results: This study analyzed a total of 121 patients with acute poisoning, who were requested to receive an antidote reserved at 20 key hospitals in 2015-2017, and whose age was $52.3{\pm}23.5\;years$; old; 54 were women. Intentional poisoning were 58.7%, and the home was the most common place of exposure (66.9%). The toxic substances were chemicals (32.2%), pesticides (27.3%), medicines (24.8%), and snake venom (4.1%). The patient's poison severity score was $2.4{\pm}0.7$ (median 3) indicating moderate-to-severe toxicity. Antidote administration was the cases treated in key hospitals 67.8% (82/121), in which transferred patients accounted for 57.3% (47/82). After receiving an antidote request from a hospital other than the key hospitals, the median was 75.5 minutes (range 10 to 242 minutes) until the antidote reached the patient, and an average of 81.5 minutes was required. The results of emergency care were intensive care unit (70.3%), general wards (13.2%), death (10.7%), and discharge from emergency department (5.0%). Conclusion: This study showed that the characteristics of acute poisoning patients treated with an antidote were different from previous reports of poisoned patients in the emergency department, and basic data on the time required for delivery from key hospitals was different.

• Journal of The Korean Society of Emergency Medicine
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• v.29 no.5
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• pp.493-499
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• 2018

Objective: This study aimed to identify the effects of serum potassium and lactate on neurologic outcomes in out-of-hospital post-cardiac arrest adult patients. Methods: This study was a single center, retrospective observational study. We recruited out-of-hospital post-cardiac arrest adult patients admitted to an intensive care unit from 2011 to 2017. Primary outcome was good neurologic outcome at discharge. To evaluate the prognostic impact of serum potassium and lactate, univariate and multivariate logistic regression analyses were performed. Results: A total of 57 patients were included in this study. The number of patients with good neurologic outcome was 19 (33.3%). In the univariate analysis, good neurologic outcome patients showed a higher smoking rate, shorter pre-hospital transportation time, higher rate of percutaneous coronary intervention, and lower severity score (all P<0.05). The good neurologic outcome patients also presented higher pH, lower partial pressure of carbon dioxide, and lower potassium regarding laboratory findings on the first hospital day (all P<0.05). In the multivariate analysis, the independent factors favoring good neurologic outcome were pre-hospital transportation time (adjusted odds ratio [aOR], 0.82; 95% confidence interval [CI], 0.69-0.97; P=0.019) and lower partial pressure of carbon dioxide on the first hospital day (aOR, 0.95; 95% CI, 0.91-0.99; P=0.034). Conclusion: Serum potassium and lactate were not significantly associated with good neurologic outcome in out-of-hospital post-cardiac arrest adult patients. The prognostic factors for good neurologic outcome were pre-hospital transportation time and initial partial pressure of carbon dioxide.