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1.
Graefes Arch Clin Exp Ophthalmol ; 261(8): 2375-2382, 2023 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-36808229

RESUMEN

PURPOSE: To report the therapeutic efficacy of intravenous methylprednisolone (IVMP) in patients with restrictive myopathy caused by thyroid eye disease (TED). METHODS: The present prospective uncontrolled study comprised 28 patients with TED and restrictive myopathy who presented with diplopia that had developed within 6 months before their visit. All patients were treated with IVMP for 12 weeks. Deviation angle, limitation of extraocular muscle (EOM) movement, binocular single vision score, Hess score, clinical activity score (CAS), modified NOSPECS score, exophthalmometric value, and the size of EOMs on computed tomography were evaluated. The patients were divided into two groups: those whose deviation angle had decreased or remained unchanged 6 months after treatment (group 1; n = 17) and those whose deviation angle had increased in that time (group 2; n = 11). RESULTS: The mean CAS of the whole cohort significantly decreased from baseline to 1 month and 3 months after treatment (P = 0.03 and P = 0.02, respectively). The mean deviation angle significantly increased from baseline to 1, 3, and 6 months (P = 0.01, P < 0.01, and P < 0.01, respectively). The deviation angle decreased in 10 (36%), remained constant in seven (25%), and increased in 11 (39%) of the 28 patients. When groups 1 and 2 were compared, no single variable was identified as a cause of deviation angle deterioration (P > 0.05). CONCLUSIONS: When treating patients with TED who have restrictive myopathy, physicians should be aware that some patients show worsening of the strabismus angle despite inflammation control with IVMP therapy. Uncontrolled fibrosis can result in motility deterioration.


Asunto(s)
Oftalmopatía de Graves , Enfermedades Musculares , Humanos , Oftalmopatía de Graves/tratamiento farmacológico , Metilprednisolona , Estudios Prospectivos , Músculos Oculomotores , Estudios Retrospectivos , Resultado del Tratamiento
2.
Pediatr Emerg Care ; 36(5): e268-e273, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-29698348

RESUMEN

OBJECTIVES: The aim of this study was to investigate the accuracy of bedside ultrasound (US) performed by emergency physicians for diagnosing skull fractures in children 0 to 4 years old compared with the accuracy of head computed tomography (CT). We also sought to investigate characteristics and precautions associated with US. METHODS: This single-center prospective study involved children 0 to 4 years old who had a history of head trauma. Bedside US was performed by emergency medicine physicians, and the results were compared with CT scan interpretations provided by attending radiologists. The accuracy of US for the diagnosis of skull fractures was calculated, and the errors were reviewed. RESULTS: A total of 87 patients were enrolled. Skull fracture was present in 13 patients (14.9%), according to CT. Bedside US had a sensitivity and specificity of 76.9% (95% confidence interval [CI], 46.0%-93.8%) and 100% (95% CI, 93.9%-100%), respectively. Overall positive predictive value was 100% (95% CI, 65.5%-100%), and negative predictive value was 96.1% (95% CI, 88.3%-99.0%). Three false-negative cases were observed. CONCLUSIONS: Bedside US performed by emergency medicine physicians with short focused US training is a useful tool for diagnosing skull fractures in children 0 to 4 years of age. However, there were 3 false-negative cases. A meticulous examination is needed in the area adjacent to the orbital wall and skull base.


Asunto(s)
Reacciones Falso Negativas , Pruebas en el Punto de Atención , Fracturas Craneales/diagnóstico por imagen , Ultrasonografía , Preescolar , Medicina de Emergencia , Reacciones Falso Positivas , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Estudios Prospectivos , Sensibilidad y Especificidad , Tomografía Computarizada por Rayos X , Ultrasonografía/métodos
3.
J Nanosci Nanotechnol ; 19(8): 4705-4709, 2019 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-30913773

RESUMEN

Thermally cross-linkable host materials, DV-TPACZ, DV-TPADBCZ, and TV-TPBI, were designed and synthesized for solution-processed organic light-emitting diodes (OLEDs). The synthesized styrene-functionalized host materials were thermally cross-linked by curing at 150-200 °C without using a polymerization initiator. Excellent solvent resistance was observed for all cured host films. They exhibited low highest occupied molecular orbital energy levels of 5.4-5.7 eV, which indicated a low hole injection barrier from the hole transport layer to the emissive layer. A solution-processed red phosphorescent OLED with 5 wt% (MPHMQ)2Ir (tmd) dopant in the thermally cross-linkable DV-TPACZ host exhibited a current efficiency of 5.3 cd/A, power efficiency of 3.2 lm/W, and external quantum efficiency of 3.6%.

4.
J Nanosci Nanotechnol ; 18(10): 7047-7052, 2018 10 01.
Artículo en Inglés | MEDLINE | ID: mdl-29954531

RESUMEN

We have synthesized and characterized a blue phosphorescent iridium(III) complex (dfpypy)2Ir(tftamp), which contains 2',6'-difluoro-2,3'-bipyridine (dfpypy) as the main ligand and 4-methyl-2-(3'-trifluoromethyl-1'H-1',2',4'-triazol-5'-yl)pyridine (tftamp) as the ancillary ligand. The photophysical, electrochemical, and electroluminescent (EL) properties of (dfpypy)2Ir(tftamp) were investigated. Vacuum-deposited blue and white organic light-emitting diodes (OLEDs) were fabricated using (dfpypy)2Ir(tftamp) in 1,3-bis(carbazol-9-yl)benzene (mCP) as the emitting layer. The EL spectrum of (dfpypy)2Ir(tftamp) exhibited emission maximum at 472 nm with a full-width at half-maximum (FWHM) of 81 nm and Commission Internationale de L'Eclairage (CIE) coordinates of (0.17, 0.27) at 100 cd · m-2. In addition, white-light-emitting devices were fabricated, which exhibited CIE coordinates of (0.42, 0.40) and a correlated color temperature (CCT) of 3,237 K at 1000 cd · m-2, close to the standard warm-white light CIE coordinates of (0.44, 0.40) and CCT of 3,000 K.

5.
Am J Emerg Med ; 36(2): 243-247, 2018 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-28807442

RESUMEN

INTRODUCTION: In this study, we retrospectively reviewed the patients' outcomes after cardiac arrest based on age in one center, to determine whether geriatric patients had worse outcomes. METHODS: This was a single-center, retrospective cohort study. The patients admitted to the intensive care unit on successful resuscitation after OHCA were retrospectively identified and evaluated. RESULTS: This was a retrospective cohort study of patients over 18years of-age with return of spontaneous circulation (ROSC) (>24h) after cardiac arrest who were admitted to the emergency intensive care unit (EICU) and received post-cardiac arrest care between March 2007 and December 2013. Finally, a total of 295 patients were enrolled during the study period; of these, 79 patients (36.6%) had a good cerebral performance category (CPC). In stepwise multivariate analysis, young age (per 10years) (odds ratio [OR] 1.42, 95% CI 1.00-1.99, p=0.044), high hemoglobin level (per 1g/dL) (OR 1.31, 95% CI 1.07-1.60, p=0.008), non-diabetic patients (OR 15.21, 95% CI 1.85-125.3, p=0.01), cardiogenic cardiac arrest (OR 8.68, 95% CI 3.72-20.30, p<0.001), pre-hospital cardiopulmonary resuscitation (CPR) by bystander (OR 3.61, 95% CI 1.23-10.57, p=0.019), short time from collapsed to ACLS (per 1min) (OR 1.12, 95% CI 1.06-1.18, p<0.001) had good CPC at 6-month post-admission. CONCLUSION: Elderly patients with OHCA had a poor neurological outcome; but several other factors were also related with the outcome. In decision-making for resuscitation, physicians should consider the patients' physiologic factors as well as age.


Asunto(s)
Hipotermia Inducida/estadística & datos numéricos , Enfermedades del Sistema Nervioso/etiología , Paro Cardíaco Extrahospitalario/terapia , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Reanimación Cardiopulmonar , Servicios Médicos de Urgencia , Femenino , Humanos , Hipotermia Inducida/mortalidad , Masculino , Persona de Mediana Edad , Enfermedades del Sistema Nervioso/mortalidad , Paro Cardíaco Extrahospitalario/mortalidad , República de Corea , Estudios Retrospectivos , Resultado del Tratamiento
6.
Am J Emerg Med ; 33(1): 131.e1-3, 2015 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-25085284

RESUMEN

Pleural or abdominal hematomas induced by spontaneous rupture of intercostal artery are very rare but can often cause fatal problems leading to hypovolemic shock. Spontaneous rupture of intercostal artery mostly occurs in association with neurofibromatosis type 1, coarctation of aorta, or trauma. In the absence of these conditions, there are very few cases. We report a 39-year-old man who complained of left flank pain after severe cough for a few days. His final diagnosis was hematoma of the left lateral abdominal wall induced by rupture of the left 11th intercostal artery. He was treated immediately by transarterial embolization. Without any serious problems during hospitalization, he was discharged. This case indicates that, in generally healthy individuals, even mild physical force such as cough can lead to rupture of the intercostal artery. Although it is very rare, injury to the intercostal artery should be considered when patients complain of unexplained chest pain, abdominal pain, or flank pain after strong cough or sneezing.


Asunto(s)
Tos/complicaciones , Hemotórax/etiología , Arterias Torácicas , Adulto , Diagnóstico Diferencial , Embolización Terapéutica , Hemotórax/diagnóstico por imagen , Hemotórax/terapia , Humanos , Masculino , Radiografía , Rotura Espontánea/diagnóstico por imagen , Rotura Espontánea/etiología , Rotura Espontánea/terapia
7.
Eur J Orthop Surg Traumatol ; 24 Suppl 1: S145-51, 2014 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-23934439

RESUMEN

Satisfactory short- and mid-term results have been observed following microscopic decompression with tubular retractor (MDT) and conventional microscopic decompression (CMD) in lumbar spinal stenosis (LSS). It is not yet clear which surgical procedure is the optimal treatment for LSS, especially in long-term follow-up period. To the best of our knowledge, there is no comparative study analyzing the clinical-radiological outcomes of MDT and CMD over a 10-year follow-up periods. The purpose of this study was to evaluate and compare clinical and radiological outcomes of MDT and CMD over a 10-year follow-up period in patients with LSS. Of total 121 patients, 102 patients (53 MDT and 49 CMD) were followed for at least 10 years following MDT and CMD for LSS. We retrospectively reviewed surgical results and clinical outcomes based on the visual analogue scale, McNab's criteria, and the Oswestry Disability Index, and radiological analysis results with the parameters, including the change of disk height and intervertebral distance, obtained preoperatively and 3- and 6-month, and 1-, 6-, and 10-year postoperatively. There was no significant difference in patient demographics between the two groups. Five patients (two in MDT, three in CMD) required re-operation for re-stenotic change of the affected segment. The number of patients requiring re-operation was not significantly different between the two groups (p > 0.05). No statistically significant differences were observed between the groups in a long-term follow-up period after a 3-month follow-up (p > 0.05). However, in the acute postoperative phase of <3-month postoperatively, MDT appears to result in less postoperative pain and better clinical outcomes compared with the CMD. In conclusion, despite relatively small sample size with retrospective design, our study suggested that MDT appears to result in less postoperative pain and better clinical outcomes in the acute postoperative period of <3 months, but both MDT and CMD were no significant differences in clinical and radiological outcomes after that time.


Asunto(s)
Descompresión Quirúrgica/métodos , Vértebras Lumbares/cirugía , Microcirugia/métodos , Estenosis Espinal/cirugía , Pérdida de Sangre Quirúrgica , Descompresión Quirúrgica/instrumentación , Femenino , Humanos , Tiempo de Internación , Masculino , Microcirugia/instrumentación , Persona de Mediana Edad , Tempo Operativo , Radiografía , Estudios Retrospectivos , Estenosis Espinal/diagnóstico por imagen , Resultado del Tratamiento
8.
J Clin Med ; 12(14)2023 Jul 09.
Artículo en Inglés | MEDLINE | ID: mdl-37510683

RESUMEN

(1) Background: Post-cardiac arrest syndrome (PCAS) is a type of global ischemic reperfusion injury that occurs after the return of spontaneous circulation (ROSC). The procalcitonin to albumin ratio (PAR) has been studied as an independent prognostic factor of various diseases. There are no previous studies of PAR in patients with PCAS. We assessed if PAR is more effective than procalcitonin (PCT) in predicting prognosis for patients with PCAS. (2) Methods: This retrospective cohort study included a total of 187 patients with PCAS after non-traumatic out-of-hospital cardiac arrest (OHCA) between January 2016 and December 2020. Multivariate logistic regression analysis was conducted to assess the association between PAR and PCAS prognosis. The predictive performance of PAR was compared with PCT via the receiver-operating characteristic (ROC) analysis and DeLong test.; (3) Results: PAR at 24 and 48 h after hospital admission were independently associated with one-month neurological outcome (OR: 1.167, 95% CI: 1.023-1.330; OR: 1.077, 95% CI: 1.012-1.146, p < 0.05). By ROC analysis, PAR showed better performance over PCT at 48 h after admission in predicting one-month CPC (0.763 vs. 0.772, p = 0.010). (4) Conclusions: Our findings suggest that PAR at 48 h after admission is more effective in predicting a one-month neurological outcome than PCT at 48 h after admission in patients with PCAS after OHCA.

9.
J Clin Med ; 12(15)2023 Jul 31.
Artículo en Inglés | MEDLINE | ID: mdl-37568442

RESUMEN

BACKGROUND: Although saline is commonly used during cardiopulmonary resuscitation (CPR) or post-cardiac arrest care, it has detrimental effects. This trial aimed to evaluate the efficacy of a balanced crystalloid solution (Plasma Solution-A [PS]) in out-of-hospital cardiac arrest (OHCA) patients and compare it with the efficacy of saline. METHODS: A randomized, unblinded clinical trial was conducted using PS and saline for intravenous fluid administration during CPR and post-cardiac arrest care of non-traumatic OHCA patients admitted to the emergency department of a tertiary university hospital. Patients received saline (saline group) or PS (PS group) within 24 h of hospital arrival. The primary outcomes were changes in arterial pH, bicarbonate, base excess (BE), and chloride levels within 24 h. The secondary outcomes were clinical outcomes including mortality. RESULTS: Of the 364 patients, data from 27 and 26 patients in the saline and PS groups, respectively, were analyzed. Analysis using a linear mixed model revealed a significant difference in BE change over time between the groups (treatment-by-time p = 0.044). Increase in BE and bicarbonate levels from 30 min to 2 h was significantly greater (p = 0.044 and p = 0.024, respectively) and the incidence of hyperchloremia was lower (p < 0.001) in the PS group than in the saline group. However, there was no difference in clinical outcomes. CONCLUSION: Use of PS for resuscitation resulted in a faster improvement in BE and bicarbonate, especially in the early phase of post-cardiac arrest care, and lower hyperchloremia incidence than the use of saline, without differences in clinical outcomes, in OHCA patients.

10.
Water Sci Technol ; 66(11): 2355-62, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-23032765

RESUMEN

The focus of water quality modeling of Korean streams needs to be shifted from dissolved oxygen to algae or organic matter. In particular, the structure of water quality models should be modified to simulate the biochemical oxygen demand (BOD), which is a key factor in calculating total maximum daily loads (TMDLs) in Korea, using 5-day BOD determined in the laboratory (Bottle BOD(5)). Considering the limitations in simulating organic matter under domestic conditions, we attempted to model total organic carbon (TOC) as well as BOD by using a watershed model. For this purpose, the Soil and Water Assessment Tool (SWAT) model was modified and extended to achieve better correspondence between the measured and simulated BOD and TOC concentrations. For simulated BOD in the period 2004-2008, the Nash-Sutcliffe model efficiency coefficient increased from a value of -2.54 to 0.61. Another indicator of organic matter, namely, the simulated TOC concentration showed that the modified SWAT adequately reflected the observed values. The improved model can be used to predict organic matter and hence, may be a potential decision-making tool for TMDLs. However, it needs further testing for longer simulation periods and other catchments.


Asunto(s)
Agua Dulce/análisis , Modelos Teóricos , Compuestos Orgánicos/análisis , Calidad del Agua , Análisis de la Demanda Biológica de Oxígeno , República de Corea
11.
Disaster Med Public Health Prep ; 16(1): 8-11, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-32843109

RESUMEN

OBJECTIVE: A disaster in the hospital is particularly serious and quite different from other ordinary disasters. This study aimed at analyzing the activity outcomes of a disaster medical assistance team (DMAT) for a fire disaster at the hospital. METHODS: The data which was documented by a DMAT and emergent medical technicians of a fire department contained information about the patient's characteristics, medical records, triage results, and the hospital which the patient was transferred from. Patients were categorized into four groups according to results of field triage using the simple triage and rapid treatment method. RESULTS: DMAT arrived on the scene in 37 minutes. One hundred and thirty eight (138) patients were evacuated from the disaster scene. There were 25 patients (18.1%) in the Red group, 96 patients (69.6%) in the Yellow group, and 1 patient (0.7%) in the Green group. One patient died. There were 16 (11.6%) medical staff and hospital employees. The injury of the caregiver or the medical staff was more severe compared to the family protector. CONCLUSIONS: For an effective disaster-response system in hospital disasters, it is important to secure the safety of medical staff, to utilize available medical resources, to secure patients' medical records, and to reorganize the DMAT dispatch system.


Asunto(s)
Planificación en Desastres , Servicios Médicos de Urgencia , Incidentes con Víctimas en Masa , Planificación en Desastres/métodos , Hospitales , Humanos , Asistencia Médica , Triaje
12.
Clin Exp Emerg Med ; 8(2): 103-110, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-34237815

RESUMEN

OBJECTIVE: To examine the features of powered mobility device-related injuries and identify the predictors of injury severity in such settings. METHODS: Emergency Department-based Injury In-depth Surveillance data from 2011 to 2018 were used in this retrospective study. Participants were assigned to the mild/moderate and severe groups based on their excess mortality ratio-adjusted injury severity score and their general injury-related factors and injury outcome-related factors were compared. RESULTS: Of 407 patients, 298 (79.2%) were assigned to the mild/moderate group and 109 (26.8%) to the severe group. The severe group included a higher percentage of patients aged 70 years or older (43.0% vs. 59.6%, P=0.003), injuries incurred in the daytime (72.6% vs. 82.4%, P=0.044), injuries from traffic accidents and falls (P=0.042), head injuries (38.6% vs. 80.7%, P<0.001), torso injuries (16.8% vs. 32.1%, P=0.001), overall hospital admission (28.5% vs. 82.6%, P<0.001), intensive care unit admission (1.7% vs. 37.6%, P<0.001), death after admission (1.4% vs. 10.3%, P=0.034), and total mortality (0.7% vs. 9.2%, P<0.001). The odds ratios (ORs) for injury severity were as follows: age 70 years or older (OR, 2.124; 95% confidence interval [CI], 1.239-3.642), head injury (OR, 10.441; 95% CI, 5.465-19.950), and torso injury (OR, 4.858; 95% CI, 2.495-9.458). CONCLUSION: The proportions of patients aged 70 years or older, head and torso injuries, injuries from traffic accidents and falls, and injuries in the daytime were higher in the severe group. Our results highlight the need for measures to address these factors to lower the incidence of severe injuries.

14.
J Nanosci Nanotechnol ; 20(8): 4661-4665, 2020 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-32126637

RESUMEN

Photo-crosslinkable hole transporting layer (HTL) consisting of a blend of poly(bis-4-butylphenyl-N,N-bisphenyl)benzidine (poly-TPD) and bis(4-azido-2,3,5,6-tetrafluorobenzoate) (FPA) was applied to red and green organic light-emitting diodes (OLEDs) by solution processing. This photocrosslinking reaction rendered the HTL insoluble in organic solvents and enabled subsequent solution deposition of an upper emissive layer. The solvent resistance of the photo-crosslinked poly-TPD:FPA (1 wt%) film was enhanced compared to that of the non-crosslinked neat poly-TPD film. Solution-processed red and green OLEDs with the poly-TPD:FPA (1 wt%) photo-crosslinked HTL exhibited higher device performances than those with the non-crosslinked poly-TPD HTL.

15.
Clin Exp Emerg Med ; 7(3): 161-169, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-33028058

RESUMEN

OBJECTIVE: No studies have evaluated the diagnostic value of ischemia-modified albumin (IMA) for the early detection of sepsis/septic shock in patients presenting to the emergency department (ED). We aimed to assess the usefulness of IMA in diagnosing sepsis/septic shock in the ED. METHODS: This retrospective, observational study analyzed IMA, lactate, high sensitivity C-reactive protein, and procalcitonin levels measured within 1 hour of ED arrival. Patients with suspected infection meeting at least two systemic inflammatory response syndrome criteria were included and classified into the infection, sepsis, and septic shock groups using Sepsis-3 definitions. Areas under the receiver operating characteristic curves (AUCs) with 95% confidence intervals (CIs) and multivariate logistic regression were used to determine diagnostic performance. RESULTS: This study included 300 adult patients. The AUC (95% CI) of IMA levels (cut-off ≥85.5 U/mL vs. ≥87.5 U/mL) was higher for the diagnosis of sepsis than for that of septic shock (0.729 [0.667-0.791] vs. 0.681 [0.613-0.824]) and was higher than the AUC of procalcitonin levels (cut-off ≥1.58 ng/mL, 0.678 [0.613-0.742]) for the diagnosis of sepsis. When IMA and lactate levels were combined, the AUCs were 0.815 (0.762-0.867) and 0.806 (0.754-0.858) for the diagnosis of sepsis and septic shock, respectively. IMA levels independently predicted sepsis (odds ratio, 1.05; 95% CI, 1.00-1.09; P=0.029) and septic shock (odds ratio, 1.07; 95% CI, 1.02-1.11; P=0.002). CONCLUSION: Our findings indicate that IMA levels are a useful biomarker for diagnosing sepsis/septic shock early, and their combination with lactate levels can enhance the predictive power for early diagnosis of sepsis/septic shock in the ED.

16.
Clin Exp Emerg Med ; 7(3): 170-175, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-33028059

RESUMEN

OBJECTIVE: Alcohol consumption is associated with an increased risk of injuries. However, its effects on injury severity and mortality remain unclear. Specifically, the effects of alcohol intake on the severity of slip injuries have not been thoroughly investigated. Therefore, our study aimed to investigate the effects of alcohol intake on injury patterns and severity in patients experiencing slip injuries. METHODS: Emergency department surveillance data collected from 2011 to 2016 were analyzed for this study. Among patients aged 15 and older who were admitted for slip injuries, we compared the type and severity of injuries between the alcohol-intake group and the no-alcohol-intake group. Injury severity was classified as non-severe and severe based on the excess mortality ratio-adjusted injury severity score. RESULTS: In total, 227,548 (alcohol-intake, n=48,581; no-alcohol-intake, n=178,967) patients were included. After adjusting for age, time of injury, use of public ambulance, and season, multivariate logistic regression analysis showed that injuries were more likely to be severe in the alcohol-intake group than in the no-alcohol-intake group (odds ratio, 1.60; 95% confidence interval, 1.47-1.75). In addition, male gender and alcohol consumption had a greater synergistic effect on injury severity than the mere sum of each effect of these factors (odds ratio, 2.65; 95% confidence interval, 2.53-2.78). CONCLUSION: Assessment of the patients influenced by alcohol was a challenge in the emergency department due to altered mental status. We suggest a considerate approach in testing and assessing male patients who slipped after alcohol-intake in the emergency department.

17.
Medicine (Baltimore) ; 98(6): e14496, 2019 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-30732223

RESUMEN

This study aimed to determine whether the combination of procalcitonin (PCT) and S100B improves prognostic performance compared to either alone in cardiac arrest (CA) patients treated with targeted temperature management (TTM).We performed a prospective cohort study of CA patients treated with TTM. PCT and S100B levels were obtained at 0, 24, 48, and 72 hours after return of spontaneous circulation. The prognostic performance was analyzed using each marker and the combination of the 2 markers for predicting poor neurological outcome at 3 months and mortality at 14 days and 3 months.A total of 97 patients were enrolled, of which 67 (69.1%) had poor neurological outcome. S100B showed a better prognostic performance (area under the curve [AUC], 0.934; sensitivity, 77.6%; and specificity, 100%) than PCT (AUC, 0.861; sensitivity, 70.2%; and specificity, 83.3%) with the highest prognostic value at 24 hours. The combination of 24-hour PCT and S100B values (S100B ≥0.2 µg/L or PCT ≥6.6 ng/mL) improved sensitivity (85.07%) compared with S100B alone. In multivariate analysis, PCT was associated with mortality at 14 days (odds ratio [OR]: 1.064, 95% confidence interval [CI]: 1.014-1.118), whereas S100B was associated with neurological outcomes at 3 months (OR: 9.849, 95% CI: 2.089-46.431).The combination of PCT and S100B improved prognostic performance compared to the use of either biomarker alone in CA patient treated with TTM. Further studies that will identify the optimal cutoff values for these biomarkers must be conducted.


Asunto(s)
Coma/etiología , Paro Cardíaco/sangre , Paro Cardíaco/clasificación , Polipéptido alfa Relacionado con Calcitonina/sangre , Subunidad beta de la Proteína de Unión al Calcio S100/sangre , Adulto , Biomarcadores , Coma/fisiopatología , Femenino , Paro Cardíaco/fisiopatología , Humanos , Hipotermia Inducida , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Prospectivos , Curva ROC , Sensibilidad y Especificidad , Factores de Tiempo
18.
Clin Exp Emerg Med ; 6(3): 235-241, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31571439

RESUMEN

OBJECTIVE: This study aimed to examine whether injury severity differs with respect to age among elderly pedestrians involved in traffic accidents and identify factors affecting injury severity. METHODS: Using emergency department-based injury in-depth surveillance data, we analyzed the data of patients aged ≥60 years who were victims of pedestrian traffic accidents during 2011 to 2016. The pedestrians' ages were divided into 5-year age strata beginning at 60 years. In a multivariate analysis, injury severity was classified as severe to critical or mild to moderate. RESULTS: The analysis included 10,449 patients. All age groups had a female predominance, and accidents most frequently occurred during the early morning. Multivariate analyses revealed that compared to the 60 to 64 years group, the odds ratios for incurring a severe injury were 1.18 (95% confidence interval [CI], 1.02 to 1.37) for the 65 to 69 years group, 1.42 (95% CI, 1.23 to 1.64) for the 70 to 74 years group, 1.70 (95% CI, 1.45 to 1.98) for the 75 to 79 years group, and 1.83 (95% CI, 1.56 to 2.15) for the ≥80 years group. CONCLUSION: In this study of emergency department-based data, we found that injury severity increased with age among elderly victims of traffic accidents. Furthermore, injury severity varied with respect to sex, time and location of the accident, and type of vehicle involved. Therefore, measures intended to reduce and prevent traffic accidents involving elderly pedestrians should consider these findings.

19.
Mol Cells ; 26(4): 387-95, 2008 Oct 31.
Artículo en Inglés | MEDLINE | ID: mdl-18612245

RESUMEN

A novel Tc1-like transposable element has been identified as a new DNA transposon in the mud loach, Misgurnus mizolepis. The M. mizolepis Tc1-like transposon (MMTS) is comprised of inverted terminal repeats and a single gene that codes Tc1-like transposase. The deduced amino acid sequence of the transposase-encoding region of MMTS transposon contains motifs including DDE motif, which was previously recognized in other Tc1-like transposons. However, putative MMTS transposase has only 34-37% identity with well-known Tc1, PPTN, and S elements at the amino acid level. In dot-hybridization analysis used to measure the copy numbers of the MMTS transposon in genomes of the mud loach, it was shown that the MMTS transposon is present at about 3.36 x 104 copies per 2 x 109 bp, and accounts for approximately 0.027% of the mud loach genome. Here, we also describe novel MMTS-like transposons from the genomes of carp-like fishes, flatfish species, and cichlid fishes, which bear conserved inverted repeats flanking an apparently intact transposase gene. Additionally, BLAST searches and phylogenetic analysis indicated that MMTS-like transposons evolved uniquely in fishes, and comprise a new subfamily of Tc1-like transposons, with only modest similarity to Drosophila melanogaster (foldback element FB4, HB2, HB1), Xenopus laevis, Xenopus tropicalis, and Anopheles gambiae (Frisky).


Asunto(s)
Cipriniformes/genética , Elementos Transponibles de ADN/genética , Secuencia de Aminoácidos , Animales , Secuencia de Bases , Clonación Molecular , Dosificación de Gen , Genoma/genética , Datos de Secuencia Molecular , Filogenia , Reacción en Cadena de la Polimerasa , Homología de Secuencia de Ácido Nucleico , Secuencias Repetidas Terminales/genética , Pez Cebra/genética
20.
Water Sci Technol ; 58(12): 2329-38, 2008.
Artículo en Inglés | MEDLINE | ID: mdl-19092211

RESUMEN

Effective watershed management often demands qualitative and quantitative predictions of the effect of future management activities as arguments for policy makers and administration. The BASINS geographic information system was developed to compute total maximum daily loads, which are helpful to establish hydrological process and water quality modeling system. In this paper the BASINS toolkit HSPF model is applied in 20,271 km(2) large watershed of the Han River Basin is used for applicability of HSPF and BMPs scenarios. For proper evaluation of watershed and stream water quality, comprehensive estimation methods are necessary to assess large amounts of point source and nonpoint-source (NPS) pollution based on the total watershed area. In this study, The Hydrological Simulation Program-FORTRAN (HSPF) was estimated to simulate watershed pollutant loads containing dam operation and applied BMPs scenarios for control NPS pollution. The 8-day monitoring data (about three years) were used in the calibration and verification processes. Model performance was in the range of "very good" and "good" based on percent difference. The water-quality simulation results were encouraging for this large sizable watershed with dam operation practice and mixed land uses; HSPF proved adequate, and its application is recommended to simulate watershed processes and BMPs evaluation.


Asunto(s)
Simulación por Computador , Sistemas de Información Geográfica , Ríos , Contaminantes del Agua/análisis , Calibración , Geografía , Eliminación de Residuos Líquidos , Agua/normas , Movimientos del Agua , Purificación del Agua/normas , Humedales
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