Cholestyramine (CS) is an ion exchange resin, which binds to iodothyronines and would lower serum thyroid hormone level. The use of CS added to conventional antithyroid drugs to control thyrotoxicosis has been applied since 1980's, and several studies indicate that using CS in combination with methimazole (MZ) produces a more rapid decline in serum thyroid hormones than with only MZ treatment. Our recent retrospective review of five patients taking high dose MZ and CS, compared to age-, gender-, initial free thyroxine (T4) level-, and MZ dose-matched 12 patients with MZ use only, showed more rapid decline of both free T4 and triiodothyronine levels without more adverse events. CS could be safely applicable short-term adjunctive therapy when first-line antithyroid medications are not enough to adequately control severe thyrotoxicosis or side effects of antithyroid drug would be of great concern.
Antithyroid Agents ; Cholestyramine Resin* ; Graves Disease ; Humans ; Ion Exchange ; Methimazole ; Retrospective Studies ; Thyroid Gland ; Thyroid Hormones ; Thyrotoxicosis* ; Thyroxine ; Triiodothyronine

PURPOSE: Trauma is a leading cause of death, even in previously healthy and disease-free individuals, and the mortality rate is very high in neck trauma patients. On the other hand, there have been few studies related to neck injuries. This study examined the characteristics and treatment results of trauma-related neck injuries using the data from Korean National Emergency Department Information System. METHODS: Neck trauma patients were classified using the 6th Korean Standard Disease Classification system. The patients' demographic factors, number of surgeries, and clinical results were investigated. Statistical analysis was conducted using SPSS to evaluate the annual differences in the demographic factors; mortality according to the site of injury and type of surgery; and mechanisms of injury. RESULTS: From 2011 to 2014, 2,458 neck trauma patients were treated in hospitals in South Korea. The number of patients admitted to regional and local emergency medical centers was 883 (35.9%) and 1,502 (61.1%), respectively. No significant annual differences were observed in age, sex ratio, location of treatment center, mortality, and injury site (vascular, tracheal, or esophageal). In addition, no significant differences in the cause of injury, performed surgery (%), and mortality according to the injured organ were observed. CONCLUSION: This study revealed no annual changes in neck injury patients or differences in mortality according to injured organs. This study can be used as a basis for national research on organ-specific injuries, and may help predict the demand for future support projects for the establishment of regional trauma centers.
Cause of Death ; Classification ; Demography ; Emergencies* ; Emergency Service, Hospital* ; Hand ; Humans ; Information Systems* ; Korea ; Mortality ; Neck Injuries ; Neck* ; Sex Ratio ; Trauma Centers ; Wounds and Injuries

Extraintestinal manifestations are not uncommon in Crohn's disease, and a thromboembolic event is a disastrous potential complication. Deep vein thrombosis is the most common manifestation of a thromboembolic event and typically occurs in association with active inflammatory disease. Peripheral neuropathy in Crohn's disease has rarely been reported and is considered an adverse effect of metronidazole therapy. Here, we describe a patient who was initially diagnosed with Crohn's disease complicated with deep vein thrombosis and ulnar neuropathy without metronidazole exposure. The simultaneous occurrence of these complications in the early stage of Crohn's disease has never been reported in the English literature.
Crohn Disease ; Humans ; Metronidazole ; Mononeuropathies ; Peripheral Nervous System Diseases ; Ulnar Neuropathies ; Venous Thrombosis

Background: The preventable trauma death rate survey is a basic tool for the quality management of trauma treatment because it is a method that can intuitively evaluate the level of national trauma treatment. We conducted this study as a national biennial follow-up survey project and report the results of the review of the 2019 trauma death data in Korea. Methods: From January 1, 2019 to December 31, 2019, of a total of 8,482 trauma deaths throughout the country, 1,692 were sampled from 279 emergency medical institutions in Korea. All cases were evaluated for preventability of death and opportunities for improvement using a multidisciplinary panel review approach. Results: The preventable trauma death rate was estimated to be 15.7%. Of these, 3.1% were judged definitive preventable deaths, and 12.7% were potentially preventable deaths. The odds ratio for preventable traumatic death was 2.56 times higher in transferred patients compared to that of patients who visited the final hospital directly. The group that died 1 hour after the accident had a statistically significantly higher probability of preventable death than that of the group that died within 1 hour after the accident. Conclusion The preventable trauma death rate for trauma deaths in 2019 was 15.7%, which was 4.2%p lower than that in 2017. To improve the quality of trauma treatment, the transfer of severe trauma patients to trauma centers should be more focused.