We present a study on the systemic insults in the early death(within one week) after head injury. The patient population consisted of 192 patients who were admitted to the Soonchunhyang University Chonan Hospital from August 1986 to May 1990 after head injury. We collected clinical features and systemic insults including blood pressure, arterial pH, PaO2, PaCO2, hematocrit, and serum concentration of Na, retrospectively. The most common cause of injury was road traffic accident(77.6%). More than half(57.8%) were under the age of 40 years. The interval from injury to admission was within one hour in 63.2%, and within four hours in 91.4%. The mean interval was 1.8 hours. However, in 154(80.2%) patients, we found the evidence of systemic insults on admission. We found hypotension(ststolic less than 90mmHg) in 22.9%, acidemia(pH<7.35) in 71.3%, arterial hypoxemia(PaO2<60mmHg) in 42.7%, hypercarbia(PaCO2>45mmHg) in 28.7%, anemia(hematocrit<30%) in 13.0%, hyponatremia(Na<135mEq/L) in 10.7%, and hypernatremia(Na>145mEq/L) in 11.2%. These results imply that the prehospital emergency care system useful at the scene of accident and during the transportation is more important than the simple quick-transport-system.
Arterial Pressure ; Chungcheongnam-do ; Craniocerebral Trauma* ; Emergency Medical Services ; Head* ; Hematocrit ; Humans ; Hydrogen-Ion Concentration ; Retrospective Studies ; Transportation

The posterolateral approaches to the spine is an effective method for the neural decompression and the spinal stabilization. This procedure has an advantages of an one-stage posterolateral decompression-stabilization. We have experienced 8 patients with burst fracture in the thoracolumbar junction. A three-quater prone position was used for patient positioning. No patient showed neurologic deterioration after surgery. Patient positioning and the operative approach are described and illustrated.
Decompression* ; Humans ; Patient Positioning ; Prone Position ; Spine*

Bacillus anthracis is a soil pathogen capable of causing anthrax in animals and humans. To establish a method for specifically detecting B. anthracis, we used nested polymerase chain reaction. Outer and inner sets of oligonucleotide primers were designed from the protective antigen (pag) gene and from the cya gene of the plasmid pXO1. Ainplification of 482 bp or 208 bp DNA fragment obtained from a nested PCR method provided the basis for rapid and reliable assay for the detection and identification of B. anthracis.
Animals ; Anthrax ; Bacillus anthracis* ; Bacillus* ; DNA ; DNA Primers ; Humans ; Plasmids ; Polymerase Chain Reaction* ; Soil

Chemistry, Clinical ; Diagnostic Tests, Routine ; Hemoglobin A, Glycosylated ; Humans

Changes in microparticles (MP) from red blood cell (RBC) concentrates in the context of irradiation have not been investigated. The aim of this study was to evaluate how irradiation affects the number of MPs within transfusion components. Twenty RBC concentrates, within 14 days after donation, were exposed to gamma rays (dose rate: 25 cGy) from a cesium-137 irradiator. Flow cytometry was used to determine the numbers of MPs derived from RBC concentrates before and 24 hr after irradiation. The mean number of MPs (±standard deviation) in RBC concentrates was 21.9×10(9)/L (±22.7×10(9)/L), and the total number of MPs ranged from 2.6×10(9)/L to 96.9×10(9)/L. The mean number of MPs increased to 22.6×10(9)/L (±31.6×10(9)/L) after irradiation. Before irradiation, the CD41-positive and CD235a-positive MPs constituted 9.5% (1.0×10(9)/L) and 2.2% (263×10(6)/L) of total MPs, respectively. After irradiation, CD41-positive MPs increased to 12.1% (1.5×10(9)/L) (P=0.014), but the CD235a-positive MPs decreased to 2.0% (214×10(6)/L) of the total MPs (P=0.369). Irradiation increases the number of CD41-positive MPs within RBC concentrates, suggesting the irradiation of RBC concentrates could be associated with thrombotic risk of circulating blood through the numerical change.
Cell-Derived Microparticles/chemistry/*metabolism/radiation effects ; Erythrocytes/*cytology/radiation effects ; Flow Cytometry ; Gamma Rays ; Humans ; Membrane Glycoproteins/metabolism ; Metalloendopeptidases/metabolism ; Platelet Membrane Glycoprotein IIb/metabolism

BACKGROUND: In Korea, a screening panel of cells from abroad without Di(a) positive cells has been commonly used when a patient has an unexpected antibody screening test. It has been reported that Di(a) occurs with a frequency of 6.14 to 14.5% among Koreans. However, the current popular antibody screening panels contain no Di(a) positive cells. In this study, we evaluate the clinical usefulness of the Di(a) Cell Panel (Diagnostic Grifols, Barcelona, Spain) for Koreans. METHODS: A total of 3,372 pretransfusion samples were employed for unexpected antibody screening testing using panels of cells by the DG Gel microtube column agglutination system, including additional Di(a) cells (Diagnostic Grifols, Barcelona, Spain). The positive cases in this system were confirmed again with DiaMed Di(a) antigen positive panel cells (DiaMed Ag, Cresssier, Morat, Switzerland) and this was followed by sequence- based Diego genotyping. RESULTS: The positive detection rate of an unexpected antibody screening test using SeraScan Diana I and II was 1.07% (36/3372), and seven samples were reactive (1+~2+) with the SeraScan Di(a) panel cells (0.21%). However, among the 5 available genotyped samples, two cases were typed as Di(a-b+). CONCLUSION: Even though there is discrepancy between the genotype and the two antibody screening kits, the addition of Di(a) positive cells as unexpected antibody screening panel cells is recommended.
Agglutination ; Genotype ; Humans ; Korea ; Mass Screening

As part of an initial inquiry into the function of the outer membrane proteins (OMPs) of Helicobacter pylori Korean strain 51, we have conducted an extensive proteome analysis via quadrupole time of flight (Q-TOF) mass spectrometry (MS). Fifty one OMPs of H. pylori were purified using sarcosine and resolved via two-dimensional electrophoresis with immobilized pH gradient strips. The most abundant proteins were observed in the alkaline pI regions (6.0~11.0) at molecular masses between 10~100 KDa. Here, 15 spots were identified, representing 9 types of genes (KHP0852, KHP0853, KHP1353, KHP1017, KHP0172, KHP0076, KHP0617, KHP1069, KHP0614) from the sarcosin-insoluble fraction of H. pylori 51. These may be employed in the characterization of the OMPs of H. pylori 51, which will help to identify new potential target proteins for vaccine development and drug therapy.
Electrophoresis ; Helicobacter ; Helicobacter pylori ; Mass Spectrometry ; Membrane Proteins ; Membranes ; Proteins ; Proteome ; Proton-Motive Force ; Sarcosine ; Sprains and Strains

BACKGROUND: BMI alone may not serve as an index of obesity because it does not reflect body composition. The present study aimed to compare arterial stiffness as assessed by the brachial-ankle pulse wave velocity (ba-PWV) among groups defined by body fat percentage (pBF) and BMI. METHODS: This cross-sectional study was based on 1,700 participants (1,044 men and 656 women) who completed a health screening examination at a national hospital between January 2011 and February 2016. Participants were divided into four groups according to BMI and pBF: normal fat and normal weight (NFNW); excessive fat and normal weight (EFNW); normal fat and obese (NFO); and excessive fat and obese (EFO). The ba-PWV and other cardiometabolic factors were compared among the four groups in men and women separately. RESULTS: For both sexes, the NFNW group had a lower metabolic risk compared to that in the other groups (EFNW, NFO, and EFO). After adjusting for multiple variables, the NFO males had a significantly lower ba-PWV compared to those in the other groups, including NFNW males. The NFO group had significantly more skeletal muscle mass and muscle mass compared the other groups (P < 0.05). Among women, the NFNW group had a significantly lower ba-PWV compared the other groups, even after adjusting for multiple variables. CONCLUSION: Lower pBF in obese men may be associated with improved cardiovascular risk.
Adipose Tissue* ; Body Composition ; Cross-Sectional Studies ; Female ; Humans ; Male ; Mass Screening ; Muscle, Skeletal ; Obesity ; Pulse Wave Analysis* ; Sex Characteristics ; Vascular Stiffness*

We made use of a neurosurgical care unit (NCN) from May 1986. The NCU differs from the intensive care unit (ICU) in several points. The NCU has 16 beds for neurosurgical patients who require continuous observation while the intensive therapy is not likely to be required. Wall units for oxygen and suction are equipped for each bed. One of the patient's family or relatives could attend the patient in the NCU. Neurosurgical nurse education has been offered monthly according to a scheduled curriculum to enhance an ability of neurosurgical close observation. The NCU has several unique advantages. The NCU can solve the bed availability problem caused by not only increased requirement for beds but also patients who were stabilized but still dependant or had some risk of sudden deterioration. Patients in the NCU require more observation than therapy. Thus, the NCU requires less equipments than the ICU, so it is cheap to set up. Regular neurosurgical nurse education fills up the efficiency of the NCU. Attendance of the family not only adds man-power but also provides a skinship and more intimate therapeutic environment. It also potentiates ability to care at home by their family. Our model of NCU has brought so significant advantages that we may advocate the efficacy of such an intermediate care facility, and present here our model of NCU.
Curriculum ; Education ; Humans ; Intensive Care Units ; Intermediate Care Facilities ; Oxygen ; Suction