Objective: Traumatic brain injury (TBI) often occurs alongside injuries to other body regions, worsening patient outcomes. This study evaluates the impact of concomitant injuries on clinical outcomes in patients with isolated versus non-isolated TBI. Methods: This retrospective cross-sectional analysis was conducted using data from the Emergency Department-based Injury In-depth Surveillance (EDIIS) for 180,058 TBI patients admitted to 23 tertiary hospitals from January 1, 2020, to December 31, 2022. Patients were categorized into isolated TBI group (iTBI; n=127,673) and non-isolated TBI group (niTBI; n=52,385) based on injury diagnostic codes. Clinical outcomes—24-hour and 30-day mortality, hospital admission, and interhospital transfer—were compared. Multivariate logistic regression analyses adjusted for potential confounders were performed. Results: The niTBI patients exhibited significantly higher 24-hour mortality (1.5% vs. 0.4%), 30-day mortality (2.6% vs. 1.0%), hospital admissions (24.5% vs. 8.4%), and interhospital transfers (3.6% vs. 1.1%) than iTBI patients (all P<0.001). Concomitant injuries increased the adjusted odds of 24-hour mortality (adjusted odds ratio [aOR], 1.456; 95% confidence interval [CI], 1.286–1.648) and 30-day mortality (aOR, 1.111; 95% CI, 1.022–1.208). Thoracic injuries were the most significant predictor of adverse outcomes in niTBI patients, increasing the odds of 24-hour mortality by nearly sixfold (aOR, 5.958; 95% CI 5.057–7.019). Conclusions Concomitant injuries significantly worsen clinical outcomes in TBI patients, with thoracic injuries being the most critical predictor of mortality. These findings highlight the importance of comprehensive trauma assessments and targeted prevention strategies to improve survival rates and optimize resource allocation for patients with multiple injuries.

Objective: The purpose of this study was to investigate the differences in the characteristics between rental car crashes and non-rental car crashes on Jeju Island, and to investigate the association between rental car crashes and the severity of injuries. Methods: This study analyzed data on traffic accidents that occurred on Jeju Island, South Korea from January 2010 to December 2019. The data on traffic accident-related factors were collected using the Traffic Accident Analysis System operated by the Road Traffic Authority. The primary outcome was a fatal injury and secondary outcomes were severe and minor injuries. We analyzed the differences in the characteristics of each factor between rental car crashes and nonrental crashes. We also analyzed the correlation between rental car accidents and the outcome variables. Results: A total of 40,713 traffic accidents occurred during the study period, of which 4,601 (11.3%) were rental car crashes and 36,112 (88.7%) were non-rental crashes. In the rental car crash group, the proportions of the 20-30s age group and female drivers were higher; however, the proportion of the risky driving behaviors was lower. Also, the incidence rate in summer and daytime was higher, and the proportions of vehicle-to-vehicle crashes, single vehicle crashes, and head-on collisions were higher. According to the results of the Poisson regression test, the rental car crash group showed a higher risk of severe injuries (adjusted incidence rate ratio, 1.07; 95% confidence interval, 1.01-1.14), but there was no significant difference in their risk of fatal injuries. Conclusion Our results suggest the need for traffic accident prevention programs considering the characteristics of rental car crashes on Jeju Island, South Korea.

Objective: This study aimed to determine whether there is a difference in mortality and medical resource utilization between geriatric (aged ≥65 years) and super-geriatric patients (aged ≥80 years) with traumatic brain injury (TBI). Methods: We obtained comprehensive data (demographics, injury characteristics, injury severities, and outcomes) of geriatric and super-geriatric TBI patients from an emergency department-based injury surveillance system database from 2011 to 2016. Multivariate logistic regression analysis was performed to compare the mortality and nonroutine discharge (NRDC) status between both groups. Results: Among 442,533 TBI patients, 48,624 were older than 65 years. A total of 48,446 patients (37,140 geriatric and 11,306 super-geriatric) without exclusion criteria were included in the final analysis. Both overall in-hospital mortality (adjusted odds ratio, 1.88; 95% confidence interval [CI], 1.28 to 2.74; P=0.001) and NRDC (adjusted odds ratio, 1.35; 95% CI, 1.07 to 1.71; P=0.011) were significantly higher in the super-geriatric group. In the stratified analysis, there were no significant differences in NRDC rate for all stratifications of treatment timing (emergency department vs. ward admission), but mortality remained to be significant for all stratifications. Conclusion Super-geriatric TBI patients showed a significantly higher risk-adjusted overall mortality and more inadequate medical resource utilization than did geriatric TBI patients. However, super-geriatric patients were more likely to undergo NRDC after admission; thus, further research about age-related health inequalities is needed in the treatment of super-geriatric patients.

Arachnoid web is a very rare disease that occurs when the normal flow of cerebrospinal fluid is disturbed due to abnormal formation of the arachnoid membrane in the arachnoid space. Consequently, symptoms appear in the form of various myelopathies, such as loss of strength and sensation in the upper and lower extremities, or bladder control disorders. In general, surgical treatment can be considered if symptoms are exhibited. Arachnoid web requires a high consideration of appropriate diagnosis and treatment methods. However, due to its extremely rare occurrence in actual clinical practice, it is difficult to differentiate from other diseases such as herniated intervertebral disc or subdural tumor causing spinal myelopathy. This would effectively lead to a completely different direction of treatment. To date, there have been no case reports of Arachnoid web in Korea, except for collecting and reporting the focal anterior displacement of the thoracic spine, which is a similar lesion in the spinal cord. This article therefore provides information through case reports and literature review.

Arachnoid web is a very rare disease that occurs when the normal flow of cerebrospinal fluid is disturbed due to abnormal formation of the arachnoid membrane in the arachnoid space. Consequently, symptoms appear in the form of various myelopathies, such as loss of strength and sensation in the upper and lower extremities, or bladder control disorders. In general, surgical treatment can be considered if symptoms are exhibited. Arachnoid web requires a high consideration of appropriate diagnosis and treatment methods. However, due to its extremely rare occurrence in actual clinical practice, it is difficult to differentiate from other diseases such as herniated intervertebral disc or subdural tumor causing spinal myelopathy. This would effectively lead to a completely different direction of treatment. To date, there have been no case reports of Arachnoid web in Korea, except for collecting and reporting the focal anterior displacement of the thoracic spine, which is a similar lesion in the spinal cord. This article therefore provides information through case reports and literature review.

Objective: This study aimed to determine whether there is a difference in mortality and medical resource utilization between geriatric (aged ≥65 years) and super-geriatric patients (aged ≥80 years) with traumatic brain injury (TBI). Methods: We obtained comprehensive data (demographics, injury characteristics, injury severities, and outcomes) of geriatric and super-geriatric TBI patients from an emergency department-based injury surveillance system database from 2011 to 2016. Multivariate logistic regression analysis was performed to compare the mortality and nonroutine discharge (NRDC) status between both groups. Results: Among 442,533 TBI patients, 48,624 were older than 65 years. A total of 48,446 patients (37,140 geriatric and 11,306 super-geriatric) without exclusion criteria were included in the final analysis. Both overall in-hospital mortality (adjusted odds ratio, 1.88; 95% confidence interval [CI], 1.28 to 2.74; P=0.001) and NRDC (adjusted odds ratio, 1.35; 95% CI, 1.07 to 1.71; P=0.011) were significantly higher in the super-geriatric group. In the stratified analysis, there were no significant differences in NRDC rate for all stratifications of treatment timing (emergency department vs. ward admission), but mortality remained to be significant for all stratifications. Conclusion Super-geriatric TBI patients showed a significantly higher risk-adjusted overall mortality and more inadequate medical resource utilization than did geriatric TBI patients. However, super-geriatric patients were more likely to undergo NRDC after admission; thus, further research about age-related health inequalities is needed in the treatment of super-geriatric patients.

BACKGROUND: AND PURPOSE: The aim of this study was to determine the diagnostic performance and safety of a new ¹⁸F-labeled amyloid tracer, ¹⁸F-FC119S. METHODS: This study prospectively recruited 105 participants, comprising 53 with Alzheimer's disease (AD) patients, 16 patients with dementia other than AD (non-AD), and 36 healthy controls (HCs). In the first screening visit, the Seoul Neuropsychological Screening Battery cognitive function test was given to the dementia group, while HC subjects completed the Korean version of the Mini Mental State Examination. Individuals underwent ¹⁸F-FC119S PET, ¹⁸F-fluorodeoxyglucose (FDG) PET, and brain MRI. The diagnostic performance of ¹⁸F-FC119S PET for AD was compared to a historical control (comprising previously reported and currently used amyloid-beta PET agents), ¹⁸F-FDG PET, and MRI. The standardized uptake value (SUV) ratio (ratio of the cerebral cortical SUV to the cerebellar SUV) was measured for each PET data set to provide semiquantitative analysis. All adverse effects during the clinical trial periods were monitored. RESULTS: Visual assessments of the ¹⁸F-FC119S PET data revealed a sensitivity of 92% and a specificity of 84% in detecting AD. ¹⁸F-FC119S PET demonstrated equivalent or better diagnostic performance for AD detection than the historical control, ¹⁸F-FDG PET (sensitivity of 80.0% and specificity of 76.0%), and MRI (sensitivity of 98.0% and specificity of 50.0%). The SUV ratios differed significantly between AD patients and the other groups, at 1.44±0.17 (mean±SD) for AD, 1.24±0.09 for non-AD, and 1.21±0.08 for HC. No clinically significant adverse effects occurred during the trial periods. CONCLUSIONS ¹⁸F-FC119S PET provides high sensitivity and specificity in detecting AD and therefore may be considered a useful diagnostic tool for AD.

OBJECTIVE: The aim of this study was to investigate the interpersonal violence (IPV) epidemiology and mortality according to the violence victim-perpetrator relationships. METHODS: A retrospective cross-sectional study was done using the comprehensive data of the emergency department (ED)-based Jeju Injury Surveillance System from all EDs in Jeju Island. The demographic characteristics of the victims, the types of perpetrators (spouse, family members, acquaintance, and stranger), injury characteristics and clinical outcomes from the injury were collected. The IPV epidemiology was reported by descriptive statistics. Multivariate Poisson regression was used to analyze the association between the mortality and violence victim-perpetrator relationships. RESULTS: Among the 23,508 violent injury patients enrolled from January 1, 2008, and December 31 of 2016, 19,879 (84.6%) were analyzed; 16 (0.08%) died at the ED. The types of perpetrators were the spouse (10.1%), family members (3.9%), acquaintances (43.4%), and strangers (42.7%). The mortality of the violence victims was increased significantly by the spouse (incidence rate ratio [IRR], 6.336; P=0.043) or family members (IRR, 11.089; P=0.016) compared to strangers. On the other hand, there was no difference between the acquaintances and strangers. CONCLUSION: The epidemiology and mortality of IPV were associated with the violence victim-perpetrator relationships. Therefore, it is necessary to develop and apply prevention programs considering these differences, particularly for intimidate/ family violence because of its high fatality.
Cross-Sectional Studies ; Domestic Violence ; Emergency Service, Hospital ; Epidemiology ; Friends ; Hand ; Humans ; Interpersonal Relations ; Mortality ; Retrospective Studies ; Spouses ; Violence

OBJECTIVES: Fluorescein angiography (FAG) is currently the most useful diagnostic modality for examining retinal circulation, and it is frequently used for the evaluation of patients with diabetic retinopathy, occlusive diseases, such as retinal venous and arterial occlusions, and wet macular degeneration. This paper presents a method for objectively evaluating retinal circulation by quantifying circulation-related parameters. METHODS: This method allows the semiautomatic preprocessing and registering of FAG images. The arterial input function is estimated from the registered set of FAG images using gamma-variate fitting. Then, the parameters can be computed by deconvolution on the basis of truncated singular value decomposition, and they can finally be presented as parametric color images in a combination of three colors, red, green, and blue. RESULTS: After the estimation of arterial input function, the parameters of relative blood flow and mean transit time were computed using deconvolution analysis based on truncated singular value decomposition. CONCLUSIONS: The parametric color image is helpful to interpret the status of retinal blood circulation and provides quantitative data on retina ischemia without interobserver variability. This system easily provides the status of retinal blood circulation both qualitatively and quantitatively. It also helps to standardize FAG interpretation and may contribute to network-based telemedicine systems in the future.
Biomedical Engineering ; Blood Circulation ; Capillaries* ; Diabetic Retinopathy ; Diagnosis, Computer-Assisted ; Eye Diseases ; Fluorescein Angiography ; Fluorescein* ; Humans ; Ischemia ; Observer Variation ; Ophthalmology ; Retina ; Retinaldehyde ; Telemedicine ; Wet Macular Degeneration

Many cases of RET proto-oncogene mutations of hereditary medullary thyroid carcinoma (MTC) have been reported in Korea. However, MTC with V804M RET proto-oncogene germline mutations have not been reported in Korea. A 33-yr-old man was diagnosed with a 0.7-cm sized thyroid nodule. Laboratory testing revealed serum calcitonin was elevated. The patient underwent total thyroidectomy with central compartment neck dissection for the thyroid tumor. RET gene analysis was performed in both the index patient and his family. There were no V804M RET mutation and abnormal laboratory findings within his family except the index patient. Therefore, this patient was a de novo V804M RET germline mutation.
Adult ; Calcitonin/blood ; Germ-Line Mutation ; Humans ; Male ; Pedigree ; Proto-Oncogene Proteins c-ret/*genetics ; Sequence Analysis, DNA ; Thyroid Neoplasms/*diagnosis/genetics/ultrasonography ; Thyroidectomy