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.

Malignant melanoma rarely develops in the paranasal sinuses, and generally has a poor prognosis. However, mucosal melanoma can masquerade both clinically and histopathologically as a benign lesion, rendering accurate early diagnosis difficult. On the other hand, angiofibroma, a benign tumor, is more easily diagnosed than a mucosal melanoma, because the former exhibits specific histopathological features. No cases of concurrent angiofibroma and mucosal melanoma have been reported to date. We describe such a case below.
Angiofibroma* ; Early Diagnosis ; Hand ; Melanoma* ; Nasal Cavity ; Nose* ; Paranasal Sinuses ; Prognosis

BACKGROUND AND OBJECTIVES: We investigated the feasibility of intra-tympanic steroid injection (ITS) treatment alone for patients with severe or profound sudden sensorineural hearing loss (SSNHL), who have medical problems in systemic steroid use. SUBJECTS AND METHOD: Medical records of 43 patients from March 2012 to March 2014 were investigated. Patients who did not have any medical problems in steroid use were treated by systemic steroid but patients with medical problems were treated by ITS alone. RESULTS: Systemic steroid was used in 32 patients, and 11 patients were treated by ITS alone. The mean follow up periods were 6.5±1.4 weeks for ITS only, and 6.5±2.6 weeks for the systemic steroid group. In the final audiometry results, the mean hearing level and the mean gain of affected ear in the two groups were not different, and the mean differences with unaffected ear in the two groups showed no differences. However, five patients of systemic steroid group recovered completely by Siegel's criteria. CONCLUSION: ITS only therapy for SSNHL is considered a great alternative for patients whose condition does not allow systemic steroid therapy.
Audiometry ; Ear ; Ear, Middle ; Follow-Up Studies ; Hearing ; Hearing Loss, Sensorineural* ; Hearing Loss, Sudden ; Humans ; Medical Records ; Steroids

Armeniacae semen (AS) has been considered a toxic herb in the Korean medicine as it contains hydrogen cyanide and amygdalin, especially in its endocarp. Therefore, prebrewed AS that is devoid of endocarp has been traditionally used. In the present study, amygdalin content of the prebrewed AS was significantly lower (2.73 +/- 0.32 microg/ml; p < 0.01) than the content in the extract that contained the endocarps (28.50 +/- 6.71 microg/ml); amygdalin content corresponded to 10% of the extract in the present study. Because of single oral dose toxicity of prebrewed AS according to the recommendation of Korea Food and Drug Administration Guidelines (2009-116, 2009), which was based on single oral dose toxicity study of prebrewed AS, mortality due to toxic principles was significantly reduced. In this study, 2,000 mg/kg of prebrewed AS led to death of 1 female rat and 1 male rat at the end of 2 hr of administration. Based on these results, the 50% lethal dose in both male and female rats was determined to be 9279.5 mg/kg. Seizure, loss of locomotion, and increases in respiration and heart rate were observed as prebrewed AS treatment-related toxicological signs; these signs were restrictedly manifested in the prebrewed AS (2,000 mg/kg)-treated rats. In addition, no changes were observed in body weight, organ weight, gross features, and histopathological parameters with 2,000 mg/kg of AS in both male and female rats. These findings serve as direct evidence that amygdalin in AS is the toxic principle, which can be reduced by the traditional prebrewing method involving the exclusion of endocarp.
Amygdalin ; Animals ; Body Weight ; Female ; Heart Rate ; Humans ; Hydrogen Cyanide ; Korea ; Locomotion ; Male ; Organ Size ; Rats ; Respiration ; Seizures ; Semen ; United States Food and Drug Administration

BACKGROUND: Malignancies are a common and important causes of exudative pleural effusions. Several tumor markers have been studied because the pleural fluid cytology and pleural biopsy specimens do not provide a diagnosis in a high percentage of malignant effusions. In an attempt to overcome this limitation, procalcitonin and C-reactive protein (CRP) in pleural effusions and serum, which are known to be inflammation markers, were measured to determine if they can differentiate an exudate from trasndate as well as the diverse causes of exudative pleural effusion. METHODS: 178 consecutive patients with pleural effusion (malignant 57, tuberculous 51, parapneumonic 31, empyema 5, miscellaneous benign 7, transudative 27)were studied prospectively. The standard parameters of pleural effusion and measured serum and pleural procalcitonin were examined using in immunoluminometric assay. The level of CRP in serum and pleural fluid was determined by turbidimetric immunoassay. RESULTS: The pleural procalcitonin levels in the exudate were significantly higher than those in the transudate, 0.81+/-3.09 ng/mL and 0.12+/-0.12 ng/mL, respectively (p=0.007). The pleural CRP levels were significantly higher in the exudate than the transudate, 2.83+/-3.31 mg/dL and 0.74+/-0.67 mg/dL, respectively (p<0.001). The pleural procalcitonin levels in the benign effusion were significantly higher than those in the malignant effusion, 1.15+/-3.82 ng/mL and 0.25+/-0.92 ng/mL, respectively (p=0.032). The pleural CRP levels were significantly higher in the benign effusion than in the malignant effusion, 3.68+/-3.78 mg/dL and 1.42+/-1.54 mg/dL, respectively (p<0.001). The pleural procalcitonin levels in the non-tuberculous effusion were significantly higher than those in the tuberculous effusion, 1.16+/-3.75 ng/mL and 0.13+/-0.37 ng/mL, respectively (p=0.008). CONCLUSION: Measuring the level of procalcitonin and CRP in the pleural fluid is helpful for differentiating between transudates and exudates. In addition, it is useful for differentiating between benign and malignant pleural effusions.
Biopsy ; C-Reactive Protein* ; Diagnosis ; Empyema ; Exudates and Transudates ; Humans ; Immunoassay ; Inflammation ; Pleural Effusion* ; Pleural Effusion, Malignant ; Prospective Studies ; Biomarkers, Tumor

BACKGROUND: This study was designed to estabilish serum LDL cholesterol(LDL-C) and HDL cholestrol(HDL-C) levels in the Korean adult population and to identify the difference in sex, age, and living place and the incidence of high risk group and the affecting factors on the serum lipid levels. METHODS: The serum LDL-C and HDL-C distribution in the normal Korean abult population were studied in 5,278 cases(males 2,802 and females 2,476) in the age groups of 3rd to 8th decade. Data were collected from 33 institutes and hospitals throughout the country during the period of June 1989 to December 1990. The serum Lipid levels were examined in the state of fasting of at least 12 hours. Total cholesterol and triglyceride levels were measured by enzymatic assays and HDL-C levels were determined by precipitation methods. The level of LDL-C was determined indirectly using the formula by Friedwald [LDL-C=total cholesterol-(HDL-C+triglyceride/5)]. RESULTS: The mean level of LDL-C was 112.1mg/dl. Males had 110.0mg/dl and females had 114.5mg/dl without statistical significance between gender, but levels were significantly higher in the 4th decade in males and in the 6th, 7th and 8th decade in females. The LDL-C levels rose gradually with the increase of age. The peak level of LDL-C for the males was in the 7th decade and that for the females was in the 8th decade. The mean level of serum HDL-C was 45.1mg/dl. Males had 43.8mg/dl and females had 46.6mg/dl without statistical significance between gender, but levels were significantly higher in the 3rd, 4th, 5th and 6th decade in females. The incidence LDL-C level of > or = 160mg/dl was 10.0%. Males had 8.2% and females had 12.1% with significantly higher incidence in females, especially in 6th decade females. The incidence of LDL-C level of > or = 160mg/dl of big cities was 10.7% and that of smaller cities & towns was 8.8% with significantly higher incidence in big cities. But, there was no significant difference in gender between big cities and smaller cities & towns. The incidence of LDL-C level of > or = 160mg/dl was significantly higher in 7th decade males in big cities and that of big cities and smaller cities and smaller cities & towns was 15.9% and 5.2%, respectively. The incidence of HDL-C level of <35mg/dl was 17.4% Males had 20.0% and females had 14.5% with significantly higher incidence in males, especially in 4th decade males. The incidence of HDL-C level of <35mg/dl of smaller cities & towns was 19.8% and that of big cities was 16.2% with significantly higher incidence in smaller cities & towms. Males in smaller cities & towns had 23.1% and males in big cities had 18.1% with statistical higher in smaller cities & towns. But, there was no significant difference in females between big cities and smaller cities & towns. The incidence of HDL-C level of <35mg/dl was significantly higher in 4th and 6th decade males in smaller cities & towns and that of smaller cities & towns and big cities was 26.8%, 25.6% and 16.2%, 17.7%, repectively. The significantly positively related factors for serum LDL-C level were age, BMI, systolic blood pressure(SBP), location and occupation. And those for serum HDL-C level were SBP and family history and negatively related factor for HDL-C level were BMI, smoking, and exercise. CONCLUSION: This study can provide the basic date base for prevention and management of coronary heart disease among Korean population.
Academies and Institutes ; Adult* ; Cholesterol ; Cholesterol, HDL* ; Cholesterol, LDL* ; Coronary Disease ; Enzyme Assays ; Fasting ; Female ; Humans ; Incidence ; Korea ; Male ; Occupations ; Smoke ; Smoking ; Triglycerides