44 results on '"Jung Hee Wee"'
Search Results
2. Stem cell laden nano and micro collagen/PLGA bimodal fibrous patches for myocardial regeneration
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Jung Hee Wee, Ki-Dong Yoo, Sung Bo Sim, Hyun Joo Kim, Han Joon Kim, Kyu Nam Park, Gee-Hee Kim, Mi Hyoung Moon, Su Jung You, Mi Yeon Ha, Dae Hyeok Yang, Heung Jae Chun, Jae Hoon Ko, and Chun Ho Kim
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Nano and micro bimodal fibrous scaffold ,Cardiac patch ,Collagen ,PLGA ,BMSCs ,Myocardial regeneration ,Medical technology ,R855-855.5 - Abstract
Abstract Background Although the use of cardiac patches is still controversial, cardiac patch has the significance in the field of the tissue engineered cardiac regeneration because it overcomes several shortcomings of intra-myocardial injection by providing a template for cells to form a cohesive sheet. So far, fibrous scaffolds fabricated using electrospinning technique have been increasingly explored for preparation of cardiac patches. One of the problems with the use of electrospinning is that nanofibrous structures hardly allow the infiltration of cells for development of 3D tissue construct. In this respect, we have prepared novel bi-modal electrospun scaffolds as a feasible strategy to address the challenges in cardiac tissue engineering . Methods Nano/micro bimodal composite fibrous patch composed of collagen and poly (D, L-lactic-co-glycolic acid) (Col/PLGA) was fabricated using an independent nozzle control multi-electrospinning apparatus, and its feasibility as the stem cell laden cardiac patch was systemically investigated. Results Nano/micro bimodal distributions of Col/PLGA patches without beaded fibers were obtained in the range of the 4-6% collagen concentration. The poor mechanical properties of collagen and the hydrophobic property of PLGA were improved by co-electrospinning. In vitro experiments using bone marrow-derived mesenchymal stem cells (BMSCs) revealed that Col/PLGA showed improved cyto-compatibility and proliferation capacity compared to PLGA, and their extent increased with increase in collagen content. The results of tracing nanoparticle-labeled as well as GFP transfected BMSCs strongly support that Col/PLGA possesses the long-term stem cells retention capability, thereby allowing stem cells to directly function as myocardial and vascular endothelial cells or to secrete the recovery factors, which in turn leads to improved heart function proved by histological and echocardiographic findings. Conclusion Col/PLGA bimodal cardiac patch could significantly attenuate cardiac remodeling and fully recover the cardiac function, as a consequence of their potent long term stem cell engraftment capability.
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- 2022
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3. Coagulation measures after cardiac arrest (CMACA).
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Hyo Joon Kim, Kurz Michael, Jung Hee Wee, Joo Suk Oh, Won Young Kim, In Soo Cho, Mi Jin Lee, Dong Hun Lee, Yong Hwan Kim, and Chun Song Youn
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Medicine ,Science - Abstract
BackgroundDuring cardiac arrest (CA) and after cardiopulmonary resuscitation, activation of blood coagulation and inadequate endogenous fibrinolysis occur. The aim of this study was to describe the time course of coagulation abnormalities after out-of-hospital CA (OHCA) and to examine the association with clinical outcomes in patients undergoing targeted temperature management (TTM) after OHCA.MethodsThis prospective, multicenter, observational cohort study was performed in eight emergency departments in Korea between September 2018 and September 2019. Laboratory findings from hospital admission and 24 hours after return of spontaneous circulation (ROSC) were analyzed. The primary outcome was cerebral performance category (CPC) at discharge, and the secondary outcome was in-hospital mortality.ResultsA total of 170 patients were included in this study. The lactic acid, prothrombin time (PT), activated partial thrombin time (aPTT), international normalized ratio (INR), and D-dimer levels were higher in patients with poor neurological outcomes at admission and 24 h after ROSC. The lactic acid and D-dimer levels decreased over time, while fibrinogen increased over time. PT, aPTT, and INR did not change over time. The PT at admission and D-dimer levels 24 h after ROSC were associated with neurological outcomes at hospital discharge. Coagulation-related factors were moderately correlated with the duration of time from collapse to ROSC.ConclusionThe time-dependent changes in coagulation-related factors are diverse. Among coagulation-related factors, PT at admission and D-dimer levels 24 h after ROSC were associated with poor neurological outcomes at hospital discharge in patients treated with TTM.
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- 2023
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4. Background frequency can enhance the prognostication power of EEG patterns categories in comatose cardiac arrest survivors: a prospective, multicenter, observational cohort study
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Youn-Jung Kim, Min-Jee Kim, Yong Hwan Kim, Chun Song Youn, In Soo Cho, Su Jin Kim, Jung Hee Wee, Yoo Seok Park, Joo Suk Oh, Dong Hoon Lee, Won Young Kim, and the Korean Hypothermia Network Investigators
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Out-of-hospital cardiac arrest ,Electroencephalography ,Prognosis ,Neurologic outcome ,Targeted temperature management ,Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
Abstract Background We assessed the prognostic accuracy of the standardized electroencephalography (EEG) patterns (“highly malignant,” “malignant,” and “benign”) according to the EEG timing (early vs. late) and investigated the EEG features to enhance the predictive power for poor neurologic outcome at 1 month after cardiac arrest. Methods This prospective, multicenter, observational, cohort study using data from Korean Hypothermia Network prospective registry included adult patients with out-of-hospital cardiac arrest (OHCA) treated with targeted temperature management (TTM) and underwent standard EEG within 7 days after cardiac arrest from 14 university-affiliated teaching hospitals in South Korea between October 2015 and December 2018. Early EEG was defined as EEG performed within 72 h after cardiac arrest. The primary outcome was poor neurological outcome (Cerebral Performance Category score 3–5) at 1 month. Results Among 489 comatose OHCA survivors with a median EEG time of 46.6 h, the “highly malignant” pattern (40.7%) was most prevalent, followed by the “benign” (33.9%) and “malignant” (25.4%) patterns. All patients with the highly malignant EEG pattern had poor neurologic outcomes, with 100% specificity in both groups but 59.3% and 56.1% sensitivity in the early and late EEG groups, respectively. However, for patients with “malignant” patterns, 84.8% sensitivity, 77.0% specificity, and 89.5% positive predictive value for poor neurologic outcome were observed. Only 3.5% (9/256) of patients with background EEG frequency of predominant delta waves or undetermined had good neurologic survival. The combination of “highly malignant” or “malignant” EEG pattern with background frequency of delta waves or undetermined increased specificity and positive predictive value, respectively, to up to 98.0% and 98.7%. Conclusions The “highly malignant” patterns predicted poor neurologic outcome with a high specificity regardless of EEG measurement time. The assessment of predominant background frequency in addition to EEG patterns can increase the prognostic value of OHCA survivors. Trial registration KORHN-PRO, NCT02827422 . Registered 11 September 2016—Retrospectively registered.
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- 2021
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5. Renal replacement therapy is independently associated with a lower risk of death in patients with severe acute kidney injury treated with targeted temperature management after out-of-hospital cardiac arrest
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Yoon Hee Choi, Dong Hoon Lee, Je Hyeok Oh, Jung Hee Wee, Tae Chang Jang, Seung Pill Choi, Kyu Nam Park, and on behalf of the Korean Hypothermia Network Investigators
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Renal replacement therapy ,Acute kidney injury ,Out-of-hospital cardiac arrest ,Targeted temperature management ,Therapeutic hypothermia ,Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
Abstract Background The effect of renal replacement therapy (RRT) on the outcomes of severe acute kidney injury (AKI) after out-of-hospital cardiac arrest (OHCA) is uncertain. This study aimed to evaluate the association of RRT with 6-month mortality in patients with severe AKI treated with targeted temperature management (TTM) after OHCA. Methods This was a retrospective analysis of a prospectively collected multicentre observational cohort study that included adult OHCA patients treated with TTM across 22 hospitals in South Korea between October 2015 and December 2018. AKI was diagnosed using the Kidney Disease: Improving Global Outcomes criteria. The primary outcome was 6-month mortality and the secondary outcome was cerebral performance category (CPC) at 6 months. Multivariate Cox regression analysis was performed to define the role of RRT in stage 3 AKI. Results Among 10,426 patients with OHCA, 1373 were treated with TTM. After excluding those who died within 48 h of return of spontaneous circulation (ROSC) and those with pre-arrest chronic kidney disease, our study cohort comprised 1063 patients. AKI developed in 590 (55.5%) patients and 223 (21.0%) had stage 3 AKI. Among them, 115 (51.6%) were treated with RRT. The most common treatment modality among RRT patients was continuous renal replacement therapy (111 [96.5%]), followed by intermittent haemodialysis (4 [3.5%]). The distributions of CPC (1–5) at 6 months for the non-RRT vs. the RRT group were 3/108 (2.8%) vs. 12/115 (10.4%) for CPC 1, 0/108 (0.0%) vs. 1/115 (0.9%) for CPC 2, 1/108 (0.9%) vs. 3/115 (2.6%) for CPC 3, 6/108 (5.6%) vs. 6/115 (5.2%) for CPC 4, and 98/108 (90.7%) vs. 93/115 (80.9%) for CPC 5, respectively (P = 0.01). The RRT group had significantly lower 6-month mortality than the non-RRT group (93/115 [81%] vs. 98/108 [91%], P = 0.04). Multivariate Cox regression analyses showed that RRT was independently associated with a lower risk of death in patients with stage 3 AKI (hazard ratio, 0.569 [95% confidence interval, 0.377–0.857, P = 0.01]). Conclusion Dialysis interventions were independently associated with a lower risk of death in patients with stage 3 AKI treated with TTM after OHCA.
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- 2020
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6. Assessment of serum biomarkers and coagulation/fibrinolysis markers for prediction of neurological outcomes of out of cardiac arrest patients treated with therapeutic hypothermia
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Jeong Ho Park, Jung Hee Wee, Seung Pill Choi, Jae Hun Oh, and Shin Cheol
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heart arrest ,biomarkers ,prognosis ,Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
Objective Despite increased survival in patients with cardiac arrest, it remains difficult to determine patient prognosis at the early stage. This study evaluated the prognosis of cardiac arrest patients using brain injury, inflammation, cardiovascular ischemic events, and coagulation/fibrinolysis markers collected 24, 48, and 72 hours after return of spontaneous circulation (ROSC). Methods From January 2011 to December 2016, we retrospectively observed patients who underwent therapeutic hypothermia. Blood samples were collected immediately and 24, 48, and 72 hours after ROSC. Neuron-specific enolase (NSE), S100-B protein, procalcitonin, troponin I, creatine kinase-MB, pro-brain natriuretic protein, D-dimer, fibrin degradation product, antithrombin-III, fibrinogen, and lactate levels were measured. Prognosis was evaluated using Glasgow-Pittsburgh cerebral performance categories and the predictive accuracy of each marker was evaluated. The secondary outcome was whether the presence of multiple markers improved prediction accuracy. Results A total of 102 patients were included in the study: 39 with good neurologic outcomes and 63 with poor neurologic outcomes. The mean NSE level of good outcomes measured 72 hours after ROSC was 18.50 ng/mL. The area under the curve calculated on receiver operating characteristic analysis was 0.92, which showed the best predictive power among all markers included in the study analysis. The relative integrated discrimination improvement and category-free net reclassification improvement models showed no improvement in prognostic value when combined with all other markers and NSE (72 hours). Conclusion Although biomarker combinations did not improve prognostic accuracy, NSE (72 hours) showed the best predictive power for neurological prognosis in patients who received therapeutic hypothermia.
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- 2019
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7. Differences in youngest-old, middle-old, and oldest-old patients who visit the emergency department
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Sang Bum Lee, Jae Hun Oh, Jeong Ho Park, Seung Pill Choi, and Jung Hee Wee
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aged ,emergency service, hospital ,admission ,outcome ,Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
Objective As aging progresses, clinical characteristics of elderly patients in the emergency department (ED) vary by age. We aimed to study differences among elderly patients in the ED by age group. Methods For 2 years, patients aged 65 and older were enrolled in the study and classified into three groups: youngest-old, ages 65 to 74 years; middle-old, 75 to 84 years; and oldest-old, ≥85 years. Participants’ sex, reason for ED visit, transfer from another hospital, results of treatment, type of admission, admission department and length of stay were recorded. Results During the study period, a total 64,287 patients visited the ED; 11,236 (17.5%) were aged 65 and older, of whom 14.4% were 85 and older. With increased age, the female ratio (51.5% vs. 54.9% vs. 69.1%, P
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- 2018
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8. Neurologic outcome after out-of-hospital cardiac arrest could be predicted with the help of bispectral-index during early targeted temperature management
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Jeong Ho Park, Jae Hun Oh, Seung Pill Choi, and Jung Hee Wee
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Hypothermia ,Induced ,Prognosis ,Out-of-hospital cardiac arrest ,Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
Abstract Background Outcome prediction is crucial for out-of-hospital cardiac arrest (OHCA) survivors. Several attempts have been made to use the bispectral index (BIS) for this purpose. We aimed to investigate the prognostic power of the BIS during the early stage of targeted temperature management (TTM) after OHCA. Methods From Jan 2014 to Feb 2017, the BIS was determined in OHCA patients as soon as possible after the start of TTM. We injected a neuro-muscular blocking agent and recoded the BIS value and the time when the electromyographic (EMG) factor reached zero. The primary outcome was the cerebral performance category scale (CPC) score at 6 months, and a poor outcome was defined as a CPC score of 3, 4, or 5. The exclusion criteria were age under 18 years, traumatic cardiac arrest, and BIS data with a non-zero EMG factor. Results Sixty-five patients were included in this study. Good outcomes were observed for 16 patients (24.6%), and poor outcomes were observed for 49 patients (75.4%). The mean time of BIS recording was 2.3 ± 1.0 h after return of spontaneous circulation (ROSC). The mean BIS values of the good outcome and poor outcome groups were 35.6 ± 13.1 and 5.5 ± 9.2, respectively (p
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- 2018
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9. Characteristics of Elderly Long-Term Care Residents Who Were Injured and Transferred to Hospital Emergency Departments in Korea: A Retrospective Multicenter Study
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Myeong Namgung, Keon Kim, Dong Hoon Lee, Ho Young Yune, Jung Hee Wee, Duk Ho Kim, Eui Chung Kim, and Jee Yong Lim
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Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
The objective of this retrospective multicenter study was to investigate the mechanism and characteristics of trauma experienced by patients aged ≥65 years who were transferred from a long-term care hospital to one of five university hospital emergency departments. Of 255,543 patients seen in one of the five emergency departments, 79 were transferred from a long-term care hospital because of trauma. The most common trauma mechanism was slipping down, with 33 (58.9%) patients, followed by falling from a bed (17.9%), striking an object such as a wall or corner (10.7%), overextending a joint (8.9%), and unknown mechanisms (3.6%). Many cases of slip (39.4%) occurred in relation to the bathroom. Comparing slip and fall from a bed, we found more hip fractures (95.2%) because of slipping down than falling from a bed (57.1%); traumatic brain injury only occurred in slip cases. These traumas cause significant morbidity in elderly patients; therefore, we sought to identify strategies that prevent slip in long-term care hospitals.
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- 2019
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10. Continuous neuromuscular blockade infusion for out-of-hospital cardiac arrest patients treated with targeted temperature management: A multicenter randomized controlled trial.
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Byung Kook Lee, In Soo Cho, Joo Suk Oh, Wook Jin Choi, Jung Hee Wee, Chang Sun Kim, Won Young Kim, and Chun Song Youn
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Medicine ,Science - Abstract
INTRODUCTION:The aim of this trial was to investigate the effect of a continuous infusion of a neuromuscular blockade (NMB) in comatose out-of-hospital cardiac arrest (OHCA) subjects who underwent targeted temperature management (TTM). METHODS:In this open-label, multicenter trial, subjects resuscitated from OHCA were randomly assigned to receive either NMB (38 subjects) or placebo (43 subjects) for 24 hours. Sedatives and analgesics were given according to the protocol of each hospital during TTM. The primary outcome was serum lactate levels at 24 hours after drug infusion. The secondary outcomes included in-hospital mortality, a poor neurological outcome at hospital discharge, changes in lactate levels, changes in the PaO2:FiO2 ratio over time and muscle weakness as assessed by the Medical Research Council (MRC) scale. RESULTS:Eighty-one subjects (NMB group: median age, 65.5 years, 30 male patients; placebo group: median age, 61.0 years, 29 male patients) were enrolled in this trial. No difference in the serum lactate level at 24 hours was observed between the NMB (2.8 [1.2-4.0]) and placebo (3.6 [1.8-5.2]) groups (p = 0.238). In-hospital mortality and a poor neurologic outcome at discharge did not differ between the two groups. No significant difference in the PaO2:FiO2 ratio over time (p = 0.321) nor the MRC score (p = 0.474) was demonstrated. CONCLUSIONS:In OHCA subjects who underwent TTM, a continuous infusion of NMB did not reduce lactate levels and did not improve survival or neurological outcome at hospital discharge. Our results indicated a limited potential for the routine use of NMB during early TTM. However, this trial may be underpowered to detect clinical differences, and future research should be conducted.
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- 2018
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11. Coagulation measures after cardiac arrest (CMACA)
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Hyo Joon Kim, Kurz Michael, Jung Hee Wee, Joo Suk Oh, Won Young Kim, In Soo Cho, Mi Jin Lee, Dong Hun Lee, Yong Hwan Kim, and Chun Song Youn
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Multidisciplinary - Abstract
Background During cardiac arrest (CA) and after cardiopulmonary resuscitation, activation of blood coagulation and inadequate endogenous fibrinolysis occur. The aim of this study was to describe the time course of coagulation abnormalities after out-of-hospital CA (OHCA) and to examine the association with clinical outcomes in patients undergoing targeted temperature management (TTM) after OHCA. Methods This prospective, multicenter, observational cohort study was performed in eight emergency departments in Korea between September 2018 and September 2019. Laboratory findings from hospital admission and 24 hours after return of spontaneous circulation (ROSC) were analyzed. The primary outcome was cerebral performance category (CPC) at discharge, and the secondary outcome was in-hospital mortality. Results A total of 170 patients were included in this study. The lactic acid, prothrombin time (PT), activated partial thrombin time (aPTT), international normalized ratio (INR), and D-dimer levels were higher in patients with poor neurological outcomes at admission and 24 h after ROSC. The lactic acid and D-dimer levels decreased over time, while fibrinogen increased over time. PT, aPTT, and INR did not change over time. The PT at admission and D-dimer levels 24 h after ROSC were associated with neurological outcomes at hospital discharge. Coagulation-related factors were moderately correlated with the duration of time from collapse to ROSC. Conclusion The time-dependent changes in coagulation-related factors are diverse. Among coagulation-related factors, PT at admission and D-dimer levels 24 h after ROSC were associated with poor neurological outcomes at hospital discharge in patients treated with TTM.
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- 2022
12. Association between acute kidney injury and neurological outcome or death at 6 months in out-of-hospital cardiac arrest: A prospective, multicenter, observational cohort study
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Jonghwan Shin, Kyoung-Chul Cha, In Soo Cho, Jung Hee Wee, Minjung Kathy Chae, Byung Kook Lee, Chun Song Youn, Dong Hoon Lee, and Je Hyeok Oh
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Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Unconsciousness ,Targeted temperature management ,urologic and male genital diseases ,Critical Care and Intensive Care Medicine ,Out of hospital cardiac arrest ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Modified Rankin Scale ,Internal medicine ,Republic of Korea ,medicine ,Humans ,Glasgow Coma Scale ,Prospective Studies ,Registries ,Aged ,business.industry ,Acute kidney injury ,030208 emergency & critical care medicine ,Acute Kidney Injury ,Middle Aged ,medicine.disease ,Survival Analysis ,030228 respiratory system ,Cohort ,Female ,Observational study ,business ,Out-of-Hospital Cardiac Arrest ,Cohort study ,Kidney disease - Abstract
This study aimed to evaluate the association between acute kidney injury (AKI) and 6 months neurological outcome after out-of-hospital cardiac arrest (OHCA).Prospective multi-center observational cohort included adult OHCA patients treated with targeted temperature management (TTM) across 20 hospitals in the South Korea between October 2015 and October 2017. The diagnosis of AKI was made using the Kidney Disease: Improving Global Outcomes criteria. The outcome was neurological outcome at 6 months evaluated using the modified Rankin scale (MRS).Among 5676 patients with OHCA, 583 patients were enrolled. AKI developed in 348 (60%) patients. Significantly more non-AKI patients had good neurological outcome at 6 months (MRS 0-3) than AKI patients (134/235 [57%] vs. 69/348 [20%], P .001). AKI was associated with poor neurological outcome at six months in multivariate logistic regression analysis (adjusted odds ratio: 0.206 [95% confidence interval: 0.099-0.426], P .001]). Cox regression analysis with time-varying covariate of AKI showed that patients with AKI had a higher risk of death than those without AKI (hazard ratio: 2.223; 95% confidence interval: 1.630-3.030, P .001).AKI is associated with poor neurological outcome (MRS 4-6) at 6 months in OHCA patients treated with TTM.NCT02827422.
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- 2019
13. Inter-scanner variability in Hounsfield unit measured by CT of the brain and effect on gray-to-white matter ratio
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Jeong Ho Park, Jae Hun Oh, Seung Pill Choi, and Jung Hee Wee
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Adult ,Male ,Scanner ,Interclass correlation ,Computed tomography ,030204 cardiovascular system & hematology ,Gray (unit) ,White matter ,03 medical and health sciences ,0302 clinical medicine ,Hounsfield scale ,Humans ,Medicine ,Density ratio ,Coma ,Gray Matter ,Aged ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,030208 emergency & critical care medicine ,General Medicine ,Middle Aged ,Prognosis ,White Matter ,Confidence interval ,Heart Arrest ,medicine.anatomical_structure ,Emergency Medicine ,Female ,Tomography, X-Ray Computed ,business ,Nuclear medicine - Abstract
Purpose: The density ratio of gray matter (GM) to white matter (WM) on brain computed tomography (CT) (gray-to-white matter ratio, GWR) helps predict the prognosis of comatose patients after cardiac arrest. However, Hounsfield units (HU) are not an absolute value and can change based on imaging parameters and CT scanners. We compared the density of brain GM and WM and the GWR by using images scanned with different types of CT machines. Method: 102 patients with normal readings who were scanned using three types of CT scanners were included in the study. HU were measured at the basal ganglia level by two observers with circular regions of interest. Result: The difference in GM was 0.98–10.30 HU and WM was 1.05–7.55 HU. The mean value of measured HU and GWR were different for each CT group. The ANOVA test showed significant difference all variables. The post hoc test for GWR, which was used to compare the differences between each scanner, was statistically significant. Interclass correlation coefficients of measured GM and WM between the two observers were very high (Cronbach's α = 0.995 and 0.990, respectively) and GWR was showed good confidence level (0.798). Conclusion: In this study, the HU values of GM and WM in the normal adult brain differed up to 23% among scanners. Unfortunately, the GWR may not compensate for the HU difference between GM and WM occurring between scanners. Therefore, rather than applying consistent GWR cut-offs, the protocol or manufacturer differences between imaging scanners should be considered.
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- 2019
14. The authors reply
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Sang Hoon Oh, Joo Suk Oh, Hyun Ho Jung, Jungtaek Park, Ji Hoon Kim, Jeong Ho Park, Jung Hee Wee, Seong Hoon Kim, Seung Pill Choi, and Kyu Nam Park
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Critical Care and Intensive Care Medicine - Published
- 2021
15. Prognostic Value of P25/30 Cortical Somatosensory Evoked Potential Amplitude After Cardiac Arrest
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Jungtaek Park, Joo Suk Oh, Jung Hee Wee, Seong Hoon Kim, Hyun Ho Jung, Jeong Ho Park, Kyu Nam Park, Sang Hoon Oh, Cerebral Resuscitation, Seung Pill Choi, and Ji-Hoon Kim
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Adult ,Male ,medicine.medical_specialty ,Resuscitation ,medicine.medical_treatment ,Comorbidity ,Targeted temperature management ,Return of spontaneous circulation ,Critical Care and Intensive Care Medicine ,Reflex, Pupillary ,03 medical and health sciences ,0302 clinical medicine ,Hypothermia, Induced ,Internal medicine ,Evoked Potentials, Somatosensory ,medicine ,Humans ,Corneal reflex ,Prospective Studies ,Rewarming ,Wakefulness ,Aged ,Academic Medical Centers ,Blinking ,business.industry ,Area under the curve ,030208 emergency & critical care medicine ,Middle Aged ,Prognosis ,eye diseases ,Heart Arrest ,Amplitude ,030228 respiratory system ,Somatosensory evoked potential ,Cardiology ,Reflex ,Female ,business - Abstract
Objectives The aim of this study was to evaluate the prognostic performance of the peak amplitude of P25/30 cortical somatosensory evoked potentials in predicting nonawakening in targeted temperature management-treated cardiac arrest patients. Design Prospective analysis. Setting Four academic tertiary care hospitals. Patients Eighty-seven cardiac arrest survivors after targeted temperature management. Interventions Analysis of the amplitude of P25/30. Measurements and main results In all participants, somatosensory evoked potentials were recorded after rewarming, and bilaterally absent pupillary and corneal reflexes were evaluated at 72 hours after the return of spontaneous circulation. We analyzed the amplitudes of the N20 and P25/30 peaks and the N20-P25/30 complex in cortical somatosensory evoked potentials. Upon hospital discharge, 87 patients were dichotomized into the awakening and nonawakening groups. The lowest amplitudes of N20, P25/30, and N20-P25/30 in the awakening patients were 0.17, 0.45, and 0.73 μV, respectively, and these thresholds showed a sensitivity of 70.5% (95% CI, 54.8-83.2%), 86.4% (95% CI, 72.7-94.8%), and 75.0% (95% CI, 59.7-86.8%), respectively, for nonawakening. The area under the curve of the P25/30 amplitude was significantly higher than that of the N20 amplitude (0.955 [95% CI, 0.912-0.998] vs 0.894 [95% CI, 0.819-0.969]; p = 0.036) and was comparable with that of the N20-P25/30 amplitude (0.931 [95% CI, 0.873-0.989]). Additionally, adding resuscitation variables or an absent brainstem reflex to the P25/30 amplitude showed a trend toward improving prognostic performance compared with the use of other somatosensory evoked potential amplitudes (area under the curve, 0.958; 95% CI, 0.917-0.999 and area under the curve, 0.974; 95% CI, 0.914-0.996, respectively). Conclusions Our results provide evidence that the absence of the P25/30 peak and a reduction in the P25/30 amplitude may be considered prognostic indicators in these patients.
- Published
- 2020
16. Elderly patients visiting the emergency department for deliberate self-poisoning: do they present a more severe poisoning severity score than the nonelderly patients in the initial 24 h?
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Hye Won Lee, Woon Jeong Lee, Sang Kook In, Seung Hwan Seol, Sungyoup Hong, Jung Hee Wee, Dae Hee Kim, June Young Lee, and Seon Hee Woo
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Adult ,Male ,Aging ,medicine.medical_specialty ,Poison control ,Suicide, Attempted ,Logistic regression ,Suicide prevention ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Injury prevention ,medicine ,Humans ,Ingestion ,030212 general & internal medicine ,Aged ,Retrospective Studies ,Aged, 80 and over ,Suicide attempt ,business.industry ,Emergency department ,Middle Aged ,Hospitalization ,Intensive Care Units ,Female ,Self poisoning ,Geriatrics and Gerontology ,Emergency Service, Hospital ,business ,030217 neurology & neurosurgery - Abstract
Many elderly patients arrive at the emergency department (ED) complaining of deliberate self-poisoning (DSP). This study determined the poisoning severity of elderly patients who committed DSP.A study was performed with 1329 patients ( 15 years of age) who were treated for DSP at two EDs between January 2010 and December 2016. We classified these patients into two groups based on age (an elderly group ≥ 65 years of age and a nonelderly group). Information was collected on age, sex, cause, ingestion time, drug type, suicide attempt history, initial poisoning severity score (PSS), final PSS, outcome, etc. RESULTS: In total, 242 (18.2%) patients were included in the elderly group, of whom 211 (86.9%) were treated for a first suicide attempt. Admission to the intensive-care unit (ICU) (43.8% vs. 25.5%) and endotracheal intubation (16.1% vs. 4.9%) occurred more frequently in the elderly group than in the nonelderly group (p 0.001). The frequencies of initial severe PSSs (3 and 4) in the elderly group were 9.1% (N = 22) and 1.2% (N = 3), respectively. Multivariate logistic regression analysis showed that the ICU admission of DSP patients was significantly associated with being elderly (OR of 1.47, 95% CI 1.04-2.09, p = 0.029) and with having a GCS of 13 (OR of 2.67, 95% CI 1.99-3.57, p 0.001) and an initial PSS of (3,4) (OR of 3.66, 95% CI 2.14-6.26, p 0.001). In addition, the presence of underlying diseases (coronary heart disease and cerebrovascular disease) yielded high ORs [(OR of 13.13, 95% CI 2.80-61.57, p = 0.001), (OR of 7.34, 95% CI 1.38-39.09, p = 0.020)].Elderly patients who visited the ED for DSP exhibited overall more severe PSSs and poorer in-hospital prognosis than did nonelderly DSP patients.
- Published
- 2018
17. Identifying Potentially Avoidable Emergency Department Visits of Long-Term Care Hospital Residents in Korea: A Multicenter Retrospective Cohort Study
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Keon Sik Kim, Seung Pil Choi, Jee Yong Lim, Duk Ho Kim, Eui Chung Kim, Ho Young Yune, Jung Hee Wee, and Dong Hoon Lee
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Male ,Patient Transfer ,Emergency Medical Services ,Article Subject ,Decision Making ,lcsh:Medicine ,General Biochemistry, Genetics and Molecular Biology ,03 medical and health sciences ,0302 clinical medicine ,Republic of Korea ,medicine ,Humans ,030212 general & internal medicine ,Aged ,Aged, 80 and over ,General Immunology and Microbiology ,DNR orders ,business.industry ,lcsh:R ,030208 emergency & critical care medicine ,Retrospective cohort study ,General Medicine ,Emergency department ,University hospital ,medicine.disease ,Long-Term Care ,humanities ,Hospitals ,Long-term care ,Cerebrovascular Disorders ,Multicenter study ,Female ,Medical emergency ,Health Facilities ,business ,Emergency Service, Hospital ,Research Article - Abstract
The aims of this study were to investigate the reasons of transfers from long-term care hospitals (LTCHs) to emergency departments (EDs) of university hospitals in geriatric patients and to categorize the avoidable causes of these transfers. This retrospective multicenter study involved patients aged 65 years and older who were transferred from LTCHs to 5 EDs of university hospitals located in the metropolitan area of South Korea between January 2017 and December 2017. The expert panel reviewed and categorized the reason of transfers as avoidable or not. Moreover, we also investigated the number of patients with do-not-resuscitate (DNR) documents and the date these DNR documents were written. A total of 255,543 patients visited 5 EDs during the study period. Of these, 1,131 patients were from LTCHs. The number of potentially avoidable transfers was 168/1,131 (14.9%). The most common reason of avoidable transfers was noncritical diagnoses that could be assessed and managed in LTCHs (57.1%). There were 162 patients with DNR orders; of these, 12 had approved the DNR order before transfer. In conclusion, in Korea, potentially avoidable transfers could be reduced by managing noncritical diseases in LTCH and preparing advance care directives, including DNR orders, during admission to LTCH.
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- 2019
18. Characteristics of Elderly Long-Term Care Residents Who Were Injured and Transferred to Hospital Emergency Departments in Korea: A Retrospective Multicenter Study
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Ho Young Yune, Myeong Namgung, Jung Hee Wee, Keon Sik Kim, Jee Yong Lim, Dong Hoon Lee, Duk Ho Kim, and Eui Chung Kim
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musculoskeletal diseases ,030222 orthopedics ,medicine.medical_specialty ,Article Subject ,Traumatic brain injury ,business.industry ,lcsh:Medical emergencies. Critical care. Intensive care. First aid ,Poison control ,lcsh:RC86-88.9 ,medicine.disease ,Suicide prevention ,Occupational safety and health ,03 medical and health sciences ,Long-term care ,0302 clinical medicine ,Falling (accident) ,Multicenter study ,Emergency medicine ,Injury prevention ,Emergency Medicine ,medicine ,030212 general & internal medicine ,medicine.symptom ,business ,Research Article - Abstract
The objective of this retrospective multicenter study was to investigate the mechanism and characteristics of trauma experienced by patients aged ≥65 years who were transferred from a long-term care hospital to one of five university hospital emergency departments. Of 255,543 patients seen in one of the five emergency departments, 79 were transferred from a long-term care hospital because of trauma. The most common trauma mechanism was slipping down, with 33 (58.9%) patients, followed by falling from a bed (17.9%), striking an object such as a wall or corner (10.7%), overextending a joint (8.9%), and unknown mechanisms (3.6%). Many cases of slip (39.4%) occurred in relation to the bathroom. Comparing slip and fall from a bed, we found more hip fractures (95.2%) because of slipping down than falling from a bed (57.1%); traumatic brain injury only occurred in slip cases. These traumas cause significant morbidity in elderly patients; therefore, we sought to identify strategies that prevent slip in long-term care hospitals.
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- 2019
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19. Neurologic outcome after out-of-hospital cardiac arrest could be predicted with the help of bispectral-index during early targeted temperature management
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Seung Pill Choi, Jung Hee Wee, Jeong Ho Park, and Jae Hun Oh
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Male ,medicine.medical_treatment ,Traumatic cardiac arrest ,Hypothermia ,030204 cardiovascular system & hematology ,Targeted temperature management ,Return of spontaneous circulation ,Critical Care and Intensive Care Medicine ,Outcome (game theory) ,Out of hospital cardiac arrest ,Body Temperature ,03 medical and health sciences ,0302 clinical medicine ,Hypothermia, Induced ,medicine ,Humans ,Prospective Studies ,Stage (cooking) ,Original Research ,Out-of-hospital cardiac arrest ,business.industry ,Induced ,lcsh:Medical emergencies. Critical care. Intensive care. First aid ,Area under the curve ,030208 emergency & critical care medicine ,lcsh:RC86-88.9 ,Middle Aged ,medicine.disease ,Prognosis ,Treatment Outcome ,Anesthesia ,Bispectral index ,Emergency Medicine ,Female ,business ,Follow-Up Studies - Abstract
Background Outcome prediction is crucial for out-of-hospital cardiac arrest (OHCA) survivors. Several attempts have been made to use the bispectral index (BIS) for this purpose. We aimed to investigate the prognostic power of the BIS during the early stage of targeted temperature management (TTM) after OHCA. Methods From Jan 2014 to Feb 2017, the BIS was determined in OHCA patients as soon as possible after the start of TTM. We injected a neuro-muscular blocking agent and recoded the BIS value and the time when the electromyographic (EMG) factor reached zero. The primary outcome was the cerebral performance category scale (CPC) score at 6 months, and a poor outcome was defined as a CPC score of 3, 4, or 5. The exclusion criteria were age under 18 years, traumatic cardiac arrest, and BIS data with a non-zero EMG factor. Results Sixty-five patients were included in this study. Good outcomes were observed for 16 patients (24.6%), and poor outcomes were observed for 49 patients (75.4%). The mean time of BIS recording was 2.3 ± 1.0 h after return of spontaneous circulation (ROSC). The mean BIS values of the good outcome and poor outcome groups were 35.6 ± 13.1 and 5.5 ± 9.2, respectively (p
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- 2018
20. Short-Latency Positive Peak Following N20 Somatosensory Evoked Potential Is Superior to N20 in Predicting Neurologic Outcome After Out-of-Hospital Cardiac Arrest
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Sung Wook, Kim, Joo Suk, Oh, Jungtaek, Park, Hyun Ho, Jeong, Ji Hoon, Kim, Jung Hee, Wee, Sang Hoon, Oh, Seung Pill, Choi, Kyu Nam, Park, and Soo Hyun, Kim
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,Targeted temperature management ,Critical Care and Intensive Care Medicine ,Out of hospital cardiac arrest ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Evoked Potentials, Somatosensory ,medicine ,Humans ,Short latency ,In patient ,Retrospective Studies ,business.industry ,Area under the curve ,Brain ,030208 emergency & critical care medicine ,Retrospective cohort study ,Middle Aged ,Prognosis ,Predictive value ,eye diseases ,female genital diseases and pregnancy complications ,Somatosensory evoked potential ,Brain Injuries ,Cardiology ,Female ,business ,030217 neurology & neurosurgery ,Out-of-Hospital Cardiac Arrest - Abstract
OBJECTIVES The absence of N20 somatosensory evoked potential after cardiac arrest is related to poor outcome. However, discrimination between the low-amplitude and the absence of N20 is challenging. P25 and P30 are short-latency positive peaks with latencies between 25 and 30 ms following N20 (P25/30). P25/30 is evident even with an ambiguous N20 in patients with good outcome. Therefore, we evaluated the predictive value of P25/30 after cardiac arrest. DESIGN A retrospective observational study. SETTING University-affiliated hospital. SUBJECTS Comatose survivors after out-of-hospital cardiac arrest treated by hypothermic targeted temperature management. INTERVENTION None. MEASUREMENTS AND MAIN RESULTS The specificity and the positive predictive value of P25/30 and N20 in predicting poor outcome were the same, showing a rate of 100%. The sensitivity of P25/30 in predicting poor outcome (90.12% [95% CI, 81.5-95.6%]) was higher than that of N20 (70.37% [95% CI, 59.2-80%]). Also, the negative predictive value of P25/30 in predicting poor outcome (81.4% [95% CI, 69.4-89.4%]) was higher than that of N20 (59.3% [95% CI, 51-67.1%]). The P25/30-based adjusted model showed a larger area under the curve (0.98 [95% CI, 0.95-1]) compared with the N20-based adjusted model (0.95 [95% CI, 0.91-0.98]) (p = 0.02). CONCLUSIONS The absence of P25/30 is related to poor outcome with a higher sensitivity, negative predictive value than the absence of N20.
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- 2018
21. Clinical characteristics of elderly drowning patients
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Jae Hoon Oh, Jeong Ho Park, Doo Hyo Lee, Jung Hee Wee, and Seung Pill Choi
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Adult ,Male ,medicine.medical_specialty ,Comorbidity ,Demographic data ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Aged ,Retrospective Studies ,Aged, 80 and over ,Drowning ,Adult patients ,business.industry ,030208 emergency & critical care medicine ,social sciences ,General Medicine ,Emergency department ,Hypothermia ,Middle Aged ,humanities ,Icu admission ,Hospitalization ,Emergency medicine ,Emergency Medicine ,Female ,medicine.symptom ,business ,Emergency Service, Hospital - Abstract
Drowning is one of the major causes of traumatic death. The impact of drowning in the elderly and patients who were not elderly will be different because of physiological differences. We wanted to analyze the clinical differences such as mortality, incidence rate of complications, degree of hypothermia and rate of cardiac arrest between elderly and adult drowning patients.This study included drowning patients over 18 years old who came to an emergency department (ED) located on a riverside from September 1997 to July 2016. Patients over the age of 65 years were classified as elderly, while those under the age of 65 years were classified as adults. Demographic data and clinical outcomes were surveyed.A total of 611 patients were included in this study. Sixty-one patients (9.9%) were elderly, and 550 patients (90.1%) were adults. There were 17 elderly patients (15.8%) and 87 adult patients (27.9%) who had cardiac arrest at the time of ED arrival (p = 0.017). The rate of body temperatures 34 °C was higher in elderly patients than that in adult patients (27.9% vs 17.5%, respectively, p = 0.025). The rates of hospitalization in the intensive care unit (ICU) and mortality were higher in elderly group (23% vs. 15.1%, respectively, p = 0.01; 37.7% vs 21.8%, respectively, p = 0.01). There was no significant difference in suicidal intent between the elderly and adult patient groups (82.0% vs 78.9%, respectively, p = 0.421).Elderly drowning patients accounted for approximately 1/10 of all drowning cases and were more likely to experience a cardiac arrest, hypothermia, mortality, and ICU admission.
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- 2017
22. Clinical Characteristics and Risk Factors in Severely Injured Elderly Trauma Presenting to Emergency Department
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Seung Pil Choi, Si Kyoung Jeong, Jeong Ho Park, Jung Hee Wee, Sung Yup Hong, and Bu Min Ahn
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medicine.medical_specialty ,business.industry ,Emergency medicine ,medicine ,Medical emergency ,Elderly trauma ,Emergency department ,medicine.disease ,business - Published
- 2015
23. Can somatosensory and visual evoked potentials predict neurological outcome during targeted temperature management in post cardiac arrest patients?
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Kyu Nam Park, Joo Suk Oh, Yoon Sang Oh, Soo-Hyun Kim, Han Joon Kim, Jung Hee Wee, Chun Song Youn, Seung Pill Choi, Jeong Ho Park, and Sang Hoon Oh
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Adult ,Male ,genetic structures ,medicine.medical_treatment ,Visual evoked potentials ,Emergency Nursing ,Targeted temperature management ,Somatosensory system ,behavioral disciplines and activities ,Sensitivity and Specificity ,03 medical and health sciences ,0302 clinical medicine ,Hypothermia, Induced ,Evoked Potentials, Somatosensory ,Medicine ,Humans ,Post cardiac arrest ,Coma ,Rewarming ,Aged ,Retrospective Studies ,Chi-Square Distribution ,business.industry ,musculoskeletal, neural, and ocular physiology ,030208 emergency & critical care medicine ,Retrospective cohort study ,Middle Aged ,body regions ,Treatment Outcome ,Somatosensory evoked potential ,Anesthesia ,Emergency Medicine ,Evoked Potentials, Visual ,Female ,Cardiology and Cardiovascular Medicine ,business ,Outcome prediction ,030217 neurology & neurosurgery ,Out-of-Hospital Cardiac Arrest - Abstract
Purposes In cardiac arrest patients treated with targeted temperature management (TTM), it is not certain if somatosensory evoked potentials (SEPs) and visual evoked potentials (VEPs) can predict neurological outcomes during TTM. The aim of this study was to investigate the prognostic value of SEPs and VEPs during TTM and after rewarming. Methods This retrospective cohort study included comatose patients resuscitated from cardiac arrest and treated with TTM between March 2007 and July 2015. SEPs and VEPs were recorded during TTM and after rewarming in these patients. Neurological outcome was assessed at discharge by the Cerebral Performance Category (CPC) Scale. Results In total, 115 patients were included. A total of 175 SEPs and 150 VEPs were performed. Five SEPs during treated with TTM and nine SEPs after rewarming were excluded from outcome prediction by SEPs due to an indeterminable N20 response because of technical error. Using 80 SEPs and 85 VEPs during treated with TTM, absent SEPs yielded a sensitivity of 58% and a specificity of 100% for poor outcome (CPC 3–5), and absent VEPs predicted poor neurological outcome with a sensitivity of 44% and a specificity of 96%. The AUC of combination of SEPs and VEPs was superior to either test alone (0.788 for absent SEPs and 0.713 for absent VEPs compared with 0.838 for the combination). After rewarming, absent SEPs and absent VEPs predicted poor neurological outcome with a specificity of 100%. When SEPs and VEPs were combined, VEPs slightly increased the prognostic accuracy of SEPs alone. Although one patient with absent VEP during treated with TTM had a good neurological outcome, none of the patients with good neurological outcome had an absent VEP after rewarming. Conclusion Absent SEPs could predict poor neurological outcome during TTM as well as after rewarming. Absent VEPs may predict poor neurological outcome in both periods and VEPs may provide additional prognostic value in outcome prediction.
- Published
- 2017
24. Outcomes of patients admitted for hanging injuries with decreased consciousness but without cardiac arrest
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Kyu Nam Park, Jung Hee Wee, Seung Pill Choi, and Jeong Ho Park
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Adult ,Male ,medicine.medical_specialty ,Poison control ,Suicide, Attempted ,Unconsciousness ,Asphyxia ,Young Adult ,Hypothermia, Induced ,Injury prevention ,medicine ,Humans ,Glasgow Coma Scale ,Stupor ,Hypoxia, Brain ,Aged ,Retrospective Studies ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Retrospective cohort study ,Magnetic resonance imaging ,Recovery of Function ,General Medicine ,Middle Aged ,Respiration, Artificial ,Surgery ,Treatment Outcome ,Emergency Medicine ,Female ,medicine.symptom ,Emergency Service, Hospital ,business - Abstract
Objective The objective of this study is to provide appropriate treatment of patients who showed decreased mentality but did not suffer cardiac arrest (CA) from hanging injury, from reviewing the characteristics and analyzing the outcomes in such patients. Methods A retrospective review of victims with decreased mentality but without CA due to hanging presenting to 2 tertiary general hospitals between January 2005 and August 2011 was performed. Treatments and examinations were evaluated, and the outcomes were assessed by cerebral performance category at hospital discharge. Results A total of 21 patients were included, and their initial Glasgow Coma Scale scores were between 3 and 11. No one received therapeutic hypothermia, but all regained consciousness spontaneously and were discharged with cerebral performance category 1. They received only conservative treatment such as respiratory care, fever control, and inotropic use. Computed tomography and magnetic resonance imaging studies revealed no definite abnormality if the patient did not show abnormal symptom and sign. Conclusion Unconscious patients without CA from hanging could recover consciousness through conservative treatment.
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- 2013
25. Prognostic Value of P25/30 Cortical Somatosensory Evoked Potential Amplitude After Cardiac Arrest.
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Sang Hoon Oh, Joo Suk Oh, Hyun Ho Jung, Jungtaek Park, Ji Hoon Kim, Jeong Ho Park, Jung Hee Wee, Seong Hoon Kim, Seung Pill Choi, Kyu Nam Park, Oh, Sang Hoon, Oh, Joo Suk, Jung, Hyun Ho, Park, Jungtaek, Kim, Ji Hoon, Park, Jeong Ho, Wee, Jung Hee, Kim, Seong Hoon, Choi, Seung Pill, and Park, Kyu Nam
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- 2020
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26. Procalcitonin as a diagnostic marker and IL-6 as a prognostic marker for sepsis
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Jehoon Lee, Jung Hee Wee, Yonggoo Kim, Yeon-Joon Park, Seung Pill Choi, So-Young Lee, Jeong Ho Park, and Dong Wook Jekarl
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Adult ,Calcitonin ,Male ,Microbiology (medical) ,medicine.medical_specialty ,Adolescent ,Calcitonin Gene-Related Peptide ,Blood Sedimentation ,Sensitivity and Specificity ,Gastroenterology ,Procalcitonin ,Cohort Studies ,Sepsis ,Leukocyte Count ,Young Adult ,Internal medicine ,White blood cell ,parasitic diseases ,medicine ,Humans ,Prospective Studies ,Protein Precursors ,Prospective cohort study ,Aged ,Aged, 80 and over ,medicine.diagnostic_test ,biology ,Interleukin-6 ,Septic shock ,business.industry ,C-reactive protein ,Bacterial Infections ,General Medicine ,Middle Aged ,Prognosis ,bacterial infections and mycoses ,medicine.disease ,Systemic inflammatory response syndrome ,C-Reactive Protein ,Infectious Diseases ,medicine.anatomical_structure ,Erythrocyte sedimentation rate ,Immunology ,biology.protein ,Female ,business ,Biomarkers - Abstract
The diagnosis and prognosis of sepsis after antimicrobial therapy among systemic inflammatory response syndrome (SIRS) patients were evaluated with the biomarkers procalcitonin (PCT), interleukin-6 (IL-6), C-reactive protein (CRP), erythrocyte sedimentation rate, and white blood cell counts. Among 177 consecutive SIRS patients, 78 exhibited sepsis, with Escherichia coli (23.1%) being the most common pathogen. PCT showed the best diagnostic performance, with 74.4% and 93.7% sensitivity and 86.7% and 75.2% specificity among sepsis and severe sepsis/septic shock patients, respectively. PCT, IL-6, and CRP levels were significantly increased in nonsurvivors compared to survivors. Serial measurements at 0, 12, 24, 48, 72, and 96 h showed that IL-6 showed better kinetics in the survivor group and was decreased in more than 86% of survivors by the second day. PCT can support the diagnosis of bacterial infection, especially in septic shock and severe sepsis patients. IL6 exhibited the better kinetics for monitoring the effectiveness of antibiotic treatment.
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- 2013
27. Physician and nurse knowledge about patient radiation exposure in the emergency department
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WJ Lee, Won Jung Jeong, Seung Pill Choi, Seon Hee Woo, SH Seol, Sang Hoon Oh, Yeon Young Kyong, Jung Hee Wee, SW Kim, and DH Kim
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Adult ,Male ,medicine.medical_specialty ,Health Knowledge, Attitudes, Practice ,Neoplasms, Radiation-Induced ,Radiography ,Nursing Staff, Hospital ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Nursing ,Risk Factors ,Surveys and Questionnaires ,Republic of Korea ,Medical imaging ,medicine ,Medical Staff, Hospital ,Diagnostic imaging, emergencies, radiation dosage ,Humans ,030212 general & internal medicine ,Ultrasonography ,Chi-Square Distribution ,medicine.diagnostic_test ,business.industry ,Magnetic resonance imaging ,General Medicine ,Emergency department ,Radiation Exposure ,Magnetic Resonance Imaging ,Radiation exposure ,Radiological weapon ,Abdominal ultrasonography ,Emergency medicine ,Female ,Radiography, Thoracic ,business ,Emergency Service, Hospital ,Tomography, X-Ray Computed ,Chi-squared distribution - Abstract
Background: Imaging methods that use ionizing radiation in emergency departments (EDs) have increased with advances in radiological diagnostic methods. Physician and nurse awareness of the radiation dose in the ED and the associated cancer risks to which the patients are exposed were surveyed with a questionnaire.Methods: A total of 191 subjects in six EDs participated in this study. ED physicians and ED nurses were asked about the risks and the radiation doses of imaging methods ordered in the ED. The differences between the two groups were compared using Student’s t‑test for continuous variables. A Fisher’s exact and Chi‑squared tests were used for categorical variables.Results: A total of 82 ED physicians and 109 ED nurses completed the questionnaire; 38 (46.3%) physicians and 8 (7.3%) nurses correctly answered the question about the chest X‑ray radiation dose. A question about the number of chest X‑rays that is equivalent to the dose of a pelvic X‑ray was answered correctly by 5 (6.1%) physicians and 9 (8.3%) nurses (P = 0.571). Questions regarding abdominal computed tomography (CT), chest CT, brain CT, abdominal ultrasonography, and brain magnetic resonance imaging were answered correctly more frequently by the physician group than the nurse group (P < 0.05). The risk of developing cancer over a lifetime due to a brain CT was correctly answered by 21 (25.6%) physicians and 30 (27.5%) nurses (P = 0.170). A similar question regarding abdominal CT was correctly answered by 21 (25.6%) physicians and 42 (38.5%) nurses (P = 0.127).Conclusions: Knowledge of the radiation exposure of radiology examinations was lower in nurses than physicians, but knowledge was poor in both groups. ED physicians and nurses should be educated about radiation exposure and cancer risks associated with various diagnostic radiological methods.Keywords: Diagnostic imaging, emergencies, radiation dosage
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- 2016
28. Prognostic value of gray matter to white matter ratio in hypoxic and non-hypoxic cardiac arrest with non-cardiac etiology
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Yooseok Park, Won Young Kim, Jae Hyung Choi, Kyoung-Chul Cha, Jung Hee Wee, Jonghwan Shin, Joo Suk Oh, Byung Kook Lee, and Kyung Woon Jeung
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Adult ,Male ,Internal capsule ,medicine.medical_treatment ,Neuroimaging ,030204 cardiovascular system & hematology ,Targeted temperature management ,Corpus callosum ,White matter ,03 medical and health sciences ,0302 clinical medicine ,Centrum semiovale ,Medicine ,Humans ,Registries ,Gray Matter ,Hypoxia ,Aged ,Retrospective Studies ,business.industry ,Putamen ,030208 emergency & critical care medicine ,Retrospective cohort study ,General Medicine ,Middle Aged ,Prognosis ,White Matter ,medicine.anatomical_structure ,Anesthesia ,Emergency Medicine ,Etiology ,Female ,business ,Tomography, X-Ray Computed ,Out-of-Hospital Cardiac Arrest ,Follow-Up Studies - Abstract
Purpose This study evaluated the prognostic performance of the gray to white matter ratio (GWR) on brain computed tomography (CT) in out-of-hospital cardiac arrest (OHCA) survivors with a noncardiac etiology and compared the prognostic performance of GWR between hypoxic and nonhypoxic etiologies. Methods Using a multicenter retrospective registry of adult OHCA patients treated with targeted temperature management, we identified those with a noncardiac etiology who underwent brain CT within 24 hours after restoration of spontaneous circulation. Attenuation of the gray matter and white matter (at the level of the basal ganglia, centrum semiovale, and high convexity) were measured and GWRs were calculated. The primary outcome was neurologic outcome. Results Of 164 patients, 145 (88.4%) were discharged with a poor neurologic outcome. Lower GWR was associated with a poor neurologic outcome. The sensitivities of this marker were markedly low (9.7%-43.5%) at cutoff values, with 100% sensitivity. The cutoff values of the GWR for hypoxic arrest showed higher sensitivities than those for nonhypoxic arrest. The area under the curve (AUC) values of the GWR for the caudate nucleus/posterior limb of the internal capsule, putamen/corpus callosum, and basal ganglia were significant in the hypoxic group, whereas the AUC of the putamen/corpus callosum was the only significant GWR in the nonhypoxic group. Conclusion A low GWR is associated with poor neurologic outcome in noncardiac etiology OHCA patients treated with targeted temperature management. Gray to white matter ratio can help to predict the neurologic outcome in a cardiac arrest with hypoxic etiology rather than a nonhypoxic etiology.
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- 2016
29. Outcome analysis of cardiac arrest due to hanging injury
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Seung Pill Choi, Jung Hee Wee, Chun Song Youn, Sang Hoon Oh, Kyu Nam Park, and Han Joon Kim
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Adult ,Male ,Utstein Style ,Resuscitation ,medicine.medical_specialty ,medicine.medical_treatment ,Poison control ,Return of spontaneous circulation ,Asphyxia ,Young Adult ,medicine ,Humans ,Cardiopulmonary resuscitation ,Asystole ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Retrospective cohort study ,General Medicine ,Middle Aged ,medicine.disease ,Cardiopulmonary Resuscitation ,Surgery ,Treatment Outcome ,Anesthesia ,Pulseless electrical activity ,Emergency Medicine ,Female ,Emergency Service, Hospital ,business ,Out-of-Hospital Cardiac Arrest - Abstract
Objective The aim of this study was to review patient characteristics and analyze the outcomes in patients who have had cardiac arrest from hanging injuries. Methods A retrospective review was performed that examined the victims of out-of-hospital cardiac arrest (OHCA) due to hanging who presented to a tertiary general hospital from January 2000 to December 2009. Utstein style variables were evaluated, and patient outcomes were assessed at the time of hospital discharge using the cerebral performance category (CPC) scale. Results Fifty-two patients with OHCA due to hanging were enrolled in this study from the aforementioned 10-year inclusion period. Resuscitation attempts were performed in 31 patients (60%), and 21 patients were pronounced dead. In all cases, the first monitored cardiac rhythms were either asystole or pulseless electrical activity (PEA) and were therefore nonshockable rhythms. Of the patients for whom resuscitation was attempted, 13 (42%) experienced a return of spontaneous circulation and 1 revealed cervical spine fracture. Of the 13 return-of-spontaneous-circulation patients, 5 survived to be discharged. The mean age of these 5 surviving patients was 36 years. All 5 patients were graded as cerebral performance category 4 at discharge. Conclusion The first monitored cardiac rhythms of patients presenting with OHCA due to hanging were nonshockable rhythms wherein the survival rate of these patients was 9.6%. All of the survivors were relatively young and demonstrated poor neurologic outcomes at discharge. Physicians must consider cervical spine fracture in patients who had cardiac arrest from hanging.
- Published
- 2012
30. Implication of cardiac marker elevation in patients who resuscitated from out-of-hospital cardiac arrest
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Jung Hee Wee, Kyu Nam Park, Soo-Hyun Kim, Won Jung Jeong, Seung Pill Choi, Han Joon Kim, Young-Min Kim, Sang Hoon Oh, and Chun Song Youn
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Adult ,Male ,medicine.medical_specialty ,Resuscitation ,Cardiac marker ,Myocardial Infarction ,Reference range ,Creatine ,Out of hospital cardiac arrest ,chemistry.chemical_compound ,Internal medicine ,Troponin I ,medicine ,Creatine Kinase, MB Form ,Humans ,In patient ,cardiovascular diseases ,Myocardial infarction ,Aged ,Retrospective Studies ,business.industry ,General Medicine ,Middle Aged ,medicine.disease ,Cardiopulmonary Resuscitation ,chemistry ,Case-Control Studies ,cardiovascular system ,Emergency Medicine ,Cardiology ,Female ,business ,Biomarkers ,Out-of-Hospital Cardiac Arrest - Abstract
Objectives It is often difficult to diagnose acute myocardial infarction (AMI) in patients who resuscitated after out-of-hospital cardiac arrest (OHCA) and had a delayed elevation in cardiac marker. This study explored whether elevations in cardiac marker were due to coronary artery occlusion or resulted from other causes. Methods The study included 19 non–ST-segment elevation patients who resuscitated after OHCA and underwent delayed coronary angiography. We checked patients' serial creatine kinase–myocardial band (CK-MB) and troponin I (cTnI) levels on arrival and 6, 12, 24, 48, 72, and 96 hours postarrest. Based on the association of elevated cTnI and the results of their delayed angiographies, the patients were retrospectively divided into 2 groups: an AMI group (n = 5) and a non-AMI group (n = 14). We then analyzed the serial cardiac marker measurements in each group. Results Peak marker levels were significantly higher in the AMI group than in the non-AMI group (CK-MB, 177.0 ± 112.7 vs 66.4 ± 85.2 ng/mL; P = .033 and cTnI, 40.4 ± 14.5 vs 10.6 ± 13.5 ng/mL; P = .005). After adjusting for covariates, the peak and 6-, 12-, and 24-hour cTnI and 6-hour CK-MB were significantly different between the 2 groups ( P = .005, P = .004, P = .005, P = .020, and P = .007). In the non-AMI group, 3 patients had cTnI values that were within the reference range at all of the evaluated times. Most patients had only low cTnI elevations that rapidly fell back to normal. Conclusion The resuscitation of patients who experience sudden OHCA but do not have an AMI may lead to elevations of cardiac markers. However, these elevations are low and normalize early.
- Published
- 2012
31. Therapeutic hypothermia in adult cardiac arrest because of drowning
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J. Y. Kim, K. N. Park, J. H. Park, Sang Hoon Oh, Chun Song Youn, S. P. Choi, Jung Hee Wee, and S. H. Kim
- Subjects
medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Advanced cardiac life support ,Poison control ,General Medicine ,Hypothermia ,medicine.disease ,Surgery ,Anesthesiology and Pain Medicine ,Anesthesia ,medicine ,Pancreatitis ,Cardiopulmonary resuscitation ,medicine.symptom ,Young adult ,Prospective cohort study ,business ,Rhabdomyolysis - Abstract
Background Therapeutic hypothermia in adult victims who suffer cardiac arrest following drowning has been applied in only a small number of cases. In the last 4 years, we have employed therapeutic hypothermia to decrease hypoxia-induced brain injury in these patients. The purpose of the present study was to report the results of the treatment of these patients. Methods This study investigated the utilisation of therapeutic hypothermia on consecutive patients with cardiac arrest because of drowning between 2005 and 2008. The study was conducted retrospectively, collecting data by reviewing medical records. Hypothermia, with a target temperature of 32–34°C, was induced for 24 h. Neurological outcomes were classified using the cerebral performance categories (CPCs). The primary outcome was neurological function at discharge. Results Twenty patients were treated with therapeutic hypothermia. Four patients (20%) exhibited a favourable neurological outcome (CPC 1–2). Two patients (10%) remained in a vegetative state at discharge (CPC 4), and 14 patients (70%) died (CPC 5). The most common complications during therapeutic hypothermia were pancreatitis and rhabdomyolysis. A longer duration of advanced cardiac life support (P = 0.035), an absence of motor response to pain after 3 days (P = 0.003), an abnormal brain imaging (P = 0.005) and a lack of cortical response to somatosensory evoked potential (P = 0.008) were related to an unfavourable outcome (CPC 3–5). Conclusion The present study did not demonstrate an advantage of therapeutic hypothermia in adult cardiac arrest after drowning compared with previous studies treated with conventional therapy. Further prospective studies are needed to evaluate the effects of therapeutic hypothermia.
- Published
- 2011
32. The associative factors of delayed-onset rhabdomyolysis in patients with doxylamine overdose
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Seung Hee Jeong, Won Jung Jeong, Jung Hee Wee, Chun Song Youn, Sang Hoon Oh, Soo-Hyun Kim, Kyu Nam Park, Ji-Hoon Kim, and Han Joon Kim
- Subjects
Adult ,Male ,Tachycardia ,Time Factors ,Drug overdose ,Rhabdomyolysis ,Statistics, Nonparametric ,chemistry.chemical_compound ,Heart Rate ,Heart rate ,Odds Ratio ,Humans ,Medicine ,Creatine Kinase ,Retrospective Studies ,Creatinine ,Chi-Square Distribution ,Doxylamine ,biology ,business.industry ,General Medicine ,Emergency department ,medicine.disease ,ROC Curve ,chemistry ,Anesthesia ,Emergency Medicine ,biology.protein ,Antiemetics ,Female ,Creatine kinase ,Drug Overdose ,medicine.symptom ,business ,medicine.drug - Abstract
Objectives The aim of this study was to investigate the associative factors of rhabdomyolysis in patients with doxylamine overdose who had normal creatine phosphokinase levels at admission. Methods This study included 169 patients who visited the emergency department of a tertiary teaching hospital after doxylamine overdose between January 1, 1998, and March 31, 2009. Demographic information, clinical variables, and laboratory data were investigated for the associative factors of rhabdomyolysis. Results Thirty-five (21%) of the 169 patients developed rhabdomyolysis. Patients who developed rhabdomyolysis differed from those who did not in the amount of doxylamine ingested, sex, heart rate, initial value of serum creatinine, and alanine aminotransferase. In the multivariate regression analysis, the only reliable predictors of rhabdomyolysis were the amount of doxylamine ingested ( P = .004) and heart rate ( P Conclusion Observation and laboratory follow-up are required for patients with large reported ingestions or tachycardia on admission, even if their creatine phosphokinase levels were normal.
- Published
- 2011
33. The clinical usefulness of initial serum procalcitonin as an aggravation predictor in a hepatobiliary tract infection at emergency department
- Author
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Won Jung Jeong, Seon Hee Woo, Jung Hee Wee, Byung Hak So, Ho-Shik Kim, Jeong Ho Park, and Seung Pill Choi
- Subjects
Adult ,Calcitonin ,Male ,medicine.medical_specialty ,Biliary Tract Diseases ,Calcitonin Gene-Related Peptide ,Disease ,Gastroenterology ,Procalcitonin ,Leukocyte Count ,Predictive Value of Tests ,Interquartile range ,Internal medicine ,White blood cell ,Humans ,Medicine ,Protein Precursors ,Stage (cooking) ,Intensive care medicine ,biology ,business.industry ,C-reactive protein ,General Medicine ,Emergency department ,Middle Aged ,C-Reactive Protein ,medicine.anatomical_structure ,Hepatobiliary tract, infection, procalcitonin ,Predictive value of tests ,biology.protein ,Female ,Emergency Service, Hospital ,business ,Biomarkers - Abstract
Background and Objectives: The ability to predict future clinical deterioration early in patients who present to an emergency care center with a hepatobiliary tract infection is difficult. We studied the clinical usefulness of the initial serum levels of procalcitonin in a hepatobiliary tract infection as an indicator for predicting aggravation in the early stages. Methods: Of the patients who presented with the clinical symptoms of a hepatobiliary tract infection, 99 were diagnosed with a hepatobiliary tract infection by imaging studies and subsequently enrolled in the study. Laboratory tests were obtained in the early stage of disease after presentation to an emergency care center. We assessed and compared the serum levels of many early inflammatory markers (white blood cell [WBC] counts, C‑reactive protein and procalcitonin) between patients whose symptoms were initially stable upon arrival to an emergency care center but then deteriorated to, those whose symptoms remained consistently stable. Thus, we examined if the above serum markers are useful in predicting the possibility of future symptom aggravation. Results: Of a total of 99 patients, 27 were assigned to the symptom aggravation group. The serum levels of WBC counts and C‑reactive protein in the aggravation group were elevated. However, the median value (interquartile range) of procalcitonin was relatively increased at 2.28 (0.41–7.84 ng/ml), demonstrating a significant difference. Conclusions: In conclusion, initial serum levels of procalcitonin might be used as an indicator for aggravation in patients with hepatobiliary tract infection at the emergency department, even though there is hemodynamic stability. Key words : Hepatobiliary tract, infection, procalcitonin
- Published
- 2015
34. Comparison of clinical characteristics of intentional vs accidental drowning patients
- Author
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Jung Hee Wee, Seung Pill Choi, Seon Hee Woo, and Jeong Ho Park
- Subjects
Adult ,Male ,Pediatrics ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Poison control ,Suicide, Attempted ,Hypothermia ,Suicide prevention ,Occupational safety and health ,Body Temperature ,Young Adult ,Age Distribution ,Swimming Pools ,Rivers ,Injury prevention ,Republic of Korea ,Medicine ,Humans ,Cardiopulmonary resuscitation ,Sex Distribution ,Child ,Aged ,Retrospective Studies ,Accidental drowning ,Aged, 80 and over ,Depressive Disorder ,Drowning ,business.industry ,Infant, Newborn ,Infant ,General Medicine ,Emergency department ,Middle Aged ,medicine.disease ,Suicide ,Accidental ,Accidents ,Child, Preschool ,Emergency Medicine ,population characteristics ,Female ,Medical emergency ,business ,human activities - Abstract
Drowning may happen by accident or as a method of committing suicide. The aim of this study was to determine some characteristics of drowning patients who committed intentionally.A retrospective review was performed on 462 patients who visited the emergency department complaining of drowning between January 1998 and October 2011. Of these patients, we only included the patients for whom the cause could be identified. Age, sex, cause, time of drowning, season, mechanism, cardiopulmonary resuscitation performance, body temperature, alcohol ingestion, history of previous suicide attempts, outcome, and other characteristics were collected.A total of 380 patients were included. Among them, 282 (74.2%) had drowned themselves intentionally, and they were older than those who had drowned accidentally (median age, 35.0 years [25.0-49.0 years] vs 26.5 years [19.0-35.5 years], P.001) and showed lower body temperature (below 34°C, 32.1% vs 12.2%, P = .027). Ninety-four cases (33.3%) jumped off the river from a bridge, and 185 (65.6%) walked into the river from the riverside. In the intentional group, 59 (20.9%) had depressive disorder in their history. The rate of death showed no clinical difference (19.5% vs 16.3%, P = .487), but more males died in the accidental group (61.8% vs 93.8%, P = .015).Intentional drowning happened more in older subjects and presented lower initial body temperature. Walking from the riverside happened more often than jumping off a bridge. More males died of drowning regardless of intentionality.
- Published
- 2015
35. Outcomes of asphyxial cardiac arrest patients who were treated with therapeutic hypothermia: a multicentre retrospective cohort study
- Author
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Kyu Nam Park, Byung Kook Lee, Yeon Ho You, Hoon Lim, Jeong Ho Park, Jung Hee Wee, Seung Pill Choi, and Wook Jin Choi
- Subjects
Adult ,Male ,medicine.medical_specialty ,Resuscitation ,Emergency Nursing ,Return of spontaneous circulation ,Asphyxia ,Hypothermia, Induced ,medicine ,Humans ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Basic life support ,Retrospective cohort study ,Hypothermia ,Airway obstruction ,Middle Aged ,medicine.disease ,Survival Analysis ,Surgery ,Treatment Outcome ,Anesthesia ,Cohort ,Emergency Medicine ,Female ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Out-of-Hospital Cardiac Arrest - Abstract
Introduction While therapeutic hypothermia (TH) is in clinical use, its efficacy in certain patient groups is unclear. This study was designed to describe the characteristics and outcomes of patients with out-of-hospital cardiac-arrest (OHCA) caused by asphyxia, who were treated with TH. Patients and methods A multicentre, retrospective, registry-based study was performed using data from the period 2007–2012. Comatose patients who were treated with TH after asphyxial cardiac arrest were included, while those who with cardiac arrest attributed to hanging, drowning or gas intoxication were excluded. Results Of a total of 932 OHCA patients in the registry, 111 were enrolled in this study. The mean age was 65.8±16.3 years with individuals who were ≥65 years of age accounted for 61.3% of the cohort. Foreign-body airway obstruction was the most common cause (70.3%) of the cardiac arrest. Eighty patients (72.1%) presented with an initial non-shockable rhythm. In all institutions target TH temperatures were 32–34°C, but TH maintenance times varied. A total of 52 patients (46.8%) survived, of whom six patients (5.4%) showed a good neurologic outcome (cerebral performance category scale 1–2). The pupil light reflex, corneal reflex and time to return of spontaneous circulation ( p =0.012, 0.015 and 0.032, respectively) were associated with survival. Witnessed arrest, age, previous lung disease, bystander basic life support and time factors were not associated with survival. Conclusion About half of patients who underwent TH after asphyxial cardiac arrest survived, but a very small number showed a good neurologic outcome. The TH maintenance times were not uniform in these patients. Additional research regarding both the appropriate TH guidelines for patients with asphyxial cardiac arrest and improvement of their neurologic outcome is needed.
- Published
- 2014
36. A comparative study of bike lane injuries
- Author
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Kyu Nam Park, Jung Hee Wee, Jeong Ho Park, and Seung Pill Choi
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,Poison control ,Critical Care and Intensive Care Medicine ,Occupational safety and health ,Injury Severity Score ,Chart ,Protective Clothing ,Risk Factors ,Injury prevention ,medicine ,Humans ,Child ,Aged ,Retrospective Studies ,business.industry ,Accidents, Traffic ,Human factors and ergonomics ,Retrospective cohort study ,Middle Aged ,Bicycling ,Bike lane ,Emergency medicine ,Surgery ,Female ,business - Abstract
Because of the increased number of bicycle riders and governmental promotions, a recent increase in the construction of bicycle lanes has occurred. We aimed to characterize injuries specific to bicycle lane accidents by comparing them with injuries that occurred on regular roadways. On the basis of our findings, we provide suggestions on proper preventive strategies.We performed a retrospective study on 408 cases obtained between January 1, 2009, and December 31, 2010. Of these cases, 387 met the criterion that the location of the injury could be confirmed by telephone or via review of the patient's chart. Data regarding age, gender, Injury Severity Score, time of the accident, location of the accident, and other characteristics were collected. Data were analyzed using SPSS 12.0K.Of the 387 cases, 204 (52.7%) patients were injured in bicycle lanes and 183 (47.3%) were injured on regular roadways. Comparing cases of bicycle lane injuries and non-bicycle lane injuries, there were no differences in age, day of the week, season, or the time at which the accident occurred. Bicycle helmets were used more frequently in bicycle lane injuries (33.2% vs. 13.7%; p0.001). In addition, the most common causes of injury for bicycle lane incidences were falls (59.3%) and collisions with other bicycles (23.5%), whereas in non-bicycle lane cases, falls (42.6%) and collisions with other vehicles (39.3%) were the most common causes of injury. Although the severity of injuries was slightly lower in bicycle lane cases, it was not significantly lower than non-bicycle lane cases.Although people are increasingly using bicycle lanes for safety, this study shows that they are not definitively safer. Therefore, improvements in the policies related to implementing bicycle lane safety are needed, for example, by enforcing the use of protective gear or preventing the use of bicycle lanes by pedestrians. More safety education programs are also needed.III.
- Published
- 2012
37. The value of procalcitonin level in community-acquired pneumonia in the ED
- Author
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Jeong Ho Park, Sang Hoon Oh, Jung Hee Wee, and Seung Pill Choi
- Subjects
Calcitonin ,Male ,medicine.medical_specialty ,Calcitonin Gene-Related Peptide ,Severity of Illness Index ,Procalcitonin ,Community-acquired pneumonia ,Internal medicine ,parasitic diseases ,Severity of illness ,Pneumonia, Bacterial ,Medicine ,Humans ,Hospital Mortality ,Prospective Studies ,Protein Precursors ,Prospective cohort study ,Aged ,Receiver operating characteristic ,business.industry ,General Medicine ,Emergency department ,Middle Aged ,medicine.disease ,Confidence interval ,Surgery ,Community-Acquired Infections ,Logistic Models ,ROC Curve ,Emergency Medicine ,Biomarker (medicine) ,Female ,business ,Emergency Service, Hospital ,hormones, hormone substitutes, and hormone antagonists ,Biomarkers - Abstract
Objectives The aim of this study was to investigate the value of procalcitonin (PCT) level in patients with community-acquired pneumonia (CAP) in the emergency department (ED). Methods We conducted a prospective study of patients with CAP in the ED. Patients presenting with a clinical and radiographic diagnosis of CAP were enrolled. The authors measured inflammatory biomarkers. The severity of CAP was assessed by 3 prediction rules. We performed an analysis to assess the value of each biomarker for the prediction of mortality and CAP severity. Results A total of 126 patients with CAP are included. Sixteen patients who were older and belonged to high-risk group died within 28 days. Nonsurvivors had significantly increased median PCT level (1.96 vs 0.18 ng/mL) and high-sensitivity C-reactive protein (158.57 vs 91.28 mg/dL) compared with survivors. The median PCT levels were significantly higher in more severe disease, on 3 prediction rules. In regression logistic analyses, the area under the receiver operating characteristic curve of PCT level were 0.828 (95% confidence interval, 0.750-0.889). The addition of PCT level to three prediction rules significantly increased the area under the receiver operating characteristic curve. These results suggest that PCT measurement is more versatile tool for predicting mortality and the severity of disease among patients with CAP in the ED. Conclusions Procalcitonin level is valuable for predicting mortality and the severity of disease among patients with CAP at ED admission. Procalcitonin level as an adjunct to CAP prediction rules may be valuable for prognosis and severity assessment.
- Published
- 2011
38. 'Is it cost-effective to use procalcitonin to predict outcome in community-acquired pneumonia in the ED?' Response to the authors
- Author
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Jeong Ho Park, Seung Pill Choi, and Jung Hee Wee
- Subjects
Calcitonin ,Male ,medicine.medical_specialty ,business.industry ,General Medicine ,medicine.disease ,Outcome (game theory) ,Procalcitonin ,Community-acquired pneumonia ,Pneumonia, Bacterial ,Emergency Medicine ,medicine ,Humans ,Female ,Protein Precursors ,Emergency Service, Hospital ,business ,Intensive care medicine - Published
- 2013
39. Lung Injury Score in Out-of-hospital Cardiac Arrest after Drowning
- Author
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K.N. Park, Chang Shik Youn, Jung Hee Wee, S. Choi, and Juri Park
- Subjects
business.industry ,Anesthesia ,Emergency Medicine ,Medicine ,Lung injury ,business ,Out of hospital cardiac arrest - Published
- 2012
40. The Appropriateness of Trauma Team Activation by Emergency Physician in the Emergency Department
- Author
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K.M. Cha, Jung Hee Wee, S. Choi, and Juri Park
- Subjects
medicine.medical_specialty ,business.industry ,Emergency medicine ,Emergency Medicine ,Emergency medical services ,medicine ,Trauma team ,Emergency department ,Medical emergency ,Emergency physician ,business ,medicine.disease - Published
- 2012
41. Therapeutic Hypothermia Following Emergent Coronary Artery Bypass Grafting After Failed Percutaneous Coronary Intervention in a Comatose Post-Cardiac Arrest Patient
- Author
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Kyu Nam Park, Jung Hee Wee, Sung Jin Hong, Seung Pill Choi, Jeong Ho Park, and Sun Hee Lee
- Subjects
medicine.medical_specialty ,Bypass grafting ,medicine.medical_treatment ,Case Report ,Hypothermia ,Body Temperature ,Electrocardiography ,Percutaneous Coronary Intervention ,Hypothermia, Induced ,Internal medicine ,Cardiac Arrest ,medicine ,Humans ,Post cardiac arrest ,Coma ,Coronary Artery Bypass ,Contraindication ,Coronary Artery Bypass Grafting ,business.industry ,Percutaneous coronary intervention ,General Medicine ,Middle Aged ,Emergency & Critical Care Medicine ,Heart Arrest ,Intensive Care Units ,Treatment Outcome ,medicine.anatomical_structure ,Cardiology ,Female ,medicine.symptom ,business ,Artery - Abstract
We report the case of 60-yr-old female in which therapeutic hypothermia (TH) was successfully induced maintaining the target temperature of 34℃ for 12 hr despite a risk of hypothermia-induced coagulation abnormalities following an emergent coronary artery bypass grafting (CABG) due to failed percutaneous coronary intervention, who suffered a cardiac arrest. Emergent CABG may be a relative contraindication for TH in post-cardiac arrest patients because hypothermia may increase the risk of infection and bleeding. However, the possibility of an improved neurologic outcome outweighs the risk of bleeding, although major surgery may be a relative contraindication for TH.
- Published
- 2013
42. Some Characteristics of Patients with Major Depressive Disorder who were Treated with Drug Intoxication in the Emergency Department
- Author
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Jung Hee Wee, S. Choi, SW Kim, and Juri Park
- Subjects
medicine.medical_specialty ,business.industry ,Emergency medicine ,Emergency Medicine ,medicine ,Major depressive disorder ,Medical emergency ,Emergency department ,Drug intoxication ,medicine.disease ,business - Published
- 2012
43. Outcome analysis after cardiac arrest due to hanging
- Author
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Se-min Choi, Hyung-Ok Kim, Kyu-Nam Park, Chun Song Youn, S. Choi, and Jung Hee Wee
- Subjects
Resuscitation ,medicine.medical_specialty ,business.industry ,Emergency medicine ,Emergency Medicine ,Outcome analysis ,medicine ,Emergency Nursing ,Cardiology and Cardiovascular Medicine ,business ,Outcome (game theory) ,Clinical death - Published
- 2010
44. Human melanoma cells adhesion on the surface of polymeric chemoattractants
- Author
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Park, K. N., Kim, H. J., Jung Hee Wee, Lee, W. K., Chun, H. J., Jang, J. W., Addison, A., and Beard, R. B.
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