Association between the simultaneous decrease in the levels of soluble vascular cell adhesion molecule-1 and S100 protein and good neurological outcomes in cardiac arrest survivors

Objective This study aimed to determine whether simultaneous decreases in the serum levels of cell adhesion molecules (intracellular cell adhesion molecule-1 [ICAM-1], vascular cell adhesion molecule-1 [VCAM-1], and E-selectin) and S100 proteins within the first 24 hours after the return of spontaneous circulation were associated with good neurological outcomes in cardiac arrest survivors. Methods This retrospective observational study was based on prospectively collected data from a single emergency intensive care unit (ICU). Twenty-nine out-of-hospital cardiac arrest survivors who were admitted to the ICU for post-resuscitation care were enrolled. Blood samples were collected at 0 and 24 hours after ICU admission. According to the 6-month cerebral performance category (CPC) scale, the patients were divided into good (CPC 1 and 2, n=12) and poor (CPC 3 to 5, n=17) outcome groups. Results No difference was observed between the two groups in terms of the serum levels of ICAM-1, VCAM-1, E-selectin, and S100 at 0 and 24 hours. A simultaneous decrease in the serum levels of VCAM-1 and S100 as well as E-selectin and S100 was associated with good neurological outcomes. When other variables were adjusted, a simultaneous decrease in the serum levels of VCAM-1 and S100 was independently associated with good neurological outcomes (odds ratio, 9.285; 95% confidence interval, 1.073 to 80.318; P=0.043). Conclusion A simultaneous decrease in the serum levels of soluble VCAM-1 and S100 within the first 24 hours after the return of spontaneous circulation was associated with a good neurological outcome in out-of-hospital cardiac arrest survivors

Analysis of the Occurrence Frequency of Seedable Clouds on the Korean Peninsula for Precipitation Enhancement Experiments

Our study analyzed the occurrence frequency and distribution of seedable clouds around the Korean Peninsula in order to better secure water resources. Cloud products from the Communication, Ocean, and Meteorological Satellite (COMS), including cloud fraction, cloud top height, cloud top temperature, cloud phase, cloud top pressure, cloud optical thickness, and rainfall intensity, were used. Daytime hourly data between 0900 and 1800 local standard time (LST) observed from December 2016 to November 2019 was used. Seedable clouds occurring within this period were evaluated based on seasonal cloud phases, occurrence frequency, and cloud characteristics according to land, sea, and cloud type. These clouds exhibited varying average occurrence frequencies in different seasons. Sc (stratocumulus) clouds exhibited the highest occurrence frequency for all seasons, with an average of 63%, followed by Cu (cumulus) at 15%, As (altostratus) at 13%, and Ac (altocumulus) at 6%. We determined that low-level clouds primarily occurred around the Korean Peninsula, and the occurrence frequency of stratiform clouds was highest for water phase seedable clouds, while the occurrence frequency of cumuliform clouds was highest for ice phase seedable clouds. We believe that precipitation enhancement experiments could be suitable for western and eastern seas around the Korean Peninsula as well as for mountainous regions on land

Hypotonic hyponatremia by primary polydipsia caused brain death in a 10-year-old boy

Hypotonic hyponatremia by primary polydipsia can cause severe neurologic complications due to cerebral edema. A 10-year-and-4-month-old boy with a psychiatric history of intellectual disability and behavioral disorders who presented with chief complaints of seizure and mental change showed severe hypotonic hyponatremia with low urine osmolality (serum sodium, 101 mmol/L; serum osmolality, 215 mOsm/kg; urine osmolality, 108 mOsm/kg). The patient had been polydipsic for a few months prior, and this had been worse in the previous few days. A diagnosis of hypotonic hyponatremia caused by primary polydipsia was made. The patient was in a coma, and developed respiratory arrest and became brain death shortly after admission, despite the treatment. The initial brain magnetic resonance imaging showed severe brain swelling with tonsillar and uncal herniation, and the patient was declared as brain death. It has been reported that antidiuretic hormone suppression is inadequate in patients with chronic polydipsia, and that this inadequate suppression of antidiuretic hormone is aggravated in patients with acute psychosis. Therefore, hyponatremia by primary polydipsia, although it is rare, can cause serious and life-threatening neurologic complications

Male patients presenting with rapidly progressive puberty associated with malignant tumors

In males, precocious puberty (PP) is defined as the development of secondary sexual characteristics before age 9 years. PP is usually idiopathic; though, organic abnormalities including tumors are more frequently found in male patients with PP. However, advanced puberty in male also can be an important clinical manifestation in tumors. We report 2 cases of rapidly progressive puberty in males, each associated with a germ-cell tumor. First, an 11-year-old boy presented with mild fever and weight loss for 1 month. Physical examination revealed a pubertal stage of G3P3 with 10-mL testes. Investigations revealed advanced bone age (16 years) with elevated basal luteinizing hormone and testosterone levels. An anterior mediastinal tumor was identified by chest radiography and computed tomography, and elevated α-fetoprotein (AFP) and β-human chorionic gonadotropin (β-hCG) levels were noted. Histopathologic analysis confirmed a yolk-sac tumor. Second, a 12-year-old boy presented with diplopia, polydipsia, and polyuria for 4 months. Physical examination revealed a pubertal stage of G3P3 with 8-mL testes. Bone age was advanced (16 years) and laboratory tests indicated panhypopituitarism with elevated testosterone level. A mixed germ-cell tumor was diagnosed with elevated AFP and β-hCG levels. Of course, these patients also have other symptoms of suspecting tumors, however, rapidly progressive puberty can be the more earlier screening sign of tumors. Therefore, in male patients with accelerated or advanced puberty, malignancy should be considered, with evaluation of tumor markers. In addition, advanced puberty in male should be recognized more widely as a unique sign of neoplasm

Progressive and Prospective Technology for Cloud Seeding Experiment by Unmanned Aerial Vehicle and Atmospheric Research Aircraft in Korea

This study applies a novel cloud seeding method using an unmanned aerial vehicle (UAV) and a research aircraft in Korea. For this experiment, the UAV sprayed a cloud seeding material (calcium chloride), and the aircraft monitored the clouds in the southern part of the Korean Peninsula on April 25, 2019. Cloud observation equipment in the aircraft indicated an increase in the number concentration and average particle size of large cloud particles after the seeding. Weather radar reflectivity increased by approximately 10 dBZ above the experimental area due to the development of clouds and precipitation systems. Rain was observed after seeding, and 0.5 mm was recorded, including natural and mixed precipitation from the cloud seeding. In addition, it showed that the rapid increase in the number of raindrops and vertical reflectivity was approximately 10 dBZ. Therefore, these results showed the possibility of cloud seeding using UAVs and atmospheric research aircraft. The effects of cloud seeding are indicated through the increased number concentration and size of cloud particles, radar reflectivity, and ground-based precipitation detection

Association between the simultaneous decrease in the levels of soluble vascular cell adhesion molecule-1 and S100 protein and good neurological outcomes in cardiac arrest survivors

Objective This study aimed to determine whether simultaneous decreases in the serum levels of cell adhesion molecules (intracellular cell adhesion molecule-1 [ICAM-1], vascular cell adhesion molecule-1 [VCAM-1], and E-selectin) and S100 proteins within the first 24 hours after the return of spontaneous circulation were associated with good neurological outcomes in cardiac arrest survivors. Methods This retrospective observational study was based on prospectively collected data from a single emergency intensive care unit (ICU). Twenty-nine out-of-hospital cardiac arrest survivors who were admitted to the ICU for post-resuscitation care were enrolled. Blood samples were collected at 0 and 24 hours after ICU admission. According to the 6-month cerebral performance category (CPC) scale, the patients were divided into good (CPC 1 and 2, n=12) and poor (CPC 3 to 5, n=17) outcome groups. Results No difference was observed between the two groups in terms of the serum levels of ICAM-1, VCAM-1, E-selectin, and S100 at 0 and 24 hours. A simultaneous decrease in the serum levels of VCAM-1 and S100 as well as E-selectin and S100 was associated with good neurological outcomes. When other variables were adjusted, a simultaneous decrease in the serum levels of VCAM-1 and S100 was independently associated with good neurological outcomes (odds ratio, 9.285; 95% confidence interval, 1.073 to 80.318; P=0.043). Conclusion A simultaneous decrease in the serum levels of soluble VCAM-1 and S100 within the first 24 hours after the return of spontaneous circulation was associated with a good neurological outcome in out-of-hospital cardiac arrest survivors.OAIID:RECH_ACHV_DSTSH_NO:T201826757RECH_ACHV_FG:RR00200001ADJUST_YN:EMP_ID:A076403CITE_RATE:0DEPT_NM:의학과EMAIL:[email protected]_YN:NY