Effect of regional climatic conditions, air pollutants, and season on the occurrence and severity of injury in trauma patients

OBJECTIVE: We analyzed the association between regional weather and temporal changes on the daily occurrence of trauma emergencies and their severity. METHODS: In this cross-sectional prospective study, we investigated daily atmospheric patterns in trauma episodes in 1,344 patients in Cheongju city, South Korea, from January 2016 to December 2016 and analyzed the association of trauma occurrence and Injury Severity Scores (ISS) with weather conditions on a daily scale. RESULTS: The mean age of trauma patients was 53.0±23.8 years and average ISS was 9.0±2.0. Incidence of trauma was positively correlated with average temperature (r=0.512, P < 0.001) and atmospheric pressure (r=0.332, P=0.010) and negatively correlated with air pollutants (particulate matter less than 2.5 µm³ [PM2.5], r=−0.629, P < 0.001; particulate matter less than 10 µm³ [PM10], r=−0.679, P < 0.001). ISS was not significantly correlated with climate parameters and air pollutants, and variability was observed in the frequency and severity of trauma by time of day (highest occurrence, 16–20 pm; highest ISS, 4–8 am), day of the week (highest occurrence and highest ISS, Saturday), month of the year (highest occurrence, July; highest ISS, November), and season (highest incidence, summer; highest ISS, autumn). CONCLUSION: The study shows a positive relationship between trauma occurrence and specific weather conditions, such as atmospheric temperature and pressure. There was a negative relationship between concentrations of PM2.5 or PM10, and trauma occurrence. However, no correlation was observed between weather conditions or the concentrations of air pollutants and ISS. In addition, seasonal, circaseptan, and circadian variations exist in trauma occurrence and severity. Thus, we suggest that evaluation of a larger, population-based data set is needed to further investigate and confirm these relationships.

Hypoplasia of Left Vertebral Artery with Intimal Fibromuscular Dysplasia in a Korean Woman

We found a case of hypoplasia of vertebral artery with fibromuscular dysplasia in an 82-yr-old Korean female cadaver during a routine dissection course. In the present case, intracranial hypoplasia in left vertebral artery and bilateral origin of posterior inferior cerebellar artery at the vertebrobasilar junction were recognized. Histopathologically, left vertebral artery showed intimal type of fibromuscular dysplasia both in its extracranial and intracranial courses. These results indicate that the association of fibromuscular dysplasia and hypoplasia does exist in the vertebral artery, although the etiologies are not verified yet.

Relationship between plasma homocysteine levels and chronic diabetic complications in NIDDM patients / 대한내과학회지

BACKGROUND: Elevated plasma homocysteine is a recently-recognized independent risk factor for cardiovascular disease. In patients with non-insulin dependent diabetes mellitus (NIDDM), plasma homocysteine concentration was reported to be elevated in association with nephropathy. However, inconsistent results were reported about the association with other microvascular complications. METHODS: To determine the relationship between plasma homocysteine and the development of chronic diabetic microvascular complications, fasting plasma homocysteine, glycemic control, lipid and lipoprotein levels, vitamin status, renal function test, and chronic diabetic microvascular complications were assessed in 101 patients with NIDDM in the present study. RESULTS: There was no difference in the plasma levels of homocysteine by sex, age, status of sugar control, duration of diabetes, other cardiovascular risk factors. Patients with diabetic microangiopathy had higher plasma homocysteine concentrations than those without diabetic microangiopathy. Moreover, there was a significant correlation between amount of urinary albumin excretion and plasma homocysteine level (p=0.004, r=0.357). However, multivariate analysis showed that only serum creatinine (beta=0.635) was independently associated with plasma homocysteine level in NIDDM patients. The increase in plasma homocysteine was not shown to increase the risk of diabetic microvascular complications independently on multiple logistic regression analysis. CONCLUSION: In conclusion, decrease of renal function is an independent determinant of plasma homocysteine level and higher plasma homocysteine is associated to diabetic microangiopathy. But an increase in plasma homocysteine in patients with NIDDM is not independently associated with diabetic microvascular complications considering renal function. Therefore, the renal function should be considered in study about relationship between plasma homocysteine level and the development and/or progression of chronic diabetic microvascular complications in diabetic patients.