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Evaluation of diagnostic biomarkers for acute kidney injury in major burn patients
Dohern Kym,Yong-Suk Cho,Jaechul Yoon,Haejun Yim,Hyeong-Tae Yang 대한외과학회 2015 Annals of Surgical Treatment and Research(ASRT) Vol.88 No.5
Purpose: Acute kidney injury (AKI) in major burn patients is a common complication with high morbidity and mortality. The mainstream treatment is early diagnosis and rapid termination and prevention of the underlying insult. Therefore, it’s essential to identify early biomarkers predicting AKI. Methods: A total of 85 patients who were admitted to the burn intensive care unit from June 2012 to July 2013 were included in this prospective cohort study. Ten biomarkers (blood urea nitrogen, serum creatinine, urine creatinine, cystatin C, cystatin C glomerular filtration rate, AST, lacate dehydrogenase [LD], creatine kinase, lactic acid, and myoglobin) were obtained at time of admission and evaluated as diagnostic biomarkers to predicting AKI and early AKI. Results: Out of 85 patients, 35 patients were dead and overall mortality was 41.2%. The mean age was 49.4 years and mean percentage of total body surface area was 53.2%. Area under the curve (AUC) of receiver operating characteristic curve of biomarkers on predicting AKI were 0.746, 0.718, and 0.717 in LD, lactic acid, and serum creatinine, respectively. AUC of cystatin C predicting AKI was much lower at 0.555. AUC of biomarkers on predicting early AKI were 0.833, 0.816, 0.790, and 0.759 in LD, serum creatinine, AST, and serum myoglobin. Conclusion: LD, lactic acid and serum creatinine were acceptable as diagnostic biomarkers of AKI and LD, serum creatinine, AST, and serum myoglobin were reasonable as diagnostic biomarkers of early AKI. However, cystatin C was an unfavorable biomarker in major burn patients.
Jaechul Yoon,Dohern Kym,Jun Hur,Yong-Suk Cho,Wook Chun,Dogeon Yoon 대한외과학회 2023 Annals of Surgical Treatment and Research(ASRT) Vol.104 No.2
Purpose: Burn injury has high clinical heterogeneity and worse prognosis in severely burned patients. Clustering algorithms using unsupervised methods to identify groups with similar trajectories in heterogeneous disease patients can provide insight into mechanisms of disease pathogenesis. This study analyzed routinely collected biomarkers to evaluate mortality prediction, find clinical meanings for these or their subtypes, and evaluate patterns. Methods: This retrospective cohort study included patients aged >18 years, between July 2012 and June 2021. All eligible patients received fluid resuscitation and survived for at least 7 days. Characteristics of clinical interest to the physician at 4 clinically important time points were evaluated. Results: Eligible patients were divided into 4 subgroups according to these time points: from 1st week to 4th week. Total of 1,249 patients admitted within 2 days after burns and receiving fluid resuscitation were included. Mean Harrell’s C-index of pH was the highest (0.816), followed by platelets (0.807), creatinine (0.796), red cell distribution width (RDW, 0.778), and lactate (0.759). Longitudinal profiles among biomarkers were different. Conclusion: The main predictors were pH, platelets, creatinine, RDW, and lactate. Creatinine and RDW showed consistent patterns. The other markers varied according to patient condition. Thus, these markers could provide clues into underlying mechanisms and predict mortality.
Dong-Kook Seo,Dohern Kym,Jun Hur 대한외과학회 2014 Annals of Surgical Treatment and Research(ASRT) Vol.87 No.5
Purpose: Severe neck contracture is a problem that must be resolved by priority. We consider the best contracture treatment to be the full-thickness skin graft. However, clinicians often encounter patients, especially extensive burn patients, who have insufficient donor sites for the full-thickness skin graft. We treated extensive burn patients with neck scar contractures with a split-thickness skin graft (STSG) combined with dermal substitutes. The purpose of this study was to evaluate clinical outcomes of neck contracture treatment in extensive burn patients performing STSG with dermal substitutes as adjuvant treatment. Methods: We analyzed the retrospective clinical and photographic records of 28 patients with severe neck contracture who were admitted to Hallym University Hangang Sacred Heart Hospital, Seoul, Korea, from January 2012 to December 2012. We performed STSG in combination with dermal substitutes to minimize the degree of contracture. Results: The overall take rate of skin to dermal substitutes was 95.9%, and no grafts failed to affect recontracture except in one patient with a partial loss of artificial dermis who underwent a follow-up skin graft without any problems. Excellent/good outcomes were shown in 27 out of 28 patients. Conclusion: In extensive burn patients, skin grafting in combination with dermal substitutes can be an alternative to STSG alone for contracture release.
Effects of pain Scrambler therapy for management of burn scar pruritus: A pilot study
Joo, So Young,Cho, Yoon Soo,Cho, Sung-Rae,Kym, Dohern,Seo, Cheong Hoon Elsevier 2017 Burns Vol.43 No.3
<P>Conclusions: Scrambler therapy is a non-invasive, non-medicinal modality that significantly reduced burn-associated pruritus. Scrambler therapy should be considered as a treatment option for burn survivors with severe pruritus. (C) 2016 Elsevier Ltd and ISBI. All rights reserved.</P>
Serial Changes of Heat Shock Protein 70 and Interleukin-8 in Burn Blister Fluid
( Kicheol Yoo ),( Kang Yeol Suh ),( Gi Hun Choi ),( In-suk Kwak ),( Dong Kook Seo ),( Dohern Kym ),( Hyeon Yoon ),( Yong Se Cho ),( Hye One Kim ) 대한피부과학회 2017 Annals of Dermatology Vol.29 No.2
Background: It has been reported that heat shock protein 70 (HSP70) and interleukin-8 (IL-8) play an important role in cells during the wound healing process. However, there has been no report on the effect of HSP70 and IL-8 on the blisters of burn patients. Objective: This study aimed to evaluate the serial quantitative changes of HSP70 and IL-8 in burn blisters. Methods: Twenty-five burn patients were included, for a total of 36 cases: twenty cases on the first day, six cases on the sec-ond, five cases on the third, three cases on the fourth, and two cases on the fifth. A correlation analysis was performed to de-termine the relationship between the concentration of HSP70 and IL-8 and the length of the treatment period. Results: The HSP70 concentration was the highest on the first day, after which it decreased down to near zero. Most HSP70 was generated during the first 12 hours after the burn accident. There was no correlation between the concen-tration of HSP70 on the first day and the length of the treat-ment period. No measurable concentration of IL-8 was de-tected before 5 hours, but the concentration started to in-crease after 11 hours. The peak value was measured on the fourth day. Conclusion: While HSP70 increased in the first few hours and decreased afterwards, IL-8 was produced after 11 hours and increased afterward in burn blister fluid. These findings provide new evidence on serial changes of in-flammatory mediators in burn blister fluid. (Ann Dermatol 29(2) 194∼199, 2017)