Koh, Jiyoon;Jeon, Woochan;Kang, Hyunggoo;Kim, Yang Weon;Kim, Hyun;Oh, Bum Jin;Lee, Mi Jin;Chun, Byeong Jo;Chung, Sung Phil;Kim, Kyung Hwan
Journal of The Korean Society of Clinical Toxicology
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v.18
no.2
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pp.85-93
/
2020
Purpose: The annual statistics for poisoning are reported based on the data from poison control centers in many advanced countries. In 2016 a study was conducted to analyze the 2016 Korea Poisoning status. This study was conducted to make a better annual report for poisoning statistics in Korea from a 2017-2018 national representative database. Methods: This study was a retrospective analysis of poisoning patients based on the data from an emergency department (ED) based injury in-depth surveillance project by the Korea Centers for Disease Control and Prevention in 2017-2018. Bite or sting injuries were not included. Results: A total of 17714 patients presented to 23 EDs because of poisoning. Adults above 20 years old age accounted for 84.6% of the population, while the proportion of intentional poisoning was 60.8%. The poisoning substance presented in the ED were therapeutic drugs (51.2%), gas (20.3%), pesticides (16.4%), and artificial substances (11.4%). Overall, 35% of patients were admitted for further treatment. The mortality was 2.4% (422 cases), and the most common fatal substances in order were carbon monoxide, other herbicides, and paraquat. Conclusion: This study showed the 2017-2018 status of poisoning in Korea. The prognosis is different from the cause of poisoning and the initial mental state of the patient. Therefore, appropriate methods for preventing poisoning and therapeutic plans in specific situations are needed.
Park, Chan Hyuk;Yang, Dong-Hoon;Kim, Jong Wook;Kim, Jie-Hyun;Kim, Ji Hyun;Min, Yang Won;Lee, Si Hyung;Bae, Jung Ho;Chung, Hyunsoo;Choi, Kee Don;Park, Jun Chul;Lee, Hyuk;Kwak, Min-Seob;Kim, Bun;Lee, Hyun Jung;Lee, Hye Seung;Choi, Miyoung;Park, Dong-Ah;Lee, Jong Yeul;Byeon, Jeong-Sik;Park, Chan Guk;Cho, Joo Young;Lee, Soo Teik;Chun, Hoon Jai
Journal of Digestive Cancer Research
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v.8
no.1
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pp.1-50
/
2020
Although surgery was the standard treatment for early gastrointestinal cancers, endoscopic resection is now a standard treatment for early gastrointestinal cancers without regional lymph node metastasis. High-definition white light endoscopy, chromoendoscopy, and image-enhanced endoscopy such as narrow band imaging are performed to assess the edge and depth of early gastrointestinal cancers for delineation of resection boundaries and prediction of the possibility of lymph node metastasis before the decision of endoscopic resection. Endoscopic mucosal resection and/or endoscopic submucosal dissection can be performed to remove early gastrointestinal cancers completely by en bloc fashion. Histopathological evaluation should be carefully made to investigate the presence of risk factors for lymph node metastasis such as depth of cancer invasion and lymphovascular invasion. Additional treatment such as radical surgery with regional lymphadenectomy should be considered if the endoscopically resected specimen shows risk factors for lymph node metastasis. This is the first Korean clinical practice guideline for endoscopic resection of early gastrointestinal cancer. This guideline was developed by using mainly de novo methods and encompasses endoscopic management of superficial esophageal squamous cell carcinoma, early gastric cancer, and early colorectal cancer. This guideline will be revised as new data on early gastrointestinal cancer are collected.
Lee, Seungmin;Youn, Han Deok;Chang, Hanseok;Won, Sinae;Kim, Kyung Hwan;Oh, Bum Jin
Journal of The Korean Society of Clinical Toxicology
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v.16
no.2
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pp.131-140
/
2018
Purpose: The National Emergency Medical Center has been running a project for the storage and delivery of antidotes for acute poisoning patients of the Department of Health and Welfare, Korea. This study analyzed the results of this project over the past two years. Methods: The requests received by the National Emergency Medical Center and the data on the delivery process were analyzed. Results: This study analyzed a total of 121 patients with acute poisoning, who were requested to receive an antidote reserved at 20 key hospitals in 2015-2017, and whose age was $52.3{\pm}23.5\;years$; old; 54 were women. Intentional poisoning were 58.7%, and the home was the most common place of exposure (66.9%). The toxic substances were chemicals (32.2%), pesticides (27.3%), medicines (24.8%), and snake venom (4.1%). The patient's poison severity score was $2.4{\pm}0.7$ (median 3) indicating moderate-to-severe toxicity. Antidote administration was the cases treated in key hospitals 67.8% (82/121), in which transferred patients accounted for 57.3% (47/82). After receiving an antidote request from a hospital other than the key hospitals, the median was 75.5 minutes (range 10 to 242 minutes) until the antidote reached the patient, and an average of 81.5 minutes was required. The results of emergency care were intensive care unit (70.3%), general wards (13.2%), death (10.7%), and discharge from emergency department (5.0%). Conclusion: This study showed that the characteristics of acute poisoning patients treated with an antidote were different from previous reports of poisoned patients in the emergency department, and basic data on the time required for delivery from key hospitals was different.
High-Resolution thoracic CT (HRCT) is a scanning protocol in which thin slice thickness and sharpness algorithm are utilized to enhance image resolution for diagnosis and assessment of interstitial lung disease (ILD). This examination is sometimes performed in both supine and prone position to improve sensitivity to early changes of these conditions. Anatomical structures (the size of lung field and heart and descending aorta) of 150 patients who underwent HRCT were retrospectively compared. HRCT had been conducted in two positions (supine and prone). Data were divided into five groups according to patient body weights (from 40 to more than 80kg, 10kg intervals, 60 patients/each group). Quantitative analysis was utilized in Image J program. In the supine position defined as the control group, the average values of lung fields and heart size and aorta were compared with the prone position defined as the experimental group. The size of the lungs was found to be higher in the supine position, and it was confirmed that there was a statistically significant difference in patients over 70 kg (p<0.05). In addition, both sizes of the heart and descending aorta were larger in prone position, but in the case of the heart, there was no correlation with the presence or absence of ILD disease (p>0.05). Also, the area of prone in the descending aorta was higher than supine position, but there was no statistically significant difference between supine and prone position (p>0.05). In conclusion, when the severity of ILD disease was severe, there was no statistically significant difference in the area difference between supine and prone position, so it is considered that it will be helpful in diagnostic decision.
Hong, Myeong Hee;Yoo, Joo Wha;Kim, Soon Ai;Lee, Jeong Rim;Roh, Na Ri;Park, Jeong Eun;Gu, Mee Ock
Journal of Korean Clinical Nursing Research
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v.15
no.3
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pp.61-74
/
2009
Purpose: In order to increase the quality of nursing care for patients with diabetes mellitus, it is important for clinical nurses to accept changes in diabetes knowledge and correct their approach immediately. This approach will also contribute to effective nursing practice. Methods: The study was designed to investigate the level of knowledge and diffusion of knowledge for nursing care of patients with diabetes mellitus among clinical nurses. It was conducted with nurses from 29 general hospitals in Korea from November 3 to December 5, 2008. The questionnaire consisted of 129 items and it was sent to the participants by mail. Of the 1,060 questionnaires returned, only 930 were valid for use in the statistical analysis. Results: 1) The average score for clinical nurses' knowledge of diabetes mellitus was 0.67 out of 1.0. 2) The level of persuasion of knowledge for nursing care of patients with diabetes mellitus averaged 0.64 out of 1.0 3) The level of practical application of knowledge for nursing care of patients with diabetes mellitus averaged 1.05 out of 2.0, indicating that they applied their knowledge 'sometimes'. 4) The level of diffusion of knowledge for nursing care of patients with diabetes mellitus was 2.37 out of 4.0 and level was estimated as the stage of 'persuasion'. 5) There were significant differences in nursing knowledge of diabetes mellitus, according to experience in practical education for diabetes mellitus. Conclusion: The results indicate that nurses with a lower level of knowledge of diabetes mellitus have a lower level of persuasion of knowledge for nursing care of patients with diabetes mellitus and lower practical application. To improve the level of nurses' knowledge of diabetes mellitus, practical training programs are needed for areas in which knowledge level is low, such as 'diagnosis and management of diabetes mellitus', 'oral diabetes medication', and 'glucose control in special conditions'.
CareDose 4D which is the Siemens's Automatic Exposure Control (AEC) can adjust the level of radiation dose distribution which is based on organ characteristic unlike other manufacturer's AEC. Currently, a wide scan range containing different organs is sometimes examined at once (defined as one scan). The purpose of this study was to figure out which organ characteristic option is suitable when one scan method is utilized. Two types of anthropomorphic phantoms were scanned in the same range which were from frontal bone to carina level according to three different organ characteristics such as Thorax, Abdomen, and Neck. All scans and image reconstruction parameters were equally applied and radiation dose were compared. Radiation dose with Thorax organ characteristic was lower than that with Neck. Also, that with Abdomen oran characteristic was lower than Thorax. There were significant differences in radiation dose according to different organ characteristics at the same parameters (P<0.05). Usage of Neck organ characteristic had a result of the highest radiation dose to all phantom. On the other hand, utilization of Abdomen organ characteristic showed the lowest radiation dose. As a result, it is desirable to set appropriate organ characteristic according to examined body part when you checkup patients. Also, when you implement one scan method, selection of Abdomen-based organ characteristic has reduced more radiation dose compared with two different organ characteristic.
Both angiography and interventional procedures accompanied by angiography provide many diagnostic and therapeutic benefits to patients and are rapidly increasing. However, unlike general radiography or computed tomography using the same X-ray, the amount of radiation is quite high, but the dose range can vary considerably for each patient and operator. The high sensitivity of the lens to radiation during cerebral angiography and neurointervention is already well known, and although there are many related studies, it is insufficient to easily reduce radiation in diagnosis and treatment. In this situation, in particular, by adding three-dimensional rotational angiography (3D-RA) to the existing two-dimensional (2D) angiography, it is now possible to make an accurate diagnosis. However, since this 3D-RA acquires images through projection of more radiation than before, the exposure dose of the lens may be higher. Therefore, we tried to analyze whether the radiation dose of the lens can be reduced by moving the lens out of the field range by adjusting the table height and magnification ratio during the examination using 3D-RA. The surface dose was measured using a rando phantom and a radiophotoluminescent glass dosimeter (PLD) and the radiation dose was compared by adjusting the table height and magnification ratio based on the central point. As a result, it was found that the radiation dose of the lens decreased as the table height increased from the central point, that is, as the lens was out of the field of view. In conclusion, in 3D-RA, moving the table position of about 2 cm in height will make a significant contribution to the dose reduction of the lens, and it was confirmed that adjusting the magnification ratio can also reduce the surface dose of the lens.
This study aimed to quantitatively compare the diameters measured directly from the coronal plane or sagittal plane of 2D digital subtraction angiography (DSA) and the cross-sectional area-converted diameters calculated from contrast-enhanced MR (CE-MR) imaging. A retrospective analysis was conducted on 20 patients who underwent both 2D DSA and CE-MR imaging. Firstly, the venous diameters of the superior sagittal sinus (SSS) and transverse sinus (TS) were directly measured from 2D DSA. Subsequently, the axial planes for SSS diameter and the sagittal plane for TS in CE-MR imaging were utilized to calculate cross-sectional area-based converted diameters. The numerical values obtained from 2D DSA and CE-MR imaging were compared pairwise at each location. For SSS, the diameter measured by 2D DSA was 27% larger than the conversion-based diameter from CE-MR imaging (9.8±1.4 mm vs. 7.1±1.3 mm, P<0.05). Similarly, for the right TS, the difference was 16% (8.8±3.2 mm vs. 7.4±2.0 mm, P<0.05), and for the left TS, the difference was 22% (8.4±2.8 mm vs. 6.6±1.3 mm, P<0.05). In conclusion, the diameter measured directly in conventional 2D DSA may be larger than the diameter converted based on the cross-sectional area. Therefore, when selecting the size of the stent, it is crucial to make precise determinations while keeping this fact in mind.
This study has been designed to collate distribution, morphology, petrology of columnar joint in South Korea. Reported columnar joint areas in South Korea are 68, until the present time. These can be divided into five group by geography and volcanic activity. 1) The 16 columnar joint areas are distributed in Hantangang region. The 15 areas in this region are composed of basaltic lava in the Quaternary period, and the other 1 area is composed of volcanic rocks in the Cretaceous period. 2) The 18 columnar joint areas are distributed in Jeju island. Most of them are composed of basaltic lava(alkali basalt and Hawaiite), and the Sanbangsan and Baegrokdam area are composed of trachyte in the Quaternary period. Colonnade, entablature and chisel mark of the columnar joint are typically occur in basaltic lava. 3) The 5 columnar joint areas are distributed into the Ulleung island and Dokdo including Guksubawi. These are consisted of relatively well-formed trachyte columns in the Quaternary period. 4) The 8 columnar joint areas are distributed into the Pohang, Gyeongju and Ulsan region and consist of the Tertiary period volcanic rock. It's shape are dome, radial, horizontal and vertical. The 4 columnar joint areas are reported in the Pyeongtaek and Asan city of Chungcheongnamdo and Gosung of Gangwondo. All of them are the Tertiary period basalt. 5) The 15 columnar joint areas are distributed into the west and south coast region. Those are consisted of various rock type(from basalt to dacite), various occurrences(lava flow to welded tuff), and various diameters(20 cm to several meters). The columnar joint of Mudeung mountain and Juwang mountain are welded tuff in the Cretaceous period. The columnar joint is distributed over a wide area in South Korea, 5 in Gangwondo, 13 in Gyeonggido, 2 in Chungnam, 14 in Gyeongbuk, 1 in Jeonbuk, 10 in Jeonnam, 5 in Gyeongnam, and 18 in Jeju. The columnar joints in South Korea can be arranged in order of formative period, 18 in the Cretaceous period, 12 in the Tertiary period, and 38 in the Quaternary period. By magma series, 36 are belong to alkaline series and 32 are belong to sub-alkaline series.
Ahn, Jun Seok;Kim, Eun young;Cho, Maeng Je;Hong, Jin Pyo;Hahm, Bong-Jin;Chung, In-Won;Ahn, Joon-Ho;Jeon, Hong Jin;Seong, Su Jeong;Lee, Dong-Woo
Korean Journal of Psychosomatic Medicine
/
v.24
no.2
/
pp.174-183
/
2016
Objectives : The aim of this study is to evaluate difference of somatic symptoms of anxiety disorder and major depressive disorder and domainal association with suicidal idealization, plan, and attempts. Methods : A total of 359 adults diagnosed with major depressive disorder and anxiety disorder of last one year participated. Participants interviewed with certain sections of Korean version of Composite International Diagnostic interview of CIDI. Sections of interests includes questionnaires regarding somatic symptoms and suicidal idea, plan and attempts of last one year. Results : Chest pain shows more prevalence in major depressive disorder. Symptoms of Headache and loose stool are more prevalent in anxiety disorder. Difficulty in equilibrium and fainting spells are more common somatic complaints of co-diagnosis states of anxiety disorder and major depressive disorder. Comparing 3 domains of pain symptoms, gastrointestinal symptoms and pseudo-neurological symptoms, pain symptom domains, gastrointestinal symptoms domain shows significant statistic difference between diagnosis. Average somatic symptom numbers of each symptom domains increase through suicidal idealization, plan and attempt, accordingly. Conclusions : Our finding shows some of somatic symptoms are more prevalent at certain diagnosis. Since increasing numbers of somatic complaints of each symptom domains goes with the suicidal idealization to suicidal attempts, proper psychiatric evaluation and consultations are crucial for patients with numerous somatic complaints in non-psychiatric clinical settings.
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