Background: Thoracic trauma is one of the leading causes of morbidity and mortality in developing countries. A rib fracture that is secondary to blunt thoracic trauma is an important indicator of the severity of the trauma. The purpose of study was to determine the morbidity and mortality rates and the management of rib fractures. Material and Method: We performed a retrospective study that involved all the blunt trauma patients with rib fractures, excluding those that were transferred to other hospital within 3 days, that were seen at our hospital between May 2002 and December 2008. Of the 474 admitted patients, 454 met the inclusion criteria. There were 356 male and 98 females, and their overall mean age was 53 years (range: 5~90 years). The outcome parameters included the mechanism of injury, the number of fractured ribs, the length of stay in the ICU, the Injury Severity Score (ISS), the length of the hospital stay, the pulmonary complications and the mortality. Result: The mechanism of trauma included traffic accidents in 189 (41.7%) cases, slipping down in 103 (22.7%) cases, falls in 85 (18.7%) cases, cultivator accidents in 30 (6.6%) cases, industrial accidents in 32 (7.0%) cases and assault in 15 (3.3%) cases. Intrathoracic injury was noted such as hemothorax in 269 (59.3%) cases, pneumothorax in 144 (31.7%) cases, pulmonary contusion in 95 (20.9%) cases, subcutaneous emphysema in 29 (6.4%) cases and great vessel injury in 5 (0.1%) cases. Conservative treatment was administered to most of the patients. Tube thoracostomy was administered in 234 (51.5%) cases, whereas thoracotomy was performed in 18 (4.0%) cases. The mean duration of thoracostomy was $5.2{\pm}6.2$ days. Most of the cases with rib fracture were treated in wards and their mean duration of hospital stay was $22.5{\pm}20$ days. The mean Injury Severity Score (ISS) was $14.8{\pm}10.9$ (range: 3~75). The mortality rate was calculated to be 4.8% (n=22). The main factors correlated with an adverse outcome were the number of ribs fractured, the duration of thoracostomy and pulmonary disease. Industrial insurance affected the length of hospitalization. Pulmonary contusion and the Injury Severity Score (ISS) affected the mortality. Conclusion: Rib fractures are a indicator of severe injury. Because of the complication and associated injuries, we believe these patients should be admitted for evaluation and treatment. Recent studies on the impact of rib fractures after blunt trauma have shown that patients as young as 40 years of age demonstrate increased morbidity and mortality with similar injuries as compared to that of older patients. The ISS and pulmonary contusion influenced the mortality rate. Patients with isolated rib fractures should be hospitalized if the number of fractured ribs is one or more.
Kim, Jung-Sook;Kim, Ji-Hyeon;Ha, Soo-Min;Hynn, Su-Jin;Yoon, Byeong-Kon;Kim, Do-Yeon
Journal of the Korean Applied Science and Technology
/
v.35
no.2
/
pp.519-531
/
2018
The purpose of this study was to investigate the effects of combined exercise program on short physical performance battery, bone mineral density and parathyroid hormone levels in elderly women. This study subjects were 22 elderly female volunteers, aged 65-75 years and they divided into the combined exercise group(n=11) and the "no exercise" control group(n=11). The combined exercise included the line dance program performed twice per week for 60 minutes and the resistance exercise program performed once per week during 12 weeks. Exercise intensity was progressively increased from RPE "fairly light" to "slightly hard" (from 11 to 14). The findings of this study were as follows; Short physical performance battery(Balance test, gait speed, and rising from a chair five times) and bone mineral density (lumbar spine L2~L4 bone densities, and the T-score) were significantly increased after 12 weeks in the exercise group compared to the baseline. The PTH level was significantly decreased in the exercise group compared to the baseline. In conclusion, regular and continuous physical activity was effective for improving short physical performance and had a positive effect on bone mineral density and parathyroid hormone. With aging, women have decreased muscle strength and bone density and therefore, it is strongly recommended that women need to carry out continuous physical activity to prevent disease and ensure a healthy retirement.
Purpose : In Rett syndrome patients, the incidence of sudden death is greater than that of the general population, and cardiac electrical instability including fatal cardiac arrhythmia is a main suspected cause. In this study, we are going to find out the possible cause of the higher risk of sudden death in Rett patients by the evaluation of heart rate variability, a marker of cardiac autonomic activity and corrected QT intervals. Methods : Diagnosis of Rett syndrome was made by molecular genetic study of Rett syndrome (MECP2 gene) or clinical diagnostic criteria of Rett syndrome. Heart rate variability and corrected QT intervals were measured by 24 h-Holter study in 12 Rett patients, and in 30 age-matched healthy children with chief complaints of chest pain or suspected heart murmurs. The were compared with the normal age-matched control. Results : Patients with total Rett syndrome, classic Rett syndrome, and Rett variants had significantly lower heart rate variability(especially rMSSD)(P<0.05) and longer corrected QT intervals than age-matched healthy children(P<0.05). Sympathovagal balance expressed by the ratio of high to low frequency(LF/HF ratio) also showed statistically significant differences between the three groups considered(P<0.05). Conclusion : A significant reduction of heart rate variability, a marker of autonomic disarray, suggests a possible explanation of cardiac dysfunction in sudden death associated with Rett syndrome.
We studied 90 patients(179 femoral heads) with avascular necrosis of femoral head, who had been performed X-ray, bone scan and MRI to compare of the findings of AVN on bone scan between each other, retrospectively. The patients were 82 males and 9 females, their mean age was 45 years. Radiographic stages were classified by Steinberg modification, radionuclide stages were classified as followed; stage o(or type 0) : normal, stage 1 : faint ring like uptake around the femoral head, stage 2: intense ring like uptake, stage 3: irregular increased uptake with central photon defect, stage 4 : Intense diffuse increased uptake at femoral head and stage 5 : hip joint deformity with relatively mild increased uptake. The findings of MRI were classified according to extent, location, early or advanced lesion, signal intensity of the lesion and joint effusion. 156(87%) of 179 femoral heads had avascular necrosis, 68(75.5%) of 90 patients had bilateral AVN, 35 femoral heads had early stage and 120 had advanced stage. The detection rate of AVN by X-ray and bone scan were 85% (134), 91.6% (143), respectively. Early AVN with atypical types of bone scan showed larger extent, moderate to large amount of joint effusion, soft tissue hypertrophy within joint, and secondary degenerative changes. Bone scan had relatively high detection rate in the diagnosis of AVN of femoral head, and demonstrated various types depending on the disease stage.
The granites in the southern Gimcheon area can be divided into two parts, marginal hornblende biotite granodiorite (Mgd) and central biotite granodiorite to granite (Cgd). Mgd and Cgd are gray in color and display gradational contact relations and are mainly composed of coarse-grained and medium-grained rocks, respectively. Mgd has more frequent and larger mafic enclaves than Cgd, and the two granites partly show parallel foliation at thire contact with gneisses. From representative samples of the granites, K-Ar biotite ages of 197∼207 Ma were obtained. Considering the blocking temperature of biotite, it is suggested that the emplacement age of the granitic magma was probably late Triassic. The anorthite contents of plagioclases in Mgd display less variation than those of Cgd, indicating that Mgd crystallized within a narrow range of temperatures. In the Al$\_$total/-Mg diagram, the biotites from the granites plot within the subalkaline field, and the smooth slope indicates differentiation from a single magma. All amphiboles from the granites belong to magnesio-hornblende. The linear trends of major oxides, AFM and Ba-Sr-Rb indicate that Mgd and Cgd were fractionally differentiated from a single granitic magma body crystallizing from the margin inwards. The relations of modal (Qz+Af) vs. Op, K$_2$O vs. Na$_2$O, Fe$_2$$O_3$ vs. FeO, Fe$\^$+3/(Fe$\^$+3/+Fe$\^$+2/) and K/Rb vs. Rb/Sr show that they belong to I-type and magnetite-series granitic rocks developed by the progressive melting products of fixed sources. REE data, normalized to chondrite value, have trends of enriched LREE and depleted HREE together with weakly negative Eu anomalies.
Oh, Jong Min;Song, Yong Hyun;Hong, Song Pyo;Shin, Young Min;Ko, Young Chin
Journal of the Korean Society of Surveying, Geodesy, Photogrammetry and Cartography
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v.38
no.4
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pp.375-382
/
2020
As the 4th Industrial Revolution era in worldwide, interest in autonomous vehicles is increasing. but due to recent safety issues such as pedestrian accidents and car accidents, as a technical model for this, the demand for 3D HD maps (High Definition maps) is increasing in including lanes, road markings, road information, traffic lights and traffic signs etc. However, since some complementary points have been continuously raised according to demand, It is necessary to collect the opinions of institutions and companies utilizing HD maps and to improve HD maps. This study was conducted by utilizing the results of the contest for usability verification of HD Maps hosted by the National Geographic Information Institute and organized by the Spatial Information Industry Promotion Institute. For this study, we researched HD maps' layers and codes for HD maps object usability to improve HD maps, constructed HD maps object usability items accordingly, and contested usability verification of HD maps according to the items The contestants conducted verification and analyzed the results. As a result, the most frequently used code for each layer was the flat intersection, and the code showing the highest usage rate was a safety sign. In addition, the use rate of the sub-section and height obstacles was 16.67% and 8.88%, respectively, showing a low ratio. In order to utilize HD maps in the future, this study is expected to require research to continuously collect opinions from customers and improve data objects and data models that are actually needed by customers.
Yoo, Eun Jung;Kim, Eun Young;Kook, Hoon;Woo, Young Jong
Journal of The Korean Society of Inherited Metabolic disease
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v.5
no.1
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pp.33-43
/
2005
Purpose: X-linked adrenoleukodystrophy(ALD) is a rare disorder that shows a great deal of phenotypic variability. We subdivided chidhood X-linked ALD patients into several phenotypes by the age at onset, the sites of most severe clinical involvement and the rate of progression of neurologic symptoms. Methods: Thirteen patients who had been diagnosed as X-linked ALD and followed up for at least one year were enrolled from 1996 to 2003. Results: 1. Ten had childhood cerebral ALD, who showed first neurologic symptoms at 7.02 years and progressed rapidly: interval between first symptoms and vegetative state was 1.35 years, and interval from initial symptoms to death was 3.35 years. Treatment with Lorenzo's oil did not prevent neurologic progression. Two patients who underwent umbilical cord blood transplantation died. 2. Two had adolescent cerebral ALD. They had first symptoms at 11.5 years, and showed tendency to progress less rapidly than childhood cerebral form patients. 3. One "Addison only" patient who had adrenal insufficiency without nervous system involvement remained asymptomatic during Lorenzo's oil treatment. 4. All cerebral form patients except one showed the lesions in both parieto-ocipital white matter in brain magnetic resonance imaging. Conclusion: The cerebral ALD was the most common form in childhood and was asoociated with a serious prognosis.
Journal of agricultural medicine and community health
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v.29
no.2
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pp.223-235
/
2004
Objectives: This study was to evaluate the actual condition of falls among community-dwelling elderly people and its related factors to prepare for the establishment of comprehensive prevention programs of senior population. Methods: The study subjects included 460 home residents over 65 years in a district of Chungnam Province and interviews were given to all of them, asking about experiences of falls and their related factors. The analysis of study results came to the following conclusions. Results: The rate of falls among total subjects was 35.5%. With the percentage by age and sex, over 70's and female were significantly higher than male(p=0.000) and under 69 (p=0.008). The groups with poor visual acuity and hearing ability had higher rate of falls than the normal groups based on their health status. In terms of place they experienced falls, out-door occurrence accounted for 53.4% of total falls, which was higher 46.6% of in-door. By season when falls are experienced, "winter" showed the greatest rate, and by time of the day, evening had the highest rate. By causes of falls, "Slippery ground"accounted for 30.5% and "Tumbled over" 23.5% of total falls, respectively, showing the major role of environmental causes for falls. For individual factors, "Irritability" and "Carelessness" occupied 11.3%, 10.8% of total falls, respectively. The Odds Ratios for falls in women was 2.19 times higher than in men, and those in 70's are 2.01 times higher than in 60's, and those with abnormal BMI was 3.68 times higher than in normal groups, and those with perceived symptoms was 1.94 times higher than those without. Conclusions: It is suggested that more consideration should be directed toward taking comprehensive and systematic prevention measures ranging from setting-up the injury-protective environments to allowing senior citizens to have competence in ADL activity as well as proper general health conditions, considering the higher rate of falls for elderly persons in a rural part of this country than that of western countries and the greater proportion of falls which can be ascribed to environmental factors.
The Journal of Korean society of community based occupational therapy
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v.7
no.1
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pp.59-70
/
2017
Objective : The purpose of this study was to examine the effect of virtual reality-based remote rehabilitation on stroke patients systematically and to look for its effect and how to apply it domestically. Methods : In order to search data, EMBASE and CINAHL database were used. Relevant research used those terms of virtual reality, telerehabilitation, and stroke. A total of 10 studies satisfying the selection criteria was analyzed according to their qualitative level, general characteristics, and PICO method. Results : Based on the selected 10 studies, virtual reality-based telerehabilitation system was applied. Sensory and motor feedback was provided with inputting visual and auditory senses through a video in the home environment, and it stimulated changes in the client's nervous system. Tools to measure the results were upper extremity function, balance and gait, activities of daily living, etc. Those virtual reality-based telerehabilitation method had an effect on upper extremity function and ability of sense of balance in all studies, and on the activities of daily living partially. Telerehabilitation service to make up environmental specificity improved satisfaction of client. That meaned the effect of the intervention to maintain the function. Conclusion : The virtual reality-based telerehabilitation system was applied to upper extremity function, sense of balance, and activities of daily living largely, and it showed that it helped to improve functions through intervention, supervision, and training of therapist in the home environment as well. This study suggests the basis and possibility of clinical application on virtual-reality based telerehabilitation. Additional research is needed to diverse virtual reality intervention methods and the effect of telerehabilitation in the future.
The Dinosaur track-bearing deposits recently found at Bangudae Petroglyph site in Ulju (National Treasure No. 285) have been studied in the aspects of sedimentology, paleoenvironments, and significance in natural history. The dinosaur tracks occur in the Daegu Formation (late Early Cretaceous), and over 80 footprints including 43 ornithopod footprints, 36 sauropod footprints, and 2 theropod footprints are preserved in this tracksite. The track-bearing deposits consist of irregularly interlaminated siltstone and mudstone, calcareous sandy to silty mudstone, thin-bedded tuffaceous sandstone, planar- to cross-laminated sandstone, and thin- to medium-bedded graded sandstone, and they are interpreted to be sheetflood deposits on an alluvial plain. Diverse types of ripples and mudcracks, rainprints, and invertebrate trace fossils are observed in these deposits, and the crest-lines of wave ripples do not show preferred orientation. Dinosaur footprints occur as true prints, underprints, overtracks, and casts on the bedding surfaces, and the orientation of trackways are scattered. It is interpreted that paleoclimatic condition of the track-bearing deposits were semiarid with alternation of wetting and drying periods, and that dinosaurs frequented small and shallow ponds during wetting periods and recorded their tracks on an alluvial plain. The frequent occurrence of dinosaur tracks in study area indicates that the Cretaceous deposits around Daegokcheon Stream are very useful sedimentological and paleontological records to understand the paleoecology and paleoenvironments during the dinosaur age in Korean Peninsula. Consequently the dinosaur track-bearing deposits around Daegokcheon Stream should be further studied in sedimentary geology and paleontology in order to enhance cultural heritage value of the Petroglyphs of Bangudae Terrace as the World Heritage.
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