• Title/Summary/Keyword: 5-year-old

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Analysis of the Risk Factors Influencing the Severity of Injury in Pediatric Multiple Trauma Patients (소아 다발성 외상 환자의 중증도에 영향을 미치는 위험인자에 관한 분석)

  • Lee, Gang-Wook;Kim, Sun-Pyo;Kim, Seong-Jung;Cho, Soo-Hyung;Cho, Nam-Soo
    • Journal of Trauma and Injury
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    • v.23 no.2
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    • pp.68-74
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    • 2010
  • Purpose: The purpose of this study is, first, to analyze the risk factors that influence the severity of injury in pediatric multiple trauma patients and, second, to present solutions for the problems related to the treatment of such patients. Our living situations are so complicated that the danger of accidents is truly open to children who are not prepared. We need to draw attention to the increased numbers of various accidents involving children. Methods: We studied patients who visited the Emergency Medical Center at Chosun University Hospital from January 1, 2006, to December 31, 2008. Using medical records, we evaluated the general characteristics: the mechanism of injury, the vital signs, the revised trauma score (RTS), the injury severity score (ISS), and the hemoglibin value, which was checked at the time of visit, and the presence or the absence of emergent on regular surgery. We divided the level of injury as follows: light level (1-8 points), mid level (9-15 points), and serious level (above 16 points). We analyzed the medical data by using SPSS 17.0 for windows. Results: The average age of the patients examined was 8.6 years. The number of 6- to 11-year-old patients was 96, which was the largest, but the degree of injury severity was the highest among infant (0-2 years), according to ISS 7.95(${\pm}6.85$). The frequency of accidents was highest on sunny days, and most accidents occurred from 16:00 to 20:00. The cause of multiple trauma for children was the greatest in the traffic accident, (95 patients, 49.0%). In addition, the trauma caused by traffic accidents showed the highest ISS value ($9.02{\pm}6.42$) and the most serious degree (P=0.004). The ISS level of injury ($8.40{\pm}6.64$) for patients moved from a secondary hospital was higher than that ($6.49{\pm}5.57$) for patients who visited the medical center directly. The severity of injury was highest for patients who used a 119 ambulance ($8.84{\pm}5.80$). According to the injured parts of body, Injuries to the arms and the feet most frequent (79 patients, 40.7%), but the level of injury was the highest for internal organs and chest, $16.42{\pm}8.56$ and $11.23{\pm}6.97$, respectively. Conclusion: We used Abbreviated Injury Scale (AIS) in order to examine the characteristics by injured body part for pediatric multiple trauma patients. Because the degree of injury was the highest for internal organs or the chest, we need to more seriously examine and provide for patients who are suspected of having injuries to the internal organs or the chest. We need to quickly determine the need for surgery in patients with serious injuries to the arms and the feet, which is the greatest in frequency. In particular, we need to consider the surgical care of patients who are not very high in the severity of injury to their brains.

Effect of Tuberculin Skin Test on Ex-vivo Interferon-gamma Assay for Latent Tuberculosis Infection (투베르쿨린 검사가 결핵에 대한 체외 IFN-γ 검사 결과에 미치는 영향)

  • Lee, Jung Yeon;Choi, Hee Jin;Cho, Sang-Nae;Park, I-Nae;Oh, Yeon-Mok;Lee, Sang Do;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong;Shim, Tae Sun
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.4
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    • pp.406-412
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    • 2005
  • Background : Recently, two commercialized whole-blood assays, $QuantiFERON^{(R)}-TB$ Gold (QFT) and T $SPOT-TB^{(R)}$ (SPOT), which measure the $IFN-{\gamma}$ released in the whole blood after being incubation with mycobacterial antigens, were approved for the diagnosis of a latent tuberculosis infection (LTBI). However, there is data on whether or not the previously used PPD skin tests (TST) have any influence on the diagnostic ability of these ex-vivo $IFN-{\gamma}$ assays. Methods : Forty-six 15 year-old students who did not appear to be infected with Mycobacterium tuberculosis were enrolled in this study. The peripheral blood was collected and used for two $IFN-{\gamma}$ assays. The $IFN-{\gamma}$ assays and TST were performed at the baseline ($1^{st}$). The TST was repeated two months later ($2^{nd}$), and the $IFN-{\gamma}$ assays were repeated two ($2^{nd}$) and four months ($3^{rd}$) later only in those subjects who had negative results at the baseline in both the $IFN-{\gamma}$ assays and TST. An induration size > 10 mm was considered to be positive in the TST. Results : The mean TST value was $3.1{\pm}5.4mm$ (range: 0-20). Of the 46 subjects examined, 13 subjects (28.3%) showed positive results in the two-step TST. Nine (19.6%) were SPOT-positive and only one (2.2%) was QFT-positive. The $2^{nd}$ and $3^{rd}$ QFT were carried out in 23 and 25 all-negative subjects, respectively, and all showed negative results. The $2^{nd}$ SPOT was performed in 23 subjects and only one (4.3%) showed a weak-positive result. Conclusion : Even though there were some discrepancies in the results of the two ex-vivo $IFN-{\gamma}$ assays, it appears that their results were not influenced by a previous TST carried out in two or four months earlier.

A Comparison of Herbage Use, Grazing and Social Behaviour by Livestock Grazing under Grassland Types (초지류형별(草地類型別) 방목축(放牧畜)에 의한 목초이용(牧草利用)과 방목(放牧) 및 사회습성(社會習性) 비교(比較))

  • Lee, In Duk;Myoung, Jeon;Seong, Woo Suk;Raim, Dong Chan
    • Korean Journal of Agricultural Science
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    • v.13 no.2
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    • pp.219-226
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    • 1986
  • A study was conducted to provide direct comparisons of the effect of variations in herbage use, grazing and social behaviour upon the flat, slope and forest grassland with a total 30 Korean Native Cattle and 5 Korean Native Goats under 4-year old grassland established by intensive sowing method in Daecheon. The results obtained are summarized as follows; 1. Relative intake index, dry matter intake per animal and dry matter digestibility by Korean Native Goats in flat, slope and forest grassland were 35.2%-462g-63.7%, 35.0%-459g-63.0% and 29.8%-391g-62.1%, respectively. 2. Grazing time by Korean Native Cattle was not different among the grassland types, but ruminating time was increased in slope grassland, whereas in forest grassland was decreased. Resting time was increased in forest grassland, whereas in slope grassland was decreased. Walking time was increased in flat grassland, but loafing time was increased in forest grassland. The number of rumination, chews per bolus and defecation number were decreased in forest grassland. The number of drinks, total drinking water and walking distance were increased in slope grassland. 3. Animal distance, occupied area per animal and sub group formation by Korean Native Cattle in flat, slope and forest grassland were $3.4m-11.9m^2-3.6head$, $3.56m-11.0m^2-3.7head$ and $3.70m-14.6m^2-3.4head$, respectively. The order of grazing movement was similar to the pear-shaped grazing formation, but the relations of dominance between first grazer and last grazer upon different grassland types was not clear.

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Characteristics of Photosynthesis and Respiration in Fraxinus rhynchophylla Hance and Fraxinus mandshurica Rupr. Leaves (물푸레나무와 들메나무엽(葉)의 광합성(光合成)과 호흡(呼吸)의 특성(特性))

  • Han, Sang Sup;Sim, Joo Suk
    • Journal of Korean Society of Forest Science
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    • v.78 no.3
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    • pp.280-286
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    • 1989
  • The present study was to examine the effects of light, temperature, and water stress on the photosynthesis and respiration rates and its seasonal changes in 3-Year-old Fraxinus rhynchophylla and Fraxinus mandshurica seedlings raised in pot in nursery. The results obtained are as follows: 1. The estimated light compensation points at which net photosynthesis approached zero were 35 and $28{\mu}Em^{-2}\;s^{-1}$ for F. rhyrachophylla and F. mandsdzurica leaves, respectively, The light saturation points occurred at $700{\mu}Em^{-2}\;s^{-1}$ in these species. 2. The maximum rates of net photosynthesis of leaves occurred at about $25^{\circ}C$ in F. rhynchophylla and at $20^{\circ}C$ in F. mandshurica. 3. The decrease in net photosynthetic rates of leaves began at -13 bars in F. rhynchophylla and -10 bars in F. mandshurica, and then its rates approached approximately zero at -23 bars in F. mandshurica and -29 bars in F. rhynchophylla. 4. The dark respiration rates of leaves were similar from $10^{\circ}C$ to $40^{\circ}C$ between these species, Also these increased from -10 bars to -28 bars, and then decreased remarkably in these species. 5. The net photosynthetic rates of leaves of F. mandshurica were higher than those of F. rhynchoplaylla until June, and after that lower than F. rhynchophylla. The dark respiration rates of leaves of F. rhynchophylla were higher than those of F. mandshurica from June to August, and After that similar between these species. 6. The respiration rates of stem and root were highest in April during the growing season. These values of F. rhynchophylla were slightly higher than those of F. mandshurica throughout the growing season.

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The Result of Bone Grafting for Fibrous Dysplasia (섬유성 골 이형성증에서 시행한 골 이식술의 결과 분석)

  • Jeong, Won-Ju;Kim, Tae-Seong;Cho, Hwan-Seong;Yoon, Jong-Pil;Park, Il-Hyung
    • The Journal of the Korean bone and joint tumor society
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    • v.20 no.2
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    • pp.74-79
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    • 2014
  • Purpose: Fibrous dysplasia is related to the mutation of gene encoding the alpha-subunit of a signal-transducing G-protein and has variable clinical course. Operation can be performed to prevent functional disorder or structural deformity. After curettage, autologous bone graft were used to fill the defects after curettage. The aim of this study is to compare the result of autogenous cancellous bone grafting and allogenic bone grafting for fibrous dysplasia. Materials and Methods: Among the patients who visit our hospital during the period of April, 1997 to October, 2013, we selected 34 patients who diagnosed fibrous dysplasia and visited our clinic over 1 year. There were 13 males and 21 females. Average age was 26.4 (range 2 to 57) years old. Autogenous bone graft (group I) in 5 cases, Non-autogenous bone graft (group II) in 30 cases. Iliac bone is used in all cases of autogenous bone graft. There were no significant difference in age, follow-up period, preoperational laboratory finding between two groups. Radiographic image was done to evaluate the recurrence of fibrous dysplasia or secondary degeneration. Results: There were four cases in recurrence (group I: 1 case, group II: 3 cases, p=0.554). In all recurrent cases, reoperations were done using curettage and autogenous iliac bone graft. There was no re-recurrence after reoperation. One case of secondary aneurysmal bone cyst was confirmed (group II) and 1 cases of pathologic fractures had developed (group I: 0 case, group II: 1 cases, p=0.559). No malignant change occurred. Conclusion: There were no significant difference between autogenous bone graft group and non-autogenous bone graft group. Our result suggested that autogenous bone graft seems to be good method to treat fibrous dysplasia, in the case of small volume of tumor lesion or non-weight bearing portion.

Stress distribution following face mask application using different finite element models according to Hounsfield unit values in CT images (CT상의 HU 수치에 따른 상악골 전방견인 효과의 유한요소 분석)

  • Chung, Dong-Hwa
    • The korean journal of orthodontics
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    • v.36 no.6
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    • pp.412-421
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    • 2006
  • Objective: The result of finite element analysis depends on material properties, structural expression, density of element, and boundar or loading conditions. To represent proper elastic behavior, a finite element model was made using Hounsfield unit (HU) values in CT images. Methods: A 13 year 6 month old male was used as the subject. A 3 dimensional visualizing program, Mimics, was used to build a 3D object from the DICOM file which was acquired from the CT images. Model 1 was established by giving 24 material properties according to HU. Model 2 was constructed by the conventional method which provides 2 material properties. Protraction force of 500g was applied at a 45 degree downward angle from Frankfort horizontal (FH) plane. Results: Model 1 showed a more flexible response on the first premolar region which had more forward and downward movement of the maxillary anterior segment. Maxilla was bent on the sagittal plane and frontal plane. Model 2 revealed less movement in all directions. It moved downward on the anterior part and upward on the posterior part, which is clockwise rotation of the maxilla. Conclusion: These results signify that different outcomes of finite element analysis can occur according to the given material properties and it is recommended to use HU values for more accurate results.

Simultaneous Elevation of Serum Parathyroid Hormone(PTH) and Parathyroid Hormone-related Protein(PTHrP) in a Case of Lung Cancer with Hypercalcemia (고칼슘혈증을 보인 폐암환자에서 부갑상선호르몬(PTH)과 부갑상선호르몬관련단백질(PTHrP)이 동시에 증가된 1예)

  • Kim, Yu-Il;Kim, Kyu-Sik;Yu, Young-Kwon;Park, Chang-Min;Rim, Myung-Soo;Ko, Kyung-Haeng;Hwang, Jun-Hwa;Park, Hyeong-Kwan;Lim, Sung-Chul;Kim, Young-Chul;Park, Kyung-Ok
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.4
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    • pp.525-532
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    • 1999
  • The parathyroid hormone related protein (PTHrP) is the most common causative peptide of humoral hypercalcemia of malignancy. In contrast, the serum level of parathyroid hormone (PTH) is low to undetectable in the majority of patients with malignancy associated hypercalcemia. Few cases exist in which the production and secretion of PTH by malignant nonparathyroid tumors have been authenticated. To our knowledge, there is very rare case in which a nonparathyroid tumor expressed simultaneously both the PTH and PTHrP. We report a case of squamous cell carcinoma of the lung with hypercalcemia which presented with simultaneous elevation of serum PTH and PTHrP. Severe hypercalcemia (serum calcium, 7.5 mEq/L) was found in a 65-year-old man who had a squamous cell carcinoma of the lung without any bony metastasis and detectable parathyroid abnormalities on isotope scintigraphy. The serum level of intact parathyroid hormone (PTH) con centration was markedly elevated as measured in two site radioimmunoreactive PTH assays (intact PTH 150 pg/mL ; normal 9~55). The serum level of a PTHrP was also increased as measured in C-terminal region specific radioimmunoassay (PTHrP 99.1 pmol/L; normal 13.8~55.3). There are no evidences of coincidental primary hyperparathyroidism in parathyroid MIBI scan and other imaging studies including neck ultrasonography and computed tomography. These results suggest that simultaneous elevation of serum PTH and PTHrP in this patient can be caused by production of both PTHrP and PTH in other nonparathyroid lesions such as squamous cell carcinoma.

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Giant Coronary Artery Aneurysm Presenting as a Calcified Mediastinal Mass a, Coronary Artery Fistula - A case report - (종격동 종양으로 오인된 거대관상동맥류와 관상동맥루 - 치험 1례 -)

  • Yoon, You-Sang;Lee, Cheol-Joo;Choi, Ho;Kang, Jun-Kyu;Choi, Jin-Wook;Kim, Hyung-Tae
    • Journal of Chest Surgery
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    • v.34 no.10
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    • pp.787-791
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    • 2001
  • Coronary artery aneurysm is a rare disorder. It is defined as abnormal dilatation of coronary artery with diameter exceeding 1.5 times the adjacent normal segments. The incidence of coronary aneurysm is 2.6% in Caucasians and 0.25% in Asians. Over half of the former were associated with atherosclerotic coronary artery disease. However, 70 percents of the latter were nonobstructive coronary artery aneurysms. Coronary artery fistula is a rare disorder. It has been identified in only 0.2% of routine cardiac angiographic studies conducted over a 10-year period. The clinical spectrums are various, asymtomatic, asymptomatic murmur, dyspnea on exertion, fatigue, and congestive heart failure. The right coronary artery (56%) and left coronary artery(36%) are mainly involved in the origin site of congenital coronary artery fistula. The draining site of fistula are right ventricle(39%), right atrium(33%), and pulmonary artery(20%) and so on. This 54 years-old woman had intermittent chest tightness and an abnormal mediastinal shadow on chest roentgenogram and chest C-T examination, which was diagnosed as a mediastinal mass such as teratoma. We performed the operation under left anterolateral thoracotomy for mass excision. However, we knew the mass had the pulsating arterial blood flow through a fine needle puncture of the mass and that it was attached to the left ventricle. We believed the excision of mass on beating heart would be very dangerous. Therefore, we closed the wound without excising the mass. After several days, we performed an echocardiography and coronary angiography, We knew it was cardiac tumor. Incidentally, the patient had a tortuous coronary fistula from the right coronary artery to pulmonary trunk. Using cardiopulmonary bypass with moderate systemic hypothermia, the mass was resected and the fistula was clipped with surgical clips. Pathology of the specimen was a giant coronary arterial aneurysm.

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Comparative Study of Cyclioxygenase-2 Expression and HER-2/neu Amplification in Korean and Caucasian Women with Early-Onset Breast Carcinoma (한국인과 백인 젊은 여성 유방암 환자에서 Cyclooxygenase-2 발현과 HER-2/neu 증폭의 비교 연구)

  • Choi, Doo-Ho;Kim, Eun-Seog;Kim, Yong-Ho;Jin, So-Young;Lee, Dong-Wha;Haffty, Bruce G.
    • Radiation Oncology Journal
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    • v.22 no.4
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    • pp.307-315
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    • 2004
  • Purpose: The purpose of this work was to study the differences of cyclooxygenase (COX-2) expression between Korean and Caucasian patients with early-onset breast carcinoma by immunohistochemistry. The test were analyzed to find a correlation between COX-2 and other biomarkers including HER-2/neu amplification, because we previously reported that a significant difference had been found in the expression of HER-2/neu between the two races. Furthermore, we investigated prognostic significance of COX-2 in korean patients. Materials and Methods: Sixty Korean women who were diagnosed breast carcinoma at 45 years old or younger and 60 Caucasian women with breast carcinoma were selected for this study. The median age of both groups was 37 years and tumor sizes were distributed evenly between the two group. Paraffin embedded blocks of primary tumor were processed for immunohistochemical staining of COX-2. The COX-2 expression was evaluated according to the percentage of positive cells and the intensity of staining. And the results were compared with the data of the previous studies to find correlation between COX-2 and other parameters and survival data. Results: Proportion of the COX-2 expression in total patients was $27.6\%$. The percentage of tumors that stained positive for COX-2 in korean and Caucasian women with early-onset breast carcinoma were $37.9\%$ and $20.8\%$, respectively. The difference was statistically not significant(p=0.090). Expression of COX-2 was not associated with several clinicopathologic parameters including HER-2/neu overexpression, but negative estrogen receptor status was correlated with significance (p=0.046). The 5 year disease free survival rate for patients with COX-2 expression was $67.9\%$, compared to $81.9\%$ of the COX-2 negative patients and the result was statistically not significant. Conclusions : A significant difference was not found in the expression of COX-2 between the two groups of patients with early-onset breast carcinoma. And correlation between COX-2 and other parameters was not observed except estrogen receptor negativity. Large scaled further research including radiotherapy factors will be needed to identify COX-2 as a prognostic role in patients with early-onset breast carcinoma.

Radiation Absorbed Dose Measurement after I-131 Metaiodobenzylguanidine Treatment in a patient with Pheochromycytoma (갈색세포종 환자에서 Medical Internal Radiation Dose법을 이용한 I-131 Metaiodobenzylguanidine 치료 후 흡수선량 평가)

  • Yang, Weon-Il;Kim, Byeung-Il;Lee, Jae-Sung;Lee, Jung-Rim;Choi, Chang-Woon;Lim, Sang-Moo;Hong, Sung-Woon
    • The Korean Journal of Nuclear Medicine
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    • v.33 no.4
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    • pp.422-429
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    • 1999
  • Purpose: The measurement of radiation absorbed dose is useful to predict the response after I-131 labeled metaiodobenzylguanidine (MIBG) therapy and determine therapy dose in patients with unresectable or malignant pheochromocytoma. We estimated the absorbed dose in tumor tissue after high dose I-131 MIBG in a patient with pheochromocytoma using a gamma camera and Medical Internal Radiation Dose (MIRD) formula. Materials and Methods: A 64-year old female patient with pheochromocytoma who had multiple metastases of mediastinum, right kidney and periaortic lymph nodes, received 74 GBq (200 mCi) of I-131 MIBG. We obtained anterior and posterior images at 0.5, 16, 24, 64 and 145 hours after treatment. Two standard sources of 37 and 74 MBq of I-131 were imaged simultaneously. Cummulated I-131 MIBG uptake in tumor tissue was calculated after the correction of background activity, attenuation, system sensitivity and count loss at a high count rate. Results: The calculated absorbed radiation dose was 32-63 Gy/ 74 GBq, which was lower than the known dose for tumor remission (150-200 Gy). follow-up studies at 1 month showed minimally reduced tumor size on computed tomography, and mildly reduced I-131 MIBG uptake. Conclusion: We estimated radiation absorbed dose after therapeutic I-131 MIBG using a gamma camera and MIRD formula, which can be peformed in a clinical nuclear medicine laboratory. Our results suggest that the measurement of radiation absorbed dose in I-131 MIBG therapy is feasible as a routine clinical practice that can guide further treatment plan. The accuracy of dose measurement and correlation with clinical outcome should be evaluated further.

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