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Prognosis and Clinical Outcome of Alcohol Withdrawal Syndrome in Trauma Patients (외상 환자에서 알코올 금단 증후군의 발생이 예후에 미치는 영향)

  • Oh, Dong Gil;Cho, Min Soo;Bae, Keum Seok;Kang, Sung Joon
    • Journal of Trauma and Injury
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    • v.21 no.2
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    • pp.115-119
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    • 2008
  • Purpose: Abrupt abstinence from alcohol in cause of chronic alcohol addiction can trigger alcohol withdrawal syndrome. The authors studied the effect of post-operative alcohol withdrawal syndrome in patients who require intensive care due to trauma. Methods: For the study group, we selected 70 patients who had undergone emergency surgery from May 2003 to March 2007 due to trauma and who had been treated with prophylactic thiamine. Data was collected retrospectively. We excluded those who extended their hospital stay for other than traumatic causes, those who died within 3 days of surgery after trauma, those who transferred to other institutions, and those who received a psychiatric diagnosis. Patient groups were determined by the existence or the non-existence of withdrawal syndrome. Age, sex, injury mechanism, mortality, complications, durations of hospital stay and intensive care, use of mechanical ventilator, and sedative use were investigated. A Chi-square test and The Mann-Whitney method were used for statistical analysis in this study. Results: Twenty-four (24) patients from the 58 who had an ISS of 16 or more showed alcohol withdrawal syndrome, and men were shown to be affected with the syndrome significantly more than women. Although ISS was higher in the group with alcohol withdrawal syndrome, statistically, the difference was not significant (P<0.08). The total hospital stay in the patient group with alcohol withdrawal syndrome was on average 10 days longer. However, the difference was not significant (P<0.054). The duration of intensive care in the patient group with alcohol withdrawal syndrome was significantly longer (P<0.029). The patients with alcohol withdrawal syndrome showed no significant difference in the duration of mechanical ventilator use (P<0.783), or in the duration of sedative use (P<0.284). Respiratory distress, pneumonia, upper airway infection, sepsis, acute renal failure, and mortality in the alcohol withdrawal syndrome group were investigated, but no statistically significant difference were noted. Conclusion: We found that the duration of intensive care in chronic alcohol abusers was longer due to the development of alcohol withdrawal syndrome. We also discovered that, when the patients overcame the symptoms of alcohol withdrawal syndrome after intensive care, no difference was found in the frequency of developing complications, the morbidity, and the mortality. Therefore, we conclude that intensive care in trauma patients who are chronic alcohol abusers decreases the incidence of complications found in patients with post-operative alcohol withdrawal syndrome and does not adversely impact the prognoses for those patients.

Rational Use of Antimicrobial Agents in Traumatic Simple Wounds (외상으로 인한 상처의 치료에 있어서 선택적 항균제의 효과 및 적응증에 관한 연구)

  • Kim, Jae Eun;Suh, Joo Hyun;Choi, Yoon Hee;Bae, Hyun A;Jung, Jin Hee;Eo, Eun Kyung;Cheon, Young Jin;Jung, Koo Young
    • Journal of Trauma and Injury
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    • v.20 no.1
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    • pp.40-46
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    • 2007
  • Purpose: The primary goal of wound management is to avoid infection. Wounds in all patients presenting to the Emergency Department are contaminated with bacteria. Despite this, there is a low incidence of infection. Unfortunately, physicians continue to use antimicrobial agents indiscriminately. The authors intended to determine the effect of selective antimicrobial agents and the indications for appropriate antimicrobial agent use in traumatic simple wounds. Methods: This prospective study was performed from Jul. 2005 to Aug. 2005. A pilot study had been performed from Nov. 2003 to Jul. 2004 at the Ewha Woman's University Mokdong Hospital. Structured data sheets were completed at the times of the patient's visits to the Emergency Department and to the Outpatient Department for follow-up. Infection was determined at the time of follow-up. The indications of antimicrobial agent use are immunocompromised patients, wounds contaminated for 3 hours or longer, devitalized tissue, and extremity wounds except hand wounds caused by sharp objects. Results: The study enrolled 216 injured patients. The general characteristics of patients and wounds between the two groups were not significantly different. The antimicrobial agent use and infection rate of the pilot study were 227 cases (90.4%) and 10 cases (4.0%), and those of this study were 100 cases (46.3%) and 9 cases (4.1%). In this study, antibiotic use was reduced to almost half compared with the previous study, but the infection rate was similar (p<0.001). Conclusion: Rational use of antimicrobial agents in simple wounds reduced the use of antimicrobial agents in the Emergency Department without increasing the infection rate.

A Study on the Management of Copyright Information for Increasing the Free Use of Government Publications as Public Works (공공저작물로서 정부간행물 자유이용 촉진을 위한 저작권정보 관리에 관한 연구)

  • Seo, Hyeongdeok;Joung, Kyoung Hee
    • Journal of Korean Society of Archives and Records Management
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    • v.22 no.3
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    • pp.125-141
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    • 2022
  • This study aims to suggest measures for handling copyright information on government publications during records and archives management to use them freely as public works according to Article 24-2 of the Copyright Act in Korea. Through email interviews with 17 records managers, persons in charge of government publication management, and government staff with experience in production from April 4 to June 13, 2022, this study determined the current situations and problems related to producing and managing copyright information on government publications. Based on the interview findings, this research suggested the following. First, Article 24-2 of the Copyright Act must be revised to apply the Korea Open Government License (KOGL) type 1 mandatorily to all public works. Second, a cooperative system for managing copyright information on government publications should be established to improve their production and management effectiveness. Third, copyright information, such as authors, copyright holders, copyright duration, information on the copyright property transfer, public works status, and reasons for nonpublic works, must be managed through records and archives management systems. Fourth and last, information on public works must be provided during the registration number application for government publication so that everyone can access the full texts of the publications on the National Archives of Korea website.

A Qualitative Case Study on the old people's Perception of Dignifiable Aging (노인의 품위 있는 노화 인식에 대한 질적사례연구)

  • Kim, So-Young;Kang, Minhee
    • 한국노년학
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    • v.41 no.1
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    • pp.1-24
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    • 2021
  • This study aims to examine how old people think about 'dignifiable aging'. For the study, the authors have tried to understand and analyze of old people's view on 'classy and gracious aging' through their life experiences. The study focuses on the questions of 'how the participants experience aging', 'how they understand well, classy and successful aging and 'how they explain their ideas of the aging, then analyzes their ideas as types of 'within cases' as well as 'inter cases'. Indepth interview has employed as main methodology of data collection with the analysis of concerned written documents such as on-line and off-line essays as secondary data. The collected data had been basically sorted and analyzed by sorting commonimity and differences. Then they have been classified into the thems that indicate meanings and forms of 'dignified aging': 'ageless mind', 'happiness determined by one's mind', 'responsibility on family', 'desire for learning and social activities'. These meaning-units are added up to the main meaning of '(fullfilled) satisfaction through life-values' mediated by 'acceptance and acknowledgement', 'efforts', 'others' gaze', 'dreams and hopes', '(fullfilled) Satisfaction through life-values' can be achieved by 'sharing with others'. An interesting fact is that the meaning-units can be devided into two groups: 'the real life is the ideal life' which explains the actualization of the ideal in the daily life and 'life, conflict, the ideal' in which the real and the ideal are parellel with constant conflicts. In the conclusion, some implications and suggestions derived from the analysis are described from the v iew of social welfare.

Mid-Term Container Forecast for Pusan Port (부산항 컨테이너 물동량의 중간예측)

  • Gu, J.Y.
    • Journal of Korean Port Research
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    • v.11 no.1
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    • pp.1-11
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    • 1997
  • The conventional methods of container forecasting is done through regression methods based on GNP growth trends and by other forecasting methods proposed by several authors. However these efforts prove to be inadequate with visible weakness and a more reasonable approach need to be determined. The succeeding sections elaborate the methodology and approach adopted. The results are then compared through a case study involving the forecast figures derived by the Pusan Port Authority and the values obtained by MRCS model introduced in this paper.

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Determination of shear wave velocity profiles in soil deposit from seismic piezo-cone penetration test (탄성파 피에조콘 관입 시험을 통한 국내 퇴적 지반의 전단파 속도 결정)

  • Sun Chung Guk;Jung Gyungja;Jung Jong Hong;Kim Hong-Jong;Cho Sung-Min
    • 한국지구물리탐사학회:학술대회논문집
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    • 2005.09a
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    • pp.125-153
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    • 2005
  • It has been widely known that the seismic piezo-cone penetration test (SCPTU) is one of the most useful techniques for investigating the geotechnical characteristics including dynamic soil properties. As the practical applications in Korea, SCPTU was carried out at two sites in Busan and four sites in Incheon, which are mainly composed of alluvial or marine soil deposits. From the SCPTU waveform data obtained from the testing sites, the first arrival times of shear waves were and the corresponding time differences with depth were determined using the cross-over method, and the shear wave velocity profiles (VS) were derived based on the refracted ray path method based on Snell's law and similar to the trend of cone tip resistance (qt) profiles. In Incheon area, the testing depths of SCPTU were deeper than those of conventional down-hole seismic tests. Moreover, for the application of the conventional CPTU to earthquake engineering practices, the correlations between VS and CPTU data were deduced based on the SCPTU results. For the empirical evaluation of VS for all soils together with clays and sands which are classified unambiguously in this study by the soil behavior type classification Index (IC), the authors suggested the VS-CPTU data correlations expressed as a function of four parameters, qt, fs, $\sigma$, v0 and Bq, determined by multiple statistical regression modeling. Despite the incompatible strain levels of the down-hole seismic test during SCPTU and the conventional CPTU, it is shown that the VS-CPTU data correlations for all soils clays and sands suggested in this study is applicable to the preliminary estimation of VS for the Korean deposits and is more reliable than the previous correlations proposed by other researchers.

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The Effect of Coffee Consumption on Serum Total Cholesterol Level in Healthy Middle-Aged Men (건강한 중년 남성에서 커피 음용 습관이 혈중 총 콜레스테롤 값에 미치는 영향)

  • Shin, Myung-Hee;Kim, Dong-Hyun;Bae, Jong-Myun;Lee, Hyung-Ki;Lee, Moo-Song;Noh, Joon-Yang;Ahn, Yoon-Ok
    • Journal of Preventive Medicine and Public Health
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    • v.27 no.2 s.46
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    • pp.200-216
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    • 1994
  • In present study, the authors investigated the possible effect of coffee consumption on serum cholesterol level in 1017 men between the ages of 40 and 59 years, who were randomly selected from the members of Seoul Cohort Study. Serum total cholesterol data was collected with other serologic indices (e.g. systolic blood pressure, diastolic blood pressure, hight, weight, etc.) through the program of biennial health check-up offered by Korean Medical Insurance Corporation (KMIC). The amount of coffee consumption was assessed by a self-administered questionnaire through mailing. Other confounding factors, such as age, body mass index, cigarette smoking, alcohol consumption, physical activity, and other dietary intake pattern were also determined by the questionnaire. The differences in means of serum total cholesterol in compared to non consumers were $-0.4{\pm}3.56mg/dl$ for those drinking less than 1 cup a day, $-0.6{\pm}3.60mg/dl$ for those drinking 1 cup a day, and $7.1{\pm}3.41mg/dl$ for those drinking more than 2 cups a day. Since smoking interacted the relationship between coffee consumption and serum total choleaterol, we re-analyzed those relationship in smokers and non-smokers separately Other atherogenic behaviors were well correlated with total cholesterol, so we adjusted the mean values of serum total cholesterol through multivariate model selection with age(r=0.12), total cigarette index (cigarette-years; r=0.10), Quetelet's index ($Kg/m^2$, r=0.16), daily calory expenditure (kcal/day, r=0.06), weekly meat and poultry consumption(g/week, r=0.05), weekly fish consumption (g/week, r=0.08), other caffeinated beverage intake (cups/week), and the amount of sugar and prim added to the coffee. Among those variables only age, Quetelet's index, fish consumption, and total cigarette index (in smokers) were remained in the models. After adjustment, the corresponing differences of total cholesterol in smokers were changed to $0.4{\pm}5.24mg/dl,\;-0.5{\pm}4.97mg/dl,\;and\;8.9{\pm}4.78mg/dl$, which were significantly different among themselves (P=0.011). In non-smokers, however, the differences were not statistically significant (P=0.76). Adjusted mean values of systolic blood pressure and diastolic blood pressure were also determined to evaluate the direct effect of coffee to cardiovascular system, but their means were not significantly different by coffee consumption(p=0.18 for SBP, p=0.48 for DBP). Asuming instant coffee in the most popular type of coffee in Korea, the association observed in our study between coffee and serum total cholesterol, especially in smokers, is very interesting finding for the connection between coffee and serum total cholesterol, because only 'boiled coffee' tend to show significant lipid raising effect rather than to other types of coffee, like filtered or espresso, in most of the western countries. We concluded that people who drink coffee more than 2 cups a day have significantly higher serum total cholesterol level than those who never drink coffee, especially in smokers.

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The Relation of Bipolar Tendency with Type A Behavior Pattern, Perceived Stress, and Lifestyle:Comparison between Mood Disorder Questionnaire Positive and Negative Respondents (양극성 경향과 스트레스 취약성:기분장애설문지 양성 반응군과 음성 반응군에서 지각된 스트레스, A형 행동, 그리고 생활습관의 비교)

  • Kim, Byung-Su;Kim, Seong-Yoon;Choe, Jae-Won;Joo, Yeon-Ho;Yoon, Dae-Hyun;Han, Nae-Jin;Kim, Yoo-Shin;Kim, Seon-Ok
    • Korean Journal of Psychosomatic Medicine
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    • v.18 no.1
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    • pp.19-29
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    • 2010
  • Objectives:Authors hypothesized that bipolar tendency of non-psychiatric person would be associated with stress vulnerability. To test the hypothesis, we compared perceived stress level, Type A Behavioral Pattern (TABP) and unhealthy lifestyle between person with and without bipolar tendency. Methods:The study cohort consisted of 1987 subjects without past and current psychiatric history. In this study, bipolar tendency was determined by MDQ response which requires endorsement of at least 7 of the 13 "yes or no" questions. We compared the scores of Perceived Stress Scale, A/B lifestyle questionnaire, and unhealthy lifestyle(alcohol, smoking, lack of exercise, irregular meal) between MDQ positive and negative respondents. Results:We identified the bipolar tendency group determined by the MDQ positive response were 329 subjects(16.6%). The overall score of the bipolar tendency group was significantly high on the A/B lifestyle questionnaire compared to the non-bipolar tendency group(125.4 vs. 115.9, p<0.001), and the rate of the subjects defined as TABP was also significantly high(41.3% vs. 30.1%, p<0.001). In comparison of subjectively perceived stress level, the bipolar tendency group was observed to be significantly higher than the non-bipolar tendency group (18.5% vs. 16.5%, p<0.001). The bipolar tendency group was significantly higher than the non-bipolar tendency group on the rate of answering:'irregular eating habit' (20.1% vs. 14.3%, p=0.002), '4-or-more-times alcohol intake per week' (29.8% vs. 16.5%, p<0.001), 'currently smoking' (41.9% vs. 23.0%, p<0.001), '2-or-less-times physical exercises per week' (63.2% vs. 55.1%, p=0.007). Conclusion:By clinical diagnosis, even a person who does not meet the criteria of bipolar disorder has a high risk of stress-related behavioral pattern, and perceived stress when possessing bipolar tendencies such as the (hypo) maniac tendency or affective instability. Such individual has significantly higher risk of having unhealthy life-style such as smoking, drinking, irregular eating habit and lack of exercise compared to non-bipolar tendency group. Since these risk factors lead to increase the risk of obesity, metabolic syndrome, diabetes, and cardiovascular diseases, the individual with the bipolar tendency requires a more effort to manage stress and to maintain healthy lifestyle.

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Ischemic Preconditioning and Its Relation to Glycogen Depletion (허혈성 전처치와 당원 결핍과의 관계)

  • 장대영;김대중;원경준;조대윤;손동섭;양기민;라봉진;김호덕
    • Journal of Chest Surgery
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    • v.33 no.7
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    • pp.531-540
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    • 2000
  • Baclgrpimd; Recent studies have suggested that the cardioprotective effect of ischemic preconditioning(IP) is closely related to glycogen depletion and attenuation of intracellular acidosis. In the present study, the authors tested this hypothesis by perfusion isolated rabbit hearts with glucose(G) is closely related to glycogen depletion and attenuation of intracellular acidosis. In the present study, the authors tested this hypothesis by perfusion isolated rabbit hearts with glucose(G)-free perfusate. Material and Method; Hearts isolated from New Zealand white rabbits(1.5~2.0 kg body weight) were perfused with Tyrode solution by Langendorff technique. After stabilization of baseline hemodynamics, the hearts were subjected to 45 min global ischemia followed by 120 min reperfusion with IP(IP group, n=13) or without IP(ischemic control group, n=10). IP was induced by single episode of 5 min global ischemia and 10 min reperfusion. In the G-free preconditioned group(n=12), G depletion was induced by perfusionwith G-free Tyrode solution for 5 min and then perfused with G-containing Tyrode solution for 10 min; and 45 min ischemia and 120 min reperfusion. Left ventricular functionincluding developed pressure(LVDP), dP/dt, heart rate, left ventricular end-distolic pressure(LVEDP) and coronary flow (CF) were measured. Myocardial cytosolic and membrane PKC activities were measured by 32P-${\gamma}$-ATP incorporation into PKC-specific peptide and PKC isozymes were analyzed by Western blot with monoclonal antibodies. Infarct size was determined by staining with TTC(tetrazolium salt) and planimetry. Data were analyzed by one-way analysis of variance (ANOVA) and Turkey's post-hoc test. Result ; In comparison with the ischemic control group, IP significantly enhanced functional recovery of the left ventricle; in contrast, functional significantly enhanced functional recovery of the left ventricle; in contrast, functional recovery were not significantly different between the G-free preconditioned and the ischemic control groups. However, the infarct size was significantly reduced by IP or G-free preconditioning(39$\pm$2.7% in the ischemic control, 19$\pm$1.2% in the IP, and 15$\pm$3.9% in the G-free preconditioned, p<0.05). Membrane PKC activities were increased significantly after IP (119%), IP and 45 min ischemia(145%), G-free [recpmdotopmomg (150%), and G-free preconditioning and 45 min ischemia(127%); expression of membrane PKC isozymes, $\alpha$ and $\varepsilon$, tended to be increased after IP or G-free preconditioning. Conclusion; These results suggest that in isolated Langendorff-perfused rabbit heart model, G-free preconditioning (induced by single episode of 5 min G depletion and 10 min repletion) colud not improve post-ischemic contractile dysfunction(after 45-minute global ischemia); however, it has an infarct size-limiting effect.

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Correlation Between Degree of Torn Rotator Cuff in MRI and Degenerative Change of Acromion and Greater Tuberosity in Simple Radiography (단순 방사선 사진에서 견봉 및 상완골 대결절의 퇴행성 변화와 MRI상 회전근 개 파열 정도와의 연관성)

  • Choi, Jung-Yun;Yum, Jae-Kwang;Song, Min-Cheol
    • Clinics in Shoulder and Elbow
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    • v.16 no.1
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    • pp.1-9
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    • 2013
  • Purpose: The purpose of this study is to analyze the correlation between the degree of torn rotator cuff as recorded by MRI and degenerative change of acromion and greater tuberosity of humerus determined by simple radiographs. Materials and Methods: Of the 518 cases included in this study, a group of 234 cases had a chronic rotator cuff tear and a control group of 284 cases had an intact rotator cuff in shoulder MRI. The degree of degenerative changes was classified according to the length of spur and morphological change of acromion and greater tuberosity through the true anteroposterior simple radiograph in supraspinatus outlet view. The degree of tear (partial-thickness or full-thickness tear) and the size of complete rotator cuff tear were analyzed according to the MRI findings of shoulder. The authors also evaluated the correlation between the degree and size of torn rotator cuff and the degenerative change of acromion and greater tuberosity. Results: There were significant differences in the size and extent of torn rotator cuff according to the age, sex and degenerative change of acromion and greater tuberosity of humerus (p<0.001). More degenerative changes of acromion and greater tuberosity in simple shoulder radiographs showed the increased degree and size of torn rotator cuff (p<0.001). In addition, the higher degree and larger size of torn rotator cuff were noted in older age subjects (p<0.001) and in the female group (p<0.001). Conclusion: More degenerative changes of acromion and greater tuberosity in simple shoulder radiographs showed the increased degree and size of torn rotator cuff. Therefore, if a high degree of degenerative change of the acromion and greater tuberosity on simple radiograph is noted, the possibility of degenerative rotator cuff tear should be considered. In addition, the age and sex could be associative factors for larger size of torn rotator cuff.