• Journal of Preventive Medicine and Public Health
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• v.15 no.1
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• pp.187-196
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• 1982

The followings are the results of the study on industrial accidents occurred at 12 factories manufacturing metal products during the period of 2 years from January 1980 to December 1981 in the area of Yong-Dung-Po in Seoul. The results of the study are as follows: 1. The incidence rate of industrial injuries was 45.7 per 1,000 workers of the sample group and the rate of male (54.0) was three times higher than that of female (17.5). 2. In age groups, the highest rate was observed in the group of under 19 years old with 83.5, while the lowest in the group of 40s. 3. It was found that those who had short term of work experience produced a higher rate of injuries, particularly, the group of workers with less than 1 year of experience showed the highest rate of it as 48.1%. 4. In working time, the highest incidence rate occurred 3 and 7 hours after the beginning of their working showing the rate of 6.0 and 6.1 per 1,000 workers, respectively. 5. The highest incidence rate was observed on Monday as 8.4 per 1,000 workers, and it was 18.3% in aspect of the days of a week. 6. In aspect of the months of a year, the highest incidence was observed on July 1,000 workers and the next was on March as 4.8. These figures account for 11.8% of total occurrence in respective month. as 5. 4 per and 10.5% 7. In causes of injuries, the accident caused by power driven machinery showed the highest rate with 37.5%, the second was due to handling without machinery with 17.2%, and the third was due to falling objects with 14.2%, and striking against objects with 10.2%, and so on. 8. By parts of the body affected, the most injuries 84.3% of them occurred on both upper and lower extremities with the rate of 58.8% for the former and 25.5% for the latter. Fingers were most frequently injured with a rate of 40.3%. Comparing the sites of extremities affected, rate of injuries on the right side was 55.0% and 45.0% on the left side. 9. In the nature of injury, laceration and open wound were the highest with 34. 0%, the next was fracture and dislocation with 31. 9%, and sprain was the third with 8.1%. 10. On the duration of treatment, it lasted less than one month in 68.9% of the injured cases, of which 14.5% of the cases were recovered within 2 weeks, and 54.4% of them were treated more than 2 weeks. And the duration of the treatment tended to be prolonged in larger industries. 11. The ratio of insured accidents to uninsured accidents was 1 to 4.7.

• Journal of Korean Academy of Nursing
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• v.5 no.2
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• pp.74-91
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• 1975

A purpose of this study was to compare the breast massage and manual expression of the breast before engagement after delivery with the time of engagement, the throbbing pain in breast, the first amount of breast milk and involution of the uterus. The subjects selected for this study were 138 women (experimental group;69, control group :69) who were admitted to the Dept. of Obtest. and Gyneco. of Kyung Hee University Hospital from Jan. 5 to June 5, 1975. The results of study were as follows; 1 The average age of the women 26.9 years old in the experimental group and 27.6 years old in the control group. As to religion, the number of those who had no religion was 58.0 percent and 62.4 percent respectively. Classified according to occupation, there were 87.0 percent in house wives of the booths group. Educational background; 87.0 percent of high school graduates or above, 78.3 percent respectively. The occupation of husband 53.7 percent of company employees stood highest and 42.0 percent respectively. In according to the grade of wards, 55.1 percent and 52.2 percent of four-men room stood highest. 2. Physical condition: Body weight before this Pregnancy(T=0.4962, N.S.), the size of breast(X²df2 = 0.1728, N.S.), the shape of nipple(X²df3 =1.3804, N.S.), hemoglobin's level of the first day after delivery(T=1.2572, N.S.), the above were showed non significant between the experimental group and control group The investigator found any difference between the two groups of the health condition during the pregnancy, 3. The rate of no experience of breast massage during pregnancy was 85 percent and 75.4 percent (X²df1=2.2562, N.S.). 4. As to the meal during hospitalization after delivery: The booth of the groups in ordinary food took usually of meyer soup and milk(X²df8=2.5957, N.S.). 5. The relation between the first step of breast massage, second step of the manual expression of breast before engagement after delivery and time of engagement : average time of engagement in the experimental group (2.1 days±0.8) was shortened than the control group (3.3 days±1.2). (T=-6.9045, P< 0.005). It toot less time in the experimental group of primipara(2.2days±0.7) than in the control group (3.1day±1.2) and it also took less time in the experimental group of multipara (2.0 days±0.9) than in the control group (3.5days±1.4). (Primipara T=-3.9266, 0< 0.005. Multipara T= 5.2356, P<0.005). 6. The relationship between the first step of the massage and second step of manual expression and the throbbing pain at the time of engagement: The experimental group showed less effect than control group (X²df4= 27.3342 P<0.005). The separate study of primipara and multipara showed remarkable difference in the group of primipara)X²df4=20.7285, p<0.005) and little difference in the multipara group (X²df4=8.8351, p< 0. 10). 7. The relationship between the first step of the breast massage, second stop of the manual expression and first amount of breast milk: The average amount of breast milk increased more conspicuously in the experimental group (33.8㎖±23.4) than in the control(29.8㎖±25.3) (T=0.8262, N.S.). No remarkable difference was found in the respective groups that investigated in the groups of primipara and of multipara. (Primipara T=1.1467, N.S., Multipara T=-0.0354, N.S.). 8. The relationship between the first step of breast massage and second step of manual expression of breast and involution of uterus : Average time needed for uttering involution was sooner in the experimental group of primipasa(-3.3 F.B.±1.1), than the control group of primipara (-2.5F. B.±1.2), and it was sooner in the experimental group of muitipara (-3.0 F. B.±l..3), than the control group of multipara(-2.3 F.B±0.9). Primipara T=-2.9272, p< 0.005, Multipara T=2.5557, p< 0.01).

• Korean Journal of Hospice Care
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• v.1 no.1
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• pp.46-69
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• 2001

Hospice Care is the best way to care for terminally ill patients and their family members. However most of them can not receive the appropriate hospice service because the Korean health delivery system is mainly be focussed on acutly ill patients. This study was carried out to clarify the situation of hospice in Korea and to develop a hospice care delivery system model which is appropriate in the Korean context. The theoretical framework of this study that hospice care delivery system is composed of hospice resources with personnel, facilities, etc., government and non-government hospice organization, hospice finances, hospice management and hospice delivery, was taken from the Health Delivery System of WHO(1984). Data was obtained through data analysis of litreature, interview, questionairs, visiting and Delphi Technique, from October 1998 to April 1999 involving 56 hospices, 1 hospice research center, 3 non-government hospice organizations, 20 experts who have had hospice experience for more than 3 years(mean is 9 years and 5 months) and officials or members of 3 non-government hospice organizations. There are 61 hospices in Korea. Even though hospice personnel have tried to study and to provide qualified hospice serices, there is nor any formal hospice linkage or network in Korea. This is the result of this survey made to clarify the situation of Korean hospice. Results of the study by Delphi Technique were as follows: 1.Hospice Resources: Key hospice personnel were found to be hospice coordinator, doctor, nurse, clergy, social worker, volunteers. Necessary qualifications for all personnel was that they conditions were resulted as have good health, receive hospice education and have communication skills. Education for hospice personnel is divided into (i)basic training and (ii)special education, e.g. palliative medicine course for hospice specialist or palliative care course in master degree for hospice nurse specialist. Hospice facilities could be developed by adding a living room, a space for family members, a prayer room, a church, an interview room, a kitchen, a dining room, a bath facility, a hall for music, art or work therapy, volunteers' room, garden, etc. to hospital facilities. 2.Hospice Organization: Whilst there are three non-government hospice organizations active at present, in the near future an hospice officer in the Health&Welfare Ministry plus a government Hospice body are necessary. However a non-government council to further integrate hospice development is also strongly recommended. 3.Hospice Finances: A New insurance standards, I.e. the charge for hospice care services, public information and tax reduction for donations were found suggested as methods to rise the hospice budget. 4.Hospice Management: Two divisions of hospice management/care were considered to be necessary in future. The role of the hospice officer in the Health & Welfare Ministry would be quality control of hospice teams and facilities involved/associated with hospice insurance standards. New non-government integrating councils role supporting the development of hospice care, not insurance covered. 5.Hospice delivery: Linkage&networking between hospice facilities and first, second, third level medical institutions are needed in order to provide varied and continous hospice care. Hospice Acts need to be established within the limits of medical law with regards to standards for professional staff members, educational programs, etc. The results of this study could be utilizes towards the development to two hospice care delivery system models, A and B. Model A is based on the hospital, especially the hospice unit, because in this setting is more easily available the new medical insurance for hospice care. Therefore a hospice team is organized in the hospital and may operate in the hospice unit and in the home hospice care service. After Model A is set up and operating, Model B will be the next stage, in which medical insurance cover will be extended to home hospice care service. This model(B) is also based on the hospital, but the focus of the hospital hospice unit will be moved to home hospice care which is connected by local physicians, national public health centers, community parties as like churches or volunteer groups. Model B will contribute to the care of terminally ill patients and their family members and also assist hospital administrators in cost-effectiveness.

• Journal of the Korean association of regional geographers
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• v.22 no.3
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• pp.529-552
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• 2016

The purpose of this study is to examine the matter as to how the meaning of the physical therapeutic landscape by water, which is associated with physical, cultural, spatial, and economical aspects, appears in the space centering on women and is to look into the feminine factors in term of a rest area, consideration, and imagery for women. From a perspective of a rest area for women, the meaning of a physical aspect is remarkable and is materialized in thermal waters and bathing, atmosphere, subsidiary facilities and safe nightlife. According to these phenomena, female visitors are able to feel freedom, power, which can return themselves to the best condition by thermal waters, therapeutic equipments provided in a watering place continuously, safe protection and exchange with strangers with an open mind. And the cultural aspect of the therapeutic landscape by water is discovered in consideration for women. It is the fact that joins the Japanese culture based on consideration towards others to the traditional culture of hot springs by itself. For example, women can feel various pleasure, experience the protection or the support by someone and pursuit not only physical beauty but also mental or spiritual one through welcome bus, service of Okami san and Nakai san, decorations, funny installments and secure of private space. Lastly, the imagery of women can be identified in cultural, spatial, and economical aspects extensively somewhat and is embodied by advertising mediums, signs of hot springs, shrines, objets and products variously. It is made into healthiness, relaxation, comfort, familiarity and image that are realized to love or are connected to a happy marriage life. To sum up the results, the healing or therapeutic elements for women appearing in hot springs are gathered to some abstraction such as freedom, safe, effect beyond the body, pleasure, durability of healing or therapy, beauty and hope; furthermore, if these abstraction are combined each other closely, the effect of healing or therapy, which transforms anxiety into a stable condition, can be exposed externally.

• Sleep Medicine and Psychophysiology
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• v.15 no.2
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• pp.94-99
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• 2008

The most common cause of obstructive sleep apnea syndrome (OSAS) in childhood is adenotonsillar hypertrophy. Adenotonsillectomy improves the symptoms quite well in most cases. However, some patients could experience the OSAS again after adenotonsillectomy, who might have several risk factors such as incomplete operation, misdiagnosis, combined anatomical malformation, sinusitis or chronic allergic rhinitis, obesity, initial severe OSAS, and early onset OSAS. We report a case of 11-year-old obese boy who presented with snoring for several years. He was obese with body mass index (BMI) of $26.3kg/m^2$ and also found to have fatty liver by ultrasonogram. Initial polysomnography (PSG) showed that he met the criteria of severe OSAS with the apnea-hypopnea index (AHI) of 70.5. He underwent adenotonsillectomy and symptoms improved immediately. Four months later symptoms were relieved with AHI of 0, but 1 year after the adenotonsillectomy he started to complain snoring again and the subsequent PSG results showed that OSAS has relapsed with AHI of 43. Paranasal sinus X-ray and physical examination showed sinusitis and re-growth of adenoid. Obesity was proved not to be a contributing factor because his BMI decreased to normal range ($23.1kg/m^2$) after diet control and regular exercise. Also, liver transaminase was normalized and fatty liver was disappeared on follow-up abdominal ultrasonogram. After treatment of sinusitis, symptoms were relieved with decreased AHI (8.5). This case suggests that simple adenotonsillectomy might not be the end of OSAS treatment in childhood. Patients who had adenotonsillectomy should be followed by subsequent PSG if symptoms recur. It is also important to be aware of risk factors in the recurrent OSAS for the proper intervention according to the cause.

• Journal of the Korean Society of Food Science and Nutrition
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• v.33 no.9
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• pp.1501-1514
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• 2004

The purpose of this study was to evaluate the health condition and nutritional status in female university students in Masan. The 285 subjects aged 20.1 years (18~26 years) were assessed with a set of questionnaire composed of general information, food, smoking, drinking and exercise habits, anthropometric measurements, blood pressure measurements, 24-hour recall and food frequency questionnaire. The rates of smoking and alcohol drinking habits were 1.8% and 82.5%, respectively. All the subjects had the experience of passive smoking. The 11% of the students exercised regularly and 11.6% ate meal regularly. The average height and weight of subjects were 161.0 ㎝ and 53.9 ㎏, respectively and the BMI was calculated as 20.8${\pm}$2.6 ㎏/$m^2$:The 13.3% of subjects were underweight, while 6.7% of them were overweight. The mean value for body fat was 26.4% and subscapular and tricep skinfolds thickness were 14.2 ㎜ and 16.9 ㎜, and waist-hip ratio was 0.72. The systolic/diastolic blood pressure of the subjects was 115.9 ㎜Hg/70.9 ㎜Hg. Except protein, phosphorous, vitamin E, B_6 and C, the average intakes of energy and nutrients were below the Korea recom-mended dietary allowance (RDA). Especially, intakes of calcium, iron and zinc were the lowest, as <70% of RDA. The proportion of energy derived from carbohydrates : protein : fat was 58.0 : 15.8 : 26.2. The 10 frequently consumed food were ssalbap (47.2/mon), kimchi (35.6/mon), onion (16.8/mon), japgokbap (15.1/mon), sesame oil (14.1/mon), carbonated drink (13.3/mon), grapes (12.7/mon), ice cream (12.4/mon), milk (11.9/mon) and water-melon (10.6/mon). Results of this study could be useful for planning nutrition education programs for female university students in this area to improve their dietary habit and health status.

• Journal of Chest Surgery
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• v.40 no.12
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• pp.837-842
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• 2007

Background: Closure of the ductus arteriosus is often delayed in premature infants, which creates a hemodynamically significant left to right shunt that exerts an adverse effect on the normal development and growth of these babies. We reviewed out experience on surgical closure of patent ductus arteriosus via axillary minithoracotomy in premature infants. Material and Method: From April 2002 to October 2006, 20 premature infants whose gestation was under 37 weeks underwent surgical closure of patent ductus arteriosus as a result of complications or contra-indications for the use of indomethacin. Their mean gestational age was 28.8+3.4 weeks, ranging from 25+3 to 34+6 weeks, and the average age at operation was $15.6{\pm}6.3$ days. The mean body weight at operation was $1,174{\pm}416\;g$, ranging from 680 to 2,100g; 16 infants were under 1,500 and 9 infants were under 1,000 g. The procedures were performed in the newborn intensive care unit via $2{\sim}3\;cm$ long axillary minithoracotomy with the infant in the lateral position with left arm abduction. The mean size of the patent ductus arteriosus was $3.8{\pm}0.3\;mm$. For the most part, the ductus was closed with clips; 2 infants in whom the ductus was ruptured while dissection was being performed underwent ductal division. Result: Ten of twelve infants who had been ventilator dependent preoperatively could be successfully weaned from the ventilator at a mean duration of 9.7 days after the operation. There was no procedure-related complication or death. Two infants eventually died of the conditions not related to the operation; one from sepsis at postoperative 131 days and the other from pneumonia at postoperative 41 days, respectively. Conclusion: Surgical closure of the patent ductus arteriosus improved the hemodynamic instability and so promoted the successful growth and normal development of premature infants. Considering the low surgical risk along with the reduced invasiveness, early and aggressive surgical intervention is highly recommended.

• Archives of Reconstructive Microsurgery
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• v.5 no.1
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• pp.24-34
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• 1996

There are many kinds of free flaps for management of extensive soft tissue defect of extremities in orthopaedic field. Free vascularized scapular flap is one of the most useful and relatively easy to application. This flap has been utilize clinically from early eighties by many microsurgical pioneers. Authors performed 102 cases of this flap from 1984 to 1995. We have to consider about the surgical anatomy of the flap, technique of the donor harvesting procedures, vascular varieties and anatomical abnormalities and success rate and the weak points of the procedure. This flap nourished by cutaneous branches from circumflex scapular vessels emerges from the lateral aspect of the subscapular artery 2.5-5cm from its lateral origin passing through the triangular space(bounded by subscapularis, teres minor, teres major, long head of triceps). The terminal cutaneous branch runs posteriorly around the lateral border of the scapular and divided into two major branches, those transeverse horizontally and obliquely to the fascial plane of overlying skin of the scapular body. We can utilize these arteries for scapular and parascapular flap. The vascular pedicle ranged from 5 to 10 cm long depends on the dissection, usually two venae comitantes accompanied circumflex scapular artery and its major branches. The diameter of the circumflex scapular artery is more than 1mm in adult, rare vascular variation. Surgical techniques : The scapular flap can be dissected conveniently with prone or lateral decubitus position, prone position is more easier in my experience. There are two kinds of surgical approaches, most of the surgeon prefer elevation of the flap from its outer border towards its base which known easier and quicker, but I prefer elevation of the flap from its outer border because of the lowering the possibilities of damage to vasculature in the flap itself which runs just underneath the subcutaneous tissue of the flap and provide more quicker elevation of the flap with blunt finger dissection after secure pedicle dissection and confirmed the course from the base of the pedicle. There are minimal donor site morbidity with direct skin closure if the flap size is not so larger than 10cm width. This flap has versatility in the design of the flap shape and size, if we need more longer and larger one, we can use parascapular flap or both. Even more, the flap can be used with latissimus dorsi musculocutaneous flap and serratus anterior flap which have common vascular pedicle from subscapular artery, some instance can combined with osteocutaneous flap if we include the lateral border of the scapular bone or parts of the ribs with serratus anterior. The most important shortcoming of the scapular free flap is non sensating, there are no reasonable sensory nerves to the flap to anastomose with recipient site nerve. Results : Among our 102 cases, overall success rate was 89%, most of the causes of the failure was recipient site vascular problems such as damaged recipient arterial conditions, and there were two cases of vascular anomalies in our series. Patients ages from 3 years old to 62 years old. Six cases of combined flap with latissimus dorsi, 4 cases of osteocutaneous flap for bone reconstruction, 62 parascapular flap was performed - we prefer parascapular flap to scapular. Statistical analysis of the size of the flap has less meaningful because of the flap has great versatility in size. In the length of the pedicle depends on the recipient site condition, we can adjust the pedicle length. The longest vascular pedicle was 14 cm in length from the axillary artery to the enter point cutaneous tissue. In conclusion, scapular free flap is one of the most useful modalities to manage the large intractable soft tissue defect. It has almost constant vascular pedicle with rare anatomical variation, easy to dissect great versatility in size and shape, low donor morbidity, thin and hairless skin.

• Journal of Chest Surgery
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• v.39 no.5 s.262
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• pp.347-353
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• 2006

Background: Despite recent advances in surgical technique and perioperative care of total anomalous pulmonary venous return (TAPVR), post-repair pulmonary vein stenosis (PVS) remains as a serious complication. We thought that the most important factors of TAPVR repair to prevent PVS were good exposure, proper alignment, and sufficient stoma size. We analyzed our experience retrospectively. Material and Method: Between Jan. 1995 and Feb. 2005, we studied 74 patients diagnosed with TAPVR suitable for biventricular repair. Supra-cardiac type (n=41, 55.4%) was the most common. Mean CPB time, ACC time, and TCA (40.5%, 30/74) time were $92.1{\pm}25.9\;min,\;39.1{\pm}10.6\;min$, and $30.2{\pm}10.7\;min$, respectively. Mean follow-up duration was $41.4{\pm}29.1$ months and follow-up was possible in all patients. Result: The median age and body weight at operation were 28.5 days ($0{\sim}478$ days) and 3.4 kg $(1.4{\sim}9\;kg)$. Early mortality was 4.1% (3/74). Causes of death were pulmonary hypertensive crisis, sepsis, and sudden death. There was PR-PVS in 2 patients (early: 1, late: 1). Both patients were cardiac type TAPVR drained to coronary sinus. Re-operations were done but only one patient survived. Cumulative survival rate in 5 year and percent freedom from PVS were $94.5{\pm}2.7%\;and\;97.2{\pm}2.0%$, respectively. Conclusion: There was no PVS in patients who underwent extra-cardiac anatomosis between LA and CPVC. Therefore it could be said that our principle might be effective in preventing PR-PVS in patients suitable two-ventricle.

• Journal of Chest Surgery
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• v.37 no.6
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• pp.504-510
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• 2004

Background: Vasodilatory shock after cardiac surgery may result from the vasopressin deficiency following cardio-pulmonary bypass and sepsis, which did not respond to usual intravenous inotropes. In contrast to the adult patients, the effectiveness of vasopressin for vasodilatory shock in children has not been known well and so we reviewed our experience of vasopressin therapy in the small babies with a cardiac disease. Material and Method: Between February and August 2003, intravenous vasopressin was administrated in 6 patients for vasodilatory shock despite being supported on intravenous inotropes after cardiac surgery. Median age at operation was 25 days old (ranges; 2∼41 days) and median body weight was 2,870 grams (ranges; 900∼3,530 grams). Preoperative diag-noses were complete transposition of the great arteries in 2 patients, hypoplastic left heart syndrome in 1, Fallot type double-outlet right ventricle in 1, aortic coarctation with severe atrioventricular valve regurgitation in 1, and total anomalous pulmonary venous return in 1. Total repair and palliative repair were undertaken in each 3 patient. Result: Most patients showed vasodilatory shock not responding to the inotropes and required the vasopressin therapy within 24 hours after cardiac surgery and its readministration for septic shock. The dosing range for vasopressin was 0.0002∼0.008 unit/kg/minute with a median total time of its administration of 59 hours (ranges; 26∼140 hours). Systolic blood pressure before, 1 hour, and 6 hours after its administration were 42.7$\pm$7.4 mmHg, 53.7$\pm$11.4 mmHg, and 56.3$\pm$13.4 mmHg, respectively, which shows a significant increase in systolic blood pressure (systolic pressure 1hour and 6 hours after the administration compared to before the administration; p=0.042 in all). Inotropic indexes before, 6 hour, and 12 hours after its administration were 32.3$\pm$7.2, 21.0$\pm$8.4, and 21.2$\pm$8.9, respectively, which reveals a significant decrease in inotropic index (inotropic indexes 6 hour and 12 hours after the administration compared to before the administration; p=0.027 in all). Significant metabolic acidosis and decreased urine output related to systemic hypoperfusion were not found after vasopressin admin- istration. Conclusion: In young children suffering from vasodilatory shock not responding to common inotropes despite normal ventricular contractility, intravenous vasopressin reveals to be an effective vasoconstrictor to increase systolic blood pressure and to mitigate the complications related to higher doses of inotropes.