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Study of the Relation of Idiopathic Facial Palsy and Imbalance of Autonomic Nerve System by the Heart Rate Variability Analysis (심박변이도(Heart Rate Variability) 분석을 통한 특발성 안면신경마비와 자율신경실조의 상관성 연구)

  • Choi, Yang-Sik;Kim, Haeng-Beom;Kim, Joo-Hee;Lee, Seung-Won;Lee, So-Young;Ko, Jeong-Min;Koh, Hyung-Kyun;Lee, Yun-Ho
    • Journal of Acupuncture Research
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    • v.25 no.6
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    • pp.109-116
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    • 2008
  • Objectives : This study investigated the effect of imbalance of autonomic nerve system on the idiopathic facial palsy by the comparison Heart Rate Variability results of Facial palsy group and healthy control group, and to clarify correlation between House-Brackmann Grade and Heart Rate Variability results. Methods : 119 idiopathic facial palsy patients and 88 health subjects who underwent HRV test were retrospectively reviewed based on medical records. We compared between the HRV results of facial palsy group and that of normal control group, and also compared the HRV results of facial palsy subgroup classified by House-Brackmann Grade. Results 1. All HRV results-Mean Heart Rat(MHRT), Standard Deviation of all the Normal RR intervals(SDNN), Total Power(TP), Very Low Frequency(VLF), Low Frequency(LF), High Frequency(HF), ratio betwween the Low Frequency and High Frequency power(LF/HF ratio) of facial palsy group are decreased compared to that of normal control group, especially SDNN, TP, VLF, LF, LF/HF ratio showed significant difference(p<0.05). 2. HRV results showed no significant correlation in House-Brackmann Grade. Conclusions : This study showed that lower HRV results of facial palsy group than normal control group and suggests that imbalance of autonomic nerve system related with facial palsy. HRV could be a objective tool to reflect condition of idiopathic facial palsy patients.

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In-depth interview about expected role and competency of future public health dental hygienist (미래 보건치과위생사에게 기대하는 인성과 그 진출전망에 대한 전국 보건치과위생사 대표단의 심층면담)

  • Kim, Sol;Kim, Su-Jeong;Jang, Mi-Rae;Kim, Min-Gyeong;Seo, Yang-Gyung;Lee, Hee-Yeon;Jang, Young-Eun;Park, Gui-Ok;Kim, Nam-Hee
    • Journal of Korean society of Dental Hygiene
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    • v.16 no.6
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    • pp.969-978
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    • 2016
  • Objectives: The purpose of the study was to examine the expected role and competency of future public health dental hygienist. Methods: This study was cross-sectional design. One dental hygienist per 16 cities and provinces was selected from the list of Korea Society of public dental hygienists. After signing in the informed consent, the interview was carried out. Transcripts were made after each interview. Six researchers recorded meaningful contents in the transcripts. They classified and integrated the information that they had recorded commonly or not. Their opinions were converged by conference. Two supervisors verified results whether they were derived from actual recordings for the reliability of the results. The records were confirmed once again and corrected into common message. Results: The main difficult subjects in public health official examination were public health, English, and medical legislation to pass the examine. The preliminary certificates included public health related certificate, computer certificate, and driver's license. In the personality aspect, creativity, activeness, cooperation and good responsibility were very important trait to public health official. Among 16 interviews, 9 were positive and 5 were negative about the future prospects of a public dental hygienist. Conclusions: The future of public health dental hygienist will be positive. Throughout effort to prepare for the public health official, the public health dental hygienist will be expanded and in many ways the dental hygienists will take the charge of the important parts of the public health administration in the near future.

Correlation between the 2-Dimensional Extent of Orbital Defects and the 3-Dimensional Volume of Herniated Orbital Content in Patients with Isolated Orbital Wall Fractures

  • Cha, Jong Hyun;Moon, Myeong Ho;Lee, Yong Hae;Koh, In Chang;Kim, Kyu Nam;Kim, Chang Gyun;Kim, Hoon
    • Archives of Plastic Surgery
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    • v.44 no.1
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    • pp.26-33
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    • 2017
  • Background The purpose of this study was to assess the correlation between the 2-dimensional (2D) extent of orbital defects and the 3-dimensional (3D) volume of herniated orbital content in patients with an orbital wall fracture. Methods This retrospective study was based on the medical records and radiologic data of 60 patients from January 2014 to June 2016 for a unilateral isolated orbital wall fracture. They were classified into 2 groups depending on whether the fracture involved the inferior wall (group I, n=30) or the medial wall (group M, n=30). The 2D area of the orbital defect was calculated using the conventional formula. The 2D extent of the orbital defect and the 3D volume of herniated orbital content were measured with 3D image processing software. Statistical analysis was performed to evaluate the correlations between the 2D and 3D parameters. Results Varying degrees of positive correlation were found between the 2D extent of the orbital defects and the 3D herniated orbital volume in both groups (Pearson correlation coefficient, 0.568-0.788; $R^2=32.2%-62.1%$). Conclusions Both the calculated and measured 2D extent of the orbital defects showed a positive correlation with the 3D herniated orbital volume in orbital wall fractures. However, a relatively large volume of herniation (>$0.9cm^3$) occurred not infrequently despite the presence of a small orbital defect (<$1.9cm^2$). Therefore, estimating the 3D volume of the herniated content in addition to the 2D orbital defect would be helpful for determining whether surgery is indicated and ensuring adequate surgical outcomes.

Development of Simple Prediction Method for Injury Severity and Amount of Traumatic Hemorrhage via Analysis of the Correlation between Site of Pelvic Bone Fracture and Amount of Transfusion: Pelvic Bleeding Score (골반골절 환자의 골절위치와 출혈량간의 상관관계 분석을 통한 대량수혈 필요에 대한 간단한 예측도구 개발: 골반골 출혈 지수)

  • Lee, Sang Sik;Bae, Byung Kwan;Han, Sang Kyoon;Park, Sung Wook;Ryu, Ji Ho;Jeong, Jin Woo;Yeom, Seok Ran
    • Journal of Trauma and Injury
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    • v.25 no.4
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    • pp.139-144
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    • 2012
  • Purpose: Hypovolemic shock is the leading cause of death in multiple trauma patients with pelvic bone fracures. The purpose of this study was to develop a simple prediction method for injury severity and amount of hemorrhage via an analysis of the correlation between the site of pelvic bone fracture and the amount of transfusion and to verify the usefulness of the such a simple scoring system. Methods: We analyzed retrospectively the medical records and radiologic examination of 102 patients who had been diagnosed as having a pelvic bone fracture and who had visited the Emergency Department between January 2007 and December 2011. Fracture sites in the pelvis were confirmed and re-classified anatomically as pubis, ilium or sacrum. A multiple linear regression analysis was performed on the amount of transfusion, and a simplified scoring system was developed. The predictive value of the amount of transfusion for the scoring system as verified by using the receiver operating characteristics (ROC). The area under the curve of the ROC was compared with the injury severity score (ISS). Results: From among the 102 patients, 97 patients (M:F=68:29, mean $age=46.7{\pm}16.6years$) were enrolled for analysis. The average ISS of the patients was $16.2{\pm}7.9$, and the average amount of packed RBC transfusion for 24 hr was $3.9{\pm}4.6units$. The regression equation resulting from the multiple linear regression analysis was 'packed RBC units=1.40${\times}$(sacrum fracture)+1.72${\times}$(pubis fracture)+1.67${\times}$(ilium fracture)+0.36' and was found to be suitable (p=0.005). We simplified the regression equation to 'Pelvic Bleeding Score=sacrum+pubis+ilium.' Each fractured site was scored as 0(no fracture) point, 1(right or left) point, or 2(both) points. Sacrum had only 0 or 1 point. The score ranged from 0 to 5. The area under the curve (AUC) of the ROC was 0.718 (95% CI: 0.588-0.848, p=0.009). For an upper Pelvis Bleeding Score of 3 points, the sensitivity of the prediction for a massive transfusion was 71.4%, and the specificity was 69.9%. Conclusion: We developed a simplified scoring system for the anatomical fracture sites in the pelvis to predict the requirement for a transfusion (Pelvis Bleeding Score (PBS)). The PBS, compared with the ISS, is considered a useful predictor of the need for a transfusion during initial management.

Characteristics of Injured Pregnant Women by the Traffic Accidents (교통사고로 수상한 임산부의 특성)

  • Kim, Duk-Hwan;Cho, Young-Duck;Kim, Jung-Youn;Yoon, Young-Hoon;Lee, Sung-Woo;Moon, Sung-Woo;Choi, Sung-Hyuk
    • Journal of Trauma and Injury
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    • v.25 no.4
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    • pp.132-138
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    • 2012
  • Purpose: Trauma is one of the major causes of maternal and fetal mortality, and the most common cause of maternal trauma is a traffic accident. In Korea, data about traffic accidents in pregnant women are not widely collected and classified so far. Hence, we studied and analyzed the characteristics of injured pregnant women by the traffic accidents. Methods: From January 2002 to August 2011, pregnant women who were in traffic accidents visiting Emergency Department were studied. Pregnancy out come and the degree of the damage were determined through the retrospective analysis of the medical records. Results: The pregnant women who visited after traffic accidents were total 204 patients. Among them, 176 patients had no complication related to the traffic accidents, 28 patients had complications. The incidence of the complications in the 3rd trimester pregnants was statistically significant higher than that in the other trimesters. The analysis based on the mechanism shows more complications in the pedestrian injury. In the survey by the type of the vehicles, the complications from the trauma associated with a car had lower incidence. The patients arrived at the emergency center by walking had greater numbers than who arrived by an ambulance in the groups occurred the complications. The patients suffered complications who complained pain in trunk especially in abdomen and pelvis than in extremities and complained vaginal discharge, and those showed a statistically significant greater incidence. Conclusion: When pregnant women were injured by the traffic accidents, the factors related to the poor pregnant prognosis were trimester of pregnancy, means of visiting the emergency center, trauma mechanism, and complaining symptoms. Therefore, these factors may be used as a prognostic tool to predict an incidence of complications, length of hospital stay and rate of complications and can be used to plan for treatments.

Prognosis for Blunt Abdominal Trauma Patients with Contrast Extravasation on the Abdominopelvic CT Scan (조영제 혈관 외 유출이 관찰된 복부 둔상 환자의 유출부위에 따른 예후)

  • Shin, Hyung Jin;Lee, Kang Hyun;Kwak, Young Soo;Kim, Sun Hyu;Kim, Hyun;Hwang, Sung Oh
    • Journal of Trauma and Injury
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    • v.22 no.1
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    • pp.57-64
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    • 2009
  • Purpose: Computed tomography (CT) is an accurate test for evaluating hemodynamically stable patients with blunt abdominal trauma. Until now, there have been few studies concentrating on the diagnostic and prognostic significance of the intravenous contrast extravasation (CE) site. We investigated the site of CE on abdominopelvic CT (APCT) and its effect on treating trauma patients and predicting the clinical outcome. Methods: The 50 patients admitted to our emergency department with blunt abdominal trauma showing CE on APCT from January 2004 to September 2006 were included in this study. Patients were prospectively collected, and medical records were reviewed and analyzed. The patients'clinical and lab findings, Focused Assessment with Sonography for Trauma (FAST) findings, CT findings were analyzed. CE sites were classified as intraperitoneal, retroperitoneal, and pelvic cavity and were correlated with post-treatment complications, mortality, and morbidity. Results: Of the 50 patients (mean age : $45{\pm}18years$, 29 males, 21 females) included in our study, 33 patients died (66%). There was no correlation between CE site and ICU or total hospitalization duration (p=0.553, p=0.523). During the first 24 hours of resuscitation, the pelvic cavity group required a mean of 20 units more of packed red blood cell (pRBC) transfusion compared to other groups (p=0.003). In the intraperitoneal group, more patients received operative invasive intervention - either laparotomy or embolization (p=0.025). The intraperitoneal group had the highest mortality, with 13 deaths (11/33, 39%), and the highest early mortality rate (10/13, 76%) in the first 24 hours (p=0.001). Conclusion: Intraperitoneal CE on the CT scan in cases of blunt abdominal trauma is regarded as an indication of a need for invasive intervention (either angiography or laparotomy) and of a higher mortality rate in the first 24 hours. A pelvic cavity CE rquires more aggressive transfusion with pRBC. However, the CT findings themselves showed no significant correlation with overall mortality, morbidity, or hospitalization.

Clinical Manifestations and Treatment Outcomes of Eosinophilic Gastroenteritis in Children

  • Choi, Jong Sub;Choi, Shin Jie;Lee, Kyung Jae;Kim, Ahlee;Yoo, Jung Kyung;Yang, Hye Ran;Moon, Jin Soo;Chang, Ju Young;Ko, Jae Sung;Kang, Gyeong Hoon
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.18 no.4
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    • pp.253-260
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    • 2015
  • Purpose: The aim of the present study was to investigate the clinical features and outcome of eosinophilic gastroenteritis (EGE) in children. Methods: Our study enrolled 24 children who were diagnosed with EGE from 1993 to 2014 at the Department of Pediatrics, Seoul National University Children's Hospital. The patients' clinical manifestations, treatments, and outcomes were reviewed from the medical records. Results: The mean age at diagnosis was 5.3 years. Most patients had gastrointestinal symptoms including diarrhea (54.2%) and abdominal pain (45.8%). Peripheral eosinophilia was present in 91.7% of the patients. Thirteen patients (54.2%) showed anemia, and 15 patients (62.5%) had hypoalbuminemia. EGE was classified as mucosal, subserosal, or muscular in 75.0%, 20.8%, and 4.2% of cases, respectively. Three patients showed gastroduodenal ulcers upon endoscopic analysis. A history of allergy was reported in 13 patients, including atopic dermatitis, allergic rhinitis, and asthma. Five patients (20.8%) improved with food restrictions. Among the 19 patients treated with steroids, 11 (57.9%) discontinued steroid treatment without subsequent relapse, 4 (21.1%) relapsed after ceasing steroid treatment, and 4 (21.1%) showed no response to steroids. Two patients who were resistant to steroids underwent therapeutic surgery. The presence of gastroduodenal ulcers was significantly associated with relapse and steroid resistance. Conclusion: A high suspicion of EGE is warranted when children have nonspecific gastrointestinal symptoms and peripheral eosinophilia. Most patients improved with food restrictions or steroid treatment, although one-third of patients showed a relapse or steroid resistance.

Risk Factors of Readmission to Hospital for Pneumonia in Children (소아 폐렴의 재입원에 대한 위험인자)

  • Hong, Yu Chan;Choi, Eom Ji;Park, Sin-Ae
    • Pediatric Infection and Vaccine
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    • v.24 no.3
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    • pp.146-151
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    • 2017
  • Purpose: We analyzed the risk factors affecting readmission of children with pneumonia. Methods: We retrospectively analyzed the medical records of pediatric patients admitted to the Department of Pediatrics at the Jeonju Presbyterian Medical Center from January 2007 to August 2016. We classified patients who were readmitted with pneumonia within 30 days of discharge as the readmission group and patients who were admitted with pneumonia for the first time as the first admission group. Results: Among 158 patients, the study (readmission) group included 82 patients and the control (first admission) group included 76 patients. Age, the percentage of segmented neutrophils and lymphocytes, the number of admissions in the last 12 months, the associated diseases (respiratory diseases such as asthma), and the affection of the right upper lung were analyzed as risk factors for readmission. However, based on a regression analysis, only age and associated diseases were found to be significant risk factors. The rate of readmission increased with younger age. When there were associated diseases, the rate of readmission also increased. Conclusions: Young age and associated diseases were significant risk factors for readmission for patients with pediatric pneumonia. When pediatric patients are admitted with pneumonia, if they are young and/or have associated diseases, a comprehensive approach is needed to reduce the rate of readmission with careful consideration of precise examination, treatment, timing of discharge, and follow-up.

Accident Conversion Effect Analysis of Installing Median Barriers (중앙분리대 설치에 따른 사고전환효과 분석)

  • Park, Min-Ho;Park, Gyu-Yeong;Jang, Il-Jun;Lee, Su-Beom
    • Journal of Korean Society of Transportation
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    • v.24 no.2 s.88
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    • pp.113-124
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    • 2006
  • Among tile traffic safety facilities, median barriers are installed above 4-lane national roads due to the awareness of haying an effect on preventing the front collision. Studies about the installation effect analysis of median harrier have been carried out through both at home and outside, mainly indicating total accident reduction effect on pertinent sections. In sum, study about how the accident occurrence form is changed at the point classified by the accident type or severity is insignificant. In the case of outside the country, calculating the accident reduction effect according to the type of median barriers is main research and in domestic, though there is a part of researches assessing reduction effect by accident types, it is not reliable in the view or statistics because of using only 1year's before-aftev data installing the facility, So in this Paper. it is the main purpose to presume the accident conversion effect. For this, we conduct an investigation and collect data about 7-year's accident data containing before-after Project, safety facilities foundation records and index of road alignment on the subject of 4-1ane national roads(108.6km) existing median barrier. Next. using the empirical bayes method, we estimate a model construction and accident conversion effect of accident type severity. We expect the result or this Paper will be applied for a policy execution and Presentation of facility standard related to median barrier from now on.

Necessity for a Whole-body CT Scan in Alert Blunt Multiple Trauma Patients. (의식이 명료한 다발성 외상환자에게 전신 전산화단층촬영이 반드시 필요한가?)

  • Mun, You-Ho;Kim, Yun-Jeong;Shin, Soo-Jeong;Park, Dong-Chan;Park, Sin-Ryul;Ryu, Hyun-Wook;Seo, Kang-Suk;Park, Jung-Bae;Chung, Jae-Myung;Bae, Ji-Hye
    • Journal of Trauma and Injury
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    • v.23 no.2
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    • pp.89-95
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    • 2010
  • Purpose: Whole-body CT is a very attractive diagnostic tool to clinicians, especially, in trauma. It is generally accepted that trauma patients who are not alert require whole-body CT. However, in alert trauma patients, the usefulness is questionable. Methods: This study was a retrospective review of the medical records of 146 patients with blunt multiple trauma who underwent whole body CT scanning for a trauma workup from March 1, 2008 to February 28, 2009. We classified the patients into two groups by patients' mental status (alert group: 110 patients, not-alert group: 36 patients). In the alert group, we compared the patients' evidence of injury (present illness, physical examination, neurological examination) with the CT findings. Results: One hundred forty six(146) patients underwent whole-body CT. The mean age was $44.6{\pm}18.9$ years. One hundred four (104, 71.2%) were men, and the injury severity score was $14.0{\pm}10.38$. In the not-alert group, the ratios of abnormal CT findings were relatively high: head 23/36(63.9%), neck 3/6(50.0%), chest 16/36(44.4%) and abdomen 9/36(25%). In the alert group, patients with no evidence of injury were rare (head 1, chest 6 and abdomen 2). Nine(9) patients did not need any intervention or surgery. Conclusion: Whole-body CT has various disadvantages, such as radiation, contrast induced nephropathy and high medical costs. In multiple trauma patients, if they are alert and have no evidence of injury, they rarely have abnormal CT findings, and mostly do not need invasive treatment. Therefore, we should be cautious in performing whole-body CT in alert multiple trauma patients.