The aim of this review is to introduce the progress in trauma surgery made during war. In the 16th century, Paré reintroduced ligature of arteries, which had been introduced by Celsus and Galen, instead of cauterization during amputation. Larrey, a surgeon in Napoleon's military, adapted the "flying artillery" to serve as "flying ambulances" for rapid transport of the wounded. He established rules for the triage of war casualties, treating wounded soldiers according to the seriousness of their injuries and the urgency of medical care. To treat fractures and tuberculosis, Thomas created the "Thomas splint", which was used to stabilize fractured femurs and prevent infection; in World War I (WWI), use of this splint reduced the mortality of compound femur fractures from 87% to less than 8%. During WWI, Cushing systematized the treatment of head injuries, reducing mortality among head injury patients. Gillies repaired facial injuries, and his experiences became the basis of craniofacial and aesthetic surgery. In WWII, McIndoe discovered that immersion in saline promoted burn healing and improved survival rates, and thus began saline baths and early grafting instead of using tannic acid. A high mortality rate in patients with acute renal failure was noted in WWII and the Korean War. In the Korean War, Teschan used the Kolff-Brigham dialyzer. The first use of medevac with helicopters was the evacuation of three British pilot combat casualties by the US Army in Burma during WWII. As a lotus blooms in the mud, military surgeons have contributed to trauma surgery during wartime.
Journal of The Korean Society of Clinical Toxicology
/
v.6
no.1
/
pp.9-15
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2008
Purpose: Dichlorvos has been in widespread use as an organophosphate (OP) insecticide compound. The purpose of this study was to access the epidemiology and clinical features of dichlorvos in Korea. Methods: This was a 38 multi-center prospective study of dichlorvos poisoning using surveys, a structural reporting system and review of hospital records from August 2005 to July 2006. A total of 54 patients with acute dichlorvos poisoning on a national basis were enrolled. We analyzed the epidemiologic characteristics and clinical manifestations of dichlorvos poisoning. In addition, the clinical features of dichlorvos poisoning were compared with others OP compounds. Results: During the study period, compounds involving pure OP poisoning were dichlorvos (22.7%), methidathion (8.4%), and phosphamidon (6.7%). In acute dichlorvos poisoning, all ingestion routes were oral. Intentional poisoning involved 74.1% of cases. The common initial complaints involved gastrointestinal (64.8%), systemic (61.1%), central or peripheral nervous system (53.7%), and respiratory symptoms (50.0%). The median arrival time to hospital after dichlorvos poisoning was 2.6 hours and mean hospitalization duration was 7.1 days. 2-PAM was administered in 35 patients in mean doses of 6.3 g/day intravenously. Atropine was administered in 30 patients with a mean dose of 62.8 mg/day (maximal 240 mg/day). Overall mortality rate for dichlorvos poisonings were 14.8% (8/54). Immediate causes for death included sudden cardiac arrest or ventricular dysrhythmias (50%), multi-organ failure (25%), acute renal failure (12.5%), and unknown causes (12.5%). Conclusion: When compared to previous reports, dichlorvos poisoning displayed relatively moderate severity. The presence of a lower GCS score, altered mental status, serious dysrhythmias, systemic shock, acute renal failure, and respiratory complications upon presentation were associated with a more serious and fatal poisoning.
A self-etching primer that combines the etchant and primer in one chemical compound saves time and should be mote cost-effective to the clinician and patient. The purpose of this study was to evaluate the clinical effectiveness of a self-etching primer by measuring shear bond strengths according to various conditions and observing adhesive failure patterns. For this Investigation, 120 upper and lower premolars extracted for orthodontic purposes were used and randomly divided into six groups of twenty teeth each. Human premolars were embedded in a metal cylinder with orthodontic resin. Metal brackets and ceramic brackets were bonded with XT primer and self-etching primer by means of XT adhesive. Upon curing, plasma arc light and visible light were used. After bonding, the shear bond strength was tested by Instron universal testing machine, and the amount of residual adhesive that remained on the tooth after debonding was measured by stereoscope and assessed with an adhesive remnant index. The results were as fellows: 1. When brackets were bonded, if other conditions remained the same, there was no significant difference in shear bond strength due to the type of primer - either self-etching primer or XT primer. 2. When metal brackets were bonded, there was no significant difference in shear bond strength according to the source of light - plasma arc light or visible light - and type of primer. 3. There was a very significant difference in shear bond strength according to the type of brackets - metal or ceramic brackets. The shear bond strength of ceramic brackets was stronger than metal brackets. 4. When the adhesive failure patterns of metal brackets bonded with self-etching primer were observed by using the adhesive remnant index, the bond failure of the metal bracket occurred more frequently at the bracket-adhesive. The failure of the ceramic bracket, however, occurred more frequently at the enamel-adhesive interface. The adhesive failure patterns of metal brackets bonded with XT primer observed the same patterns. The above results suggest that self-etching primer can be clinically useful for bonding the brackets without fear of a decrease in shear bond strength.
Kim, Ha-Rang;Yoo, Jae-Ha;Choi, Byung-Ho;Sul, Sung-Han;Mo, Dong-Yub;Lee, Chun-Ui
Maxillofacial Plastic and Reconstructive Surgery
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v.31
no.6
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pp.544-549
/
2009
Failure to use effective methods of reduction, fixation and immobilization may lead to osteomyelitis with the exposed necrotic bone, as the overzealous use of transosseous wires & plates that devascularizes bone segments in the compound comminuted fractures of mandible. Once osteomyelitis secondary to fractures has become established, intermaxillary fixation should be instituted as early as possible. Fixation enhances patient comfort and hinders ingress of microorganisms and debris by movement of bone fragments. Teeth and foreign materials that are in the line of fracture should be removed and initial debridement performed at the earliest possible time. Grossly necrotic bone should be excised as early as possible ; no attempt should be made to create soft tissue flaps to achieve closure over exposed bone. The key to treatment of chronic osteomyelitis of the mandible is adequate and prolonged soft tissue drainage. If good soft tissue drainage is provided over a long period, sequestration of infected bone followed by regeneration or fibrous tissue replacement will occur so that appearance and function are not seriously altered. Localization and sequestration of infected mandible are far better performed by natural mechanism of homeostasis than by cutting across involved bone with a cosmetic or functional defect. As natural host defenses and conservative therapy begin to be effective, the process may become chronic, inflammation regresses, granulation tissue is formed, and new blood vessels cause lysis of bone, thus separating fragments of necrotic bone(sequestra) from viable bone. The sequestra may be isolated by a bed of granulation tissue, encased in a sheath of new bone(involucrum), and removed easily with pincettes. This is a case report of the long-term conservative drainage care in osteomyelitis associated with mandibular fractures.
In this study, doffusion barrier properties of 1000 $\AA$ thick molybdenum compound(Mo, Mo-N, $MoSi_2$, Mo-Si-N) films were investigated using sheet resistance measurement, X-ray diffraction(XRD), X-ray photoelectron spectroscopy(XPS), Scanning electron mircoscopy(SEM), and Rutherford back-scattering spectrometry(RBS). Each barrier material was deposited by the dc magnetron sputtering and annealed at 300-$800^{\circ}C$ for 30 min in vacuum. Mo and MoSi2 barrier were faied at low temperatures due to Cu diffusion through grain boundaries and defects in Mo thin film and the reaction of Cu with Si within $MoSi_2$, respectively. A failure temperature could be raised to $650^{\circ}C$-30 min in the Mo barrier system and to $700^{\circ}C$-30 min in the Mo-silicide system by replacing Mo and $MoSi_2$ with Mo-N and Mo-Si-N, respectively. The crystallization temperature in the Mo-silicide film was raised by the addition of $N_2$. It is considered that not only the $N_2$, stuffing effect but also the variation of crystallization temperature affects the reaction of Cu with Si within Mo-silicide. It is found that Mo-Si-N is the more effective barrier than Mo, $MoSi_2$, or Mo-N to copper penetraion preventing Cu reaction with the substrate for $30^{\circ}C$min at a temperature higher than $650^{\circ}C$.
Kim, Chiwoo;Hwang, Jeongyun;Yang, Aram;Kim, Jinsup;Lee, Taeheon;Jang, Ja-Hyun;Cho, Sung Yoon;Jin, Dong-Kyu
Journal of The Korean Society of Inherited Metabolic disease
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v.17
no.2
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pp.69-76
/
2017
Citrin deficiency is an autosomal recessive disorder caused by mutations in the SLC25A13 gene on chromosome 7q21.3, and a type of urea cycle disorder that causes hyperammonemia. Although neonatal intrahepatic cholestasis and adult-onset type II citrullinemia, a type of citrin deficiency, have been described well in many articles for several decades, failure to thrive and dyslipidemia caused by citrin deficiency (FTTDCD), the other type of citrin deficiency, has been only identified recently. There was previously no case report about FTTDCD in Korea. Patients with FTTDCD could present with loss of appetite, fatigue, failure to thrive, hypoglycemia, hypercitrullinemia, dyslipidemia, and an increased lactate/pyruvate ratio. Routine evaluation may not reveal the cause of hypoglycemia caused by citrin deficiency. We recently had a case that presented with recurrent hypoglycemia in a 30-month-old boy. Chemistry profiling, urine organic acid analysis, plasma acylcarnitine analysis, and hormone studies indicated values within the normal range or non-specific findings. Mutation analysis to identify the cause of hypoglycemia identified the subject as a compound heterozygote carrying each of the c.852_855del ($p.Met285Profs^*2$), and c.1177+1G>A mutant alleles. We report here on this unusual case of citrin deficiency presenting with FTTDCD for the first time in Korea.
Kim, Sung-Hyuk;Park, Gyu-Tae;Lee, Byeong-Rok;Kim, Jae-Myeong;Yoo, Sehoon;Park, Young-Bae
Journal of the Microelectronics and Packaging Society
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v.22
no.2
/
pp.47-53
/
2015
The effects of electroless nickel immersion gold (ENIG) and organic solderability preservative (OSP) surface finishes on the in-situ intermetallics reaction and the electromigration (EM) reliability of Sn-3.0Ag-0.5Cu (SAC305) solder bump were systematically investigated. After as-bonded, $(Cu,Ni)_6Sn_5$ intermetallic compound (IMC) was formed at the interface of the ENIG surface finish at solder top side, while at the OSP surface finish at solder bottom side,$ Cu_6Sn_5$ and $Cu_3Sn$ IMCs were formed. Mean time to failure on SAC305 solder bump at $130^{\circ}C$ with a current density of $5.0{\times}10^3A/cm^2$ was 78.7 hrs. EM open failure was observed at bottom OSP surface finish by fast consumption of Cu atoms when electrons flow from bottom Cu substrate to solder. In-situ scanning electron microscope analysis showed that IMC growth rate of ENIG surface finish was much lower than that of the OSP surface finish. Therefore, EM reliability of ENIG surface finish was higher than that of OSP surface finish due to its superior barrier stability to IMC reaction.
In 2008, baby formula containing melamine was found to be responsible for a large outbreak of renal failure in infants in China. A total of 294,000 infants were hospitalized, and at least 6 babies died due to ingestion of the tainted formula. Melamine contains high levels of nitrogen (>60%), which is used as an indicator of protein content. Therefore, high levels of melamine in infant formula were thought to be the result of deliberate contamination m an attempt to increase its apparent protein content. Following inspections by China's national inspection agency, assorted products from at least 22 dairy manufacturers across China were found to have varied levels of melamine (range: 0.096196.61 mg/kg). Melamine co-exposure with cyanuric acid can induce acute melamine-cyanurate crystal nephropathy, which can lead to renal failure at much lower doses than if either compound were ingested alone. However, currently, there are very few data on melamine analogues other than cyanuric acid. At an expert meeting of the WHO and FAO held to review toxicological aspects of melamine and cyanuric acid on December 14, 2008, a new tolerable daily intake (TDI) of melamine was established that could be applied to the entire population, including infants. Therefore, a risk assessment of the various theoretical melamine contamination levels in infant formula and selected representative foods (other than infant formula and sole-source nutrition products) is urgently needed for Korean babies and children up to 7 years of age. Although the undetectable level regulation for infant formula may be low enough to guarantee the safety of babies under the age of 1 year (including premature babies), the melamine standard of 2.5 ppm for foods other than baby formula could be insufficient to protect the 95th percentile population aged 1~2 years because of this demographic's high consumption of milk, yogurt, and soy milk (hazard index = 1.79). Because TDIs are chronic values intended to protect an individual over his/her lifetime, occasional modest ingestion in excess of the TDI is not likely to be a health concern. However, children aged 1~2 years may have renal systems that are comparatively more sensitive to the crystallization of melamine and its analogues. Therefore, governmental jurisdictions may need to practice more prudent management of food items that could raise the melamine exposure for this population.
Park, Hyun-Joon;Lee, Choong-Jae;Min, Kyung Deuk;Jung, Seung-Boo
Journal of the Microelectronics and Packaging Society
/
v.26
no.4
/
pp.163-169
/
2019
Sn-Pb solder alloys in electronics rapidly has been replaced to Pb free solder alloys because of various environmental regulations such as restriction of hazardous substances directive (RoHS), European Union waste electrical, waste electrical and electronic equipment (WEEE), registration evaluation authorization and of chemicals (REACH) etc. Because Sn58%Bi (in wt.%) solder alloy has low melting point and higher mechanical properties than that of Sn-Pb solder, it has been studied to manufacture electronic components. However, the reliability of Sn58%Bi solder could be lowered because of the brittleness of Bi element included in the solder alloy. Therefore, we observed the microstructures of Sn58%Bi composite solders with various contents of Sn-decorated multiwalled carbon nanotube (Sn-MWCNT) particles and evaluated bonding strength of the FR-4 components assembled with Sn58%Bi composite solder. Also, microstructures and bonding strengths of the Sn58%Bi composite solder joints were evaluated with the number of reflows from 1 to 7 times, respectively. Bonding strengths and fracture energies of the Sn58%Bi composite solder joints were measured by die shear test. Microstructures and fracture modes were observed with scanning electron microscope (SEM). Microstructures in the Sn58%Bi composite solder joints were finer than that of only Sn58%Bi solder joint. Bonding strength and fracture energy of Sn58%Bi composite solder including 0.1 wt.% of Sn-decorated MWCNT particles increased up to 20.4% and 15.4% at 5 times in reflow, respectively.
Journal of the Microelectronics and Packaging Society
/
v.24
no.2
/
pp.23-27
/
2017
This paper proposes an approach to predict the reliability of high temperature heaters by identifying their primary failure modes and mechanisms in the field. Test specimens were designed to have the equivalent stress conditions with the high temperature heaters in the field in order to examine the effect of stress conditions on the solder joint failures. There failures often result from cracking due to intermetallic compound (IMC) or void formation within a solder joint. Aging tests have been performed by exposing the test specimens to a temperature of $170^{\circ}C$ in order to reproduce solder joint failures in the field. During the test, changes in IMC formation were investigated by scanning electron microscopy (SEM) on the cross-sections of the test specimens, while changes in void formation were monitored both by resistance spectroscopy and by micro-computed tomography (microCT), alternately. The test results demonstrated the void volume within the solder increased as the time at the high temperature increased. Also, the phase shift of high frequency resistance was found to have high correlation with the void volume. These results implied the failure of high temperature heaters can be non-destructively predicted based on the correlation.
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