• Korean Journal of Culture and Social Issue
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• v.8 no.1
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• pp.41-59
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• 2002

The present study explored the major behavior patterns of drivers and the environmental settings having an effect on traffic accident using the data collected from drivers and traffic police. Drivers and traffic police read questionnaire which contain the passible causes of traffic accident and selected the major causes on the basis of their latest accidents. Unexperienced drivers were forced to answer the questionnaire by referring to their friends and neighborhoods. The results showed that the major causes of traffic accident were connected with the driver's factors. The most important cause of traffic accidents was inattention/incautiousness. The next were lack of competence, skill, and experience. One interesting fact was that drivers and traffic police attributed differently. Drivers pointed out the lack of ability coping with an emergency and the insufficient skill of defensive driving as causes of the traffic accident. On the other hand, traffic polices indicated the intentional violations such as the disregard for traffic rules, trespassing on the central line of the roadway, speed limit violation, and breaking into the vehicle's line. The implications for appling the this results to driver education institutions were discussed.

• Journal of the Society of Disaster Information
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• v.20 no.1
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• pp.69-81
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• 2024

Purpose: Recently, there has been a movement to guarantee the right to watch sports for the disabled. However, the sports stadium is designed without considering the wheelchair users, so the right to move in the stadium is not secured. Restrictions on the movement of the disabled make the evacuation vulnerable in an emergency. This study aims to develop a plan to ensure the safety of movement and evacuation of wheelchair users by conducting simulations targeting indoor sports stadiums. Method: The simulation was performed by constructing a scenario with the shape of the stands as a variable. The effect of the installation of wheelchair seats on evacuation was confirmed. Result: The results according to whether wheelchair seats are installed, the evacuation route of wheelchair movement, and whether wheelchair seats are separately arranged were compared. The impact of wheelchair seat installation on evacuation and its characteristics were derived. As a result, upward and separation seat was the most vulnerable to evacuation. Conclusion: A plan to secure evacuation performance was derived for the top floors of upward and separation seat. It is judged that the content can be use as a way to secure the safety of movement and evacuation of the disabled in sports stadiums.

• Journal of Chest Surgery
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• v.41 no.3
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• pp.347-353
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• 2008

Background: Esophageal perforation is an emergency that. requires early diagnosis and effective treatment. A delay in diagnosis and treatment. significantly increases morbidity and mortality. Material and Method: Thirty-seven patients with esophageal perforation were surgically treated at our institutions between January 1990 and December 2006. We retrospectively reviewed the results of surgical treatment for esophageal perforation to understand the risk factors affecting survival inpatients. Result: Patients ranged in age from 21 to 87 years, with an average age of $52.7{\pm}16.98$ years. Thirty-one of the patients were men and six were women. There were 23 patients (62%) with spontaneous perforations, 10 patients (27%) with a traumatic perforation, and 4 patients (11%) with an iatrogenic perforation. The site of esophageal perforation was the cervical esophagus in 5 patients, the thoracic esophagus in 31 patients, and the abdominal esophagus in one patient. Twenty-nine patients underwent primary closure of the perforation and five patients had T-tube drainage. Exclusion-diversion procedures were performed in two patients and an esophagectomy was performed in one patient. There were six cases of mortality (16.22%) and 25 cases of postoperative complications in 15 patients (40.5%). Patients that were treated later than 24 hours after detection of the perforation showed a statistically significant high morbidity and mortality rate (p<0.05). Conclusion: The most important risk factor of esophageal perforation was the time interval between detection of the perforation and the initiation of treatment. A prompt diagnosis and effective treatment are necessary to decrease morbidity and mortality.

• Journal of radiological science and technology
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• v.31 no.4
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• pp.337-346
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• 2008

A questionaire survey was conducted for patients who had been examined at the Department of Radiology to investigate the items that need to be improved. Brainstorming was also conducted by team members to suggest the tactics that can efficiently perform the QI activity by selecting the most frequently answered topics for the reduction of waiting time of x-ray examination. From September 2006 to November 2007, number of patients before and after conducting QI was compared for 3 months by each category differentiated by types of detailed causes. A patient case was set as one shooting for one patient. After conducting QI, the waiting cases before conducting QI were evaluated for the method of improvement for 3 month through the QI team discussion and conducted by following the improvement method for the next 1 month and the waiting cases were measured and the difference before and after the QI activity was compared in percentage. 1. When patient waiting cases were compared before and after conducting QI activity against the causes of repetition, it resulted in 3.9% of reduction effect. 2. When patient waiting cases were compared before and after conducting QI activity against the causes for the lack of guiding, it resulted in 1.1% of reduction effect. 3. When patient waiting cases were compared before and after conducting QI activity against the causes of miss-inputting prescription, it resulted in 1.1% of reduction effect. 4. When patient waiting cases were compared before and after conducting QI activity against the causes for emergency patients, patients with acute pain and discomfort patients, it resulted in 12.0% of reduction effect. 5. When patient waiting cases were compared before and after conducting QI activity against the causes for shooting overlapping of outpatients and hospitalized patients, it resulted in 4.7% of reduction effect. There are many factors to reduce the patient waiting cases in radiography. The first step is for radiology department to find these factors through QI, to improve them, which is the reason why the QI team is organized to perform the QI activities.

• Journal of the Korean Chemical Society
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• v.51 no.3
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• pp.251-257
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• 2007

The Tumor necrosis factor-α, (TNF-α), is involved in the pathogenesis of multiple sclerosis and contributes to the degeneration of oligodendrocytes as well as neurons. Nicotine has been found to have immunosuppressive and inflammation-suppressing effects. Astrocytes, the major glial cells in the CNS, are capable of producing TNF-α at both the mRNA and protein levels in response to interleukin-1 (IL-1) or TNF-α. Nicotine has been shown to influence glial cell functions. To order to explore the role of astrocytes in the production of TNF-α, astrocytes were pretreated with nicotine and are stimulated with IL-1β to determine their effects on TNF-α production. The results are as follows. Cytotoxic effects of nicotine on human fetal astrocytes were noted above 10 μg/ml of nicotine. The effect of IL-1β on TNF-α mRNA expression in primary cultured human fetal astrocytes was maximal at 2 h after IL- 1β(100 pg/ml) treatment. Human fetal astrocytes were pretreated with 0.1, 1, and 10 μg/ml of nicotine and then stimulated with IL-1β (100 pg/ml) for 2 h. The inhibitory effect of nicotine on expressions of TNF-α mRNA in human fetal astrocytes with pretreated 0.1 μg/ml of nicotine is first noted at 8 hr, and the inhibitory effect is maximal at 12 h. The inhibitory effect at 1 μg/ml of nicotine is inhibited maximal at 24 h. Nicotine at 0.1, 1 and 10 μg/ml concentrations significantly inhibits IL-1β-induced NF-κB activation. Collectively, this study indicates that nicotine might inhibit the expression of TNF-α in activated human fetal astrocytes.

• Tuberculosis and Respiratory Diseases
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• v.46 no.5
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• pp.645-653
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• 1999

Introduction : Although myocardial ischemia tends to occur more frequently than can he documented in ventilated patients, it has not been well studied on the factors related to the occurrence of the ischemia. Methods : To investigate the related factors to ischemia development, a prospective study was done in 95 cases with consecutive 73 patients who had received mechanical ventilation(MV) in MICU. In addition to 24 h holter monitoring, echocardiogram, electrolytes, cardiac enzymes, hemodynamic, and gas exchange measurements were done within 24 h after initiation of MV in 69 cases. The measurements were repeated at weaning period in 26 cases. The ischemia was defined by the ST segment changes; up-sloping depression more than 1.5 mm or down-sloping or horizontal depression more than 1.0 mm from isoelectric baseline for 80 ms following J point. Results : Twelve patients(12.6% in 95 cases) developed ischemia in total. The incidence of ischemia development showed an increased tendency in the initial 24 hr after MV (15.9%) and in patients with left-sided heart failure found by echocardiogram (18.2%) compared with that of the weaning period (3.8%) and patients without heart failure (10.9%) (P=0.12, P=0.09, in each). There were no differences in APACHE III score, baseline ECG findings, electrolytes abnormalities, use of inotropics or bronchodilators, presence of sepsis or shock, mode of ventilation, and survival rate according to the development of ischemia. Maximal heart rates and mean arterial pressure also were not different between patients with ($137.2{\pm}30.9/min$, $82.5{\pm}15.9$ mm Hg) and without ischemia ($l29.5{\pm}29.7/min$, $83.8{\pm}17.6$ mm Hg). Conclusion : Although the incidence of myocardial ischemia was 12.6% in total, there were no clinically predictable factors to the development of ischemia during mechanical ventilation.

• Korean Journal of Clinical Laboratory Science
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• v.52 no.3
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• pp.284-295
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• 2020

In December 2019, the first coronavirus disease- 2019 (COVID-19) patient was reported in Wuhan, Hubei Province, China. Since then, the number of patients who suffered severe acute respiratory syndrome caused by the novel Coronavirus (SARS-CoV-2 or 2019-nCoV) has increased dramatically in Korea. This new variant virus induces pulmonary diseases, including cough, sore throat, rhinorrhea, dyspnea, and pneumonia. Because SARS-CoV-2 is an RNA virus, real-time reverse-transcriptase PCR has been used widely to diagnose COVID-19. As the Korea Centers for Disease Prevention and Control (KCDC) and Ministry of Food & Drug Safety (MFDS) approved emergency use authorization, clinical specimens collected from COVID-19 patients and even healthy people have been clinically diagnosed by laboratory medicine. Based on a literature search, this paper reviews the epidemiology, symptoms, molecular diagnostics approved by KCDC, a current diagnosis of COVID-19 in the laboratories, the difference between molecular and serological diagnosis, and guidelines for clinical specimens. In addition, the Korean guidelines of biosafety for clinical laboratory scientists are evaluated to prevent healthcare-associated infection. The author's experience and lessons as clinical laboratory scientists will provide valuable insights to protect the domestic and international health community in this COVID-19 pandemic around the world.

• Journal of Chest Surgery
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• v.42 no.4
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• pp.480-486
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• 2009

Background: The Fogarty thromboembolectomy catheter technique was devised to extract distal arterial emboli and it represents a milestone for the treatment of patients with acute arterial occlusion since the 1960s. The major causes of arterial occlusion have changed from emboli of a heart origin to atherosclerosis over the past 30 years. Accordingly, questions have been raised about the effectiveness of simple Fogarty thromboembolectomy. Material and Method: During the period from March 1990 through August 2008, 156 patients who requiring Fogarty thromboembolectomy were analyzed. The patients were divided into two groups: those with simple Fogarty thromboembolectomy (Group 1, 79 patients) and those with additional vascular bypass graft surgery (Group 2, 77 patients). The duration of symptoms, the cause of thrombi, admission via the emergency room, a history of acupuncture or misdiagnosis, combined diseases, the anatomic occlusion site and the cause of death were analyzed using T-tests, cross tab tests, Chi square tests and Kaplan-Meier tests, respectively. Result: The mean age was 64$\pm$10 years in the 2 groups. The duration of symptoms (pain) in Group 1 vs Group 2 was 12$\pm$4 days vs 71$\pm$14 days (p=0.001). 50 (63%) patients in Group 1 were admitted via the emergency room vs 18 (23%) patients in Group 2 (p=0.005). Misdiagnosis and the treatment for herniated intervertebral disc or acupuncture were given to, 20 (25%) patients in Group 1 vs 30 (39%) patients in Group 2. Anticoagulation treatment before admission was performed in 22 (28%) patients in Group 1 vs 11 (14%) patients in Group 2. The causes of thrombi were heart disease in, 24 (30%) patients in Group 1 vs 6 (8%) patients in Group 2 (p=0.001), atherosclerosis in 46 (58%) patients in Group 1 vs 67 (87%) patients in Group 2 (p=0.001) and trauma in 9 (11%) patients in Group 1 vs 6 (8%) patients in Group 2. The combined diseases were cerebrovascular accident, hypertension and diabetes mellitus in 22 $\sim$ 37% of the total patients. The occlusion sites were mainly in the iliac and femoral arteries. Endarterectomy was performed in 7 (9%) patients in Group 1 vs 18 (23%) patients in Group 2 (p=0.012). Treatment was successful in 27 (34%) patients in Group 1 and in 40 (52%) patients in Group 2 (p=0.019). Reocclusion occurred in 37(47%) patients in Group 1 vs 20 (26%) patients in Group 2 (p=0.000), Amputation was done in 4 (5%) patients in Group 1 vs 12 (16%) patients in Group 2 (p=0.012) and death occurred in 10 (13%) patients (Group 1) vs 3(4%) patients (Group 2) (p=0.044). Conclusion: The recent past has shown a decline in the effectiveness of simple Fogarty thromboembolectomy with a changing pattern of acute arterial occlusion from a rheumatic heart origin to atherosclerosis. Additional bypass procedures play a role for the treatment of arterial occlusion instead of always performing simple Fogarty thromboembolectomy.

• Tuberculosis and Respiratory Diseases
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• v.67 no.1
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• pp.21-26
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• 2009

Background: Non-invasive positive pressure ventilation (NPPV) ensures adequate gas exchange during bronchoscopy in spontaneously breathing, hypoxemic patients, thus avoiding endotracheal intubation. However, in some patients, endotracheal intubation is eventually required after bronchoscopy. This study investigated the incidence of intubation and predictors of a need for emergency intubation prior to NPPV bronchoscopy initiation. Methods: On a retrospective basis, we reviewed the medical records of 36 patients (median age, 55 years; interquartile range [IQR], 43~65 years) with acute hypoxemic respiratory failure who required NPPV during bronchoscopy between January 2005 and October 2007. Results: All patients were hypoxemic (median $PaO_2/FiO_2$ ratio 155; IQR 90~190), but tolerated bronchoscopy with NPPV support. SOFA score and SAPS II score immediately before NPPV initiation were 4 (3~7) and 36 (30~42), respectively. Seventeen (47%) patients needed endotracheal intubation at a median time of 22 (2~50) hours after bronchoscopy. Patients who needed intubation after bronchoscopy had a higher in-hospital mortality (11 [65%] vs. 4 [21%], p=0.017). Upon multiple logistic regression analysis, the need for intubation after bronchoscopy was independently associated with a $P_aO_2/FiO_2$ ratio (OR, 0.961; 95% CI, 0.924~0.999; p=0.047) immediately before NPPV initiation for bronchoscopy. Conclusion: The severity of the hypoxemia immediately prior to NPPV initiation for bronchoscopy was associated with the need for intubation after bronchoscopy in patients with hypoxemic respiratory failure.

• Journal of the Korean Society of Radiology
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• v.5 no.1
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• pp.37-49
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• 2011

To examine the possible changes in the SNRs, CNRs, and ADC values for lumbar spines with metastasis based on the DW images before and after contrast agent injection taken from metastatic spinal cancer patients using a 1.5 T MR machine. The quantitative analysis revealed that in case of spinal cancer subjects, both SNRs and CNRs at all of those assessed locations significantly increased on the DWI after contrast agent injection compared to before, while on the ADC map images, SNRs significantly decreased. On the other hand, significantly decreased ADC values at all the assessed locations were found on the ADC map images. With reference to the normal group, significantly increased SNRs were found at all of the assessed locations on the DWI image after injection compared to before, while significantly decreased SNRs were found on the ADC map images. Also, significantly decreased ADC values at all the assessed locations were found on the ADC map images. For the qualitative analysis, after contrast agent injection, significantly increased signal intensities were found at the locations with spinal cancer on the DWI. In contrast, significantly decreased signal intensities were found on the ADC map images. The implication from the results showing that SNR and CNR significantly increased while ADC value significantly decreased at, above, and below the location of metastatic spinal cancer on DWI after contrast agent injection is that DWI obtained after contrast agent injection can be made available for wider application to vertebral disorders.