• Title/Summary/Keyword: Hazard Factors

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Predictors of Success of Selective Laser Trabeculoplasty Adjusted for Intraocular Pressure Variations (단안 선택적 레이저섬유주성형술에서 안압 변동을 보정한 성공예측인자의 분석)

  • Lee, Jun Seok;Lee, Chong Eun;Seo, Sam;Lee, Kyoo Won
    • Journal of The Korean Ophthalmological Society
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    • v.59 no.12
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    • pp.1166-1172
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    • 2018
  • Purpose: To investigate the efficacy, and identify predictors of success of selective laser trabeculoplasty (SLT) in open-angle glaucoma (OAG) patients after adjusting for intraocular pressure (IOP) changes in the untreated fellow eye. Methods: This retrospective chart review included 52 eyes of 52 OAG patients who underwent SLT in one eye and were followed-up for at least 1 year after the procedure. The IOP was measured before the treatment, at 1, 2, and 3 months posttreatment, and every 3 months thereafter. To account for the possible influence of IOP fluctuations on laser outcomes, post-laser IOP values of the treated eye of each patient were also analyzed, after adjusting for IOP changes in the untreated fellow eye. Success was defined as an IOP decrease ${\geq}20%$ of the pretreatment IOP. The success rate was determined based on Kaplan-Meier survival analysis and factors predictive of success were analyzed using the Cox proportional hazard model. Results: The mean pretreatment IOP was $23.17{\pm}6.96mmHg$. The mean IOP reduction was $5.59{\pm}4.78mmHg$ (29.7%) and the success rate was 65.4% at 1 year. The adjusted mean IOP reduction was $4.70{\pm}4.67mmHg$ (23.9%) and the adjusted success rate was 53.9%. Pretreatment IOP was associated with SLT success; the higher the pretreatment IOP, the greater the post-laser IOP reduction (p = 0.025). Age and mean deviation index did not show a significant association with SLT success (p = 0.066 and p = 0.464, respectively). Conclusions: SLT is a safe and effective alternative method of IOP reduction in OAG patients. Herein, pretreatment IOP was the only factor significantly associated with SLT success. IOP fluctuations of the untreated eye should be considered for a better understanding of the impact of treatment.

Epidemiologic Study of Frostbites and Its Current Managements in Community Hospital (지역 병원에서 동상 환자에 대한 역학에 관한 연구 및 최근 치료)

  • Kim, Dong Chul;Min, Byung Duk;Kim, Ji Hoon;Chung, Chang Eun;Lee, Chong Kun;Yu, Sung Hoon
    • Journal of the Korean Burn Society
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    • v.24 no.2
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    • pp.21-29
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    • 2021
  • Purpose: Frostbite is a hazard to people exposed to cold environments. With the progression of modern industrial development and change of leisure behavior encountering cold environments, frequent accidental exposure to frostbite injury during work and human behavior is increasing, and the predisposing factors of frostbite were greatly changed than before. The purpose of this study was to make epidemiological analysis, and to review the treatment outcomes of frostbite. Methods: From March 2010 to February 2021, this study has included 27 patients with second- to third-degree frostbite injuries in Advanced Burn Reconstruction Center, Bundang Jesaeng Hosptial. A retrospective study was made about the distribution of age, gender, predisposing factors, prevalent area, type of managements, and the length of treatment period. Results: In our institution, acute management of frostbite patients has included rewarming, anticoagulation therapy (acetylsalicylic acid), and agents to improve vascular perfusion (lipo-prostaglandin E1 [Eglandin®]). The 25 frostbite patients with second-degree frostbite (92.6%) were successfully managed by the conservative treatment alone with a mean of 20.3 days healing time. Two patients with third-degree frostbite (7.4%) also showed good outcomes after surgical reconstruction with a mean of 59 days healing time. In our clinical experiences of third-degree frostbite, definitive surgical reconstruction should be recommended to wait for more than 4~6 weeks for identification of clear demarcation of necrotic tissue caused by frostbite. In this study, 43 frostbite injuries site in 27 frostbite patients occurred. Among them, 15 patients (55.6%) had multiple-site frostbite injury. The most common predisposing cause of frostbite was refrigerant gas accidents (44.4%), followed by outdoor activity in cold environments (40.8%), misapplying ice pack for treatment purposes (7.4%), barefoot walking on the cold ground (3.7%), and loss of consciousness in cold grounds (3.7%). The most prevalent sites of frostbite injuries revealed as the hand (58.1%), followed by the foot (32.6%), face (7.0%), and abdomen (2.3%). And in the winter season from the November to March, the incidence rate of frostbite injuries was high at 74.1%. Conclusion: This study included 27 frostbite patients with 43 frostbite sites since last decade in a single institution at the community hospital. The frostbite patients with second-degree frostbite (92.6%) were successfully healed by the conservative treatment alone with a mean of 20.3 days healing time. The most common predisposing cause of frostbite was refrigerant gas accidents (44.4%), followed by outdoor activity in cold environments, etc. The most prevalent site of frostbite injuries was the hand (58.1%). And the most prevalent seasonal incidence of frostbite was from November to March (74.1%).

The Clinical Application and Results of Palliative Damus-Kaye-Stansel Procedure (고식적 Damus-Kaye-Stansel 술식의 임상적 적용 및 결과)

  • Lim, Hong-Gook;Kim, Soo-Jin;Kim, Woong-Han;Hwang, Seong-Wook;Lee, Cheul;Shinn, Sung-Ho;Yie, Kil-Soo;Lee, Jae-Woong;Lee, Chang-Ha
    • Journal of Chest Surgery
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    • v.41 no.1
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    • pp.1-11
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    • 2008
  • Background: The Damus-Kaye-Stansel (DKS) procedure is a proximal MPA-ascending aorta anastomosis used to relieve systemic ventricular outflow tract obstructions (SVOTO) and pulmonary hypertension. The purpose of this study was to review the indications and outcomes of the DKS procedure, including the DKS pathway and semilunar valve function. Material and Method: A retrospective review of 28 patients who underwent a DKS procedure between May 1994 and April 2006 was performed. The median age at operation was 5.3 months ($13\;days{\sim}38.1\;months$) and body weight was 5.0 kg ($2.9{\sim}13.5\;kg$). Preoperative pressure gradients were $25.3{\pm}15.7\;mmHg$ ($10{\sim}60\;mmHg$). Eighteen patients underwent a preliminary pulmonary artery banding as an initial palliation. Preoperative main diagnoses were double outlet right ventricle in 9 patients, double inlet left ventricle with ventriculoarterial discordance in 6,. another functional univentricular heart in 5, Criss-cross heart in 4, complete atrioventricular septal defect in 3, and hypoplastic left heart variant in 1. DKS techniques included end-to-side anastomosis with patch augmentation in 14 patients, classical end-to-side anastomosis in 6, Lamberti method (double-barrel) in 3, and others in 5. The bidirectional cavopulmonary shunt and Fontan procedure were concomitantly performed in 6 and 2 patients, respectively. Result: There were 4 hospital deaths (14.3%), and 3 late deaths (12.5%) with a follow-up duration of $62.7{\pm}38.9$ months ($3.3{\sim}128.1$ months). Kaplan-Meier estimated actuarial survival was $71.9%{\pm}9.3%$ at 10 years. Multivariate analysis showed right ventricle type single ventricle (hazard ratio=13.960, p=0.004) and the DKS procedure as initial operation (hazard ratio=6.767, p=0.042) as significant mortality risk factors. Four patients underwent staged biventricular repair and 13 received Fontan completion. No SVOTO was detected after the procedure by either cardiac catheterization or echocardiography except in one patient. There was no semiulnar valve regurgitation (>Gr II) or semilunar valve-related reoperation, but one patient (3.6%) who underwent classical end-to-side anastomosis needed reoperation for pulmonary artery stenosis caused by compression of the enlarged DKS pathway. The freedom from reoperation for the DKS pathway and semilunar valve was 87.5% at 10 years after operation. Conclusion: The DKS procedure can improve the management of SVOTO, and facilitate the selected patients who are high risk for biventricular repair just after birth to undergo successful staged biventricular repair. Preliminary pulmonary artery banding is a safe and effective procedure that improves the likelihood of successful DKS by decreasing pulmonary vascular resistance. The long-term outcome of the DKS procedure for semilunar valve function, DKS pathway, and relief of SVOTO is satisfactory.

Postoperstive Chemoradiotherapy in Locally Advanced Rectal Cancer (국소 진행된 직장암에서 수술 후 화학방사선요법)

  • Chai, Gyu-Young;Kang, Ki-Mun;Choi, Sang-Gyeong
    • Radiation Oncology Journal
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    • v.20 no.3
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    • pp.221-227
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    • 2002
  • Purpose : To evaluate the role of postoperative chemoradiotherapy in locally advanced rectal cancer, we retrospectively analyzed the treatment results of patients treated by curative surgical resection and postoperative chemoradiotherapy. Materials and Methods : From April 1989 through December 1998, 119 patients were treated with curative surgery and postoperative chemoradiotherapy for rectal carcinoma in Gyeongsang National University Hospital. Patient age ranged from 32 to 73 years, with a median age of 56 years. Low anterior resection was peformed in 59 patients, and abdominoperineal resection in 60. Forty-three patients were AJCC stage II and 76 were stage III. Radiation was delivered with 6 MV X rays using either AP-PA two fields, AP-PA both lateral four fields, or PA both lateral three fields. Total radiation dose ranged from 40 Gy to 56 Gy. In 73 patients, bolus infusions of 5-FU $(400\;mg/m^2)$ were given during the first and fourth weeks of radiotherapy. After completion of radiotherapy, an additional four to six cycles of 5-FU were given. Oral 5-FU (Furtulone) was given for nine months in 46 patients. Results : Forty $(33.7\%)$ of the 119 patients showed treatment failure. Local failure occurred in 16 $(13.5\%)$ patients, 1 $(2.3\%)$ of 43 stage II patients and 15 $(19.7\%)$ of 76 stage III patients. Distant failure occurred in 31 $(26.1\%)$ patients, among whom 5 $(11.6\%)$ were stage II and 26 $(34.2\%)$ were stage III. Five-year actuarial survival was $56.2\%$ overall, $71.1\%$ in stage II patients and $49.1\%$ in stage III patients (p=0.0008). Five-year disease free survival was $53.3\%$ overall, $68.1\%$ in stage II and $45.8\%$ in stage III (p=0.0006). Multivariate analysis showed that T stage and N stage were significant prognostic factors for five year survival, and that T stage, N stage, and preoperative CEA value were significant prognostic factors for five year disease free survival. Bowel complication occurred in 22 patients, and was treated surgically in 15 $(12.6\%)$, and conservatively in 7 $(5.9\%)$. Conclusion : Postoperative chemoradiotherapy was confirmed to be an effective modality for local control of rectal cancer, but the distant failure rate remained high. More effective modalities should be investigated to lower the distant failure rate.

Geochemical Characteristics and Pollution Level of Heavy Metals of Asian Dust in Daejeon Area, 2007 (spring season) (2007년 봄철 대전지역에서 발생한 황사 및 대기부유물의 지구화학적 특성 및 중 금속의 오염도)

  • Lee, Pyeong-Koo;Youm, Seung-Jun;Bae, Beob-Geun
    • Economic and Environmental Geology
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    • v.45 no.3
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    • pp.217-235
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    • 2012
  • We evaluated the geochemical characteristics and their potential pollution of Asian Dusts in Daejeon, Korea during spring 2007. Compared with the chemical compositions of soils in source area of Asian Dust, those of aerosols in Daejeon were enriched with trace elements (ten to hundred fold), inferring that pollutants from China have affected on local environment in adjoining country such as Korea. Chemical analysis of aerosols during Asian dust showed that fine particles ($PM_{2.5}$) contained high contents of trace elements such as Cr, Cu, Pb, Zn, V, S, As, Cd, Co, Ni, Mo, Sb, Cs, Rb, Th, Sc and Y. In the case of TSP (Total Suspended Particle), Zr, Sr, Ba, Li, Th and U were contained much more than other trace elements. The contents of some elements (i.e. Li, Cs, Co, U, Cr, Ni, Rb, V, Th, Y, Sr and Sc) in aerosols collected in Asian Dust period, which are not likely enriched by air pollutants, were higher (2 - 4.2 fold) than those in Non Asian Dust period, indicating that these elements could be used as indicator elements for determining the occurrence of Asian Dust phenomena (especially, Sr, V, Cr & Li). In the case of Asian Dust coming through the big cities and/or industrial areas of China, the domestic aerosols had higher contents of trace elements (such as S, Cd, Zn, Pb, Cu, Mo and As) than those from Northeastern China via North Korea, indicating that the transportation courses of air mass are very important to determine the pollution degrees. Using the enrichment factors of trace elements in aerosols during Asian Dust and Non Asian Dust, we identified that some elements (i.e. S, Zn, Cu, Pb, As, Mo and Cd) were most problematic in terms of environmental hazard aspects, and these elements could affect adverse effects on human health as well as ecosystem and surface environment (soil and water) through long-lived precipitation.

Assessment of Contamination and Geochemical Dispersion by Heavy Metals in Roadside Tree Leaves of Platanus occidentalis and Soils in the City of Seoul (서울시 가로수목 중 플라타너스 잎과 토양의 중금속 원소에 대한 지구화학적 분산과 오염평가)

  • Choo, Mi Kyung;Lee, Jin-Soo;Lee, Jeonghoon;Kim, Kyu-Han
    • Economic and Environmental Geology
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    • v.47 no.4
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    • pp.405-420
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    • 2014
  • To investigate geochemical characteristics of soil and atmospheric environments by anthropogenic source, we have analyzed and determined heavy metal concentrations of the surface soils beneath roadside trees and leaves of Platanus occidentalis from 52 points in Seoul during autumn 2001. For comparison of the contents of heavy metal for the soil and leaf, we have analyzed heavy metal contents of the surface soils beneath roadside trees and leaves from 2 points in rural area of Yesan during the same time period. The composition of heavy metals of soils are relatively high for Cd, Co, Cr and Ni in industrial area (IA, Industrial Area) and high for Cu, Pb and Zn in heavy traffic area (HTA, Heavy Traffic Area). The heavy metal contents of rural area in Seoul are higher than those in Yesan. The differences of chemical compositions between the washed and unwashed leaves are high for Cd, Cu, Pb and Zn in the HTA. The element couples of Cd-Co, Cr-Ni and Pb-Zn for the soils had shown a good correlation and their contamination sources could be similar. The relationship for Pb-Cu and Cu-Zn showed good correlation in Platanus leaves. The relationship between soils and unwashed leaves show a good correlation for Cr, Cu, Pb and Zn but low correlation for Cd, Co, Fe, Mn and Ni. It is thought that the Cr, Cu, Pb and Zn were derived from contaminants of soils, whereas Cd, Co, Fe, Mn and Ni were originated from atmospheric source. From the spatial variations of elements for soils and leaves, Ni and Cr were dominant in the soils of IA and Cd, Cu and Zn were dominant in those of HTA. The Contamination by Cd-Pb and Cu-Zn in unwashed leaves were analyzed to show similar patterns. Using the enrichment factors (EF) of heavy metals in unwashed leaves, the EF sequences were to be Cu, Zn, Pb, Mn, Co, Ni, Cd and Cr. We identified that Cu, Zn, Pb and Mn were most problematic of environmental hazard in Seoul.

A Study Security Measures for Protection of VIP in the G20 Summit (G20 정상회의 시 주(主)행사장에서의 VIP 안전대책 방안에 관한 연구)

  • Lee, Sun-Ki;Lee, Choong-Soo
    • Korean Security Journal
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    • no.24
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    • pp.91-123
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    • 2010
  • The threat factors available for occurrence given G20 Summit Meeting are expected leader terrorism, hostage terrorism, bomb terrorism, public facilities terrorism, and aircraft terrorism. As for the threat groups, which are expected in Korea, the North Korea, Islam extremist group, and the group such as NGO organization of being opposed to international meeting are regarded as having possibility of causing hazard. Thus, the purpose of this study is to suggest VIP Security-measure plans in the main site in preparation for G20 Summit Meeting. Accordingly, each country in the world is adopting 'the principle of Triple Ring' in common. Thus, it elicited a coping plan by 1st line(inner ring) 2nd line(middle ring) 3rd line(outer ring) based on this principle, and proposed even an opinion together that will need to be reflected in light of policy for the VIP security measures. In conclusion, as for the VIP Security-measure plans in the main site in preparation for G20 Summit Meeting, In the inner ring(safety sector), first, an intercepting measure needs to be devised for a spot of getting into and out of vehicles given the Straight Street. Second, the Walking Formation needs to be reinforced boldly in the exposed area. In the middle ring(security sector), first, the control plan needs to be devised by considering particularity of the main site. Second, there is necessity for adopting the efficient security badge operation plan that is included RFID function within security badge. In the outer ring(aid protective sector), first, there is necessity of preparing for several VIP terrorisms, of collecting information and intelligence, and of reinforcing the information collection system against terrorism under the cooperation with the overseas information agency. Second, the urgent measure training in time of emergency needs to be carried out toward security agent event manpower. Third, to maintain the certain pace in VIP motorcade, the efficient traffic control system needs to be operated. Finally, as for what will need to be reflected in light of policy for VIP security measures, first, there is necessity for allowing VIP residence to be efficiently dispersed to be distributed and controlled. Second, there is necessity for allowing impure element to misjudge or attack to be failed by utilizing diverse deception operations. Third, according to the reorganization in North Korea's Organization of the South Directed Operations, the powerful 'military-support measure' needs to be driven from this G20 Summit Meeting. For this, the necessity was proposed for further reinforcing the front back defense posture under the supervision of the Ministry of National Defense and for positively coping even with detecting and removing poison in preparation for CBR (chemical, biological, and radio-logical) terrorism.

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Comparative Analysis on the Perceptions for Food Additives Between Elementary School Teachers and Nutrition Teachers (식품첨가물에 대한 초등교사와 영양교사의 인식 비교)

  • Kim, Jeong-Weon;Lee, Eun-Ju
    • Journal of Food Hygiene and Safety
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    • v.31 no.2
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    • pp.74-84
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    • 2016
  • Literacy on food additives of elementary school teachers (ET) and nutrition teachers (NT) could be influential factor on safe dietary education for school children. Therefore, the perceptions and information needs on food additives were surveyed from 351 elementary school teachers and nutrition teachers in metropolitan area of Korea, and the basic data for the promotion of risk communication on food additives among them were obtained. Compared to ET who consider 'taste' (39.1%) as the most important factor while purchasing food, NT considered 'safety' (68.1%) first (p < 0.001). Among the food labelling items, the level of understanding on food additives was the lowest both in ET (3.53) and NT (4.17), and NT showed better levels of understanding overall on food labels. Both ET and NT regarded hazardous factors of food as environmental pollutants, foodborne pathogens, and food additives in order, and tended to select 'no additives' or 'no artificial color' products while purchasing processed food. Although NT answered that they know all food additives had been passed the evaluation of safety and effectiveness tests (100%) and have standards of use (81.9%), majority of them (87.5%) believed the consumption of food additives are harmful on human health. ET (75.2%) also regarded food additives as dangerous materials. Above results suggested the necessity of proper and enough risk communication for both ET and NT. Both ET and NT wanted to have information on the safety or hazard of food additives. Most preferred media to get the information on food additives was TV (3.80) among ET and lecture (3.65) among NT. ET and NT trusted hospital, research institution/universities or the personnels working in these institutions as the provider of information on food additives. The result that the trust levels of ET and NT on government were relative low suggested the weakness of risk communication in Korean government. Although ET and NT answered that they do not trust mass media, their behaviors were affected by them such as reading food labels in ET (39.4%) and reducing the consumption of food additives in NT (50%). They also indicated mass media's problem of sensitive approach on food additives and asked the urgent reaction of government by providing sound information through experts on food additives. Above results revealed that ET and NT have different perceptions and information needs on food additives, therefore, proper risk communication should be provided for them to serve as dietary educators for elementary school children.

Changes of the Clinicopathological Characteristics and Survival Rates of Gastric Cancer with Gastrectomy - 1990s vs early 2000s (위절제 위암 환자의 임상병리학적 특성과 생존율의 변화: 1990년대와 2000년대 초기의 비교)

  • Sim, Young-Kwan;Kim, Chan-Young;Jeong, Yeon-Jun;Kim, Jong-Hun;Hwang, Yong;Yang, Doo-Hyun
    • Journal of Gastric Cancer
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    • v.9 no.4
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    • pp.200-206
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    • 2009
  • Purpose: The incidence of upper gastric cancer and especially the diffuse type have increased in western countries. The aim this study was to investigate the chronologic changes of the clinicopathological features and survival rates of Korean upper gastric cancer patients. Materials and Methods: 1,638 gastric cancer patients who underwent gastrectomy were included in this study and they were divided into two groups; the 1990's (1991~1999, n=987) and the early 2000's (2000~2003, n=651). We evaluated the differences of the clinicopathologic features and the factors that affected the survival rates by univariative and multivariative analysis. Results: The older age (>60) patients increased from 42.7% to 50.7% respectively. Being overweight (body mass index$\geq$23) also increased from 31.5% to 43.2%. For the pathology, the incidence of stage Ia gastric cancer increased (29.8% to 44.5%) and the incidence of stage IV gastric cancer decreased (23.5% to 11.8%). Yet there was no difference according to the WHO classification, Lauren's classification and the location of tumor between the groups. The 5 year survival rates increased 67.7% to 83.7%, according to the group. Multivariative analysis showed that the odd ratios of the early 2000s was 0.715 (95% CI; 0.555~0.921) as compared to that of the 1990s. Conclusion: There were no changes of the clinicopathologic features, like the pattern in western countries, although the incidence early gastric cancer, old age patients and overweight patients increased. The survival rate of early 2000s was better that that of the 1990s.

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A Study on Development of Evaluation Indicator for Golf Course User's Preference (골프장 이용자 선호도 평가지표 개발)

  • Seok, Young-Han;Moon, Seok-Ki;Lee, Eun-Yeob
    • Journal of the Korean Institute of Landscape Architecture
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    • v.38 no.4
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    • pp.25-34
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    • 2010
  • This study was conducted to develop evaluation indicators to improve athletic performance and operational management of golf courses and the results of the research are as follows. Through theoretical research and a preliminary professional survey, 15 on-going evaluations of golf course composition and operational management and 55 sub-evaluation indices were rejected while 10 on-going evaluations and 52 sub-evaluation indicators were reconfigured as final for environmental-friendliness, level of member services, level of human service of game personnel, difficulties of course, management level of the course, fairness of operational management, accessibility and location characteristic, traditions and ambiance of the golf club, quality of course, and course layout. When analyzing the important decision factors in golf course user preference evaluation indicators, the following contributed in the order of higher to lower contributions: the management level of the course, excellence of the course, level of human services for personnel, course layout and environmental-friendliness. When identifying the path coefficient of golf course evaluation indicators, the curvature of a hole and the length of the course had a causal effect on the 'course layout' section. Tournament facilities and various shot values had a causal relationship with 'excellence of the course', in the order of higher to lower, and convenience of waiting and fair allocation of reservations for 'fairness of operational management'. The history of the golf course and its environmental characteristics, history and culture of the region have relatively higher causal effects on 'traditions of the golf club' and geographical conditions on 'accessibility and location characteristics', pesticide and fertilizer usage and water pollution on 'environmental-friendliness', and member benefit and kindness of employees on 'level of member services'. The kindness and expertise of the game personnel had a relatively higher causal effect on the 'level of human services of game personnel', the location of tenning area, and location of OB and hazards on 'difficulties of course', and rough conditions and obstacles management on 'management level of the course'. There is a need to complete a systematic evaluation index system for golf course user preferences through future studies for a more detailed assessment, as well as a process to verify these evaluation indicators by application to domestic and international golf courses.