• Journal of Trauma and Injury
• /
• v.25 no.2
• /
• pp.49-56
• /
• 2012

Purpose: For determining the prognosis of critically injured patients, transporting patients to medical facilities capable of providing proper assessment and management, running rapid assessment and making rapid decisions, and providing aggressive resuscitation is vital. Considering the high mortality and morbidity rates in critically injured patients, various studies have been conducted in efforts to reduce those rates. However, studies related to diagnostic factors for predicting severity in critically injured patients are still lacking. Furthermore, patients showing stable vital signs and alert mental status, who are injured via a severe trauma mechanism, may be at a risk of not receiving rapid assessment and management. Thus, this study investigates diagnostic factors, including physical examination and laboratory results, that may help predict severity in trauma patients injured via a severe trauma mechanism, but showing stable vital signs. Methods: From March 2010 to December 2011, all trauma patients who fit into a diagnostic category that activated a major trauma team in CHA Bundang Medical Center were analyzed retrospectively. The retrospective analysis was based on prospective medical records completed at the time of arrival in the emergency department and on sequential laboratory test results. PASW statistics 18(SPSS Inc., Chicago, IL, USA) was used for the statistical analysis. Patients with relatively stable vital signs and alert mental status were selected based on a revised trauma score of more than 7 points. The final diagnosis of major trauma was made based on an injury severity score of greater than 16 points. Diagnostic variables include systolic blood pressure and respiratory rate, glasgow coma scale, initial result from focused abdominal sonography for trauma, and laboratory results from blood tests and urine analyses. To confirm the true significance of the measured values, we applied the Kolmogorov-Smirnov one sample test and the Shapiro-Wilk test. When significance was confirmed, the Student's t-test was used for comparison; when significance was not confirmed, the Mann-Whitney u-test was used. The results of focused abdominal sonography for trauma (FAST) and factors of urine analysis were analyzed using the Chi-square test or Fisher's exact test. Variables with statistical significance were selected as prognostics factors, and they were analyzed using a multivariate logistics regression model. Results: A total of 269 patients activated the major trauma team. Excluding 91 patients who scored a revised trauma score of less than 7 points, 178 patients were subdivided by injury severity score to determine the final major trauma patients. Twenty-one(21) patients from 106 major trauma patients and 9 patients from 72 minor trauma patients were also excluded due to missing medical records or untested blood and urine analysis. The investigated variables with p-values less than 0.05 include the glasgow coma scale, respiratory rate, white blood cell count (WBC), serum AST and ALT, serum creatinine, blood in spot urine, and protein in spot urine. These variables could, thus, be prognostic factors in major trauma patients. A multivariate logistics regression analysis on those 8 variables showed the respiratory rate (p=0.034), WBC (p=0.005) and blood in spot urine (p=0.041) to be independent prognostic factors for predicting the clinical course of major trauma patients. Conclusion: In trauma patients injured via a severe trauma mechanism, but showing stable vital signs and alert mental status, the respiratory rate, WBC count and blood in the urine can be used as predictable factors for severity. Using those laboratory results, rapid assessment of major trauma patients may shorten the time to diagnosis and the time for management.

• Korean Journal of Construction Engineering and Management
• /
• v.24 no.6
• /
• pp.12-23
• /
• 2023

The goal of international development projects is to assist sustainable development in recipient countries through foreign aid from donor countries. However, despite the need for both countries to negotiate and work together from the initial stages to maintain sustainability after the project, clear guidelines or standards have not been established. Additionally, despite the need for donor countries, which are relatively advanced, to understand the situation of recipient countries, many projects are donor-centric and fail to prioritize the value of sustainability. Therefore, this study extracted economic, social, and environmental risks that threaten sustainability through literature review and proposed a sustainability framework based on these criteria. To validate framework, actual international development cases conducted by advanced donor countries such as Australia, the United States, and Japan, in collaboration with South Korea, were analyzed by applying content analysis with the reports, which covers the overall contents from the planning stage to the operation stage. Analysis of sustainability perspectives focused on economy, society and the environment, advanced donor countries emphasized (1) the importance of pre-assessment, (2) the need for coordination with the local population and communities despite the existence of donor-specific values, and (3) addressing economic considerations such as pre-operational and maintenance costs, social communication with the local population, and environmental considerations starting from the initial stages of construction regarding the treatment of pollutants as values to be improved. Compared to other advanced donor countries, the Republic of Korea should also focus on consultation with local residents to achieve social integration, and improve sustainability by deployment the managers in local sites for better negotiation.The proposed framework in this study will serve as a tool to enhance communication among the countries and the locals, with the expectation of increasing project efficiency and sustainability.

• Clinical and Experimental Pediatrics
• /
• v.52 no.11
• /
• pp.1273-1278
• /
• 2009

Purpose:Congenital muscular torticollis (CMT), a common musculoskeletal disorder in infants, is characterized by the rotation and flexion deformity of the neck caused by sternocleidomastoid muscle shortening. We investigated the clinical courses and perinatal risk factors of CMT. Methods:Less than 6-month-old patients (98; M:F = 60:38) diagnosed with CMT between February 2007 and August 2008 were classified into 2 clinical subgroups, namely, SMT (sternocleidomastoid tumor) and POST (postural torticollis). All the patients were physically and neurologically examined prospectively and their cervical X-rays and ultrasonographies were obtained. Their medical histories about perinatal problems were recorded. Of the 98 patients, 45 with normal range of motion were taught passive physical exercises and 43 were referred to the Department of Rehabilitation for undergoing manual stretching therapy. Results:The mean age at initial assessment was 2.2 months (SMT: $1.4{\pm}1.0$, POST: $2.7{\pm}1.6$). SMT presented earlier than POST. All ophthalmologic examinations and cervical X-rays were normal. SMT was associated with higher incidence of caput succedaneum and cephalhematoma. POST was highly associated with plagiocephaly. Mean duration of rehabilitative physical therapy was 3.7 months (SMT: $4.6{\pm}2.5$, POST: $2.6{\pm}1.9$). POST resolved earlier than SMT. Of the 88 patients with follow-up, 87 had total resolution and only 1 had residual torticollis. Conclusion:All the patients received early treatment with passive stretching exercises. CMT was associated with perinatal problems and had various risk factors such as obstetrical problems.

• The Korean Journal of Nuclear Medicine
• /
• v.33 no.2
• /
• pp.143-151
• /
• 1999

Purpose: Dermatolymphangioadenitis (DLA) is a common and serious complication of lymphedema which deteriorates lymphatic function. The purpose of this study was to assess the risk of DLA by lymphos-cintigraphy in patients with lower extremity lymphedema. Materials and Methods: The subjects were 59 edematous lower extremities of 50 patients without previous episode of DLA and 12 lower extremities of 6 controls. Whole body images were acquired 1 min and 2 hr after subcutaneous injection of 37 MBq of Tc-99m-antimony sulfide colloid into interdigital spaces of both feet before therapy for lymphedema. The lymphosintigraphic and clinical variables were compared between groups with or without occurrence of DLA during clinical follow up. Results: There were 20 episodes of DLA in 12 extremities during clinical follow-up (19 :6 months). On univariate analysis, there were significant differences in ilioinguinal lymph node uptake, uptake pattern of main lymphatic vessel, clinical stage and therapy compliance between the two groups. After multivariate analysis, only the uptake pattern of main lymphatic vessel and therapy compliance fore confirmed to be independent variables. In other words, non-visualized main lymphatic vessel and poor compliance to therapy were more frequent in extremities with subsequent occurrence of DLA. Conclusion: Lymphoscintigraphy can be used to predict the risk of DLA and may thus be helpful for determining the initial therapeutic plan in patients with lower extremity lymphedema.

• Journal of the Korean Society for Nondestructive Testing
• /
• v.18 no.5
• /
• pp.389-397
• /
• 1998

For an effective and efficient management of large amounts of preservice/inservice inspection(PSI/ISI) data in nuclear power plants, an intellegent Windows 95-based data management program was developed. This program enables the prompt extraction of previously conducted PSI/ISI conditions and results so that the time-consuming data management, painstaking data processing and analysis in the past are avoided. The program extracts, and the associated remedies. Furthermore, additional inspection data and comments can be easily added or deleted for subsequent PSI/ISI operation. Although the initial version of the program was applied to Kori nuclear power plant, this program can be equally applied to other nuclear power plant. And also this program can be used to offer the fundamental data for application of evaluation data related to fracture mechanics analysis(FMA), probabilistic reliability assessment(PRA) of PSI/ISI results, performance demonstration initiative(PDI) and risk-informed ISI based on probability of detection(POD) information of ultrasonic examination. Besides, the program can be further developed as a unique PSI/ISI data management expert system that can be apart of PSI/ISI data management expert system that can be a part of PSI/ISI Total Support System(TSS) for Korean nuclear power plants.

• Journal of Soil and Groundwater Environment
• /
• v.16 no.4
• /
• pp.38-52
• /
• 2011

Sorption and sequential desorption experiments were conducted for Zn using a natural soil (NS) in background status by aging (1, 30 and 100 days). The sorption isotherm showed that Zn had high sorption capacity but low sorption affinity in NS. Sequential desorption was biphasic with appreciable amount of sorbed Zn residing in the desorption-resistant fraction after several desorption steps. The biphasic desorption behavior of Zn was characterized by a biphasic desorption model that includes a linear term to represent labile or easily-desorbing fraction and a Langmuirian-type term to represent desorption-resistant fraction. The biphasic desorption model indicated that the size of the maximum capacity of desorption-resistant fraction ($q^{irr}_{max}$) increased with aging in NS. Desorption kinetics and desorption-resistance of Zn in the soils collected from mine tailings (MA, MB and MC collected from surface, subsurface soils and mine waste, respectively) were investigated and compared to the bioavailability to earthworm (Eisenia fetida). Desorption kinetic data of Zn were fitted to several desorption kinetic models. The ratio ($q_{e,d}/q_0$) of remaining Zn at desorption equilibrium ($q_{e,d}$) to initial sorbed concentration ($q_0$) was in the range of 0.53~0.90 in the mine tailings which was higher than that in NS, except MA. The sequential desorption from the mine tailings with 0.01M Na$NO_3$ and 0.01M $CaCl_2$ showed that appreciable amounts of Zn are resistant to desorption due to aging or sequestration. The SM&T (Standard Measurements and Testing Programme of European Union) analysis showed that the sum of oxidizable (Step III) and residual (Step IV) fractions of Zn was linearly related with its desorption-resistance ($q^{irr}_{max}$) determined by the sequential desorption with 0.01M Na$NO_3$ ($R^2$= 0.9998) and 0.01M $CaCl_2$ ($R^2$= 0.8580). The earthworm uptake of Zn and the desorbed amount of Zn ($q_{desorbed}$ = $q_0-q_{e,d}$) in MB soil were also linearly related ($R^2$ = 0.899). Our results implicate that the ecological risk assessment of heavy metals would be possible considering the relation between desorption behaviors and bioavailability to earthworm.

• Journal of Korean Society of Occupational and Environmental Hygiene
• /
• v.24 no.3
• /
• pp.247-255
• /
• 2014

Objectives: We reviewed the CAREX (CARcinogen EXposure) program designed to estimate the prevalence of occupational exposure to carcinogens and summarized the advantages and limitations of this program. Methods: All literature, including reports on CAREX and the use of CAREX, were reviewed. The keyword search term was CAREX. Additional articles were identified from references cited in articles and reviewed. Results: An exposure information system, CAREX was developed based on data from the Finnish Institute of Occupational Health of Finland and from the US. CAREX has been applied in several countries, including in the EU, in order to estimate national exposure patterns to carcinogens. The initial exposure assessment carried out through CAREX was aimed at estimating exposures over the period of 1990-1993. To estimate the number of workers exposed to carcinogens by using CAREX, reference exposure prevalence from Finland and the United States was computed, which was then reviewed and corrected by national experts. Finally the overall number of workers exposed to carcinogens can be estimated. We found that CAREX has been used in a total of 18 countries. No Asian country has used CAREX. Conclusions: CAREX can be applied not only to estimate the number of workers exposed to carcinogens in Korea, but also to identify high-risk industries with workers most exposed to carcinogens.

• Journal of Korea Water Resources Association
• /
• v.51 no.10
• /
• pp.929-939
• /
• 2018

In North Korea, hydropower which occupies about 63% of power generation is a major electric power source, and North Korea has many advantages in the geographical for developing hydroelectric power. In this study, Information on the basin and dam capacity for 33 potential development site of hydroelectric dam was analyzed using DEM, and potential annual power generation was estimated by applying results of long-term runoff simulation with MWSWAT model for recent 30-year. The potential annual power generation at 33 dam was estimated to be about 28% of the current hydroelectric power in North Korea. In addition, a priority of dam development in each province was assessed by estimating the scale of an industry and prospecting the population change in the future. And a priority for dam development within the province was estimated based on the dam capacity and the potential annual power generation. The priority of each province was ranked in order of Pyeongannamdo, Hamgyungnamdo, Hamgyungbukdo, Hwanghaebukdo, Pyeonganbukdo, Jagangdo, Ryanggangdo, Hwanghaenamdo, and Gangwondo. The results of this study can be used as an initial review data for advancing to hydropower development project in North Korea.

• The Korean journal of internal medicine
• /
• v.39 no.3
• /
• pp.439-447
• /
• 2024

Background: Helicobacter pylori infection, prevalent in more than half of the global population, is associated with various gastrointestinal diseases, including peptic ulcers and gastric cancer. The effectiveness of early diagnosis and treatment in preventing gastric cancer highlights the need for improved diagnostic methods. This study aimed to develop a simple scoring system based on endoscopic findings to predict H. pylori infection. Methods: A retrospective analysis was conducted on 1,007 patients who underwent upper gastrointestinal endoscopy at Asan Medical Center from January 2019 to December 2021. Exclusion criteria included prior H. pylori treatment, gastric surgery, or gastric malignancies. Diagnostic techniques included rapid urease and ¹³C-urea breath tests, H. pylori culture, and assessment of endoscopic features following the Kyoto gastritis classification. A new scoring system based on endoscopic findings including regular arrangement of collecting venules (RAC), nodularity, and diffuse or spotty redness was developed for predicting H. pylori infection, utilizing logistic regression analysis in the development set. Results: The scoring system demonstrated high predictive accuracy for H. pylori infection in the validation set. Scores of 2 and 3 were associated with 96% and 99% infection risk, respectively. Additionally, there was a higher prevalence of diffuse redness and sticky mucus in cases where the initial H. pylori eradication treatment failed. Conclusions: Our scoring system showed potential for improving diagnostic accuracy in H. pylori infection. H. pylori testing should be considered upon spotty redness, diffuse redness, nodularity, and RAC absence on endoscopic findings as determined by the predictive scoring system.

• Journal of Chest Surgery
• /
• v.38 no.2 s.247
• /
• pp.132-138
• /
• 2005

Background: Mitral valve repair (MVP) is the optimal procedure for mitral regurgitation (MR), however, failure and subsequent reoperations are the limitations. The current study assessed the procedure in relation to the primary valve related causes of recurrent MR. Material and Method: MR was treated in 493 patients undergoing MVP from January of 1994 to January of 2002. The causes of MR were degenerative $(n=252,\;51.5\%),$ rheumatic $(n=156,\; 31.6\%),$ and others $(n=85,\; 16.9\%).$ Surgery comprised 446 ring annuloplasties $(90.5\%),$ 227 new chordae formations $(46\%),$ 125 quadriangular resections $(25.3\%),$ 28 chordae transfers $(5.7\%),$ and 8 Alfieri's stitches $(1.6\%).$ The mean follow up was $29.04\pm22.81$ months. Result: There were 5 early $(1.01\%)$, and 5 late deaths $(1.01\%).$ The reoperation rate was $1.42\%$. There were 45 $(9.1\%)$ recurrent MR (grade III or IV). Of these, 24 were procedure related including incomplete repair (n=14), discordant new chordae length (n=8) and others (n=2). In 21 patients, the cause was valve related including rheumatic disease progression (n=10), recurrent chordae elongation or prolapse (n=5) and others (n=6). Severe MR was higher after incomplete repair (p < 0.001), and valve related failure strongly correlated with rheumatic progression (p < 0.05). Conclusion: Since completeness of operation is the prime risk factor that determine the repair durability, intra-operative assessment of the initial repair with trans-esophageal echocardiography is essential.