• Journal of Chest Surgery
• /
• v.7 no.2
• /
• pp.163-168
• /
• 1974

Five cases of traumatic diaphragmatic hernia were repaired in the Department of Thoracic Surgery, Seoul National University Hospital, during the period from 1967 to 1974. The first case, a 14-year aid girl, was diagnosed as diaphragmatic hernia during laparotomy because of jejunal perforation 3 days after traffic accident. Herniated stomach, transverse colon, spleen and left lobe of the liver were repositioned and the diaphragmatic rupture on left posterolateral portion was repaired with two layers of nonabsorbable sutures by transthoracic approach. The second case, a 26-year old man,was diagnosed immediately after traffic accident at a local clinic and transferred to this hospital 24 hours later. Herniated stomach, transverse colon and jejunum were repositioned amd diaphragmatic rupture,about 9 cm in length,from the posterolat.edge to the base of pericardium was sutured in two layers. The third case, a 26-year old man who had stab wound on the left lower lateral chest two years ago,was admitted with sudden abdominal pain and vomiting. Upper gastrointestinal series with barium meal revealed diaphragmatic hernia. The herniated stomach and transverse colon through the defect,about 3.5cm in diameter, at anterolateral portion on the left side,were repositioned and repaired with two layers of nonabsorbable sutures. The forth case, a 26-year old man, sustained blunt trauma to the chest by a roller and was transferred to the emergency room complaining of dyspnea 40 minutes after the accident. The diaphragmatic rupture extended from left midaxillary line to contralateral anterior axillary line,about 20cm long, at anterior portion of diaphragm, which was repaired with two layers, of nonabsorbable sutures. The fifth case, a 4-year old girl, had two separate diaphragmatic ruptures on both sides, which were caused by traffic accident. Immediate upper gastrointestinal series after injury showed herniated stomach, colon and spleen into left Chest cavity. Another small rupture with anterior edge of right lobe of the liver in chest cavity was noted. These were repaired with non-absorbable sutures via thoracotomy.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.15 no.9
• /
• pp.5578-5584
• /
• 2014

In this study, 46 patients from a local hemodialysis center were enrolled to assess the effects of a self-motivated virtual reality (VR) exercise program on the heart rate variability and quality of life control in hemodialysis patients. The VR group (n = 23) completed a VR exercise program, where the subjects performed the exercise 40 min per session, 3 sessions per week, for 8weeks. After the exercise program, the heart rate variability and quality of life were measured. The VR group showed significant improvement in the heart rate variability and quality of life. The self-motivated VR exercise program provided both the role of supervisor as well as feedback, which is important for hemodialysis patients.Therefore, a self-motivated VR exercise program may be a useful tool for improving the psychosocial function in chronic disease patients undergoing hemodialysis.

• Journal of Korean Society of Water and Wastewater
• /
• v.34 no.5
• /
• pp.335-344
• /
• 2020

Due to global climate change, mega-droughts have occurred frequently. Since long-term droughts make it difficult to secure the water resources, water supply needs to be restricted in a reasonable manner. In the event of limited water supply, the waterworks need to develop a restricted water supply strategy. This study showed that analyzing daily water supply could be used to respond to the first stage of a drought. According to an analysis of Korea's major water authorities, there was about 7~21% of room for daily minimum water supply in case of a drought. Restricting the water supply by lowering pressure is a good strategy for local water authorities with high water leakage rate since leakage is inversely dependent with pressure. For this method, it is necessary to quantify water deficiency and pressure at each node using a simulation. Since DDA-based software is not possible to predict changes in demand at nodes with pressure reduction, WaterGEMS, a PDA software, was used to quantitatively predict water shortages and pressures at each node. Locations where water is deficient need to install booster pumps or to be dispatched with water tank truck and bottled water. Without these support, lowering pressure could not be an option for water works. This paper suggests a method for waterworks to plan a drought by lowering pressure to restrict water supply using daily water supply analysis and PDA based simulation.

• Journal of Digital Convergence
• /
• v.16 no.10
• /
• pp.357-366
• /
• 2018

The purpose of this study is to provide data for the development of a nursing intervention program by analyzing the concept of prisoner correction. From April 1st, 2016, to July 30th, the research literature on all domestic and international prisoner correction from 2011 to 2015 were searched using PubMed and NDSL RISS. 37 documents were analyzed according to conceptual analysis method procedures by Walker and Avant. In order to promote a positive attitude toward life through internal reflection of prisoner correction, individual characteristics for improvements in problem solving abilities, social adaptation abilities, re-socialization and the protection of the people and society to inmates displaying anti-social and moral behaviors that violated the law. The purpose of this study was to establish a desirable direction for prisoner correction, and provide a theoretical basis for the development of a nursing intervention program.

• Journal of The Korean Society of Clinical Toxicology
• /
• v.19 no.2
• /
• pp.133-138
• /
• 2021

Glufosinate-containing herbicides is a non-selective herbicide commonly used worldwide. As the use of them increased gradually since paraquat was banned in 2012, the number of suicides by their ingestion is also increasing continuously. Complications of glufosinate-containing herbicide poisoning include various central nervous system (CNS) toxicities such as convulsions, loss of consciousness, memory impairment, and respiratory depression, which may be accompanied by hemodynamic changes such as bradycardia and hypotension. However, it is very rare that arrhythmias other than bradycardia occurred and Takotsubo cardiomyopathy was combined due to cardiotoxicity. A 71-year-old female patient was transferred to our hospital after ingesting 500 mL of glufosinate-containing herbicide and receiving 5 L of gastric lavage at a local hospital. A few hours later, she presented stuporous mentality, respiratory depression, and convulsions, and was accompanied by hypotension and bradycardia. On the second day of admission, electrocardiogram (ECG) showed bradycardia and QTc prolongation with hemodynamic Instability. Accordingly, we conducted the early treatment with continuous renal replacement therapy (CRRT) and the application of temporary cardiac pacemaker. An echocardiogram demonstrated decreased ejection fraction (EF) and Takotsubo cardiomyopathy on the third day of admission. Then, she was discharged safely with conservative treatment. At the follow-up after 1 year, Takotsubo cardiomyopathy, EF and QTc prolongation were recovered on echocardiogram and ECG. Because cardiac toxicity after glufosinate-containing herbicide poisoning may cause life-threatening consequences, caution is required while treating the patient. Therefore, if electrocardiogram changes are seen in the elderly with a large amount of glufosinate herbicide ingestion, additional cardiac function test through echocardiography should be concerned, and early treatment through CRRT or artificial cardiac pacing should be considered.

• Tuberculosis and Respiratory Diseases
• /
• v.40 no.5
• /
• pp.610-615
• /
• 1993

Silicone (polydimethylsiloxane) has widely been used in breast augmentation and other cosmetic procedures. Despite the stability of its chemical nature, local and systemic adverse reactions associated with silicone have been reported. There were several patients who suffered from pulmonary embolism associated with injection of silicone. Silicone-induced pneumonitis and sudden death after subcutaneous injection of silicone has been also described. However, there is no case in the literature of clinically diagnosed silicone-induced pulmonary embolism in Korea. We experienced 2 women who developed respiratory symptoms after illicit subcutaneous injection of silicone for the purpose of colporrhaphy. One patient was admitted because of dyspnea, chest pain, hemoptysis and bilateral pulmonary infiltration after repeated injection of silicone. Pulmonary function test initially showed severe restrictive pattern and transbronchial lung biopsy disclosed numerous oil-like material filling the alveolar septal capillaries and macrophages. High resolution C. T., bronchoalveolar lavage, transbronchial lung biopsy and pulmonary angiogram disclosed abnormalities compatible with silicone fluid-induced pulmonary embolism. The other patient expired shortly after arrival in the emergency room. It is suggested that illicit injecion of silicone fluid carries serious respiratory problems and can induce pulmonary embolism followed by acute respiratory failure.

• Radiation Oncology Journal
• /
• v.14 no.4
• /
• pp.299-306
• /
• 1996

Purpose : Respiratory symptoms related with malignant airway disease have been the main causes of lowered qualify of life and also sometimes may be life-threatening if not properly managed. The authors report the short-term experiences of endobronchial brachytherapy for symptomatic malignant airway obstruction using high dose rate after-loading brachytherapy unit. Materials and Methdos : Twenty-five Patients with symptomatic malignant airway obstruction were treated with endobronchial brachytherapy between the period of December 1994 and March 1996 at Department of Radiation Oncology of Samsung Medical Center Twenty-one ($84\%$) were patients with non-small cell lung cancer, three with tracheal malignancies, and one with recurrence of esophageal cancer. Twenty Patients were given elective external beam radiation therapy, while six were given endobronchial laser evaporation therapy on emergency bases in addition to endobronchial brachytherapy. Three procedures for each patient were planned and total of 70 procedures were completed. Results : Improvement rates of major respiratory symptoms after endobronchial brachytherapy procedures were $88\%$(22/25). $96\%$(22/23), $100\%$ (15/15), and $100\%$(9/9) for cough, dyspnea, hemoptysis and obstructive pneumonia, respectively. ECOG performance scores were improved in $56\%$ of total patients group, while there was no case with worsened ECOG score. Fifteen patients died and the median interval from the start of treatment to death was 4 months (range: $1\~17$ months), while that of ten survivors was 9 months (range $5\~19$ months). There were five patients with controlled intrathoracic disease, who have survived over one rear. All deaths were associated with uncontrolled local and/or distant disease. Four Patients died of massive fatal hemoptysis, three of who received emergency endobronchial laser evaporation therapy before the start of endobronchial brachytherapy. Conclusion : Endobronchial brachytherapy has been confirmed as an excellent palliative treatment modality improving respiratory symptoms as well as patients' general performance status. Based on the current observations, use of endobronchial brachytherapy in curative setting as a boost technique may be warranted.

• Tuberculosis and Respiratory Diseases
• /
• v.83 no.1
• /
• pp.81-88
• /
• 2020

Background: Use of appropriate antibiotics for the treatment of pneumonia is integral in patients admitted to intensive care units (ICUs). Although it is recommended that empirical treatment regimens should be based on the local distribution of pathogens in patients with suspected hospital-acquired pneumonia, few studies observe patients admitted to ICUs with nursing home-acquired pneumonia (NHAP). We found factors associated with the use of inappropriate antibiotics in patients with pneumonia admitted to the ICU via the emergency room (ER). Methods: We performed a retrospective cohort study of 83 pneumonia patients with confirmed causative bacteria admitted to ICUs via ER March 2015-May 2017. We compared clinical parameters, between patients who received appropriate or inappropriate antibiotics using the Mann-Whitney U, Pearson's chi-square, and Fisher's exact tests. We investigated independent factors associated with inappropriate antibiotic use in patients using multivariate logistic regression. Results: Among 83 patients, 30 patients (36.1%) received inappropriate antibiotics. NHAP patients were more frequently treated with inappropriate antibiotics than with appropriate antibiotics (47.2% vs. 96.7%, p<0.001). Methicillin-resistant Staphylococcus aureus was more frequently isolated from individuals in the inappropriate antibiotics-treated group than in the appropriate antibiotics-treated group (7.5% vs. 70.0%, p<0.001). In multivariate analysis, NHAP was independently associated with the use of inappropriate antibiotics in patients with pneumonia admitted to the ICU via ER. Conclusion: NHAP is a risk factor associated with the use of inappropriate antibiotics in patients with pneumonia admitted to the ICU via the ER.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.39 no.2
• /
• pp.186-191
• /
• 2012

The sodium hypochlorite is widely used in endodontic treatment. While it is effective solution for disinfection of root canal system, complications during canal irrigation are rarely reported, especially in primary teeth. This report demonstrates that sodium hypochlorite extruding through the root apex might cause severe complications. A 4-year-old female patient was referred from local dental clinic to the emergency room for the management of sudden facial swelling and pain during re-endodontic treatment of the maxillary primary central incisor using sodium hypochlorite. The patient was given systemic steroids, antihistamines, antibiotics and analgesics and the maxillary primary central incisor was extracted to prevent secondary infection. Swelling began to subside after 2 days. A negative result was obtained from skin patch test with sodium hypochlorite. Thorough care must be taken in primary teeth to prevent the inadvertent injection of sodium hypochlorite to periapical tissues during root canal irrigation. When adverse reaction occurs, proper management such as analgesia, cold compression and adequate medication should be done.

• Journal of the Korean Society for Marine Environment & Energy
• /
• v.20 no.1
• /
• pp.55-61
• /
• 2017

This study conducted a survey to evaluate the disaster response capability of coastal residents and analyzed the characteristics. For the sampling process, nonrandom sampling method was used. Sample size is 4,520 and sample error is ${\pm}1.5%p$ at 95% confidence level. As a result of the survey, 72% and 68% of the respondents said that they recognized the emergency contact network and listened to the disaster broadcast. On the other hand, 17% and 18% said that they organized the local voluntary disaster prevention teams and participated in disaster preparedness training. In addition, male's disaster response capability was higher than female's, and first aid techniques and participation in disaster preparedness training were higher in teens and twenties. By occupation, public official possess the highest response capability. By region, it was high in the East coast and low in the South coast. It is necessary that the authorities improve the national disaster preparedness training and publicity to enhance the coastal disaster response capability of coastal residents.