• 제목/요약/키워드: Local mean age

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Clinical Analysis of Trauma Surgery Patients in a Local Emergency Center; Does Emergency Physicians'Treatment Delay the Surgeons'Special Care like Emergency Operations for Trauma Victims? (응급수술을 시행한 응급의료센터 내원 외상 환자 분석; 응급의학과 진료는 외상환자에 대한 외과의 수술과 같은 전문적인 진료를 오히려 지연시키는가?)

  • Lee, Kyung Won
    • Journal of Trauma and Injury
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    • v.20 no.1
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    • pp.19-25
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    • 2007
  • Purpose: Trauma surgery is not an official medical specialty in the Republic of Korea (South Korea). Thus, a trauma victim transported to an emergency room (ER) is resuscitated and surveyed by an intern, a resident, or an emergency physician (EP) at first. Currently an operative management is decreasing because of multiple factors. Nevertheless, trauma surgery is the key for some patients. Does the EP's treatment in the ER delay the surgeon's emergency operation? Methods: A retrospective study was performed for trauma victims who underwent trauma surgery from March 2004 to February 2005 in a local emergency center of Daegu-city. We reviewed the medical records and analyzed the trauma victim's age, sex, cause of injury, method of transport, time from the trauma to the operation, EP's treatment, surgical department, mortality, and injury severity score (ISS). Results: Of the 223 trauma victims included in this study, males were predominant (83.4%). The mean age was 37.98 years of age. The main Causes of trauma were trauma NOS (not otherwise specified) and motor vehicle accidents (MVA). The main methods of transport was privately owned automobile. The mean time from trauma to operation was 617.46 min. The mean ISS was 7.67. Trauma surgery with the EP's treatment group included 40 trauma victims with higher ISS, and the time from trauma to operation was shorter than it was for the 183 trauma victims not in that group. Conclusion: The EP's treatment of high-ISS multiple-injury trauma victims can shorten the time from trauma to trauma surgery and will help the surgical department treatment. In the trauma care system of the Republic of Korea, and increased role should be encouraged for emergency physician.

Development of CFD model for Predicting Ventilation Rate based on Age of Air Theory using Thermal Distribution Data in Pig House (돈사 내부 열환경 분포의 공기연령 이론법 적용을 통한 전산유체역학 환기 예측 모델 개발)

  • Kim, Rack-woo;Lee, In-bok;Ha, Tae-hwan;Yeo, Uk-hyeon;Lee, Sang-yeon;Lee, Min-hyung;Park, Gwan-yong;Kim, Jun-gyu
    • Journal of The Korean Society of Agricultural Engineers
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    • v.59 no.6
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    • pp.61-71
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    • 2017
  • The tracer gas method has an advantage that can estimate total and local ventilation rate by tracing air flow. However, the field measurement using tracer gas has disadvantages such as danger, inefficiency, and high cost. Therefore, the aim of this study was to evaluate ventilation rate in pig house by using the thermal distribution data rather than tracer gas. Especially, LMA (Local Mean Age), which is an index based on the age of air theory, was used to evaluate the ventilation rate in pig house. Firstly, the field experiment was conducted to measure micro-climate inside pig house, such as the air temperature, $CO_2$ concentration and wind velocity. And then, LMA was calculated based on the decay of $CO_2$ concentration and air temperature, respectively. This study compared between LMA determined by $CO_2$ concentration and air temperature; the average error and root mean square error were 3.76 s and 5.34 s. From these results, it was determined that thermal distribution data could be used for estimation of LMA. Finally, CFD (Computational fluid dynamic) model was validated using LMA and wind velocity. The mesh size was designed to be 0.1 m based on the grid independence test, and the Standard $k-{\omega}$ model was eventually chosen as the proper turbulence model. The developed CFD model was highly appropriate for evaluating the ventilation rate in pig house.

Estimation of Local Mean Ages of Air in a Room with Multiple Inlets (다중 급기구를 갖는 실내공간에서의 공기연령 산정방법에 관한 연구)

  • Han, Hwa-Taik;Shin, Cheol-Yong;Lee, In-Bok;Kwon, Kyeong-Seok;Kwon, Yong-Il
    • Proceedings of the SAREK Conference
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    • 2009.06a
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    • pp.148-153
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    • 2009
  • This paper considers the age of air in a ventilated space with multiple supply inlets. The local mean age of air at a point from one supply inlet is different from those from the other supply inlets. It is the purpose of the present paper to investigate theoretically the relations between the LMA's from each supply and overall combined LMA whether or not to trace the origins of supply air. Transient concentration distributions are calculated with a step-up injection of tracer gas at each supply inlet, and at both inlets simultaneously. The steady state concentration with a continuous tracer injection at a supply inlet works as a weighting factor for the corresponding LMA in calculating the average overall LMA from multiple inlets.

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THE USE OF A VARIETY OF INTRAORAL FLAPS IN RECONSTRUCTION OF INTRAORAL SOFT TISSUE DEFECTS (구강내 연조직 결손 재건을 위한 다양한 구내피판의 이용)

  • Kim, Young-Kyun;Yeo, Hwan-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.19 no.3
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    • pp.243-249
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    • 1997
  • The purpose of this study is to describe the clinical availability of a variety of intraoral local flaps in reconstruction of oral soft tissue defects, Forty patients with oral soft tissue defects were treated by tongue, buccinator, palatal, labial, facial artery musculomucosal, buccal fat pad, and masseter muscle crossover flap. Total 43 intraoral flaps were used to reconstruct a variety of intraoral soft tissue defects, such as oronasal fistula, oroantral fistula, traumatic deformities and other. The age of patients ranged from 7 to 72 years, with mean age of 39.6 years. Follow up period ranged from 2 to 66 months, mean follow up period of 21.6 months. There were 9 complications, of which four were partial necrosis, three infections, one total necrosis, and 1 speech problem. Except for total necrosis, most of the recipient sited healed uneventually without severe morbidity. We consider that a variety of intraoral local flaps can be available for reconstruction of small of moderate large intraoral soft tissue defects.

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Age of initiation, Determinants and Prevalence of Cigarette Smoking among Teenagers in Mushin Local Government Area of Lagos State, Nigeria

  • Abiola, AO;Balogun, OS;Odukoya, OO;Olatona, FA;Odugbemi, TO;Moronkola, RK;Solanke, AA;Akintunde, OJ;Fatoba, OO
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.3
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    • pp.1209-1214
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    • 2016
  • Background: Cigarette smoking constitutes a major threat to the health and wellbeing of teenagers. While smoking has been on decline in the developed countries, the reverse is the case in developing countries. The aim of this study was to determine the age of initiation, determinants and prevalence of cigarette smoking among teenagers in Mushin Local Government Area of Lagos state, Nigeria. Materials and Methods: This was a descriptive cross-sectional study among 475 teenagers selected by multistage sampling. A pre-tested, structured, interviewer-administered questionnaire was used for data collection. The study was carried out in November, 2014. Results: Response rate was 84.6%. Mean age of the respondents was $16.4{\pm}1.65years$. Range and mean age of initiation of cigarette smoking were 7 to 17 years and $12.0{\pm}3.32years$ respectively. Teenagers who were above 15 years (OR:5.13, 95%CI: 0.87-30.26), males (OR:5.19, 95%CI: 1.57-17.18), married (OR:8.41, 95%CI: 1.04-63.35), had ${\leq}$primary school education(OR:4.31, 95%CI: 1.07-17.33), influenced by friends(OR:308.84, 95%CI:84.87-1123.81), and influenced by advertisements (OR:27.83, 95%CI: 3.92-197.64) were more likely to have initiated cigarette smoking. Furthermore, teenagers who were males (OR:12.77, 95%CI: 2.90-56.28), married (OR:19.24, 95%CI: 2.05-180.45), had ${\leq}$primary school education(OR:7.85, 95%CI: 2.37-26.01), influenced by friends(OR:28.56, 95%CI: 10.86-75.07), and influenced by advertisements (OR:5.95, 95%CI: 1.72-20.61) were more likely to be current cigarette smokers. In addition, 24.9% had initiated cigarette smoking while 14.7% were current smokers of cigarette. Conclusions: Mean age of initiation of cigarette smoking was $12.0{\pm}3.32years$. Determinants of cigarette smoking were age, gender, marital status, educational background, friends and advertisements. Life time prevalence of cigarette smoking was higher than prevalence of current cigarette smokers. Cigarette smoking reduction programs should take these factors into consideration.

Clinical Outcomes of Pulsed Radiofrequency Neuromodulation for the Treatment of Occipital Neuralgia

  • Choi, Hyuk-Jai;Oh, In-Ho;Choi, Seok-Keun;Lim, Young-Jin
    • Journal of Korean Neurosurgical Society
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    • v.51 no.5
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    • pp.281-285
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    • 2012
  • Objective : Occipital neuralgia is characterized by paroxysmal jabbing pain in the dermatomes of the greater or lesser occipital nerves caused by irritation of these nerves. Although several therapies have been reported, they have only temporary therapeutic effects. We report the results of pulsed radiofrequency treatment of the occipital nerve, which was used to treat occipital neuralgia. Methods : Patients were diagnosed with occipital neuralgia according to the International Classification of Headache Disorders classification criteria. We performed pulsed radiofrequency neuromodulation when patients presented with clinical findings suggestive occipital neuralgia with positive diagnostic block of the occipital nerves with local anesthetics. Patients were analyzed according to age, duration of symptoms, surgical results, complications and recurrence. Pain was measured every month after the procedure using the visual analog and total pain indexes. Results : From 2010, ten patients were included in the study. The mean age was 52 years (34-70 years). The mean follow-up period was 7.5 months (6-10 months). Mean Visual Analog Scale and mean total pain index scores declined by 6.1 units and 192.1 units, respectively, during the follow-up period. No complications were reported. Conclusion : Pulsed radiofrequency neuromodulation of the occipital nerve is an effective treatment for occipital neuralgia. Further controlled prospective studies are necessary to evaluate the exact effects and long-term outcomes of this treatment method.

Clinical Outcomes of Differentiated Thyroid Cancer Patients with Local Recurrence or Distant Metastasis Detected in Old Age

  • Han, Ji Min;Bae, Ji Cheol;Kim, Hye In;Kwon, Sam;Jeon, Min Ji;Kim, Won Gu;Kim, Tae Yong;Shong, Young Kee;Kim, Won Bae
    • Endocrinology and Metabolism
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    • v.33 no.4
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    • pp.459-465
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    • 2018
  • Background: Differentiated thyroid carcinoma (DTC) shows a very good prognosis, but older patients have a higher recurrence rate and those show poor prognosis than younger patients. The aim of this study was to determine the clinical outcomes of thyroid cancer patients who experienced recurrence in old age according to the treatment strategy used. Methods: This retrospective observational cohort study was conducted at Asan Medical Center, Seoul, Korea. Among DTC patients with no evidence of disease after initial treatment, we enrolled 86 patients who experienced recurrence at an age >65 years from 1994 to 2012. Sixty-nine patients had local recurrence and 17 patients showed distant metastasis. Results: The mean age of patients at recurrence was 72 years. Patients were followed up for a median of 4.1 years after recurrence. Sixty-three of the 69 patients with local recurrence received additional treatment, while the other six received conservative care. The cancer-specific mortality rate was 15.5% in the local recurrence group. Airway problems were the main cause of death in patients who did not receive further treatment for local recurrence. Among the 17 patients with distant metastasis, 10 underwent specific treatment for metastasis and seven received only supportive management. Seven of those 17 patients died, and the cancer-specific mortality rate was 35% in the distant metastasis group. Conclusion: The overall cancer-specific mortality rate was 20% in DTC patients in whom recurrence was first detected at an age >65 years. Mortality due to uncontrolled local disease occurred frequently in patients who did not receive definitive management for recurrence.

When do we need more than local compression to control intraoral haemorrhage?

  • Sohn, Jun-Bae;Lee, Ho;Han, Yoon-Sic;Jung, Da-Un;Sim, Hye-Young;Kim, Hee-Sun;Oh, Sohee
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.45 no.6
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    • pp.343-350
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    • 2019
  • Objectives: The aims of this study were to determine the effectiveness of local compression in patients presenting to the emergency room with intraoral bleeding and to identify when complex haemostatic measures may be required. Materials and Methods: Five hundred forty patients who had experienced intraoral haemorrhage were retrospectively reviewed. The outcome variable was the haemostasis method used, i.e., simple (local compression with gauze) or complex (an alternative method after local compression has failed). Predictor variables were sex, age, American Society of Anesthesiologists (ASA) class, hepatic cirrhosis, bleeding disorder, use of antithrombotic agents, and site/cause of haemorrhage. Results: The mean patient age was 48.9±23.9 years, 53.5% were male, 42.8% were ASA class II or higher, and 23.7% were taking antithrombotic agents. Local compression was used most often (68.1%), followed by local haemostatic agents, sutures, systemic tranexamic acid or blood products, and electrocautery. The most common site of bleeding was the gingiva (91.7%), and the most common cause was tooth extraction (45.7%). Risk factors for needing a complex haemostasis method were use of antithrombotic agents (odds ratio 2.047, P=0.009) and minor oral surgery (excluding extraction and implant procedures; odds ratio 6.081, P=0.001). Conclusion: A haemostasis method other than local compression may be needed in patients taking antithrombotic agents or having undergone minor oral surgery.

Assessment of Nicotine Dependence among Smokers in a Selected Rural Population in Kerala, India

  • Jayakrishnan, R.;Mathew, Aleyamma;Lekshmi, Kamala;Sebastian, Paul;Finne, Patrik;Uutela, Antti
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.6
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    • pp.2663-2667
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    • 2012
  • Objectives: An attempt was made to understand the nicotine dependence of smokers selected for an ongoing smoking cessation intervention programme in rural Kerala, India. Methods: Data were collected from resident males in the age group of 18 to 60 years from 4 randomly allocated community development blocks of rural Thiruvananthapuram district (2 intervention and 2 control groups). Trained accredited social health activist workers were utilised to collect data from all groups through face to face interview. Nicotine dependence among participants was assessed by means of the six-item Fagerstrom Test for Nicotine Dependence (FTND) translated into the local language. The internal consistency of FTND was computed using Cronbach's alpha coefficient. Criterion validity (concurrent) was assessed by correlations of nicotine dependence scores with age at initiation of smoking and cumulative smoking volume in pack-years. Results: Among the 928 smokers identified, 474 subjects were in the intervention area (mean age = 44.6 years, SD = 9.66 years) and 454 in the control area (mean age = 44.5 years, SD = 10.30 years). The overall FTND score among current daily smokers was 5.04 (SD: 5.05). FTND scores in the control and intervention areas were 4.75 (SD: 2.57) and 4.92 (SD: 2.51) respectively. The FTND scores increased with age and decreased with higher literacy and socioeconomic status. The average FTND score was high among smokers using both bidi and cigarettes (mean 6.10, SD 2.17). Internal consistency analysis yielded a Cronbach's alpha coefficient of 0.70 in a subsample of 150 subjects, a moderate result. The association of the scale was strongest, with the number of pack-years smoked (rho = 0.677, p < 0.001). Conclusion: A moderate level of nicotine dependence was observed among smokers in the current study. Tobacco cessation strategies could be made more cost effective and productive if a baseline assessment of nicotine dependence is completed before any intervention.

A Retrospective Analysis of Eight Cases of Merkel Cell Carcinoma (8례의 메켈세포암종의 후향적 연구)

  • Oh, Seung Il;Jin, Ung Sik;Chang, Hak;Kwon, Sung Tack;Minn, Kyung Won
    • Archives of Craniofacial Surgery
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    • v.14 no.1
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    • pp.41-45
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    • 2013
  • Background: Merkel cell carcinoma (MCC) is a rare locally aggressive cutaneous neuroendocrine carcinoma with a high incidence of local recurrence, regional lymph node metastasis, followed by distant metastasis. Because of shortage of the retrospective study, standard treatment has not been established. The purpose of this study was to present the surgical treatment and outcome of 8 patients with MCC. Methods: We report our experiences with 8 patients who underwent treatment for MCC at our institution from 2000 through 2012. Two men and 6 women received treatment for MCC. The mean age was 76.4 years (range, 53 to 93 years). Results: The follow-up period ranged from 7 to 26 months (mean, 22.9). During the follow-up period, three of 8 patients had a relapse (mean time before recurrence, 10 months; 1 month, 7 months, and 22 months). After primary surgery, 3 patients underwent radiotherapy, and 1 patient received chemotherapy. Conclusion: MCC is an aggressive skin cancer with a high rate of local recurrence. Complete surgical excision is the mainstay of local treatment, but adjuvant radiotherapy should be considered for better local control.