• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.40
• /
• pp.27.1-27.8
• /
• 2018

Purpose: Various complications occur when a maxillofacial fracture is malunionized or improperly resolved. Malocclusion is the most common complication, followed by facial deformity, temporomandibular joint disorder (TMD), and neurological symptoms. The purpose of this study was to evaluate the dental treatment of postoperative complications after maxillofacial fracture. Materials and methods: In this study, nine patients with a postoperative complication after maxillofacial fracture who had been performed the initial operation from other units and were referred to the authors' department had been included. Of the nine patients, six had mandibular fractures, one had maxillary fractures, one had maxillary and mandibular complex fractures, and one had multiple facial fractures. All the patients had tooth fractures, dislocations, displacements, and alveolar bone fractures at the time of trauma, but complications occurred because none of the patients underwent preoperative and postoperative dental treatment. Malocclusion and TMD are the most common complications, followed by dental problems (pulp necrosis, tooth extrusion, osteomyelitis, etc.) due to improper treatment of teeth and alveolar bone injuries. The patients were referred to the department of dentistry to undergo treatment for the complications. One of the nine patients underwent orthognathic surgery for a severe open bite. Another patient underwent bone reconstruction using an iliac bone graft and vestibuloplasty with extensive bone loss. The other patients, who complained of moderate occlusal abnormalities and TMDs such as mouth-opening limitation, underwent occlusal treatment by prosthodontic repair and temporomandibular joint treatment instead of surgery. Results: One patient who underwent orthognathic surgery had complete loss of open bite and TMD after surgery. One patient who underwent reconstruction using an iliac bone graft had a good healing process. Other patients were treated with splint, injection, and physical therapy for mouth-opening limitation and temporomandibular joint pain. After treatment, the TMDs were resolved, but the remaining occlusal abnormalities were resolved with prosthetic restoration. Conclusions: Considering the severity of malocclusion and TMJ symptom and the feasibillity of reoperation, nonsurgical methods such as orthodontic and prosthodontic treatments and splint therapy can be used to manage the dental and TMD complication after the trauma surgery. However, reoperation needs to be strongly considered for severe malocclusion and TMD problem.

• The Korean Journal of Emergency Medical Services
• /
• v.12 no.3
• /
• pp.55-69
• /
• 2008

Purpose : The purpose of this study was to analyze the prehospital care report prepared by EMS squads of 119 center in Gyeonggi area and to identify the status of prehospital care activities, problems and improvement possibilities of the emergency care. Method : Five hundred copies of prehospital care report prepared by EMS squads in thirty-eight 119 centers under 18 fire stations in Gyeonggi area from March to April in 2008 were randomly chosen for the analysis. Data abstracted according to the purpose of the study were input and the analysis of prehospital care activities were performed using SPSS-WIN(ver. 16) statistics package. Results : 1. Total 500 cases of prehospital emergency care activities were reviewed. By sex, females were 219 (43.8%) and males were 281 (56.2%). The places of reporting were home (57.8%). According to the type of emergency, 281 cases (56.2%) were caused by disease and 291 (43.8%) were from other causes such as traffic accidents or incidental injuries. 2 The average time needed for the 119 EMS squad to arrive at the scene after being reported was 7.29 minutes. The time used at the scene for the emergency care was 7.3 minutes in average and the time to arrive at the hospital was 25.4 minutes in average. 3. In patient evaluation, in 68% of the cases more than two vital signs were measured at one time and emergency patients were 31%, and non-emergency patients were 69%. 4. In one EMS activity, average 2.15 cases of emergency care were provided to a patient. The cases where two kinds of emergency care were given were 14.4%, which is the most frequent cases. When reviewing the details of the emergency cares given to the patient including multiple cares, trivial cards (taking it easy and giving comfort) were the most frequent one as 40.6% and the medical direction of the doctor was given in only one case out of 500 cases. 5. In patient evaluation and emergency care, vital signs were provided to emergency patients at significantly higher rate comparing to the non-emergency patients. The number of emergency care performance was significantly higher in emergency cases. In emergency dispatch, the cases that EMT (1st class) was on board was 86.2%. When comparing the cases when the 1st class EMT was on board and otherwise, the cases with the presence of 1st class EMT showed more vital signs were detected but there was no significant difference in the number of emergency cares provided. Conclusion : It seemed that the on-scene emergency care did not satisfy the expectations. So it is necessary to enforce the cooperation between the elements, the qualifications of the 119 EMS squads and to improve the prehospital working environment in order to provide the better medical service at any time.

• The Journal of Korean Society for School & Community Health Education
• /
• v.4
• /
• pp.79-95
• /
• 2003

This dissertation aims to analyze various safety accidents taking place during physical education class according to physical education teacher's value orientation, to identify teacher's value orientation that can minimize safety accidents, and to provide basic materials for safe and smooth class management. For this purpose, data have been collected from 261 physical education teachers at some middle and high schools in G City in Kyung-Ki Province and Busan Metropolitan City. The materials were treated as follows: The variables on demographic characteristics of physical education teachers are determined by t-test ; The analysis of one-way ANOVA and relationship between value orientation and safety accident prevention activities was conducted through Pearson's linear correlation analysis and multiple regression; The analysis of the relationship between value orientation and actual conditions of safety accidents was conducted through logistic regression. First, there is almost no awareness difference of physical education teachers' value orientation according to demographical variables. The value orientation physical education teachers consider to be the most important is, however, mainly 'mastery of disciplinary lesson.' There is a statistically significant difference in safety accident prevention activities according to demographical variables. Teachers' focuses in class contents showed a significant difference according to teaching experience and working area, while the dependency on facility has a significant difference according to teaching experience and school type. Second, there is no correlation between physical education teacher's value orientation and safety accident prevention activities because there is virtually no statistically significant difference between them. It means that safety accident prevention activities are not related with on which teachers place emphasis among mastery of disciplinary lesson, social reconstruction, self-realization, ecological integration and value orientation on learning process. Third, the analysis of safety accident prevention activities according to physical education teachers' value orientation revealed that the lower value orientation in social reconstruction is, the more safety accidents teachers experience. It is also found that crashes among students, ball games and leg injuries are inter-related with social reconstruction in value orientation, over-motivation and unskilled motor function ; athletic sports with value orientation on learning process and safety prevention training ; unskilled motor functions with value orientation in ecological integration and disobedience to teacher's directions ; winter accidents with mastery of disciplinary lesson in value orientation. In conclusion, the research indicates that physical education teacher's value orientation according to demographical variables didn't show any significant difference, while one according to safety accident prevention activities showed significant difference. Besides, physical education teachers' value orientation is not related to safety accident prevention activities, but the relationship between value orientation and actual conditions of safety accidents showed correlations according to each variable. Especially, teachers with lower value orientation in social reconstruction experienced more safety accidents. Therefore, physical education teachers can manage physical education class more safely with more emphasis on value orientation in social reconstruction.

• The Korean Journal of Gastroenterology
• /
• v.72 no.6
• /
• pp.308-312
• /
• 2018

Percutaneous endoscopic gastrostomy (PEG) is widely used to provide nutritional support for patients with dysphagia and/or disturbed consciousness preventing oral ingestion, and PEG tube placement is a relatively safe and convenient non-surgical procedure performed under local anesthesia. However, the prevention of PEG-insertion-related complications is important. A 64-year-old man with recurrent pneumonia underwent tracheostomy and nasogastric tube placement for nutritional support and opted for PEG tube insertion for long-term nutrition. However, during the insertion procedure, needle puncture had to be attempted twice before successful PEG tube placement was achieved, and a day after the procedure his hemoglobin had fallen and he developed hypotension. Abdominal computed tomography revealed injury to a pancreatic branch of the superior mesenteric artery (SMA) associated with bleeding, hemoperitoneum, and pancreatitis. Transarterial embolization was performed using a microcatheter to treat hemorrhage from the injured branch of the SMA, and the acute pancreatitis was treated using antibiotics and supportive care. The patient was discharged after an uneventful recovery. Clinicians should be mindful of possible pancreatic injury and bleeding after PEG tube insertion. Possible complications, such as visceral injuries or bleeding, should be considered in patients requiring multiple puncture attempts during a PEG procedure.

• Journal of Life Science
• /
• v.33 no.2
• /
• pp.183-190
• /
• 2023

Red yeast rice, also known as Hong Qu and red Koji, has been used for a long time in Asian functional food and traditional medicine. It consists of multiple bioactive substances, which can potentially be used as nutraceuticals. Alcoholic liver disease (ALD) can range from simple steatosis or inflammation to fibrosis and cirrhosis, possibly through leaky gut and systemic endotoxemia. This study examined the liver and gut effects of red yeast rice (RYR) (Monascus purpureus) ethanol extract against binge ethanol-induced liver injury in mice. RYR extract was orally administered to C57BL/6N mice at a concentration of 200 mg/kg body weight per day for 10 days. Then, mice were administered binge alcohol (5 g/kg/dose) three times at 12 hr intervals. Binge alcohol exposure significantly elevated the endotoxin, aspartate aminotransferase (AST), and alanine transaminase (ALT) activity of plasma, as well as hepatic triglyceride levels; however, RYR treatments reduced these levels. In addition, RYR pretreatment significantly reduced the alcohol-induced oxidative maker protein and apoptosis maker in binge alcohol-induced gut and liver injuries. These results suggest that RYR may prevent alcohol-induced acute leaky gut and liver damage.

• Journal of Industrial Convergence
• /
• v.21 no.10
• /
• pp.167-180
• /
• 2023

The aim of this study is to explore the factors that influence the health care utilization of disabled workers who returned to their original workplace after an occupational accident. The study sample consisted of 457 workers who suffered from occupational accidents and were rated as disabled based on the data from the PSWCI in 2021. Data analysis was performed using a hierarchical multiple regression analysis with SPSS WIN 26.0. The study findings revealed that the number of outpatient visits was affected by factors such as daily wage payment, economic status, physical activity limitations, subjective health status, and chronic diseases. Moreover, health care expenditures were determined by factors such as having a caregiver for daily living, burn injuries, and physical activity limitations. Therefore, to increase the accessibility of health care utilization for disabled workers, the role of nurses in the workplace should be expanded, employers should include a health care utilization plan when developing a return-to-work plan, and research on the introduction of a paid sick leave system that allows workers to rest when they are sick is needed. It is also necessary to alleviate the economic burden by increasing the coverage of benefits for burn and rehabilitation treatments.

• Journal of Trauma and Injury
• /
• v.37 no.1
• /
• pp.13-19
• /
• 2024

Purpose: Trauma is an important public health concern, and it is important to increase the survival rate of patients with trauma and enable them to return to society in a better condition. Initial treatment in the emergency department (ED) is closely associated with the prognosis of patients with trauma. However, studies regarding laboratory biomarker tests that can help predict the prognosis of trauma patients are limited. Presepsin is a novel biomarker of inflammation that can predict a poor prognosis in patients with sepsis. This study aimed to determine whether presepsin could be used as a prognostic indicator in patients with polytrauma. Methods: The study included patients with trauma who had visited a single regional ED from November 2021 to January 2023. Patients who had laboratory tests in the ED were included and analyzed retrospectively through chart review. Age, sex, injury mechanism, vital signs, surgery, the outcome of ED treatment (admission, discharge, transfer, or death), and trauma scores were analyzed. Results: Overall, 550 trauma patients were enrolled; 59.1% were men, and the median age was 64 years (interquartile range, 48.8-79.0 years). Patients in a hypotensive state (systolic blood pressure, <90 mmHg; n=39) had higher presepsin levels (1,061.5±2,522.7 pg/mL) than those in a nonhypotensive state (n=511, 545.7±688.4 pg/mL, P<0.001). Patients hospitalized after ED treatment had the highest presepsin levels (660.9 pg/mL), followed by those who died (652.0 pg/ mL), were transferred to other hospitals (514.9 pg/mL), and returned home (448.0 pg/mL, P=0.041). Conclusions: Serum presepsin levels were significantly higher in trauma patients in a hypotensive state than in those in a nonhypotensive state. Additionally, serum presepsin levels were the highest in hospitalized patients with trauma, followed by those who died, were transferred to other hospitals, and returned home.

• Journal of Chest Surgery
• /
• v.31 no.10
• /
• pp.952-963
• /
• 1998

Background: Cardiopulmonary bypass(CPB)-induced hemostatic defects may result increased possibility of excessive hemorrhage and additional multiple transfusion reactions or reoperation. Particularly, fibrinolytic activation and decreased platelet count and function by CPB were proposed as a predictor of hemorrhage during postoperative periods in several reports. Materials and methods: Present study, which was conducted in 20 adult patients undergoing CPB, was prospectively designed to examine the hematologic changes, including fibrinolytic activation during and after CPB and to clarify the relationships between these changes and the magnitude of the postoperative nonsurgical blood loss. The serial blood samples for measurment of hematologic parameters were taken during operation and postoperative periods. Blood loss was respectively counted via thoracic catheter drainage at postoperative 3, 6, 12, 24, 48 hours and total period. Results: The results were obtained as follows:Platelet count rapidly declined following CPB(p<0.01), which its decreasing rate was an inverse proportion to total bypass time(TBT, r=0.55, p=0.01), And platelet count in postoperative 7th day was barely near to its control value. Fibrinogen degradating product(FDP) and D-dimer level significantly increased during CPB(p<0.0001, p<0.0001, respectively), and both of fibrinogen and plasminogen concentration correlatively decreased during CPB(r=0.57, p<0.01), implying activation of fibrinolytic system. Postoperative bleeding time (BT), postoperative activated partial thromboplastin time(aPTT) and postoperative prothrombin time (PT) were significantly prolonged as compare with each control value (p=0.05, p<0.0001, p<0.0001, respectively). Total blood loss was positively correlated with patient's age, aortic clamping time (ACT) and TBT, while there was negative correlation between platelet count and blood loss at pre-CPB, CPB-off and the 1st postoperative day, and in some periods. Postoperative aPTT and postoperative PTwere positively related to postoperative 6 hr and 48 hr blood loss(r=0.53, p=0.02; r=0.43, p=0.05) but not to total blood loss, whereas there was no relationship between postoperative BT and blood loss at any period. Conclusions: These observations suggest that CPB results various hematologic changes, including fibrinolytic activation and severe reduction in platelet count. Diverse factors such as age, platelet count, ACT, TBT and postoperative aPTT and PT may magnify the postoperative bleeding. This study will be a basic reference in understanding CPB-induced hemostatic injuries and in decreasing the postoperative hemorrhage

• Journal of Korean Public Health Nursing
• /
• v.9 no.1
• /
• pp.83-102
• /
• 1995

As the society is being industrialized, the fast-paced economic development that has caused substantial increase in cerebrovascular and coronary artery diseases and the industrial development and increased use of means of transportation have resulted in the rapid rise of incidents in external injuries as well. So the pubic has become acutely aware of the need for fast and effective emergency care delivery system. The goal of emergency care delivery system is to meet the emergency care needs of patients. The emergency care delivery system is seeking to efficiently satisfy the care needs of people. Therefore the purpose of this study is designed to develop an effective programs for emergency care delivery system in Korea. The following specific objectives were investigated. This emergency care delivery system must have the necessary man power, for transfering the patients, communication net work, and emergency care facilities. 1) Man power Emergency care requires n0t only specialized traning in the emergency treatment but also knowledge and experience i11 other related area, so emergency care personnel traning program should be designed in order to adapt to the specific need of emergency patients. It will be necessary to ensure professional personnel who aquires the sufficient traning and experience for emergency care and to look for legal basis. We have to develop re-educational programs for emergency nurse specialist. They should be received speciality of emergency nursing care so that they will work actively and positively in emergency part. Emergency medical doctor and nurse specialist should be given an education which is related in emergency and critical care. Emergency care personnel will continue to provide both acute and continuing care as partner with other medical team. 2) Transfering the patients. Successful management of pre-hospital care requires adequate traning for the emergency medical technician. Traning program should be required to participate in a actual first aids activites in order to have apportunities to acquire practical skills as well as theoretical knowledge. The system of emergency medical technician should be remarkablly successful with first responder firefighters. Establishing this system must add necessary ambulances operating at any given time. It will be necessary to standardize the ambulance size and equipment. Ambulance should be arranged with each and every fire station. 3) Communication net work. The head office of emergency commumication network should be arranged with the head office of fire station in community. It is proposed that Hot-line system for emergency care should be introduce. High controlled ambulance and thirtial emergency center should simultaneously equip critical-line in order to communication with each other. Ordinary ambulance and secondary emergency facility should also simultaneously equip emergency-line in order to communication with each other. 4) Emergency care facilities. Primary emergency care facilities should be covered with the ambulatory emergency patients-minor illness and injuires. Secondary emergency care facilities should be covered with the emergency admission patients. Third emergency care center should be covered with the critical patients who need special treatments and operation. Secondary and third emergency care facilities should employ emergency medical doctor and emergency nurse specialist to treat in-patients with severe and acute illness and multiple injuires. It should be fashioned for a system of emergency facilities that meets emergency patients needs. Provide incentives for increased number of emergency care facilities with traning in personal/clinical emergency care. 5) Finance It is recommended to put the finance of a emergency care on a firm basis. The emergency care delivery system should be managed by the government or accreditted organizations. In order to facilitate this relevant program the fund is needed for more efficient and effective emergency researchs, service, programs, and policy. 6) Gaining understanding and co-operation of pubic It is also important to undertake pubic education to improve understanding of first aids and C. P. R of individuals, communities and business. It is proposed that teachers and health officers be certified in C. P. R. The C. P. R education can be powerful influence save lives. Lastly appropriate emergency care information must be provided to the pubic for assisting them in choosing emergency care.

• Journal of agricultural medicine and community health
• /
• v.39 no.1
• /
• pp.1-13
• /
• 2014

Objective: The objectives were to estimate the rate of the injury in the elderly over the past year and to identify factors related to injury in the elderly in South Korea. Method: Using data from the 2008 Community Health Survey, 43,049 elderly persons, aged 65 years and older, were selected as study subjects. Their experience of injury during the past year and other variables, including socio-demographic factors, health-related factors, and diagnosed chronic diseases, were used. The chi-squared test and multiple logistic regression analysis with weighted analysis were conducted and statistical significance was set at p<0.05. Result: The rate of injury in the elderly during the past year was 5.1%. The most common types of the injury were falling/slipping down and traffic accidents. Factors related to injury in the elderly were living alone, current drinking, depression, poor self-rated health, stroke, and osteoporosis. Living alone (odds ratio 1.23, 95% CI: 1.05-1.45), current drinkers (OR 1.19, 95% CI: 1.05-1.35), poor self-rated health (OR 1.72, 95% CI: 1.43-2.08), depression (OR 1.23, 95% CI: 1.17-1.68), and history of stroke (OR 1.40, 95% CI: 1.17-1.68), and history of osteoporosis (OR 1.45, 95% CI: 1.26-1.66) were related to an increased risk of injury. Conclusions: Intervention programs that consider the risk factors related to injury should be developed and implemented to decrease and prevent injuries in the elderly.