• Title/Summary/Keyword: Non-emergency

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Single Centre Experience on Decision Making for Mechanical Thrombectomy Based on Single-Phase CT Angiography by Including NCCT and Maximum Intensity Projection Images - A Comparison with Magnetic Resonance Imaging after Non-Contrast CT

  • Kim, Myeong Soo;Kim, Gi Sung
    • Journal of Korean Neurosurgical Society
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    • v.63 no.2
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    • pp.188-201
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    • 2020
  • Objective : The purpose of this study was to suggest that computed tomography angiography (CTA) is valuable as the only preliminary examination for mechanical thrombectomy (MT). MT after single examination of CTA including noncontrast computed tomography (NCCT) and maximum intensity projection (MIP) improves door-to-puncture time as well as results in favorable outcomes. Methods : A total of 157 patients who underwent MT at Dong Kang Medical Center from April 2015 to March 2019 were divided into two groups based on the examination performed prior to MT : CTA group who underwent CTA with NCCT and MIP, and NCCT+magnetic resonance image (MRi) group who underwent MRI including perfusion images after NCCT. In the two groups, time to CTA imaging or NCCT+MRi imaging after symptom onset, and time to arterial puncture and reperfusion were characterized as time-related outcomes. The evaluation of vascular recanalization after MT was defined as a modified thrombolysis in cerebral infarction (mTICI) scale. National Institutes of Health Stroke Scale (NIHSS) was assessed at the time of the visit to the emergency room and modified Rankin Scale (mRS) was assessed after 90 days. Results : Typically, there were 34 patients in the CTA group and 33 patients in the NCCT+MRi group. A significantly shorter delay for door-to-puncture time was observed (mean, 86±22.1 vs. 176±47.5 minutes; <0.01). Also, a significantly shorter door-to-imege time in the CTA group was observed (mean, 13±6.8 vs. 93±30.8 minutes; p<0.01). Moreover, a significantly shorter onset-to-puncture time was observed (mean, 195±128.0 vs. 314±157.6 minutes; p<0.01). Reperfusion result of mTICI ≥2b was 100% (34/34) in the CTA group and 94% (31/33) in the NCCT+MRi group, and mTICI 3 in 74% (25/34) in the CTA group and 73% (24/33) in the NCCT+MRi group. Favorable functional outcomes (mRS score ≤2 at 90 days) were 68% (23/34) in the CTA group and 60% (20/33) in the NCCT+MRi group. Conclusion : A single-phase CTA including NCCT and MIP images was performed as a single preliminary examination, which led to a reduction in the time of the procedure and resulted in good results of prognosis. Consequently, it is concluded that this method is of sufficient value as the only preliminary examination for decision making.

Review on asbestos analysis (석면 분석방법에 대한 고찰)

  • Ham, Seung hon;Hwang, Sung Ho;Yoon, Chungsik;Park, Donguk
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.19 no.3
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    • pp.213-232
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    • 2009
  • This document was prepared to review and summarize the analytical methods for airborne and bulk asbestos. Basic principles, shortcomings and advantages for asbestos analytical instruments using phase contrast microscopy(PCM), polarized light microscopy(PLM), X-ray diffractometer (XRD), transmission electron microscopy(TEM), scanning electron microscopy(SEM) were reviewed. Both PCM and PLM are principal instrument for airborne and bulk asbestos analysis, respectively. If needed, analytical electron microscopy is employed to confirm asbestos identification. PCM is used originally for workplace airborne asbestos fiber and its application has been expanded to measure airborne fiber. Shortcoming of PCM is that it cannot differentiate true asbestos from non asbestos fiber form and its low resolution limit ($0.2{\sim}0.25{\mu}m$). The measurement of airborne asbestos fiber can be performed by EPA's Asbestos Hazard Emergency Response Act (AHERA) method, World Health Organization (WHO) method, International Standard Organization (ISO) 10312 method, Japan's Environmental Asbestos Monitoring method, and Standard method of Indoor Air Quality of Korea. The measurement of airborne asbestos fiber in workplace can be performed by National Institute for Occupational Safety and Health (NIOSH) 7400 method, NIOSH 7402 method, Occupational Safety and Health Administration (OSHA) ID-160 method, UK's Health and Safety Executive(HSE) Methods for the determination of hazardous substances (MDHS) 39/4 method and Korea Occupational Safety and Health Agency (KOSHA) CODE-A-1-2004 method of Korea. To analyze the bulk asbestos, stereo microscope (SM) and PLM is required by EPA -600/R-93/116 method. Most bulk asbestos can be identified by SM and PLM but one limitation of PLM is that it can not see very thin fiber (i.e., < $0.25{\mu}m$). Bulk asbestos analytical methods, including EPA-600/M4-82-020, EPA-600/R-93/116, OSHA ID-191, Laboratory approval program of New York were reviewed. Also, analytical methods for asbestos in soil, dust, water were briefly discussed. Analytical electron microscope, a transmission electron microscope equipped with selected area electron diffraction (SAED) and energy dispersive X-ray analyser(EDXA), has been known to be better to identify asbestiform than scanning electron microscope(SEM). Though there is no standard SEM procedures, SEM is known to be more suitable to analyze long, thin fiber and more cost-effective. Field emission scanning electron microscope (FE-SEM) imaging protocol was developed to identify asbestos fiber. Although many asbestos analytical methods are available, there is no method that can be applied to all type of samples. In order to detect asbestos with confidence, all advantages and disadvantages of each instrument and method for given sample should be considered.

The Role of Occupational Therapist in Disaster Management (재난상황에서 작업치료사의 역할에 대한 고찰)

  • Kim, Jung-Hun
    • The Journal of Korean society of community based occupational therapy
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    • v.6 no.2
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    • pp.21-30
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    • 2016
  • Objective : In October 2016, the most powerful earthquake, magnitude 5.1 and 5.8 struck the city of Gyeongju in Korea. Although it did not take a toll, this implicates potential disaster in the future. Taking this earthquake, this paper considers the healthcare system responding to disaster in non-government organization and other countries, and investigates the roles of occupational therapist in disaster management. Methods : This paper reviews literature related to healthcare system and roles of occupational therapist in disaster response. Results : Humanitarian recovery mission of Red Cross impacted and facilitated the recovery of vulnerable population including children, elderly and people with disabilities in disaster response. It was also emphasized by occurring large population with disabilities after disasters so that the concept of rehabilitation and occupational therapist's role was required. Occupational therapy practitioners play an important role in the stage of disaster preparedness, response and recovery and their target population is children, elderly and people with disabilities. Conclusion : The most of NGO and counties take the concept of rehabilitation into healthcare system responding to disaster. However, the system in Korea stays in emergency level. It is important to take the humanitarian recovery and rehabilitation concept to disaster relief. the survivors would be able to return to their normalcy and health life.

Inhibition of Transient Receptor Potential Melastain 7 Enhances Apoptosis Induced by TRAIL in PC-3 cells

  • Lin, Chang-Ming;Ma, Ji-Min;Zhang, Li;Hao, Zong-Yao;Zhou, Jun;Zhou, Zhen-Yu;Shi, Hao-Qiang;Zhang, Yi-Fei;Shao, En-Ming;Liang, Chao-Zhao
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.10
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    • pp.4469-4475
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    • 2015
  • Transient receptor potential melastain 7 (TRPM7) is a bifunctional protein with dual structure of both ion channel and protein kinase, participating in a wide variety of diseases including cancer. Recent researches have reported the mechanism of TRPM7 in human cancers. However, the correlation between TRPM7 and prostate cancer (PCa) has not been well studied. The objective of this study was to investigate the potential the role of TRPM7 in the apoptosis of PC-3 cells, which is the key cell of advanced metastatic PCa. In this study, we demonstrated the influence and potential function of TRPM7 on the PC-3 cells apoptosis induced by TNF-related apoptosis inducing-ligand (TRAIL). The study also found a novel up-regulated expression of TRPM7 in PC-3 cells after treating with TRAIL. Suppression of TRPM7 by TRPM7 non-specific inhibitors ($Gd^{3+}$ or 2-aminoethoxy diphenylborate (2-APB) ) not only markedly eliminated TRPM7 expression level, but also increased the apoptosis of TRAIL-treated PC-3 cells, which may be regulated by the phosphatidylinositol 3-kinase/protein kinase B (PI3K/AKT) signaling pathway accompany with up-regulated expression of cleaved Caspase-3, (TRAIL-receptor 1, death receptors 4) DR4, and (TRAIL-receptor 2, death receptors 5) DR5. Taken together, our findings strongly suggested that TRPM7 was involved in the apoptosis of PC-3 cells induced by TRAIL, indicating that TRPM7 may be applied as a therapeutic target for PCa.

Impact Assessment of Climate Change on Drought Risk (기후변화가 가뭄 위험성에 미치는 영향 평가)

  • Kim, Byung-Sik;Kwon, Hyun-Han;Kim, Hung-Soo
    • Journal of Wetlands Research
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    • v.13 no.1
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    • pp.1-11
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    • 2011
  • A chronic drought stress has been imposed during non-rainy season(from winter to spring) since 1990s. We faced the most significant water crisis in 2001, and the drought was characterized by sultry weather and severe drought on a national scale. It has been widely acknowledged that the drought related damage is 2-3 times serious than floods. In the list of the world's largest natural disaster compiled by NOAA, 4 of the top 5 disasters are droughts. And according to the analysis from the NDMC report, the drought has the highest annual average damage among all the disasters. There was a very serious impact on the economic such as rising consumer price during the 2001 spring drought in Korea. There has been flood prevention measures implemented at national-level but for mitigation of droughts, there are only plans aimed at emergency (short-term) restoration rather than the comprehensive preventive measures. In addition, there is a lack of a clear set of indicators to express drought situation objectively, and therefore it is important and urgent to begin a systematic study. In this study, a nonstationary downscaling model using RCM based climate change scenario was first applied to simulate precipitation, and the simulated precipitation data was used to derive Standardized Precipitation Index (SPI). The SPI under climate change was used to evaluate the spatio-temporal variability of drought through principal component analysis at three different time scales which are 2015, 2045 and 2075. It was found that spatio-temporal variability is likely to modulate with climate change.

Special Issue for the 30th Anniversary of the Korean Academy of Health Policy and Management (한국보건행정학회 30주년 기념 특별호)

  • Park, Eun-Cheol
    • Health Policy and Management
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    • v.28 no.3
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    • pp.195-196
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    • 2018
  • The Korean Academy of Health Policy and Management (KAHPM) has shown remarkable achievements in the field of health policy and management in Korea for the last 30 years. The KAHPM consists of experts in various fields of health policy and management, and has been the leading academic discussion forum for health policy agendas of interest to the public. Health Policy and Management (HPM), the official journal of the KAHPM, published the first issue of volume 1 in October, 1991 and is publishing the second issue of volume 28 as of 2018. Currently, it is one of Korea' main journals in the field of health policy and management. HPM has published a special issue in commemoration of the 30th anniversary of the KAHPM. The HPM invited authors, including former presidents of the KAHPM and current board members, to write about main issues in health policy and management. Although the HPM tried to set up an invited author on all subjects in the health policy and management field, 19 papers are published, that completed the peer review process by August, 2018. The authors of the special issue of the 30th anniversary of the KAHPM include six former presidents, a senior professor, and 12 board members. The subjects of this issue are reform of the healthcare delivery system, health insurance and medical policy, reform of health system governance, the role of National Health Insurance Service (NHIS), the Korea Institute for Health and Social Affairs (KIHASA) and the National Evidence-based healthcare Collaborating Agency (NECA), ethical aspects of health policy change, regional disparities of healthcare, healthcare accreditation, new healthcare technology evaluation system, globalization of the healthcare industry, the epidemiological investigator system, the quarantine system, safety and disaster, and official development assistance. There are some remaining topics to deal with for the KAHPM: aged society, anti-smoking, non-infectious disease, suicide, healthcare resources, emergency medical care, out-of-pocket money, medical fee payment system, medical aid system, long-term care insurance, industrial accident compensation insurance, community-centered health welfare system, and central government and local government of health. The HPM will continue to publish review articles on the main topics in health policy and management. This is because the KAHPM, which has been the leading academic society of Korea's health policy and management for the last 30 years, feels responsible for continuing its mission for the next 30 years.

The Effect of Basic Cardiopulmonary Resuscitation Training Education Program for High School Students (고등학생에게 적용한 기본심폐소생술 실기교육프로그램 효과)

  • Kim, Soon-Sim;Kam, Sin
    • Korean Journal of Health Education and Promotion
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    • v.23 no.4
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    • pp.155-171
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    • 2006
  • Objective: The purpose of this study was to apply the Basic CPR(Cardiopulmonary resuscitation) training education program and identify its effects on knowledge of Basic CPR and skills of Basic CPR in second grade high school students. Methods: The training program was conducted for 16 weeks between March 26 and July 9, 2005 using a non-equivalent control group pretest-post test design by dividing 60 students in a half for both the experimental group and the control group. General characteristics, the effect of the education were evaluated with $x^2-test$, t-test, ANCOVA, Repeated Measure ANOVA and Bonferonni with SPSS 11.0/pc. Result: After the CPR education program application, knowledge score in the experimental group increased to 20.57 right after the education from 9.32, the score measured before the training, 19.11 after 8 weeks and 18.29 after 12 weeks. On the contrary, the control group's score showed no significant before the training. According to the result of knowledge score comparison between the experimental and control group at each point in time, the experimental group had a significantly high score in knowledge at every point(p<0.001). In the effect durability for knowledge of the training education program in process time after the training program in the experimental group, the durability of effect was identified despite the elapsing time. Scores of skills for Basic CPR increased from 1.21, the score measured before the training program, to 30.07 right after the education, 23.50 after 8 weeks and 17.57 after 12 weeks in experimental group. On the contrary, the control group showed an immaterial increase. According to the result of skill score comparison between the experimental and control group at each point in time, the experimental group had a significantly high score in skill at every point(p<0.001). The score for skill increased significantly right after the education compared to the score prior to the education. Conclusions: These findings suggest that Basic CPR training education program facilitate knowledge of CPR and skill of CPR in high school students. Therefore, it would be necessary to include the Basic CPR training program in high school education curriculum. However, the effect of Basic CPR knowledge maintains for a few period, and the effect of maintaining the skill is shorter than the maintenance of knowledge so regular reeducation is considered to be needed.

A STUDY ON CLINICAL USE OF HYPERBARIC OXYGEN THERAY OF THE ORAL AND MAXILLOFACIAL REGION (고압산소치료의 구강악안면영역에서의 임상적 이용에 관한 연구)

  • Lyoo, Jung-Ho;Um, Ki-Hun;Bae, Jun-Su;You, Jun-Young;Jang, Myung-Jin;Kim, Yong Kwan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.5
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    • pp.447-452
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    • 2001
  • Hyperbaric oxygen therapy(HBO) is defined as breathing 100% oxygen while in an enclosed system pressurized to greater than on atmosphere(sea level). This increased oxygen delivery furthers your body's ability to kill germs and to increase healing. HBO is a supplemental therapy to be used in addition to the current medical and surgical therapy you are receiving. HBO typically is used to complement treatments of medical problems such as bone infections, complication of radiotherapy, and certain chronic, non-healing wounds. On an emergency basis, the chamber also is used to treat problems such as carbon monoxide poisoning and the decompression sickness. We analysed stastically cases which are treated by hyperbaric oxygen therapy in point of oral and maxillofacial region on the Kangnam General Hospital for aid in comprehension and application of this therapy. Total 760 patients were treated at Gangnam General Hospital from July 1996 to September 1999. They were classified by region to Decompression sickness(DCS), Carbon monoxide poisoning(CO), General surgery(GS), Orthopedics(OS), Oral and Maxillofacial surgery(OMFS), others. Patients of Oral and Maxillofacial surgery were divided by diseses to Osteomyelitis, Osteoradionecrosis, Reconstruction, Bone graft, Difficult wounds, others. The results were as follows. 1. This institute conducts HBO therapy for DCS which takes up 62% and 10.5% for OMF region. 2. In OMF region, Osteomyelitis is 40%, Osteoradionecrosis is next, Bone graft, and Reconstruction is a row. 3. According to our precious study, HBO has been frequently conducted in OMF region compared to past, however, it is less actively conducted in this area for research than other conturies. Therefore, We need further application to the clinical use.

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A Case of Podostroma Cornu-Damae Intoxication Induced Pancytopenia and Skin Desquamation: Successful Treatment with Granulocyte Colony Stimulation Factor (G-CFS) (과립구집락자극인자 투여로 치료한 범혈구감소증과 피부 박리를 보인 붉은사슴뿔버섯 중독 1례)

  • Kim, Jung Seok;Kim, Gyu Won;Chung, Jae Il;Sim, Myoung Ki;Yoon, Ki Chul;Choi, Yong Hoon;Yi, Ha Ram;Choi, In Zoo;Shim, Chan Sup;Han, Joung Ho
    • Journal of The Korean Society of Clinical Toxicology
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    • v.13 no.1
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    • pp.50-54
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    • 2015
  • Podostroma cornu-damae is a rare species of fungus belonging to the Hyocreaceae family. Its fruit body is highly toxic, as it contains trichothecene mycotoxins. The morphology is similar to that of immature Ganoderma lucidum, making identification difficult for non-experts. We experienced such a case of a 56- year-old male who picked and consumed podostroma cornu-damae, and consumed. Later that day, he developed digestive system symptoms, including nausea, vomiting, and abdominal pain. He presented to the emergency room (ER), there were no abnormal physical findings, symptoms improved after gastric lavage, and the patient voluntarily discharged himself on the same day. The following day, as the symptoms gradually deteriorated, he was admitted via the ER. He was presented with severe pancytopenia, alopecia, desquamation of skin, and acute renal failure. He recovered without any complications after conservative care, antibiotics therapy, and granulocyte colony stimulating factor administration. The most commonly reported complications of podostroma cornu-damae intoxication were reported pancytopenia, infection, disseminated intravascular coagulation, acute renal failure, etc. since Prevention is especially important because its toxicity can be lethal and there is no particular treatment to date, prevention is especially important. Promotion and education for the public are needed.

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Convergence of Explanation Meeting in Cadaveric Dissection with Communication Skill : Correlation between Self-evaluation Factor and Academic Achievement of Medical Students (의사소통 기술과 해부학 실습 설명의 융합 : 의과대학 학생들의 자기평가 요소와 학문적 성취감의 상관관계)

  • Park, Jeong-Hyun;Im, Hee-Kyung;Kim, Jee-Hee
    • Journal of Digital Convergence
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    • v.14 no.8
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    • pp.363-370
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    • 2016
  • This study aimed to evaluate correlation between self-evaluation factors and academic achievement of medical students according to introduction of explanation meeting in cadaveric dissection. The students explained cadaveric structure to health allied sciences students and discussed with each other. Just after the meeting, 102 medical students filled out a self-reported questionnaire on impact of self-evaluation factors and communication. The data were analyzed by frequency analysis, t-test and analysis of variance. Regardless of their gender, age, previous experience, the majority of the students gave high scores in all of self-evaluation factors. Among them, linkage with major and verbal communication factor were closely related to their academic achievement(p<0.05). The verbal and non-verbal communication factors also had a high correlation of 0.580(p<0.01). The explanation meeting provided a chance to learn further with positive attitude to medical students and motivated them academically.