• Journal of Trauma and Injury
• /
• v.37 no.1
• /
• pp.20-27
• /
• 2024

Purpose: Severe abdominal injuries often require immediate clinical assessment and surgical intervention to prevent life-threatening complications. In Jeju Regional Trauma Center, we have instituted a protocol for emergency department (ED) laparotomy at the trauma bay. We investigated the mortality and time taken from admission to ED laparotomy. Methods: We reviewed the data recorded in our center's trauma database between January 2020 and December 2022 and identified patients who underwent laparotomy because of abdominal trauma. Laparotomies that were performed at the trauma bay or the ED were classified as ED laparotomy, whereas those performed in the operating room (OR) were referred to as OR laparotomy. In cases that required expeditious hemostasis, ED laparotomy was performed appropriately. Results: From January 2020 to December 2022, 105 trauma patients admitted to our hospital underwent emergency laparotomy. Of these patients, six (5.7%) underwent ED laparotomy. ED laparotomy was associated with a mortality rate of 66.7% (four of six patients), which was significantly higher than that of OR laparotomy (17.1%, 18 of 99 patients, P=0.006). All the patients who received ED laparotomy also underwent damage control laparotomy. The time between admission to the first laparotomy was significantly shorter in the ED laparotomy group (28.5 minutes; interquartile range [IQR], 14-59 minutes) when compared with the OR laparotomy group (104 minutes; IQR, 88-151 minutes; P<0.001). The two patients who survived after ED laparotomy had massive mesenteric bleeding, which was successfully ligated. The other four patients, who had liver laceration, kidney rupture, spleen injury, and pancreas avulsion, succumbed to the injuries. Conclusions: Although ED laparotomy was associated with a higher mortality rate, the time between admission and ED laparotomy was markedly shorter than for OR laparotomy. Notably, major mesenteric hemorrhages were effectively controlled through ED laparotomy.

• Tunnel and Underground Space
• /
• v.34 no.2
• /
• pp.89-103
• /
• 2024

In the disposal environment, gases can be generated at the interface between canister and buffer due to various factors such as anaerobic corrosion, radiolysis, and microbial degradation. If the gas generation rate exceeds the diffusion rate, the gas within the buffer may compress, resulting in physical damage to the buffer due to the increased pore pressure. In particular, the rapid movement of gases, known as gas breakthroughs, through the dilatancy pathway formed during this process may lead to releasing radionuclide. Therefore, understanding these gas generation and movement mechanism is essential for the safety assessment of the disposal systems. In this study, an experimental apparatus for investigating gas migration within buffer was constructed based on a literature review. Subsequently, a gas injection experiment was conducted on a compacted bentonite block made of Bentonile WRK (Clariant Ltd.) powder. The results clearly demonstrated a sharp increase in stress and pressure typically observed at the onset of gas breakthrough within the buffer. Additionally, the range of stresses induced by the swelling phenomenon of the buffer, was 4.7 to 9.1 MPa. The apparent gas entry pressure was determined to be approximately 7.8 MPa. The equipment established in this study is expected to be utilized for various experiments aimed at building a database on the initial properties of buffer and the conditions during gas injection, contributing to understanding the gas migration phenomena.

• Clinics in Shoulder and Elbow
• /
• v.26 no.4
• /
• pp.343-350
• /
• 2023

Background: Our purpose was to evaluate a custom reverse total shoulder arthroplasty glenoid baseplate for severe glenoid deficiency, emphasizing the challenges with this approach, including short-term clinical and radiographic outcomes and complications. Methods: This was a single-institution, retrospective series of 29 patients between January 2017 and December 2022 for whom a custom glenoid component was created for extensive glenoid bone loss. Patients were evaluated preoperatively and at intervals for up to 5 years. All received preoperative physical examinations, plain radiographs, and computed tomography (CT). Intra- and postoperative complications are reported. Results: Of 29 patients, delays resulted in only undergoing surgery, and in three of those, the implant did not match the glenoid. For those three, the time from CT scan to implantation averaged 7.6 months (range, 6.1-10.7 months), compared with 5.5 months (range, 2-8.6 months) for those whose implants fit. In patients with at least 2-year follow-up (n=9), no failures occurred. Significant improvements were observed in all patient-reported outcome measures in those nine patients (American Shoulder and Elbow Score, P<0.01; Simple Shoulder Test, P=0.02; Single Assessment Numeric Evaluation, P<0.01; Western Ontario Osteoarthritis of the Shoulder Index, P<0.01). Range of motion improved for forward flexion and abduction (P=0.03 for both) and internal rotation up the back (P=0.02). Pain and satisfaction also improved (P<0.01 for both). Conclusions: Prolonged time (>6 months) from CT scan to device implantation resulted in bone loss that rendered the implants unusable. Satisfactory short-term radiographic and clinical follow-up can be achieved with a well-fitting device. Level of evidence: III.

• Nuclear Engineering and Technology
• /
• v.55 no.12
• /
• pp.4357-4366
• /
• 2023

MARS-KS, a domestic regulatory confirmatory code of Republic of Korea, had been developed by integrating RELAP5/MOD2 and COBRA-TF. The integration of COBRA-TF allowed to extend the capability of MARS-KS, limited to one-dimensional analysis, to multi-dimensional analysis. The use of COBRA-TF was mainly focused on subchannel analyses for simulating multi-dimensional behavior within the reactor core. However, this feature has been remained as a legacy without ongoing maintenance. Meanwhile, MARS-KS also includes its own multidimensional component, namely MULTID, which is also feasible to simulate three-dimensional convection and diffusion. The MULTID is capable of modeling the turbulent diffusion using simple mixing length model. The implementation of the turbulent mixing is of importance for analyzing the reactor core where a disturbing cross-sectional structure of rod bundle makes the flow perturbation and corresponding mixing stronger. In addition, the presence of this turbulent behavior allows the secondary transports with net mass exchange between subchannels. However, a series of assessments performed in previous studies revealed that the turbulence model of the MULTID could not simulate the aforementioned effective mixing occurred in the subchannel-scale problems. This is obvious consequence since the physical models of the MULTID neglect the effect of mass transport and thereby, it cannot model the void drift effect and resulting phasic distribution within a bundle. Thus, in this study, the turbulence mixing model of the MULTID has been improved by means of the inter-channel mixing model, widely utilized in subchannel analysis, in order to extend the application of the MULTID to small-scale problems. A series of assessments has been performed against rod bundle experiments, namely GE 3X3 and PSBT, to evaluate the performance of the introduced mixing model. The assessment results revealed that the application of the inter-channel mixing model allowed to enhance the prediction of the MULTID in subchannel scale problems. In addition, it was indicated that the code could not predict appropriate phasic distribution in the rod bundle without the model. Considering that the proper prediction of the phasic distribution is important when considering pin-based and/or assembly-based expressions of the reactor core, the results of this study clearly indicate that the inter-channel mixing model is required for analyzing the rod bundle, appropriately.

• The Journal of Internal Korean Medicine
• /
• v.45 no.3
• /
• pp.497-507
• /
• 2024

Objectives: This study investigated the treatment response to Korean medicine of a paraneoplastic cerebellar degeneration (PCD) patient with dysarthria and weakness of distal extremity. Case presentation: A 53-year-old female diagnosed with PCD complained of dysarthria and weakness of distal extremity. During 32-day hospitalization, she was treated with Korean medicine, namely, herbal medicine (modified Gamiguibi-tang), acupuncture (15 minutes twice a day at CV23, HT7, LI4, LR3, ST36, SP6, GB20, TE17, PC6, GV20, Ex-HN1, GV24 etc.), moxibustion, and cupping, combined with Western medicine (prednisolone, azathioprine) and physical therapy. Post-treatment, the patient global assessment (PGA) score of dysarthria fell from 100 to 60; grasp power rose from 15 kg to 19 kg and 13 kg to 17 kg in the right and left hands, respectively; and the 5-level EQ-5D version (EQ-5D-5L), EQ visual analogue scale (EQ-VAS), and Beck depression inventory (BDI-II) scores changed from 10 to 8, 0 to 80, and 34 to 7 respectively. Follow-up visits continued for about a month after discharge, improvement in symptoms maintained, and there were no significant side effects. Conclusions: Given the lack of standard treatment for PCD, Korean medicine can be tried clinically for the treatment of PCD patients with dysarthria and weakness of distal extremity. However, further studies with control groups are needed.

• Journal of Soil and Groundwater Environment
• /
• v.12 no.4
• /
• pp.25-31
• /
• 2007

Characterizing the risk posed by a mixture of chemicals is a challenging task due to the chemical interactions of individual components that may affect their physical behavior and hence alter their exposure to receptors. In this study, cell tests that represent subsurface environment were carried out using benz[a]anthracene (BaA) and p-xylene focusing on phasetransforming interaction to verify increased mobility and risk of highly sorbed pollutants in the presence of less sorbed, mobile liquid pollutants. A transport model was also developed to interpret results and to simulate the same process on a field scale. The experimental results showed that BaA had far greater mobility in the presence of p-xylene than in the absence of that. The main transport mechanisms in the vadose zone were by dissolution to p-xylene or water. The transport model utilizing Defined Time Steps (DTS) was developed and tested with the experimental results. The predicted and observed values showed similar tendency, but the more work is needed in the future study for more precise modeling. The field-scale simulation results showed that transport of BaA to groundwater table was significantly faster in the presence of NAPL, and the oral carcinogenic risk of BaA calculated with the concentration in groundwater was 15${\sim}$87 times larger when mixed with NAPL than when solely contaminated. Since transport rate of PAHs is very slow in the subsurface without NAPL and no degradation of PAHs was considered in this simulation during the transport, the increase of risk in the presence of NAPL is expected to be greater for the actual contaminated site.

• Journal of Hospice and Palliative Care
• /
• v.9 no.2
• /
• pp.77-85
• /
• 2006

Purpose: The purpose of this study is to develop the basic curriculum for the nurses who work at hospice and palliative care settings. Methods: Seven curricula of hospice and palliative care for the nurses in Korea and other countries were reviewed, and Education Need for hospice and palliative care was surveyed from 162 nurses by mailing the questionnaires to hospice palliative care settings. Results: 1. The curricula of hospice and palliative care for the nurses in Korea and other countries in common include 'understanding of hospice and palliative care', 'understanding of lift and death', 'pain and symptom management for person with terminal disease', 'on-the-spot study and practical training', 'management of hospice and palliative ward', 'hospice and palliative care at home', 'physical assessment', 'therapeutic communication skills', 'children's hospice', 'administration and management of hospice and palliative care', 'interdisciplinary team of hospice and palliative care', 'ethics and laws in hospice and palliative care', 'psychological, social and spiritual care', 'care of the dying', 'bereavement care', etc. 2. The scores above 3.3 were marked for 34 items in education Need Survey. The highest scores were given in the order for the items 'understanding of death and dying', 'attitude and response to death and dying', 'understanding and assessment of pain' etc. respondents marked that they have been trained for 'pain and symptom management', 'ethics and laws in hospice and palliative care', 'building the system for cooperation and publicity activities in hospice' etc. 3. The basic curriculum of hospice and palliative care for the nurses requires 78 studying hours for 17 subjects, comprising 48 hours of theory education and 30 hours of practical training. The education methods are lectures, discussions, and case studies. Conclusion: The efforts of developed basic curriculum should be evaluated after educating nurses. It is necessary to develop the standard curriculum and regularly update it based on the result of education Need Survey for actively working nurses in hospice and palliative care settings.

• Journal of Environmental Impact Assessment
• /
• v.26 no.4
• /
• pp.272-289
• /
• 2017

This study analyzed the status of the naturalized plants in islands in Jeollanamdo from an island biogeographic perspective. As a result of a floristic analysis at 47 inhabited islands and 194 uninhabited islands, 30 families and 134 species naturalized plants are reported. The most commonly occurring naturalized plant from 141 islands was Rumex crispus. The average number of naturalized plants by islands is 20.6 species (${\pm}14.22$) at the inhabited islands and 3.7 species (${\pm}3.89$) at the uninhabited islands. Presence of fifty nine naturalized species at Geumodo in Yeosu-si is the largest in number. The naturalization ratio, which is the ratio of naturalized plants to native plants, is 7.66% (${\pm}3.96$) in the inhabitable islands and 4.97% (${\pm}3.70$) in the uninhabitable islands. The naturalization ratio among islands of the West Sea in Jeollanam-do is 5.92% (${\pm}4.49$), and it is higher than 4.96% (${\pm}2.15$) in islands in the South Sea. Especially, the naturalization ratio at the inhabitable islands, i.e., 8.39% (${\pm}4.37$) at the islands of the West Sea is higher than 5.80% (${\pm}1.41$) at islands in the South Sea. The naturalization ratio of naturalized plants at the islands shows positive correlation with the size of the island (r=0.412, p<0.01), but the correlations with distance from the mainland and altitude above sea level are not significant. Eight ecosystem disturbing species designated by law are reported, and each species shows distinct distributional ranges. The regional differences in the number of naturalized plant species seem to be a result of the complex reflection of natural and human environmental factors, such as the degree of traffic between mainland and islands, degree of cultivation activities, along with the physical environmental differences. Since islands have limited habitats and resources, islands could be more vulnerable to the incoming species from outside, and environmental changes than mainland. Therefore, continuous monitoring and management against the naturalized plants in islands are needed.

• Korean Journal of Biological Psychiatry
• /
• v.3 no.2
• /
• pp.222-239
• /
• 1996

The purpose of this study was to evaluate the effects of alcohol on the psychomotor performance and subjective assessment in healthy Korean adults with acetaldehyde dehydrogenase I(ALDH-I) isozyme variance. A total of 20 male subjects, half with active ALDH-I and the other half with inactive ALDH-I, were selected through both a self-reporting questionnaire examining alcohol sensitivity and the Higuchi's ethanol patch test detecting ALDH-I deficiency. In a doule-blind, placebo-controlled cross-over design, each subject consumed four doses of alcohol(0.25, 0.5, 0.75, 1.0g/kg) and placebo on five separate occasions at weekly intervals, Treatment order was fully balanced using a $5{\times}5$ Latin square, Psychomotor performance tests[coritical flicker fusion threshold(CFF) and choice reaction time(CRT)] and self-estimate questionnaires were conducted at baseline and at time points of 20, 40, 60, 90, 120, 150, 180 minutes after consuming the test drug for 20 minutes, Blood alcohol concentrations(BACs) using breath analyzer were measured at baseline and at time points of 10, 20, 30, 40, 50, 60, 75, 90, 105, 120, 150, 180 minutes after drinking, The BACs and the mean changes in the psychomotor performances and subjective assessments from pre-alcohol baseline, were compared between the two groups. The findings were summarized as follows : 1) BACs were tended to be higher in the inactive group than the active in all of the four alcohol doses. However significant group differences were only after the 0.5g/kg dose of alcohol. 2) The inactive group showed significant impairment in CFFT at most time points alter 0.75 and 1.0g/kg doses of alcohol. 3) In CRT, total reaction time(TRT) significantly prolonged in the inactive group than the active group at 20 minutes after 0.25 and 1.0g/kg doses of alcohol and at 40, 60, 90 minutes alter 0.75g/kg dose of alcohol. In the inactive group, recognition time component significantly increased at 20, 60, 90 minutes after 1.0g/kg dose of alcohol, while movement time component significantly increased at 40, 60 minutes after 0.75g/kg dose of alcohol. 4) Subjective evaluation of the effect of alcohol revealed that physical and mental conditions as well as a self-estimate of the effects of alcohol on performance were significantly worse in the inactive group than the active at some time points alter all of the lour alcohol doses, wihch were more pronounced after 0.75 and 1.0g/kg doses of alcohol. 5) Most of the group differences mentioned above, still remained statistically significant after BAC was entered as a covariate, These findings demonstrated that the alcohol sensitivity is higher in individuals with inactive ALDH-I than those with active ALDH-I both on the subjective assessments and the objective psychomotor performances. Furthermore, these results suggest thai the alcohol sensitivity may be determined by acetaldehyde concentration rather than BAC per se. In future studies, after more accurate genotyping for ALDH-I, the relationships between BAC, acetaldehyde concentration and alcohol sensitivities should be clearly defined.

• Korean Journal of Psychosomatic Medicine
• /
• v.5 no.2
• /
• pp.185-194
• /
• 1997

A comparison was made regarding illness behavior among patients with somatoform disorders, depressive disorders and psychosomatic disorders. The subjects consisted of out-patients with somatoform disorders(N=52), depressive disorders(N=52) and psychosomatic disorders(N=51). illness behavior was assessed by illness Behavior Assessment Schedule and the questionnaire about help-seeking behavior. The patients with somatoform disorders and psychosomatic disorders more often affirmed the presence of somatic disease, were more likely to have phobia of disease, had more preoccupation with ideas of disease and more frequently shopped around oriental clinics than the patients with depressive disorders. The patients with somatoform disorders more often attributed its cause to physical factors, less often attributed the origin of affective disturbance to psychological causes, showed Less depression and irritability, and were less likely to accept psychiatric treatment recommended by other physicians than depressive patients. The patients with somatoform disorders were more likely to report having been told that they suffered from a mild illness than those with psychosomatic disorders. The patients with somatoform disorders with psychological problems tended to inhibit expression of their emotion. Female patients with somatoform disorders more often affirmed the presence of psychological disorder and attributed its cause to psychological factors than male ones. These results suggest that in illness behavior, patients with somatoform disorders are different from depressive patients, whereas the former patients are similar to psychosomatic patients except the discrepancy between therapists and patients regarding evaluation of their symptoms. Thus, it is emphasized that first, therapists need to approach patients with somatoform disorders somatically with understanding of their underlying need to deny psychological problems, followed by either psychological or biopsychosocial approach.