Iatrogenic ureteral injury is a complication that can occur during a variety of pelvic or abdominal surgeries. The most frequent causes are gynecological ones, followed by colon and vascular surgeries. Management of ureteric injury depends on the time of diagnosis and the severity of organ damage. Injuries diagnosed intraoperatively should be treated immediately. Occasionally, intraoperative ureteral injury is overlooked, and symptoms of the late diagnosis of ureteral injury are usually nonspecific; therefore, the diagnosis is delayed for days or weeks postoperatively. Management of injuries diagnosed postoperatively is more complex. There are differing opinions on whether an initial conservative or immediate operative intervention is the best line of action. Delayed repair is suggested on the grounds that it will reduce inflammation and tissue edema. However, many authors are in favor of early repair, perhaps because tissue planes are easier to find before fibrosis becomes too dense. Ureteral injuries occurring at the level of the pelvic brim should be best managed with an end-to-end anastomosis, preferably around a ureteric stent. More distal injuries also should be ideally managed with an end-to-end anastomosis, after excision of the crushed or compromised segments. However, if the remaining distal segment is short, ureteral reimplantation is the procedure of choice. The Boari flap technique for ureteral reimplantation is invaluable in cases with a short proximal segment. Delayed recognition of iatrogenic ureteral injury may be associated with serious complications, so prompt recognition of ureteral injuries is important. Recognition of the injury before closure is the key to easy, successful, and complications-free repair. Increased awareness of the risk for ureteral damage during certain operative maneuvers is vital to prevent injury, and to decrease the incidence of iatrogenic injury. A sound knowledge of abdominal and pelvic anatomy is the best prevention.
Purpose: Supraventricular arrhythmia is a well-known complication of cardiothoracic surgery, and is common in patients wirth underlying cardiovascular disease. Also, it's treatment and prognosis are well known. However the incidence, the contributing factors, and the prognosis for supraventricular arrhythmias in noncardiothoracic surgical patients are less well known. This study was undertaken to investigate the incidence, the clinical presentation, the prognosis, and the factors comtributing to the prognosis for supraventricular arrhythmia in the surgical intensive care unit. Methods: We performed a retrospective study of 34 patients with newly developed or aggravated supraventricular arrhythmias in the surgical intensive care unit between March 2004 and February 2005. The incidence, the risk factors, and the prognosis of supraventricular arrhythmias were analyzed. Results: During a 12month period, the incidence of supraventricular arrhythmia was 1.79% (34/1896). Most patients had pre-existing cardiovascular disease and sepsis. The mortality rate was 29.4%, and the most common cause of death was multiple organ failure due to septic shock. The mean value of the APACHE II score was 20.9, and the surgical intensive care unit and the hospital lengths of stay were 9.9 days and 25.8 days, respectively. The APACHE II score measured when the arrhythmia developed was a significant factor in predicting mortality, Conclusion: Supraventricular arrhythmias result in increased mortality and increased length of stay in both the surgical intensive care unit and the hospital. The arrhythmia itself did not cause death, but a high APACHE II score incicated a poor prognosis. This may reflect the severity of the illness rather than an independent contributor to mortality.
Journal of the Korea Society of Computer and Information
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v.17
no.2
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pp.127-137
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2012
Recently, as modern Internet uses mashups, Web 3.0, JavaScript/AJAX widely, the rate at which new vulnerabilities are being discovered is increasing rapidly. It can subsequently introduce big security threats. In order to efficiently mitigate these web application vulnerabilities and security threats, it is needed to rank vulnerabilities based on severity and consider the severe vulnerabilities during a specific phase of software development lifecycle (SDLC) for web applications. In this paper, we have first verified whether the risk rating methodology of OWASP Top 10 vulnerabilities is a reasonable one or not by analyzing the vulnerability data of web applications in the US National Vulnerability Database (NVD). Then, by inspecting the vulnerability information of web applications based on OWASP Top-10 2010 list and CWE (Common Weakness Enumeration) directory, we have mapped the web-related entries of CWE onto the entries of OWASP Top-10 2010 and prioritized them. We have also presented which phase of SDLC is associated with each vulnerability entry. Using this approach, we can prevent or mitigate web application vulnerabilities and security threats efficiently.
This study is a descriptive study to understand the effect on the health behavior compliance of men who got coronary intervention, focusing on the elapsed period. The subjects of this study were 249 men who underwent coronary intervention at a university hospital, and the collected data were analyzed using Stepwise multiple regression. As a result of the study, the influencing factors the implementation of healthy behaviors were self-regulation(β=0.35, p<.001), risk factors among educational request(β=-0.26, p<.001), and the elapsed period(β=0.19, p<.001), marital status(β=0.15, p=.001), educational level(β=-0.12, p=.035), and the total explanatory power was 29.1%. IIn order to increase the health behavior performance of male patients who underwent coronary intervention, it is necessary to develop a program that can strengthen the autonomous motivation of subjects with high severity and elapsed time of less than 1 year and more than 1 year.
Cho, Eun Ji;Jeong, Seol;Gwak, Seung Yeon;Jerng, Ui Min
Herbal Formula Science
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v.29
no.4
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pp.285-295
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2021
Objective : This systematic review was conducted to investigate the effect of herbal medicine on Helicobacter pylori(H. pylori) infection compared to amoxicillin included synthetic drugs. Methods : Relevant randomized controlled trials(RCTs) which were published prior to December 26, 2020, were collected using PubMED database. Risk of bias evaluation and data extraction were done independently by two reviewers, and the third reviewer reassessed mismatching parts. Results : Two RCTs testing two different herbal medicines against synthetic drugs solitary treatment or synthetic drugs with placebo for herbal medicine were included. One study reported that there was no significant difference between the eradication rate of synthetic drugs and the herbal medicine. The other study did not report the eradication rate of the herbal medicine. One study reported histologic severity, the other reported dyspepsia score as efficacy indicators. There was no adverse event reported in all studies. However, the number of included RCTs was too small, the quality of reported data was not enough to verify efficacy of herbal medicine, and there were some methodological problems. Conclusion : It was difficult to conclude that solitary treatment of herbal medicine was as effective as amoxicillin included synthetic drugs for H. pylori infection.
Ko, Ji Wool;Park, Il Hwan;Byun, Chun Sung;Jang, Sung Woo;Jun, Pil Young
Journal of Trauma and Injury
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v.34
no.3
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pp.162-169
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2021
Purpose: For severe lung injuries or acute respiratory distress syndrome that occurs during critical care due to trauma, extracorporeal membrane oxygenation (ECMO) may be used as a salvage treatment. This study aimed to describe the experiences at a single center with the use of ECMO in trauma patients. Methods: We enrolled a total of 25 trauma patients who were treated with ECMO between January 2015 and December 2019 at a regional trauma center. We analyzed and compared patients' characteristics between survivors and non-survivors through a medical chart review. We also compared the characteristics of patients between direct and indirect lung injury groups. Results: The mean age of the 25 patients was 45.9±19.5 years, and 19 patients (76.0%) were male. The mean Injury Severity Score was 26.1±10.1. Ten patients (40.0%) had an Abbreviated Injury Scale (AIS) 3 score of 4, and six patients (24.0%) had an AIS 3 score of 5. There were 19 cases (76.6%) of direct lung injury. The mortality rate was 60.0% (n=15). Sixteen patients (64.0%) received a loading dose of heparin for the initiation of ECMO. There was no significant difference in heparin use between the survivors and non-survivors (70% in survivors vs. 60% in non-survivors, p=0.691). When comparing the direct and indirect lung injury groups, there were no significant differences in variables other than age and ECMO onset time. Conclusions: If more evidence is gathered, risk factors and indications will be identified and we expect that more trauma patients will receive appropriate treatment with ECMO.
Ivaz, Jelena S.;Stojadinovic, Sasa S.;Petrovic, Dejan V.;Stojkovic, Pavle Z.
Safety and Health at Work
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v.12
no.4
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pp.479-489
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2021
Background: During 2011, a study was undertaken to assess safety conditions in Serbian underground coalmines by analysis of injury data. The study covered all Serbian coalmines, identified week spots from the aspect of safety, and recommended possible courses of action. Since then, Serbia has made changes to safety and health legislation; all coalmines introduced new preventive measures, adopted international standards, and made procedures for risk management. After 10 years a new study has been performed to analyze the impact of these changes. Materials and methods: In this study, the injuries that have occurred in the Serbian underground coal mines over the last 20 years were analyzed. Statistical data analysis was performed by IBM SPSS Statistics v23. The injuries that occurred in the last ten years were compared with the results of the previous study (2000-2009). The average values of injury rates for both periods were compared for each of the categories (severity, age, body part, qualification), and the results were presented as absolute difference or percentile difference. Results: The results showed reduction in the number of injuries in the category of 20-30 years old workers, where the new training procedures for workers, which were set by mandatory legal regulations, certainly contributed. They also showed an increase in the number of injuries in the category of old workers, which indicates that the law did not have a positive effect on this category. Conclusion: The total number of injuries is still high; therefore, it is necessary to introduce mechanization and automation in mines and have a better policy for older workers who retire later nowadays.
Journal of the Korea Institute of Information and Communication Engineering
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v.25
no.7
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pp.962-970
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2021
The cause of the majority of vehicle accidents is a safety issue due to the driver's inattention, such as drowsy driving. A forward collision warning system (FCWS) can significantly reduce the number and severity of accidents by detecting the risk of collision with vehicles in front and providing an advanced warning signal to the driver. This paper describes a low power embedded system based FCWS for safety. The algorithm computes time to collision (TTC) through detection, tracking, distance calculation for the vehicle ahead and current vehicle speed information with a single camera. Additionally, in order to operate in real time even in a low-performance embedded system, an optimization technique in the program with high and low levels will be introduced. The system has been tested through the driving video of the vehicle in the embedded system. As a result of using the optimization technique, the execution time was about 170 times faster than that when using the previous non-optimized process.
Kwak, Bong Jun;Kim, Dong Goo;Han, Jae Hyun;Choi, Ho Joong;Bae, Si Hyun;You, Young Kyoung;Choi, Jong Young;Yoon, Seung Kew
Annals of Surgical Treatment and Research
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v.95
no.5
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pp.267-277
/
2018
Purpose: The aim of this study was to analyze survival outcomes in 1,000 consecutive liver transplantations (LTs) performed at a single institution from 1993 to April 2017. Methods: The study population was divided into 2 groups based on donor type: deceased donor LT (DDLT; n = 181, 18.1%) and living donor LT (LDLT; n = 819; 81.9%), and into 3 periods based on the number of cases (first 300 cases, middle 300 cases, last 400 cases). Results: Infection was the most common cause of death, accounting for 34.8% (95 of 273). Mortality due to hepatocellular carcinoma recurrence occurred most frequently between 1 and 5 years after transplantation. Mortality rate by graft rejection was highest between 5 and 10 years after transplantation. And mortality by de novo malignancy occurred most frequently after 10 years after transplantation. The patient survival rates for the entire population at 5 and 10 years were 74.7%, and 68.6%, respectively. There was no difference in survival rate between the LDLT and DDLT groups (P = 0.188). Cause of disease, disease severity, case period, and retransplantation had a significant association with patient survival (P = 0.002, P = 0.031, P = 0.003, and P = 0.024, respectively). Conclusion: Surgical techniques and perioperative management for transplant patients have improved and undergone standardization. Controlling perioperative infection and managing patients with HCC as LT candidates will result in better outcomes.
Objective : Although traumatic brain injury (TBI) occurs in people of all age groups, the elderly population is at a particular risk. The proportion of elderly population in the society is markedly increasing and Korea is one of the most rapidly aging societies. Here, we analyzed the data from 904 patients older over 65 years who were registered in the Korean Neuro-Trauma Data Bank System (KNTDBS). Methods : The Korean Society of Neurotraumatology recorded data from 20 institutions between September 2010 and March 2014. This retrospective study examined the clinical epidemiology, sex difference, outcome epidemiology, sociodemographic variables, and outcomes in the geriatric population related to TBI based on data from the KNTDBS. Results : The study included 540 men and 364 women. The age distributions in the male and female groups were statistically significantly different. The most common cause of trauma was a fall and diagnosis was acute subdural hematoma. The incidence was the highest in men aged 80-84 years and in women aged 75-79 years. The most common time of arrival to hospital after TBI was within 1 hour and 119 rescue team provided first aid earliest to patients with TBI. The mortality rate stratified according to the cause of trauma was significantly different, with mortality rates of 3.77% in fall and 11.65% in traffic accident. The mortality rates according the severity of brain injury, Glasgow Coma Scale score, and treatment were statistically significant. Conclusion : To our knowledge, this study is the first to focus on elderly patients with TBI in Korea and particularly investigate mortality and characteristics related to TBI-related death based on data from the KNTDBS. Although the study has some limitations, our results may be used to obtain useful information to study targeted prevention and more effective treatment options for older TBI patients and establish novel treatment guidelines and health polish for the geriatric population.
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