• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제34권2호
• /
• pp.117-126
• /
• 2012

Epidermolysis bullosa (EB) represents a spectrum of conditions that are characterized by blistering and mechanical fragility of the skin. There is genetic heterogeneity and marked variation in clinical phenotypes in the multiple EB disorders. The most recent classification recognizes four major EB grouping and over 30 EB subtypes. The severity of EB ranges from mild to severe skin involvement, and it can be localized or generalized. Oral features include repeated occurrence of blisters, erosions, and scars, which lead to limited mouth opening, ankyloglossia, elimination of buccal vestibule, and increased risk of oral carcinoma. Routine dental care or even normal tooth brushing might cause bullae on the oral mucosa. Occasionally, the clinician will be called upon to treat patients with EB and should therefore be aware of specific treatment modifications. we present a reviews of the literature with a case providing adequate anesthetic and surgical care.

• 임상간호연구
• /
• 제23권2호
• /
• pp.202-210
• /
• 2017

Purpose: In this study an investigation was done of injuries from inpatient falls and diagnostic tests and treatment after falls to identify what factors affect the occurrence of injury from inpatient falls in a tertiary hospital. Methods: Data for this cross-sectional study were retrieved for 428 fall events from data reported between January 1 and December 31, 2015 and were retrieved from the patient-safety reporting system in the hospital's electronic health records. A multivariate logistic regression model was developed with STATA 13.0. Results: Of the patients, 197 (46.0%) had physical injuries due to falls, 119 (27.8%) were given further diagnostic tests, and 358 (83.6%) received treatment including close observation after inpatient falls. Logistic-regression results identified that age, department, and risk factors had significant impact on injuries from falls. Conclusion: Findings indicate that to reduce the severity of injury after inpatient falls, each hospital should regularly evaluate identified factors, design fall-prevention practices specialized for elders and vulnerable patients, and initiate environmental and equipment innovations.

• Safety and Health at Work
• /
• 제1권2호
• /
• pp.112-123
• /
• 2010

The paper gives an overview of the problems to be tackled nowadays by occupational health with regards to shift work as well as the main guidelines at organizational and medical levels on how to protect workers' health and well-being. Working time organization is becoming a key factor on account of new technologies, market globalization, economic competition, and extension of social services to general populations, all of which involve more and more people in continuous assistance and control of work processes over the 24 hours in a day. The large increase of epidemiological and clinical studies on this issue document the severity of this risk factor on human health and well being, at both social and psychophysical levels, starting from a disruption of biological circadian rhythms and sleep/wake cycle and ending in several psychosomatic troubles and disorders, likely also including cancer, and extending to impairment of performance efficiency as well as family and social life. Appropriate interventions on the organization of shift schedules according to ergonomic criteria and careful health surveillance and social support for shift workers are important preventive and corrective measures that allow people to keep working without significant health impairment.

• 한국안전학회지
• /
• 제20권4호
• /
• pp.148-153
• /
• 2005

Computer dominated jobs and industrial automation have rapidly created work-related musculoskeletal disorders(WMSDs) and WMSDS are expanding to employee of other general industry. Specific risk factors associated with WMSDs include repetitive motion, heavy lifting, forceful exertion, contact stress, vibration awkward posture and rapid hand and wrist movement. The purpose of this paper is to analyze the effects of the neck muscle workload according to posture(joint angle) and load weight. Seven male students participated in this study. To analyze neck muscle workload was studied on electromyographic(EMG) activity for sternocleidomastoid and trapezius, was subjectively rated using a Borg's CR-10 scale. ANOVA showed that the CR-10 ratings and most EMG root-mean-square (RMS) value were statistically significant improvement according to posture(joint angle) and load weight. The results of this study indicate the joint angle and weight of neck muscle workload to provide safe working conditions. To reduce the large number and severity of WMSDs employees have been experiencing, we need to redesign the job in workplace to identify and control hazards that are reasonably likely to be causing or contributing to the WMSDs.

• 한국안전학회지
• /
• 제29권4호
• /
• pp.160-167
• /
• 2014

To determine a proper ASIL for each hazardous event with a proper safety goal, the right classes should first be determined for the three properties of the hazardous event; (i) severity of harm from the resultant accident, (ii) exposure to the relevant operational situation, and (iii) controllability to avoid the induced risks. ASIL can be clearly determined with right classes of these three properties. But no specific methodologies or processes for their classification can be found in ISO 26262, except only a rough guideline with a simplified set of illustrative tables. In this paper, we try to present a systematic model for classifying the three properties of the hazardous event and suggest a refined procedure of ASIL determination. The proposed model provides a specific method to get a more objective ASIL compared with that in the standard. Scrutinizing the current methodology, we develop a refined method and also provide an illustrative example.

• The Korean Journal of Pain
• /
• 제26권1호
• /
• pp.3-13
• /
• 2013

Chronic noncancer pain is a significant and growing public health challenge in the United States. Lacking effective alternative interventions for effective chronic noncancer pain management, many physicians have turned to opioid pharmacotherapy. Increased opioid prescribing brings not only gains in therapeutic benefit but also a higher incidence of adverse drug events including increased medication misuse and opioid related mortality. Currently the United States must confront the dual problems of widespread undertreated chronic noncancer pain and a prescription opioid abuse crisis. Withholding pain relieving drugs from patients in need is unjustifiable, yet drug diversion, abuse and adverse drug events have become major social as well as medical problems. At the heart of this crisis is the lack of definitive evidence about the risk to benefit ratio of opioid pharmacotherapy for chronic noncancer pain both on an individual case and on a population basis. This article describes the extent and severity of the American chronic noncancer pain problem and the history of opioid pharmacotherapy for chronic noncancer pain in the United States. It then discusses the concept of evidence based practice and reviews current evidence supporting opioid pharmacotherapy for chronic noncancer pain as well as adverse drug events related to opioid pharmacotherapy including misuse and abuse. Finally, it considers the conflict of providing pain relief versus protecting society and reviews steps that governmental agencies, industry and others are taking to contain and ultimately resolve the problems of excessive prescribing and conflicting priorities.

• Journal of Nutrition and Health
• /
• 제32권2호
• /
• pp.166-174
• /
• 1999

To study the relation between serum fatty acids and coronary artery disease(CAD), 194 subjects were randomly selected and divided into three groups(control, single vessel disease group(SVD), muliple vessel disease group(MVD)) according to the angiographic results. Total serum levels of fatty acids and serum phospholipid(PL)-fatty acids(FAs)were analysed using gas chromatography and their associations with CAD were examined. Different patterns of total serum fatty acid levels were found in men and women. Levels of most fatty acids of SVD and MVD were significantly lower in men, while those of MVD were significantly higher in women. In terms of PL-FAs in both men and women, the levels of PL-FAs follow the order of control < SVD < MVD and in women, the difference was significant. Various ratio(including ratios denoting the activites of desaturase and elongase) of total serum-and PL-FAs were similar in the three groups. In the relation of serum fatty acids to serum lipid profiles, PUFA & LDL showed a negative correlation, while, SFA & LDL-cholesterol and PUFA and HDL-cholesterol showed positive correlatons. correlations. Systolic blood pressure and alcohol intake levels negatively affected the levels of serum LA, AA, EPA and DHA in the risk factor analysis. These findings are consistent with other evidence indicating that fatty acid compositions are changed in CAD, especially on the concentration base and the change was related to the severity of the disease. Therefore, for the purpose of disease prevention and therapeutic use, balanced intakes of various fatty acids must be seriously considered.

• 문화기술의 융합
• /
• 제5권1호
• /
• pp.417-428
• /
• 2019

본 연구는 급성 뇌졸중 입원 환자의 연하장애 유병률과 그 관련요인을 탐색하기 위한 서술적 조사연구로, 일상급종합병원에 급성 뇌졸중으로 진단받은 입원 환자 131명(연령 범위 34-92세, 58.0% 남성)을 대상으로 수행되었다. 본 연구의 결과 급성 뇌졸중 입원 환자의 유병률은 24.4%였으며, 대상자의 나이, 뇌졸중 중증도, 구강상태, 일상활동 의존도가 연하장애에 영향을 미치는 것으로 나타났다. 이러한 결과를 기반으로 뇌졸중 발병 직후부터 연하장애 조기 발견을 위한 적극적인 간호사정과 예방적 중재 프로그램 개발과 적용이 필요하다.

• Structural Monitoring and Maintenance
• /
• 제6권2호
• /
• pp.125-145
• /
• 2019

Bridge scour is one of the predominant causes of bridge failure. Current climate deterioration leads to increase of flooding frequency and severity and thus poses a higher risk of bridge scour failure than before. Recent studies have explored extensively the vibration-based scour monitoring technique by analyzing the structural modal properties before and after damage. However, the state-of-art of this area lacks a systematic approach with sufficient robustness and credibility for practical decision making. This paper attempts to develop a data-driven methodology for bridge scour monitoring using support vector machines. This study extracts features from the bridge dynamic responses based on a generic sensitivity study on the bridge's modal properties and selects the features that are significantly contributive to bridge scour detection. Results indicate that the proposed data-driven method can quantify the bridge scour damage with satisfactory accuracy for most cases. This paper provides an alternative methodology for bridge scour evaluation using the machine learning method. It has the potential to be practically applied for bridge safety assessment in case that scour happens.

• Clinical and Experimental Pediatrics
• /
• 제64권12호
• /
• pp.608-618
• /
• 2021

Hypoxic-ischemic encephalopathy (HIE) is the most common cause of neonatal encephalopathy with a global incidence of approximately 1 to 8 per 1,000 live births. Neonatal encephalopathy can cause neurodevelopmental and cognitive impairments in survivors of hypoxic-ischemic insults with and without functional motor deficits. Normal neurodevelopmental outcomes in early childhood do not preclude cognitive and behavioral difficulties in late childhood and adolescence because cognitive functions are not yet fully developed at this early age. Therapeutic hypothermia has been shown to significantly reduced death and severe disabilities in term newborns with HIE. However, children treated with hypothermia therapy remain at risk for cognitive impairments and follow-up is necessary throughout late childhood and adolescence. Novel adjunctive neuroprotective therapies combined with therapeutic hypothermia may enhance the survival and neurodevelopmental outcomes of infants with HIE. The extent and severity of brain injury on magnetic resonance imaging might predict neurodevelopmental outcomes and lead to targeted interven tions in children with a history of neonatal encephalopathy. We provide a summary of the long-term cognitive outcomes in late childhood and adolescence in children with a history of HIE and the association between pattern of brain injury and neurodevelopmental outcomes.