• 한국도로학회논문집
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• 제16권6호
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• pp.149-158
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• 2014

PURPOSES : The bridge section of the expressway has a worse driving environment than the general section. However, traffic safety countermeasures are focused only on the bridge section. Traffic safety countermeasures on the section before entry to the bridge and the section after exit from the bridge are applied only when the bridge has a long-span section. Accordingly, this study will verify the necessity of extending the application of traffic safety countermeasures to areas that are affected by the bridge. METHODS : This study determines the areas that are affected by the bridge as well as the areas that are affected by locations with frequent traffic accidents and suggests the risk factors by affected areas through canonical discriminant analysis. For the analysis, traffic accident data for 3 years, which occurred on bridge sections in six major expressway lines, were used. RESULTS : The numbers of traffic accidents were 469 before the bridge, 281 on the bridge, and 468 after the bridge. The variables that have impact on the seriousness of accidents are as follows: speeding, excess manipulation of the steering wheel, and failure to secure safety distance for accidents that occurred before the bridge section; speeding, excess manipulation of the steering wheel, and dozing off for accidents that occurred on the bridge; and speeding and failure to secure safety distance for accidents that occurred after the bridge section. CONCLUSIONS : Areas affected by the bridge show higher accident rates than the bridge section; therefore, imposing traffic safety countermeasures on the integrated section of the bridge and the affected areas is required. It is believed that the results suggested in this study could be effectively used in the prevention of traffic accidents by imposing custom-made safety countermeasures for each section.

• 한국학교ㆍ지역보건교육학회지
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• 제5권
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• pp.1-9
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• 2004

The purpose of this study was to assess the adolescents' perceptions of AIDS by reviewing the research findings on adolescents' knowledge and attitudes about AIDS, and to provide basic data for the development of AIDS prevention education program. Literature for the analysis was searched by using the terms 'AIDS', 'HIV', 'Adolescent', 'Student'. Finally, 17 articles from Korea and 3 from abroad were analysed. Major conclusions were as follows: 1. For the knowledge level of AIDS, most of the adolescents knew the definition, high risk group, and infection rout of AIDS. On the contrary, the knowledge level of the treatment of AIDS was low. 2. For the attitudes toward AIDS, the level of perceived severity was high. But the level of perceived susceptibility found to be low. Middle and high school students showed more positive attitudes toward AIDS patients than college students. Attitudes toward AIDS prevention education program were positive, but taking the blood test for the detection of AIDS was negative. 3. The experience rates of AIDS Education were ranged from 13.6% to 60%. Major channel for getting AIDS information were TV, newspaper and radio. The experience rates of sexual intercourse were ranged from 4% to 48.3%. The intention of using condom was 66.7%, but the rate of condom use was 38.4%. AIDS infection rates have been increasing rapidly among teens in recent years. Therefore, It is urgent to identify the determinants affecting AIDS related perception and preventive behavior, and to develop the prevention program for AIDS.

• 한국임상약학회지
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• 제27권2호
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• pp.77-82
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• 2017

Background: Clostridium difficile associated diarrhea (CDAD) is a leading cause of hospital-associated gastrointestinal illness. Risk factors for CDAD include advanced age, long-term admission, antibiotics, proton-pump inhibitor or $H_2$ blocker use and immunosuppression. The practice guideline of American Journal of Gastroenterology (2013) suggests metronidazole for the first-line therapy of mild-moderate CDAD as well as vancomycin for severe CDAD. MICU inpatients receiving stress ulcer prophylaxis and antibiotics are susceptible to nosocomial CDAD. Therefore, this study aimed to evaluate occurrence and treatment of CDAD in MICU. Methods: Patients who were admitted to the MICU and had CDAD from August 2012 to August 2015 were analyzed retrospectively. Results: Of the 90 patients with CDAD, 20 patients (2.22%) had mild-moderate CDAD (16 received metronidazole and 4 received vancomycin therapy) and 70 patients (77.8%) had severe CDAD(54 received metronidazole and 16 received vancomycin therapy). Among the patients with mild- moderate CDAD, treatment with metronidazole or vancomycin resulted in same clinical cure in 50% of the patients (p=1.00). Among the patients with severe CDAD, treatment with metronidazole or vancomycin resulted in clinical cure in 40.7% and 50.0% of the patients, respectively (p=0.511). Clinical symptoms recurred in 7.4% of the severe CDAD patients treated with metronidazole and 6.3% of those treated with vancomycin(p=0.875). Conclusion: Our findings suggest that metronidazole and vancomycin are equally effective for the treatment of mild-moderate CDAD; however, vancomycin demonstrated higher clinical cure rate and lower recurrence rate for severe CDAD, although the difference was not statistically significant. For better clinical outcomes, appropriate medication use by disease severity is needed.

• 성인간호학회지
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• 제14권2호
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• pp.222-232
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• 2002

Background and Purpose: After the coronary angiography procedure, patients are required to remain on bed rest to reduce the risk of bleeding and hematoma formation at the puncture site. This prolonged bed rest in the supine position is difficult for many patients, who frequently complain of low back pain. The purpose of the study was to determine whether a specially designed exercise therapy and transcutaneous electrical nerve stimulation (TENS) had an effect on the alleviation of low back pain. Method: Sixty-two patients were assigned to one of three groups : specially designed exercise therapy plus TENS plus general nursing care (exercise group N=21), general nursing care plus TENS (TENS group, N=23) or general nursing care (control group, N=18). The exercise therapy consisted of five movements including stretching, pelvic tilting, knee to chest, modified situps and trunk rotation with minimizing the motion of the puncture site. The severity of low back pain was assessed by a visual analogue scale(VAS) every two hours. The use of analgesic and any development of bleeding or other complications were monitored as well. The level of serum ${\beta}$-endorphin was determined before and after the three interventions. Result: The pain score of the exercise group was significantly lowered compared to that of the other groups. There was no difference in the serum ${\beta}$-endorphin level among three groups. Analgesic were less frequently taken by the exercise group. However the incidence of bleeding complications was not significantly different among the three groups. Conclusion: Exercise therapy is more effective than general care or TENS in alleviating low back pain of the patients with coronary angiography.

• 자동차안전학회지
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• 제7권2호
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• pp.15-18
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• 2015

The availability of in-depth accident data is a prerequisite for each efficient traffic safety management system. Identification and definition of the relevant problem together with knowledge of the data and parameters describing this problem is essential for its successful solution. Comprehensive, up-to-date, accident data is needed for recognition of the scope of road safety problems and for raising public awareness. Reliable and relevant data enable the identification of the contributory factors of the individual accidents, and an unveiling of the background of the risk behaviour of the road users. It offers the best way to explore the prevention of accidents, and ways to implement measures to reduce accident severity. In this study, reviewing the existing iGlad and GIDAS system, KIDAS data format can be finalized through feasibility evaluation. The progressive approach is proposed to successful settlement of Korea in-depth accident study. As the initial stage of in-depth investigation DB construction, the KIDAS is not repetition of the current police based TAAS. It is essential part of improving vehicle safety and reduction of traffic fatality in Korea. 72 Contributing factors like road and traffic characteristics, vehicle parameters, and information about the people involved in the accident have to be investigated and registered as well in the KIDAS.

• Clinical and Experimental Pediatrics
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• 제61권6호
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• pp.200-204
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• 2018

Atopic dermatitis (AD) is a chronic inflammatory skin disease in children. Patients with AD experience a high rate of colonization of the skin surface by Staphylococcus aureus. Because of a skin barrier defect, there is a potential risk of staphylococcal invasive infection in patients with AD. Here, we present 2 cases of breast abscess caused by S. aureus in 2 adolescent girls with severe AD. Methicillin-sensitive S. aureus was identified from the breast abscess material. They were treated with appropriate antibiotics, however surgical drainage of the abscess was needed in case 1. Identical strains were found from the breast abscess material as well as the lesional and the nonlesional skin of the patients through matrix-assisted laser desorption/ionization time-of-flight analysis. We characterized the differential abundance of Firmicutes phylum in patients' skin in microbiota analysis. In particular, S. aureus, a member of Firmicutes, differed significantly between the lesional and the normal-appearing skin. Our cases demonstrate the potential severity of bacterial deep tissue infection in AD and the dysbiosis of skin microbiota may be involved in inflammation in AD.

• 대한족부족관절학회지
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• 제1권2호
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• pp.112-118
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• 1997

Tarsometatarsal fracture-dislocation is uncommon but severe lesion. Since this lesion is sometimes difficult to recognize by roentgenography, it is easily overlooked. Three patients were treated with open reduction and internal fixation with 3.5 mm cannulated screw and K-wire, two had treatment with open reduction and internal fixation with 3.5 mm cannulated screw only and two had treatment with dosed reduction and short leg cast only between January 1994 and May 1996. The duration of follow-up ranged from twelve to twenty-nine months after the diagnosis. Results were assessed by a subjective questiormaire, physical examination, and radiographic analysis. Multiple fixation techniques for maintaining the reduction of tarsometatarsl joint have been introduced. We recent]y used the 3.5 mm cannulated screw for internal fixation of the tarso-first and second metatarsal fracture-dislocation. We think cannulated screw fixation has several advantages; 1. The cannulated screw fixation is more rigid than the K-wire fixation. 2. There is an decreased risk of screw breakage with early weight bearing. 3. It is possible to compress the involved joints, if necessary. There were no disability in all patients. One patient who was treated with delayed open reduction and internal fixation with 3.5 mm cannulated screw and K-wire had a radiographic mild degenerative arthritis. And one patient who was treated with dosed reduction and short leg cast had a mild metatarsus adductus. But. these two patients were symptom free. There was no correlation between the severity of the diastasis and the patient s functional result.

• Archives of Plastic Surgery
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• 제42권5호
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• pp.532-543
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• 2015

Capsular contracture is the most common complication following implant based breast surgery and is one of the most common reasons for reoperation. Therefore, it is important to try and understand why this happens, and what can be done to reduce its incidence. A literature search using the MEDLINE database was conducted including search terms 'capsular contracture breast augmentation', 'capsular contracture pathogenesis', 'capsular contracture incidence', and 'capsular contracture management', which yielded 82 results which met inclusion criteria. Capsular contracture is caused by an excessive fibrotic reaction to a foreign body (the implant) and has an overall incidence of 10.6%. Risk factors that were identified included the use of smooth (vs. textured) implants, a subglandular (vs. submuscular) placement, use of a silicone (vs. saline) filled implant and previous radiotherapy to the breast. The standard management of capsular contracture is surgical via a capsulectomy or capsulotomy. Medical treatment using the off-label leukotriene receptor antagonist Zafirlukast has been reported to reduce severity and help prevent capsular contracture from forming, as has the use of acellular dermal matrices, botox and neopocket formation. However, nearly all therapeutic approaches are associated with a significant rate of recurrence. Capsular contracture is a multifactorial fibrotic process the precise cause of which is still unknown. The incidence of contracture developing is lower with the use of textured implants, submuscular placement and the use of polyurethane coated implants. Symptomatic capsular contracture is usually managed surgically, however recent research has focussed on preventing capsular contracture from occurring, or treating it with autologous fat transfer.

• Journal of Trauma and Injury
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• 제25권4호
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• pp.109-114
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• 2012

Purpose: Deep vein thrombosis and pulmonary thromboembolism are major causes of death after severe multiple trauma. Although various means of prevention have been presented and utilized, still, there are no standard guidelines for anticoagulation of multiple trauma because of some contraindications. Methods: A retrospective study of adult major trauma patients whose injury severity scores (ISSs) were over 16 and who had visited one university hospital in Daegu city was performed. We compared some features of patients diagnosed DVT or PTE with those of patients without DVT by computed tomography or ultra sonography. Those features included accompanying various kinds of intracranial hemorrhages, possibility of ambulation, emergent operation, early transfusion, and suspicious symptoms. Results: The mean age of the 58 subjects included in this study was $50.9{\pm}17.2years$, the mean ISS was $22.7{\pm}6.0$, and the mean hospital stay was $55.2{\pm}37.9days$. Ten(17.2%) patients had emergent surgery, and 44(75.9%) experienced delayed surgery. Early transfusion was needed in 34(58.6%) patients. Among the 18 patients diagnosed with DVT, accompanying intracranial hemorrhages were noted in 8(44.4%) patients; one of the 8 also had PTE. Among the same 18 patients, early transfusions were required in 11(61.1%) patients; one of the 11 also had PTE. Conclusion: The risk of DVT is increased in cases of severe multiple trauma, and many difficulties in applying anticoagulants are experienced. Though we need additional studies to decide proper prophylaxis for DVT and PTE, if the patient's general condition permits, a screening test for DVT as soon as possible could be an effective method to reduce the possibility of a bad outcome.

• Journal of Trauma and Injury
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• 제26권3호
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• pp.207-213
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• 2013

Purpose: Traumatic pancreas injuries are rare conditions that result in high morbidity and mortality. Thus, early diagnosis and intervention are very important to manage pancreatic injuries. The purpose of this study is to review the management and outcomes of the pancreatic injuries in the Korean population. Methods: Original articles published from January 2001 to December 2012 and addressing the Korean population were selected by using indices such as 'pancreas injury', 'traumatic pancreas injury', and 'pancreatic trauma' to search KoreaMed and PubMed. Nine reports were selected to review the management options for surgery or endoscopic retrograde cholangio-pancreatography. We assessed the injury mechanisms, injury severities, associated injuries, types of operation, and outcomes. Results: Two hundred fifty of the 332 patients included in the 9 selected reports were men, and the mean age of all patients was 36.4 years. The main injury mechanism was traffic accidents(65.6%). Most patients had grade II or III injuries(68.9%). The most common extra-pancreatic injury site was the liver, followed by the chest and spleen. Operative management, including distal pancreatectomies(129), drainage procedures(64), pancreaticoduodenectomies(23), and others(60), was used for 276 patients. The reported mortality rate was 10.2%, and the morbidity rate ranged from 38% to 76.9%. The average length of hospital stay was 39.5 days. Risk factors for mortality were amount of transfusion, injury severity, base deficit, age, and presence of shock. Conclusion: In this study, we found neither significant data nor a consensus. If national guidelines are to be developed and established, a national data bank or registry, and nationwide data collection are required.