• Journal of Chest Surgery
• /
• v.31 no.11
• /
• pp.1076-1080
• /
• 1998

Background: Spontaneous hemopneumothorax, occurring in 1% to 12% of patients with spontaneous pneumothorax, is a rare disorder that can potentially lead to life-threatening complications. Materials and methods: We have experienced 15 cases (2.28%) with spontaneous hemopneumothorax among 659 episodes of spontaneous pneumothorax for eight years, from 1990 to 1997, at our hospital. We studied our previously treated patients by retrospective case studies to determine the nature of optimal management. Results: There were 14 male and 1 female patients whose mean age was 27.5 years, ranging from 19 to 58. The sides with disorder were as following: right in 10 cases and left in 5, unilaterally. The amount of initial bleeding ranged from 400 to 1,500 mL and 8 patients received a homologous blood transfusion. Patients exhibited symptoms of chest pain, dyspnea, chest discomfort, and hypovolemic shock. We concluded that causes of this disease in our patients were a torn pleural adhesion (14 cases) and a rupture of vascularized bullae (1 case with an underlying intrinsic lung disease, tuberculosis). All patients underwent closed thoracostomy and had good results except for 3. One patient underwent thoracotomy within 3 days from the onset because of continuous active hemorrhage. Decortication was required in one case because of a reactive fluid collection in the pleural space, which led to impaired lung expansion. Another patient underwent thoracotomy due to a ipsilateral recurrent pneumothorax without blood collection. Conclusions: The goals of treatment include hemostasis and reexpansion of the collapsed lung. Thus, if patients arrive early at hospital, closed thoracostomy and transfusion are thought to be sufficient treatments, although early surgical repair has been considered recently.

• Korean Journal of Head & Neck Oncology
• /
• v.7 no.2
• /
• pp.120-128
• /
• 1991

Reconstruction of the pharynx and cervical esophagus presents a tremendous surgical challenge to the Head and Neck Surgeon. Because life expectancy of patients with advanced carcinoma of the hypopharynx, and cervical esophagus is limited, treatment must be aimed at palliation. A variety of techiques have been proposed over the years with none proving entirely satisfactory. These techiques include prosthesis; skin graft; cervical flaps; tubed cutaneous and myocutaneous chest flaps; visceral reconstruction with stomach, colon. and jejunum; and jejunal free autografts. Many factors dictate the best method of reconstruction in any given clinical situation. The goal of the surgery is a one-stage reconstruction of swallowing function with minimal morbidity to allow as short a hospital stay as posible. Nine patients underwent the free jejunal autograft reconstruction of the pharyngoesophagus after the ablative surgery for the advanced hypopharyngeal cancer. Postoperative complications included one perioperative death, two abdominal wound dehiscences, two neck hematomas, one carotid rupture, one funtional dysphagia, one late strictures. There were no graft failure, no immediate stenosis and no fistula. An oral diet was started between days 8 and 16, with an average of 9 days and median of 8 days. Patients left the hospital between days 9 and days 38, with an average of 23.4 days and median of 23 days. This method of reconstruction is advocated as reliable palliative procedure with short-term follow-up. In conclusion, we at Korea Cancer Center Hospital are of the opinion that the free jejunal autograft offers an excellent, safe and relative easy method of the pharyngeal and cervical esophageal reconstruction with significant advantages over other techiques.

• KSCE Journal of Civil and Environmental Engineering Research
• /
• v.9 no.3
• /
• pp.125-131
• /
• 1989

Since the paved road suffers from various types of repeated loads for the duration of it's life, it is likely to cause permanent deformation and fatigue finaly destroying the pavement performance. Accordingly, if we are to keep the pavement performance in good condition, it is required to take staps to prevent such troubles from happening in each stage of pavement, and thus to improve the stability of pavement. We find it is quite important to settle the problems such as permanent deformation and fatigue rupture by repeated loads both on subbase course and on subgrade. In this regard, we examined the deformation characteristics of soil cements, on which repeated loads are applied. For the effective examination, we chose to use soil-cements made of cohesive soil and sandy soil respectively, which had $20kg/cm^2$ of unconfined compression strength, at the age of 7 days. The experimental results are: 1. The elastic modulus of soil cement from sandy soil is higher than that of soil cement from cohesive soil. 2. The elastic modulus thends to decrease as the repeated loads rund up to 1,000 times, while increasing between 1,000 times and $1{\times}10^5$ times. 3. Unconfined compression strength is seen to increase about 30%.

• Journal of Trauma and Injury
• /
• v.22 no.1
• /
• pp.77-86
• /
• 2009

Purpose: The appropriate management of traumatic truncal arterial injury is often difficult to determine, particularly if the injury is associated with severe additional truncal lesions. The timing of repair is controversial when patients arrive alive at the hospital. Also, there is an argument about surgery versus stent-graft repair. This study's objective was to evaluate the appropriate method and the timing for treatment in cases of truncal abdominal injury associated with other abdominal lesions. Methods: The medical records at Ajou University Medical Center were reviewed for an 8-year period from January 1, 2001, to December 31, 2008. Twelve consecutive patients, who were diagnosed as having had a traumatic truncal arterial injury, were enrolled in our study. Patients who were dead before arriving at the hospital or were not associated with abdominal organ injury, were excluded. All patients involved were managed by using the ATLS (Advanced Trauma Life Support) guideline. Data on injury site, the timing and treatment method of repair, the overall complications, and the survival rate were collected and analyzed. Results: Every case showed a severe injury of more than 15 point on the ISS (injury severity score) scale. The male-to-female ratio was 9:3, and patients were 41 years old on the average. Sites of associated organ injury were the lung, spleen, bowel, liver, pelvic bone, kidney, heart, vertebra, pancreas, and diaphragm ordered from high frequency to lower frequency. There were 11 cases of surgery, and one case of conservative treatment. Two of the patients died after surgery for truncal organ injury: one from excessive bleeding after surgery and the other from multiple organ failure. Arterial injuries were diagnosed by using computed tomography in every case and 9 patients were treated by using an angiographic stent-graft repair. There were 3 patients whose vessels were normal on admission. Several weeks later, they were diagnosed as having a truncal arterial injury. Conclusion: In stable rupture of the truncal artery, initial conservative management is safe and allows management of the major associated lesions. Stent grafting of the truncal artery is a valuable therapeutic alternative to surgical repair, especially in patients considered to be a high risk for a conventional thoracotomy.

• Journal of the Korean Wood Science and Technology
• /
• v.35 no.6
• /
• pp.13-22
• /
• 2007

This study was carried out to scrutinize possibility of manufacturing pitch pine (Pinus rigida) glued laminated timber in order to add values of pitch pine trees. Also, it was investigated to improve bending performance of pitch pine glulam. Pitch pine was imported as one of major plantation species in Korean peninsula. Machine stress rated grades of pitch pine lumber mostly ranged between E7 and E9. which grades were more or less inferior to producing high quality glulam. However, the adhesive properties between pitch pine and pitch pine, and between pitch pine and Japanese larch (Larix kaempferi Carr.), such as shear bond strength, wood failure rate and de-lamination rate of bonded layer submerged in cold and boiling water, were higher than Korean Standard criteria. These properties are essential for manufacturing glulam with single species or multiple species. The modulus of rupture (MOR) of pitch pine glulam exceeded the criterion of Korean Standard for glulam strength grade but modulus of elasticity (MOE) was lower than the criterion. On the other hand, the bending performances (MOR and MOE) were improved 20 percent by mixing with Japanese larch laminar. It is effective to arrange higher quality Japanese larch laminar at the outer layer of glulam for improving bending performances. In conclusion, it is possible to use low quality pitch pine as laminar of structural glulam for adding values of pitch pine.

• Journal of the Korean Institute of Gas
• /
• v.22 no.1
• /
• pp.18-25
• /
• 2018

As the industries become more developed, the amounts of hazardous materials have been increased. Because of that, the possibility of accidents in plants is expected to increase. Especially, the dispersions of toxic materials cause serious effect to human life and environment, So it is very important to confirm safety distance of discharge accident. For this paper, we proposed new algorithms for toxic liquid, such as benzene and acrylonitrile. and using this argorithm, we are going to predict safety distance. The scenario of accidental release was assumed to be the release of entire quantity in 10 minutes is defined as worst-case scenario and Instantaneous release. Also the release from a partial rupture of line is used as an alternative case scenarios as NICS(National Institute of Chemical Safety) guidelines. Using ALOHA program and the algorithm for liquid toxic materials and suggested the graph, as well as correlated equations which can utilize emergency responders.

• Women's Studies Review
• /
• v.28 no.1
• /
• pp.79-120
• /
• 2011

The purpose of this paper is to illuminate the implication of feminist oral history from a postcolonial feminist perspective as critically reexamining the relationship between hearer and speaker, representer and narrator, the said and the unsaid, and secrecy and silence. Based upon oral (life) history of a U.S. military prostitute (yanggongju), I tried to show the experiences of a historically-excluded and marginalized 'Other,' and then critically reevaluate the meaning of encountering 'Other', not just through the research process but also in the post/colonial society in Korea. The narrative of an old woman in the "kijichon" (a formal prostitute in U.S. military base) shows how woman has navigated the boundaries between inevitability/coincidence, the enforced/the voluntary, prostitution/intimacy, and military prostitute/military bride while continually negotiating as well as having conflict with various myths and ideologies of the 'normative woman,' 'nationhood,' and 'normal family.' In addition, her narrative which causes the rupture of our own stereotypical images of a military prostitute not only proves the possibility of reconstructing the self-identity of a subaltern woman, but also redirects the research focus from the research object to the research subject (ourselves). Consequently, the implication in feminist oral history is that feminist researchers who whish to represent the experiences of other should first inquire 'what/how we can hear,' 'why we want to know others,' and 'who we are,' while simultaneously asking if subaltern woman can speak.

• 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.

• Journal of Life Science
• /
• v.21 no.7
• /
• pp.953-960
• /
• 2011

Necrosis is characterized by the cell membrane rupture and release of the cellular contents, including high-mobility group box 1 protein (HMGB1), into the extracellular microenvironment. HMGB1 acts as a transcriptional regulator in nuclei, but exerts a pro-inflammatory and tumor-promoting cytokine activity when released into the extracellular space. Its overexpression is associated with tumor progression and chemoresistance. Thus, HMGB1 acts as a clinically important molecule in tumor biology. In this study, we examined whether HMGB1 affects cell death induced by anti-cancer drugs. Here we show that HMGB1 prevented cisplatin (alkylating agent)-induced apoptosis and switched the cell fate to necrosis in MCF-7, MDA-MB231, and MDA-MB361 cells. Similar apoptosis-to-necrosis switch effects of HMGB1 were observed in cells treated with 4-HC, another alkylating agent. In contrast, HMGB1 did not exert any significant effects on docetaxel (DOC)-induced apoptosis in MCF-7 cells. We also show that cisplatin-induced apoptosis was switched to necrosis in MCF-7 multicellular tumor spheroids (MTS) that were cultured for 8 days and had necrotic cores, but DOC-induced apoptosis was prevented without the apoptosis-to-necrosis switch. Finally, the levels of RAGE, a receptor of HMGB1, were increased with extended culture of MTS. These findings demonstrate that HMGB1 switches alkylating agent-induced apoptosis to necrosis, suggesting that the strategy to prevent necrosis occurring as an undesirable action of alkylating agent-based chemotherapy should be delineated to improve the efficacy of chemotherapy for cancer.

• Journal of Life Science
• /
• v.26 no.2
• /
• pp.226-233
• /
• 2016

Vascular smooth muscle cell (VSMC) apoptosis has been identified in various vascular diseases, including atherosclerosis and restenosis after angioplasty, and has been known to precipitate atherosclerotic plaque instability and rupture. Oxysterols are known as inducers of apoptosis in VSMC, and 7-ketocholesterol (7KC) is the major nonenzymically formed oxysterol in atherosclerotic lesions. The precise mechanism underlying VSMC apoptosis is still poorly understood. In this study, we investigated whether 7KC causes apoptosis, and characterized its apoptotic mechanisms in primary cultured rat aortic VSMC. Cell viability was assessed by MTT assay and trypan blue assay. Apoptosis was assessed by flow cytometry, immunofluorescence, immunoprecipitation, and Western blot analyses. 7KC markedly decreased the VSMC viability in a time- and concentration-dependent manner, and increased the production of 4-hydroxynonenal (HNE), a major end-product of lipid peroxidation, which also decreased the VSMC viability. Pretreatment with 2,4-dinitrophenylhydrazine, a well-known reagent of lipid peroxidation-derived aldehydes, significantly restored the 7KC-decreased viability of VSMC. Furthermore, HNE, as well as 7KC, reduced the level of total Akt, a major mediator of cell survival. The 7KC-decreased level of total Akt was significantly restored by pretreatments with 2,4-dinitrophenylhydrazine and N-acetylcysteine. Lactacystin, a proteasome inhibitor, protected VSMC against apoptosis and Akt degradation, but did not inhibit HNE production. In the immunoprecipitation assay, 7KC increased HNE-modified Akt. From the results, it seems that, in atherosclerotic lesions, 7KC induces HNE production in VSMC, and this HNE binds to Akt, proceeding to proteasomal degradation of Akt, through which mechanism the atherosclerotic plaque instability may be facilitated.