• Journal of Chest Surgery
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• v.43 no.3
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• pp.285-291
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• 2010

Background: Thoracic trauma is one of the leading causes of morbidity and mortality in developing countries. A rib fracture that is secondary to blunt thoracic trauma is an important indicator of the severity of the trauma. The purpose of study was to determine the morbidity and mortality rates and the management of rib fractures. Material and Method: We performed a retrospective study that involved all the blunt trauma patients with rib fractures, excluding those that were transferred to other hospital within 3 days, that were seen at our hospital between May 2002 and December 2008. Of the 474 admitted patients, 454 met the inclusion criteria. There were 356 male and 98 females, and their overall mean age was 53 years (range: 5~90 years). The outcome parameters included the mechanism of injury, the number of fractured ribs, the length of stay in the ICU, the Injury Severity Score (ISS), the length of the hospital stay, the pulmonary complications and the mortality. Result: The mechanism of trauma included traffic accidents in 189 (41.7%) cases, slipping down in 103 (22.7%) cases, falls in 85 (18.7%) cases, cultivator accidents in 30 (6.6%) cases, industrial accidents in 32 (7.0%) cases and assault in 15 (3.3%) cases. Intrathoracic injury was noted such as hemothorax in 269 (59.3%) cases, pneumothorax in 144 (31.7%) cases, pulmonary contusion in 95 (20.9%) cases, subcutaneous emphysema in 29 (6.4%) cases and great vessel injury in 5 (0.1%) cases. Conservative treatment was administered to most of the patients. Tube thoracostomy was administered in 234 (51.5%) cases, whereas thoracotomy was performed in 18 (4.0%) cases. The mean duration of thoracostomy was $5.2{\pm}6.2$ days. Most of the cases with rib fracture were treated in wards and their mean duration of hospital stay was $22.5{\pm}20$ days. The mean Injury Severity Score (ISS) was $14.8{\pm}10.9$ (range: 3~75). The mortality rate was calculated to be 4.8% (n=22). The main factors correlated with an adverse outcome were the number of ribs fractured, the duration of thoracostomy and pulmonary disease. Industrial insurance affected the length of hospitalization. Pulmonary contusion and the Injury Severity Score (ISS) affected the mortality. Conclusion: Rib fractures are a indicator of severe injury. Because of the complication and associated injuries, we believe these patients should be admitted for evaluation and treatment. Recent studies on the impact of rib fractures after blunt trauma have shown that patients as young as 40 years of age demonstrate increased morbidity and mortality with similar injuries as compared to that of older patients. The ISS and pulmonary contusion influenced the mortality rate. Patients with isolated rib fractures should be hospitalized if the number of fractured ribs is one or more.

• Tuberculosis and Respiratory Diseases
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• v.66 no.1
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• pp.37-41
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• 2009

Hot tub lung has been described as a pulmonary illness associated with exposure to nontuberculous mycobacteria,mainly hot bathtub water contaminated with Mycobacterium avium complex (MAC) and hence the name. Although not entirely clear, its etiology has been thought to involve either an infection or a hypersensitivity pneumonitis secondary to MAC. Herein, we describe 2 female patients (60 and 53 years old) admitted to our hospital with hot tub lung, and both of whom worked in a public bath. Both women were initially admitted following several months of exertional dyspnea and cough. The patients had been working as body-scrubbers in a public bath for several years. Their chest CT scans showed bilateral diffuse ground-glass opacities with multifocal air-trappings and poorly defined centrilobular nodules in both lungs. Pathological findings from lung specimens revealed small non-necrotizing granuloma in the lung parenchyme with relatively normal-looking adjacent alveoli. Discontinuation of working in the public bath led to an improvement in symptoms and radiographic abnormalities, without antimycobacterial therapy.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.4
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• pp.2159-2164
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• 2016

Background: A diagnosis of chronic myeloid leukemia (CML) is made on discovery of the presence of a Philadelphia (Ph) chromosome. The success of the treatment of this form of leukemia with tyrosine kinase inhibitor (TKI) is monitored by reduction of the Ph chromosome. Objective: To compare the role of conventional cytogenetic (CC) methods with a real time quantitative polymerase chain reaction (RQ-PCR) and fluorescence in situ hybridization (FISH) for diagnosis and treatment monitoring of CML patients. The secondary outcome was to analyze the treatment responses to TKI in CML patients. Materials and Methods: This was a retrospective study of CML patients who attended the Hematology clinic at Chiang Mai University Hospital from 2005-2010. Medical records were reviewed for demographic data, risk score, treatment response and the results of CC methods, FISH and RQ-PCR. Results: One hundred and twenty three cases were included in the study, 57.7% of whom were male with a mean age of 46.9 years. Most of the patients registered as intermediate to high risk on the Sokal score. At diagnosis, 121 patients were tested using the CC method and 118 (95.9%) were identified as positive. Five patients failed to be diagnosed by CC methods but were positive for BCR-ABL1 using the FISH method. Imatinib was the first-line treatment used in 120 patients (97.6%). In most patients (108 out of 122, 88.5%), a complete cytogenetic response (CCyR) was achieved after TKI therapy and in 86 patients (70.5%) CCyR was achieved long term by the CC method. Five out of the 35 analyzed patients in which CCyR was achieved by the CC method had a positive FISH result. Out of the 76 patients in which CCyR was achieved, RQ-PCR classified patients to only CCyR in 17 patients (22.4%) with a deeper major molecular response (MMR) in 4 patients (5.3%) and complete molecular response (CMR) in 55 patients (72.4%). In the case of initial therapy, CCyR was achieved in 95 patients (79.1%) who received imatinib and in both patients who received dasatinib (100%). For the second line treatment, nilotinib were used in 30 patients and in 19 of them (63.3%) CCyR was achieved. In half of the 6 patients (50%) who received dasatinib as second line or third line treatment CCyR was also achieved. Conclusions: CML patients had a good response to TKI treatment. FISH could be useful for diagnosis in cases where CC analysis failed to detect the Ph chromosome. RQ-PCR was helpful in detecting any residual disease and determining the depth of the treatment response at levels greater than the CC methods.

• Journal of Distribution Science
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• v.13 no.10
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• pp.115-122
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• 2015

Purpose - This study was conducted to develop a beekeeping farm management standard checklist. This is essential to increase the competitive power of beekeeping farmers. Checklists in relation to crops and livestock were established by the Rural Development Administration in the 2000s. To date, 60 checklists have been created by crop and livestock experts. However, other farmers outside the 60 checklists are increasing. Therefore, extra development is required for these farmers. This study was conducted to meet farmers' requirements. The special farming dealt with in this study is beekeeping. Such checklists were not developed due to the small number of beekeeping farmers. However, these days, a number of such farmers are emerging. Research design, data, and methodology - Many related experts participated in this study. This study was conducted in four stages. First, a basic outline of beekeeping was created by surveying many kinds of beekeeping experts. The draft of the beekeeping checklist was created by a secondary advisory council. This draft was then sent to 14 beekeeping experts to confirm whether or not it was suitable as a management checklist. For collecting the experts' opinions, a direct visit survey was done through an arranged questionnaire. Additionally, a basic management checklist blueprint was reviewed by many experts. In the third stage, a Delphi survey method was utilized with a special Delphi questionnaire. In this stage, experts who participated in the first and second stages were excluded. As there were uncertain answers among them, a second Delphi survey was done. As a result of this survey, all answers were agreed among them. Results - From the results of this survey, four subjects in the management accomplishment index were determined. These are farming scale, average product per beehive, the sale price of honey (1kg), and the number of bee plates in the beehive. In the case of the management checklist content, five items were determined. These are beekeeping farming facilities, the environment around the farm land and general management, the product management of the beekeeping harvest, the management of the disease and pest, and farming management. This checklist will be utilized for beekeeping farmers to implement in a management situation. Conclusions - These days, the number of beekeeping farmers is increasing. The management checklist for beekeeping farmers will be used to improve their farming situation and marketing. Beekeeping farmers can understand their management by reviewing their checklist. After checking, the situation of management can be analyzed. Farmers can supplement weaknesses with expert advice. This checklist will be used by agricultural technique extension workers for farming management consulting. This checklist has to be complemented by a change in the management of the environment. This checklist will be delivered to beekeeping farmers after a verification survey is done. The result of the checklist score will be utilized for a benchmarking service to be implemented for beekeeping farmers to utilize.

• Korean Journal of Remote Sensing
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• v.36 no.5_3
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• pp.1053-1066
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• 2020

Sulfur dioxide (SO₂) is primarily released through industrial, residential, and transportation activities, and creates secondary air pollutants through chemical reactions in the atmosphere. Long-term exposure to SO₂ can result in a negative effect on the human body causing respiratory or cardiovascular disease, which makes the effective and continuous monitoring of SO₂ crucial. In South Korea, SO₂ monitoring at ground stations has been performed, but this does not provide spatially continuous information of SO₂ concentrations. Thus, this research estimated spatially continuous ground-level SO₂ concentrations at 1 km resolution over South Korea through the synergistic use of satellite data and numerical models. A stacking ensemble approach, fusing multiple machine learning algorithms at two levels (i.e., base and meta), was adopted for ground-level SO₂ estimation using data from January 2015 to April 2019. Random forest and extreme gradient boosting were used as based models and multiple linear regression was adopted for the meta-model. The cross-validation results showed that the meta-model produced the improved performance by 25% compared to the base models, resulting in the correlation coefficient of 0.48 and root-mean-square-error of 0.0032 ppm. In addition, the temporal transferability of the approach was evaluated for one-year data which were not used in the model development. The spatial distribution of ground-level SO₂ concentrations based on the proposed model agreed with the general seasonality of SO₂ and the temporal patterns of emission sources.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.13 no.1
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• pp.30-35
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• 2010

Purpose: Infectious ileocecitis is an infection confined to the ileocecal area and one of the most common causes of pediatric abdominal pain. This study was performed to demonstrate the clinical features of infectious ileocecitis in children. Methods: The medical records and radiologic findings of 37 patients with ileocecitis diagnosed by ultrasonography and/or computed tomography, who were admitted to Pusan National University Hospital from January 2004 and July 2008, were reviewed retrospectively. Viral gastroenteritis and secondary ileocecitis were excluded. Results: The mean age of the patients was 4.8${\pm}$3.4 years. One-half of the patients were preschool children. The chief complaint was abdominal pain (75.7%), diarrhea (10.8%), and vomiting (8.1%). Accompanying symptoms were fever (56.8%), vomiting (21.6%), and diarrhea (16.2%). The mean duration of abdominal pain, fever, diarrhea, and vomiting was 3.8${\pm}$2.1, 3.0${\pm}$1.9, 3.4${\pm}$1.9, and 2.4${\pm}$2.3 days, respectively. The frequency of diarrhea and vomiting was 5.8${\pm}$2.2 and 4.0${\pm}$2.8 per day, respectively. Diagnosis was made by abdominal ultrasonography in 22 patients (59.5%), abdominal CT in 2 patients (5.4%), and both modalities in 13 patients (35.1%). Besides the radiologic finding of thickening of the bowel wall, mesenteric lymphadenitis (59.5%), ascites (5.4%), and both mesenteric lymphadenitis and ascites (16.2%) were revealed. The mean duration of illness was 7.5${\pm}$5.0 days. There were no specific laboratory findings, and culture studies with stool or blood were negative. All of the patients recovered completely without specific treatment. Conclusion: Infectious ileocecitis has acute appendicitis-mimicking symptoms, but is self-limited within a few days, thus unnecessary treatment and work-up is avoided. However, distinguishing infectious ileocecitis from appendicitis, inflammatory bowel disease, and mesenteric lymphadenitis is important.

• The Korean Journal of Nuclear Medicine
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• v.28 no.2
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• pp.206-213
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• 1994

We studied 90 patients(179 femoral heads) with avascular necrosis of femoral head, who had been performed X-ray, bone scan and MRI to compare of the findings of AVN on bone scan between each other, retrospectively. The patients were 82 males and 9 females, their mean age was 45 years. Radiographic stages were classified by Steinberg modification, radionuclide stages were classified as followed; stage o(or type 0) : normal, stage 1 : faint ring like uptake around the femoral head, stage 2: intense ring like uptake, stage 3: irregular increased uptake with central photon defect, stage 4 : Intense diffuse increased uptake at femoral head and stage 5 : hip joint deformity with relatively mild increased uptake. The findings of MRI were classified according to extent, location, early or advanced lesion, signal intensity of the lesion and joint effusion. 156(87%) of 179 femoral heads had avascular necrosis, 68(75.5%) of 90 patients had bilateral AVN, 35 femoral heads had early stage and 120 had advanced stage. The detection rate of AVN by X-ray and bone scan were 85% (134), 91.6% (143), respectively. Early AVN with atypical types of bone scan showed larger extent, moderate to large amount of joint effusion, soft tissue hypertrophy within joint, and secondary degenerative changes. Bone scan had relatively high detection rate in the diagnosis of AVN of femoral head, and demonstrated various types depending on the disease stage.

• Korean Journal of Ecology and Environment
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• v.38 no.2 s.112
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• pp.225-236
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• 2005

The protection of public health In wastewater reclamation and reuse is one of the most important issues. Monitoring data of Escherichia coli were collected from paddy rice plots in 2003 and 2004 experiments. Five treatments were used and each one was triplicated to evaluate the changes of E. coli: surface water, biofilter effluent (secondary level), UV-disinfected water and pond treatment. Microbial risk was quantified to assess human health risk by exposure to E. coli in paddy rice plots, which were irrigated with reclaimed wastewater. Beta-Poisson model was used to estimate the microbial risk of pathogen ingestion that may occur to farmer and neighbor children. Monte-Carlo analysis (10,000 trials) was used to estimate the risk characterization of uncertainty. In the following analysis, two scenarios were related to the reduction of risk against direct ingestion and exposure times. Scenarios A and B were assumed that the risk was 1,000 and 10,000 times lower than direct ingestion.'Golfers were assumed to be 0.001 L of reclaimed water by contact with balls and their cloths. Opportunity of contact in paddy rice field with pathogens was more frequent than handing golf balls, because of agricultural activity was practiced in ponded water in paddy rice culture. As a result of microbial risk assessment using total data of experimental period, risk value of E. coli in 2003 and 2004 experiment ranged from $10^{-5}$ to $10^{-8}$ and $10^{-4}$ to $10^{-8}$, respectively. The risk values in biofilter effluent irrigation was the highest, which is $10^{-4}$ in 2003 and $10^{-5}$ in 2004 experiments with scenario A. Ranges of $10^{-6}$ to $10^{-8}$ were considered at reasonable levels of risk for communicable disease transmission from environmental exposure and the risk value above $10^{-4}$ was considered to be attributable to the risk of infection. Irrigation with UV-disinfected water in the paddy field during the agricultural Period showed significantly lower microbial risk than others, and their levels of risk value were within the range of actual paddy rice field with surface water.

• Tuberculosis and Respiratory Diseases
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• v.43 no.5
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• pp.693-700
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• 1996

Background : Antituberculous therapy is set a short-term therpy used isoniazid(INH), rifampin(RFP), ethambutol(EMB), pyrazinamide(PZA) from 1970s' and treatment rate has been very improved. But drug interruption or irregular medication due to side effects and resistance of drug are serious problem to retreatment cases, specially. Ofloxasine(OFX), developed from Quinolone at 1980's is effective not only other respiratory infectious disease but also pulmonary tube rculosis. And this is useful drug instead of injection agents for retreatment patients who have side effects to other drugs, lived far distance from medical clinics. So, we will evaluate theffectiveness as four oral drugs involving OFX. Method : A retrospective study was made through the regular follow up of smear positive cases,who treated by four drug, namely, prothionamide (PTA) cycloserine(CS), OFX, paraminosalicylic acid(pAS). Results: 1) Out of 66case with positive sputum AFB smear, 42(64%)cases achieved the negative conversion. 2) Considering the negative conversion in all group, 34 case (52%) of sputum conversion occured within first 6 months, on the extent of diease was minimal, moderate, far advanced pulmonary tuberculosis, sputum AFB smear negative response to treatment was 100%, 78%, 46% respectively. 3) The roentgenological improvement occured in 38(58%), extent of diease was minimal, moderately, far advanced pulmonary tuberculosis, Roentgenological improvement to retreatment was 75%, 64%, 46%. 4) When the drnation of patients illness was less than 1 year, 1 to 3 years, 3 10 5 years and more than 5 years, sputum AFB smear negative response to retreatment was 100%, 88%, 80%, 52 %. 5) On side effects, major problems are gastrointestinal troubles, mild liver function abnormality, psychotic problemes, and skin problem(urticaria, itching sensation). Conclusion : The duration & extents of patients illness was shorter & minimal, sputum AFB smear negative response rate was better. Radiologic response is better as shorter duration and minimal extent of diease. But, as diease is longer duration & far advanced, sputum negative conversion & Roentgenological improvement is poor and limited. The adverse reaction was mainly observed gastrointestinal troubles(indigestion, abdominal pain, nausea, vomiting, diarrhea) and are well controled by symptomatic management in most patients, as regard to tolerance to the secondary drugs.

• Tuberculosis and Respiratory Diseases
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• v.45 no.6
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• pp.1154-1166
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• 1998

Background : In the management of patients whose primary chemotherapy has failed, careful assessment is essential. It is important to find out as accurate a chemotherapy history as possible. Preferably it should contain the drugs which has never used before. The purpose of present study is establishment of retreatment regimen for pulmonary tuberculosis. The present report concerns the results of retreatment of pulmonary tuberculosis patients treated at National Masan Tuberculosis Hospital. Methods : Retrospective cohort study was made of 104 drug-resistant pulmonary tuberculosis patients who were treated by five regimens between Jan. 1994 and Nov. 1996. All the patients taken medicine for second anti-tuberculosis regimens for the first time. We separated the patients by three groups(Group I ; OFX+PTA+CS+PAS+Aminoglycoside, Group II : PZA+PTA+CS+PAS+Aminoglycoside, Group III : PZA+OFX+PTA+PAS+Aminoglycoside). Results : The age distribution was most frequent in fourth decade(36patients, 34.6%) and the mean age was 42.6 year. The sex distribution was more frequent in the males(81 patients, 85.7%). There was 31 patients(29.8%) with combined diseaes, 18 patients with complication and 24 patients(27.9%) with family history. Primary chemotherapy regimens were HERZ(S or K) in 48 patients (46.2%), HER(S or K) in 41 patients(39.4%) and others in 15 patients(14.4%). Result of drug sensitivity test showed that the resistance to INH and RFP is in 68 patients(65.4%), RFP is 12 patients(11.5%), INH is in 3 patients(2.9%) and all sensitive to INH and RFP is 3 patients(2.9%). The clinical symptoms on admission were coughing(89.4%), sputum(69.2%), dyspnea on exertion(37.5%), weight loss(33.7%) blood tinged sputum(15.4%) and others. The extent of disease on the radiograph was far-advanced in 73 patients(70.2%), moderate in 28 patients(26.9%) and minimal in 3 patients(2.9%). The side effects for drugs were gastrointestinal troubles in 31 patients(29.8%), arthralgia in 22 patients(21.2%), skin rash in 12 patients(11.5%) and others. The negative conversion rate on sputum AFB smear was 85.6%(87.5% in Group I, 80.0% in Group II and 90.5% in Group III). The average negative conversion time on sputum was 4 month(4.0 month in Group I, 4.6 month in Group II and 3.0 month in Group III). Conclusion : In the retreatment of pulmonary tuberculosis, ofloxacin is useful drug for the patients who are not available to use PZA and combination of PZA and OFX can be use effectively substituting for CS.