• Journal of Trauma and Injury
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• v.24 no.1
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• pp.18-24
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• 2011

Purpose: Missing cervical pathology after injury may lead to disability and influence long-term survival. Controversies continue to evolve concerning the initial screening methods used to predict cervical spine injury. Through a retrospective chart review, we attempted to analyze and propose factors predictive of cervical trauma. Methods: Of all the patients who had visited the Emergency Department of Korea University, from January 2009 to December 2009, a retrospective review of the clinical records of the 217 patients who had undergone cervical spine computed tomography was done. We investigated whether we could predict the need for cervical spine computed tomography shortly after presentation in trauma patients by comparing the group with fractures and group without fractures and by finding risk factors showing significant differences between the two groups that might be used as guides in decision making. Results: Of the 217 subjects who underwent cervical spine computed tomography scans, 33 were identified with fractures of the cervical spine while 184 were not. The most common mechanisms of trauma, in order, for those with fractures were falls, followed by traffic accidents. We found that the injury severity score, multiple injuries, a high-energy injury mechanism, neurologic deficit, and pain and tenderness of the cervical spine showed statistically significant differences between the two groups. Conclusion: Fractures of the cervical spine that are not observed with simple radiography occur with a relatively high frequency in trauma patients. Consideration should be given to the risk factors for cervical spine fracture, and if pertinent, cervical spine computed tomography should be performed with speed for early diagnosis of cervical spine fractures.

• The Journal of Pediatrics of Korean Medicine
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• v.21 no.2
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• pp.13-34
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• 2007

Objectives The purpose of this study is to examine of the effect of SPAR medicines on the atopy eruption control Methods This experiment is about the expression of IgE, IL-4, IL-6, IL_13, IgM, IgG2a, IgG2b, IgG1 level in serum, and $IFN-{\gamma}$ production by SPAR medicines. We assayed for $CD3e^+/CD69^+$, $CD044^+/CD19^+$ positive cells by flow cytometry in splenocytes and observed the revelation of $CD3e^+/CD69^+$, $CD4^+/CD8^+$, $CD44^+/CD19^+$ marker in PBMC, spleen and DLN. We also observed the outturn of IL-4, IL-5, CCR3, $IFN-{\gamma}$ in skin of a NC/Nga mice. We also analyzed NC/Nga mice's ear and neck-back skin after biopsy and dye by H&E staining method, measured about epidermis and dermis part in comparison with control group. Results SPAR medicines as treatment result to a NC/Nga mice, clinical skin severity score decreased remarkably than the ontrol group. Specially, experiment was results by measuring IgE and IL-6 content in serum 8 weeks, 10 weeks, 12 weeks, 16 weeks, 20 weeks respectively, and it was decreased remarkably than the control group. After experiment ended, the result that observed the revelation CD3e, CD4, CD8, CD19, CD69, CD11a marker in lymph node establishment were observed and that B/T rate becomes recover as normal with political background. In addition to that, the control group was decreased in the measured value of IL-4, IL-5, IL-13, IgM, IgG2a, IgG1's level in serum, and $IFN-{\gamma}$' production secreted in Th1 cell displayed increase by SPAR medicines. IL-4, IL-5, CCR3, and $IFN-{\gamma}$'s gene revelation amount displayed marked decrease than the control group in result that observe effect that get in skin of a NC/Nga dermatitis mouse. Moreover in culture supernatant which cultivate for 14 days after separate skin cell, IL-13 and IL-6 production, and $CD69^+/CD3e^+$, $CD44^+/CD19^+$ expression cell number was decreased than the control group's number. Course inflammation immunocyte permeated of result that effect that SPAR medicines get to NC/Nga mice's skin establishment analyzes ear and neck-back skin after biopsy, and dye by H&E method decreased about epidermis and inflammation of dermis part remarkably than the control group. Conclusions Th1 cell and Th2 cell observe to be shifted by secretion amount of IL-4 and $IFN-{\gamma}$ by SPAR medicines could know that SPAR medicines can be use for treatung allergy autoimmune disease.

• Korean Journal of Psychosomatic Medicine
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• v.18 no.2
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• pp.72-81
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• 2010

Objectives : Early detection and proper management of distress are known to be important for efficient care in cancer patients. The aim of this study was to investigate the prevalence of distress and to evaluate its influence on quality of life in subjects with breast cancer. Methods : A total of 95 patients were recruited from a breast cancer patient community of a general hospital in Seoul. The Hospital Anxiety and Depression Scale(HADS), the Insomnia Severity Index(ISI), the Impact of Event Scale-Revised(IES-R) and the Functional Assessment of Cancer Therapy-Breast(FACT-B) were measured. Results : The prevalence of anxiety, depression, insomnia and posttraumatic stress disorder symptom among breast cancer patients was 26.3%, 26.3%, 13.7%, 24.3%, respectively. Nearly half(47.4%) of total subjects were under one or more significant distress, and they showed significantly lower mean FACT-B total score than patients without distress(82.91 vs. 107.20, p<0.001). Distress was negatively correlated with the quality of life to a significant level even in patients who were in normal range of distress scale scores. Conclusion : These results support the importance of regular screening and proper management of distress for breast cancer patients.

• Korean Journal of Psychosomatic Medicine
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• v.13 no.1
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• pp.32-40
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• 2005

Objectives : This study looked at the symptoms of alexithymia in schizophrenia and their association with clinical variables and schizophrenic symptomatology. Methods Consecutive fifty eight inpatients with DSM-IV diagnoses of schizophrenia completed 26item version of Toronto Alexithymia Scale (TAS), Symptom Checklist-90-Revised(SCL-90-R), and Positive and Negative Syndrome Scale(PANSS). Results : Authors did not find any correlation between scores of PANSS and TAS. However, all the subscale scores of SCL-90-R were significantly correlated with total score of TAS. Also, 'difficulty identifying and deistinguishing between feelings and bodily sensations' and 'difficulty describing feelings' significantly correlated with SCL-90-R subscale scores. 'Reduced daydreaming' had mixed findings and 'externally oriented thinking' did not correlate. Multiple regression model included Global Severity Index of SCL-90-R accounting 28.2% of variance for TAS scores. Conclusion : These findings together with discrepancy in results between objective and subjective tests suggest that alexithymia in schizophrenia may have two constructs, 'difficulty to describe and communicate feelings(state)' and 'externally oriented thinking(trait)' Authors suggest further study needs to confirm construct validity of TAS in this population.

• Journal of Trauma and Injury
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• v.28 no.4
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• pp.241-247
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• 2015

Purpose: To evaluate the influence of how the trauma care system is applied on the management of trauma patients. Methods: We divided the patients into a pre-trauma system group and a post-trauma system group according to the time when we began to apply the trauma care system in our institution. We compared the general characteristics, injury severity score, initial response time to the trauma patients, number of preventable deaths, and clinical outcomes between the two groups. Results: The numbers of patients in the pre-trauma system group and the post-trauma system group were 188 and 257, respectively. No differences in the patient's median ages, trauma scores (ISS, RTS, TRISS) and proportions of severe trauma patients (ISS>15) were observed between the two groups. The number and the proportion of patients who were admitted to our hospital were increased in the post-trauma system group. The time interval from trauma CP activation to emergency surgery or angio-embolization, and the patient's time spent in emergency room were shortened in the post-trauma system group. However, the lengths of the ICU stay and the hospital stay, and the number of in-hospital mortalities were not improved in the post-trauma system group. In severe trauma patients (ISS>15), there were no differences between the two groups in the number and the proportion of admitted patients, and the time interval from trauma CP activation to performing a diagnostic and therapeutic procedure was not shortened in the post-trauma system group. Conclusion: Application of the trauma care system has shortened the time between the initial response and patient management. However, this improvement was not enough to result in better clinical outcomes. More trauma physicians, multidisciplinary cooperation, and a well-organized trauma management process will be needed if the maximum efficacy of the trauma system is to be achieved.

• Journal of Digital Convergence
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• v.18 no.11
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• pp.559-569
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• 2020

This study was conducted to examine relationships among job environment, psychological work demand, fatigue, musculoskeletal symptoms, then to investigate the factors influencing musculoskeletal symptoms of care workers in long-term care hospitals. A total of 128 care workers recruited from three long-term care hospitals in S city. Self-reported questionnaire survey was conducted from April to May, 2020. The results were as follows: The musculoskeletal symptoms of the care workers were the sum of the frequency of symptom occurrence, duration of symptoms, and intensity of pain in the three parts of the shoulder, hand/wrist/finger, and waist. The average score was 11.41±9.50 points out of 42. According to the hierarchical regression analysis, their musculoskeletal symptoms were significantly influenced by working department(β=.18, p=.034), psychological work demand(β=.21, p=.013) and fatigue(β=.25, p=.003), explained 21.6% of the total variance(F=6.87, p<.001). Based on our results, in order to reduce musculoskeletal symptoms of care workers in nursing hospitals, it is necessary to develop and apply an intervention program that can reduce psychological work demand and fatigue in consideration of the severity of the patient in charge.

• Journal of the korean academy of Pediatric Dentistry
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• v.43 no.3
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• pp.264-274
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• 2016

It is a trend that carbonated drink intake among adolescents is increasing, which makes young people more vulnerable to dental erosion. However, in Korea, public knowledge about dental erosion is very insufficient. The aim of this study was to investigate the prevalence of dental erosion and to assess its risk indicators among 13-15 years old students in Yangsan, Korea. A total of 1,371 adolescents were examined by one calibrated clinician. Dental erosion was assessed by using the Visual Erosion Dental Examination system. Correlation between their dietary habit, oral hygiene and dental erosion was assessed. The data showed that 676 (49.3%) adolescents had dental erosion. The prevalence of dental erosion was significantly higher in females than in males. The prevalence of tooth erosion in mandible is higher than in maxilla. Dental erosion was generalized to develop mostly on anterior teeth, especially lateral incisor, however, the severity score was highest in canines. Following questionnaire analysis, dental erosion was significantly associated with milk and flavored milk. No other associations were detected. The prevalence of dental erosion in this study is higher than those of previous reports. On the contrary to previously reported studies, the prevalence of dental erosion in females is higher than in males.

• Tuberculosis and Respiratory Diseases
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• v.70 no.5
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• pp.397-404
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• 2011

Background: To evaluate chest CT findings of pandemic influenza A/H1N1 pneumonia without co-infection. Methods: Among 56 patients diagnosed with pandemic influenza A/H1N1 pneumonia, chest CT was obtained in 22 between October 2009 and Februrary 2010. Since two patients were co-infected with bacteria, the other twenty were evaluated. Predominant parenchymal patterns were categorized into consolidation, ground glass opacity (GGO), and mixed patterns. Distribution of parenchymal abnormalities was assessed. Results: Median age was 46.5 years. The CURB-65 score, which is the scoring system for severity of community acquired pneumonia, had a median of 1. Median duration of symptoms was 3 days. All had abnormal chest x-ray findings. The median number of days after the hospital visit that Chest CT was performed was 1. The reasons for chest CT performance were radiographic findings unusual for pneumonia (n=13) and unexplained dyspnea (n=7). GGO was the most predominant pattern on CT (n=13, 65.0%). Parenchymal abnormalities were observed in both lungs in 13 cases and were more extensive in the lower lung zone than the upper. Central and peripheral distributions were identified in ten and nine cases, respectively. One showed diffuse distribution. Peribronchial wall thickening was found in 16 cases. Centrilobular branching nodules (n=7), interlobular septal thickening (n=4), atelectasis (n=1), pleural effusion (n=5), enlarged hilar and mediastinal lymph nodes (n=6 and n=7) were also noted. Conclusion: Patchy and bilateral GGO along bronchi with predominant involvement of lower lungs are the most common chest CT findings of pandemic influenza A/H1N1 pneumonia.

• Tuberculosis and Respiratory Diseases
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• v.80 no.3
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• pp.296-303
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• 2017

Background: Acute respiratory distress syndrome (ARDS) is related to high mortality and morbidity. There are no proven therapeutic measures however, to improve the clinical course of ARDS, except using low tidal volume ventilation. Metformin is known to have pleiotropic effects including anti-inflammatory activity. We hypothesized that pre-admission metformin might alter the progress of ARDS among intensive care unit (ICU) patients with diabetes mellitus (DM). Methods: We performed a retrospective cohort study from January 1, 2005, to April 30, 2005 of patients who were admitted to the medical ICU at Seoul National University Hospital because of ARDS, and reviewed ARDS patients with DM. Metformin use was defined as prescribed within 3-month pre-admission. Results: Of 558 patients diagnosed with ARDS, 128 (23.3%) patients had diabetes and 33 patients were treated with metformin monotherapy or in combination with other antidiabetic medications. Demographic characteristics, cause of ARDS, and comorbid conditions (except chronic kidney disease) were not different between metformin users and nonusers. Several severity indexes of ARDS were similar in both groups. The 30-day mortality was 42.42% in metformin users and 55.32% in metformin nonusers. On multivariable regression analysis, use of metformin was not significantly related to a reduced 30-day mortality (adjusted ${\beta}-coefficient$, -0.19; 95% confidence interval, -1.76 to 1.39; p=0.816). Propensity score-matched analyses showed similar results. Conclusion: Pre-admission metformin use was not associated with reduced 30-day mortality among ARDS patients with DM in our medical ICU.

• Advances in pediatric surgery
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• v.3 no.2
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• pp.98-107
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• 1997

To determine whether bile juice exclusion can prevent the mucosal damage, and Insulin-like growth factor-I can promote mucosal regeneration in ischemia-reperfusion injury of the bowel, 39 weanling rats with 10 cm of Thiry-Vella loop were studied. Animal groups were; Control, BL(common bile duct ligation), IGF{insulin-like growth factor-I(IGF-I) infusion} and IGF-BL(combined treatment). IGF-I(1.5 mg/kg/day) was continuously delivered through a subcutaneously implanted miniosmotic pump. After 15 minutes of superior mesenteric artery clamping, a tissue specimen(P) was taken after 30 minutes of reperfusion. Intestinal continuity was restored to allow oral feeding. A specimen of main tract(M) and another of the Thiry-Vella loop(T) were collected for histomorphometry after 48 hours of reperfusion and free feeding. Villus size ratio(VSR), crypt depth(CD), crypt-depth/villus-height ratio(CVR) and injury score(IS) were measured in 15 consecutive villi. The postoperative mortalities of bile duct ligation groups(BL and IGF-BL) were higher than those of other groups. In control group, VSR of M was lower(P<0.05) than P or T, but not in the other groups. VSR of M in control was lower than those in other groups. CD of T in control, IGF and IGF-BL group were higher than those of M. CD of M and T showed gradual increments from control, IGF and IGF-BL group, respectively. CVR of M and T in IGF group were higher than those in control. CVR in IGF-BL group, T was higher than M, and M was higher than P. About IS, M of BL($20.1{\pm}2.5$) and IGF-BL($20.9{\pm}3.3$) groups were significantly lower than that of control($32.4{\pm}2.5$). These results suggest that the exclusion of bile juice reduces the severity of the reperfusion injury of the mucosa, by inability to activate pancreatic enzymes and IGF-I stimulates mucosal regeneration in injured bowel, and the effect is potentiated by bile juice exclusion.