• 대한임상독성학회지
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• 제15권1호
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• pp.56-59
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• 2017

Pneumatosis cystoides intestinalis and portomesenteric venous gas are uncommon radiological findings, but are found commonly in cases of bowel ischemia, or as a result of various non-ischemic conditions. A 72-year-old man visited an emergency center with altered mental status 2 hours after ingestion of an unknown pesticide. On physical examination, he showed the characteristic hydrocarbon or garlic-like odor, miotic pupils with no response to light, rhinorrhea, shallow respiration, bronchorrhea, and sweating over his face, chest and abdomen. Laboratory results revealed decreased serum cholinesterase, as well as elevated amylase and lipase level. We made the clinical diagnosis of organophosphate poisoning in this patient based on the clinical features, duration of symptoms and signs, and level of serum cholinesterase. Activated charcoal, fluid, and antidotes were administered after gastric lavage. A computerized tomography scan of the abdomen with intravenous contrast showed acute pancreatitis, poor enhancement of the small bowel, pneumatosis cystoides intestinalis, portomesenteric venous gas and ascites. Emergent laparotomy could not be performed because of his poor physical condition and refusal of treatment by his family. The possible mechanisms were believed to be direct intestinal mucosal damage by pancreatic enzymes and secondary mucosal disruption due to bowel ischemia caused by shock and the use of inotropics. Physicians should be warned about the possibility of pneumatosis cystoides intestinalis and portomesenteric venous gas as a complication of pancreatitis following anticholinesterase poisoning.

• 한국운동역학회지
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• 제25권2호
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• pp.141-147
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• 2015

Objective : This study aimed to understand how increased heart rates at the time of drop landing during a step test would affect biomechanical variables of the lower extremity limbs. Background : Ballet performers do more than 200 landings in a daily training. This training raises the heart rate and the fatigability of the lower extremity limbs. Ballet performance high heart rate can trigger lower extremity limb injury. Method : We instructed eight female ballet dancers with no instability in their ankle joints(mean ${\pm}$ SD: age, $20.7{\pm}0.7yr$; body mass index, $19.5{\pm}1.2kg/m^2$, career duration, $8.7{\pm}2.0yr$) to perform the drop landing under the following conditions: rest, 60% heart rate reserve (HRR) and 80% HRR. Results : First, the study confirmed that the increased heart rates of the female ballet dancers did not affect the working ranges of the knee joints during drop landing but only increased angular speeds, which was considered a negative shock-absorption strategy. Second, 80% HRR, which was increased through the step tests, led to severe fatigue among the female ballet dancers, which made them unable to perform a lower extremity limb-neutral position. Hence, their drop landing was unstable, with increased introversion and extroversion moments. Third, we observed that the increasing 80% HRR failed to help the dancers effectively control ground reaction forces but improved the muscular activities of the rectus femoris and vastus medialis oblique muscles. Fourth, the increasing heart rates were positively related to the muscular activities of the vastus medialis oblique and rectus femoris muscles, and the extroversion and introversion moments. Conclusion/Application : Our results prove that increased HRR during a step test negatively affects the biomechanical variables of the lower extremity limbs at the time of drop landing.

• 한국의류학회지
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• 제27권8호
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• pp.992-1003
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• 2003

This study analyzes the actual state of the working uniforms worn by burning waste workers to protect their body from the hazardous environment. Directions for improvement of the clothing fabrics is also suggested. We visited and interviewed those persons who worked in the burning waste plant in Seoul and in Gyunggi Province. 245 workers were surveyed by questionnaires, and 211 workers out of 245 were statistically analyzed. Frequencies and percentages were calculated and $\chi$$^2$ test, ANOVA and Scheffe Post hoc comparison methods were utilized to test some hypothesis. The working uniforms were classified as four general types: separate type, disposable-coverall. overall, and winter clothes. At present, the working uniforms are not suitable for the conditions which they are used. There is a lack of ventilation and an inability to absorb perspiration limited elasticity, and the uniforms are prone to static shock. The degree of satisfaction varied significantly, based on the worker's educational background and main work. However, only a small percentage of workers interviewed were satisfied with the appearance and the fit of the present working uniforms. The working duration had a negative impact on the satisfaction of the worker. This results suggest that materials, colors, design and size of working clothes must be improved. The suggestions are as follows: Firstly. to use disposable non-woven fabrics finished to increase moisture regain. Secondly. to use the bad air permeability fabrics to protect the skin from absorbtion of harmful gases, flying dust, heavy metals, etc.

• Archives of Reconstructive Microsurgery
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• 제21권1호
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• pp.50-55
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• 2012

Purpose: We reviewed 66 cases of the glomus tumors in the hands. The purpose of this study was to review the characteristic signs and symptoms of glomus tumors and the surgical outcomes. We made hypothesis that (1) our guideline for surgical excision are reliable and (2) our surgical technique is efficient and less harmful to the nail root. Materials and Methods: The clinical diagnosis was made with occasional radiological studies and surgical excision was performed according to our indications. Patients with electrical shock-like pain by touching (the essential symptom) and at least 2 of 4 clinical signs and symptoms (cold hypersensitivity, paroxysmal pain that radiated proximally, blue discoloration, nail deformity for dorsal tumor or a palpable nodule for pulp tumor) underwent surgical excision. Results: The duration of symptoms of the patients was about 5.3 years. No difference of prevalence was found in both hands, but the thumb and the middle finger were more affected than the other fingers. The mean follow up period was 2.4 years and none of the patients complained the same characteristic pain at the last visit. Conclusion: To the best of our knowledge, this report is the largest case series about glomus tumors in the finger tip. The clinical signs and symptoms are important to make a diagnosis of glomus tumors, and surgical excision is the treatment of choice.

• Journal of Chest Surgery
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• 제25권9호
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• pp.968-975
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• 1992

A clinical analysis was performed on 404 cases of the chest trauma who were admitted and treated at department of thoracic and cardiovascular surgery, Chung Ang University, Yong San Hospital during the past 8 years from July 1984 to April 1992. The results were as follows. 1. The sex ratio was 3: 1 with male predominence. 2. The common age groups were 3rd, 4th, 5th and 6th decades. 3. The most common chief complaint was chest pain[58.2%]. 4. Of 404 cases of chest trauma, 50 cases were resulted from penetrating injuries whereas 354 cases were from non penetrating injuries. The most common cause of the non penetrating injuries was traffic accident[234/354, 66.1%] and of the penetrating injuries were stab wound[47/50, 94%]. 5. The left thorax was the preferred site of chest trauma. 6. The range of hospital stay was from less than 1 week to over 6 weeks and the average duration was about 2 weeks. 7. The common chest trauma was rib fracture[51.6%] and others were simple contusion [18.8%], hemothorax[14.6%], hemopneumothorax[14.9%] and pneumothorax[8.7i]. The rib fracture was prevalent between 4th to 9th rib laterally. 8. There were 92 cases of associated injuries which were bone fracture[66/92, 71.7%], head injury[17/92, 18.5%] and abdominal injury[9/92, 9.8%]. 9. The methods of treatment were conservative management[58.6%], closed tho-racostomy[23.3%], open thoracotomy[3.4%] and others. 10. There were 28 cases[6.9%] of complication, such as pneumonia, atelectasis, emp-yema, respiratory failure and others. 11. The overall mortality was 2.5%[10 cases] and causes of death were hypovolemic shock, acute renal failure, adult respiratory distress syndrome, sepsis and multiple organ failure.

• Journal of Chest Surgery
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• 제48권6호
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• pp.381-386
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• 2015

Background: Postinfarction ventricular septal defects (pVSDs) are a serious complication of acute myocardial infarctions. The aim of this study was to analyze the clinical outcomes of the surgical treatment of pVSDs. Methods: The medical records of 23 patients who underwent operations (infarct exclusion in 21 patients and patch closure in two patients) to treat acute pVSDs from 2001 to 2011 were analyzed. Intra-aortic balloon counterpulsation was performed in 19 patients (82.6%), one of whom required extracorporeal membrane support due to cardiogenic shock. The mean follow-up duration was $26.2{\pm}18.6months$. Results: The in-hospital mortality rate was 4.3% (1/23). Residual shunts were found in seven patients and three patients required reoperation. One patient needed reoperation due to the transformation of an intracardiac hematoma into an abscess. No patients required reoperation due to recurrence of a ventricular septal defect during the follow-up period. The cumulative survival rate was 95.5% at one year, 82.0% at five years, and 65.6% at seven years. Conclusion: The use of a multiple-patch technique with sealants appears to be a reliable method of reducing early mortality and the risk of significant residual shunting in patients with pVSDs.

• Journal of Chest Surgery
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• 제49권3호
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• pp.151-156
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• 2016

Background: Survival of children experiencing cardiac arrest refractory to conventional cardiopulmonary resuscitation (CPR) is very poor. We sought to examine current era outcomes of extracorporeal CPR (ECPR) support for refractory arrest. Methods: Patients who were <18 years and underwent ECPR between November 2013 and January 2016 were including in this study. We retrospectively investigated patient medical records. Results: Twelve children, median age 6.6 months (range, 1 day to 11.7 years), required ECPR. patients' diseases spanned several categories: congenital heart disease (n=5), myocarditis (n=2), respiratory failure (n=2), septic shock (n=1), trauma (n=1), and post-cardiotomy arrest (n=1). Cannulation sites included the neck (n=8), chest (n=3), and neck to chest conversion (n=1). Median duration of extracorporeal membrane oxygenation was five days (range, 0 to 14 days). Extracorporeal membrane oxygenation was successfully discontinued in 10 (83.3%) patients. Nine patients (75%) survived more than seven days after support discontinuation and four patients (33.3%) survived and were discharged. Causes of death included ischemic brain injury (n=4), sepsis (n=3), and gastrointestinal bleeding (n=1). Conclusion: ECPR plays a valuable role in children experiencing refractory cardiac arrest. The weaning rate is acceptable; however, survival is related to other organ dysfunction and the severity of ischemic brain injury. ECPR prior to the emergence of end-organ injury and prevention of neurologic injury might enhance survival.

• Journal of Chest Surgery
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• 제45권2호
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• pp.91-94
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• 2012

Background: Despite improved managements for acute respiratory distress syndrome (ARDS), its mortality remains high. Extracorporeal membrane oxygenation (ECMO) has emerged as the final option for the treatment of ARDS unresponsive to conventional measures. This study describes our experiences of venovenous ECMO support for the treatment of ARDS. Materials and Methods: Between 2007 and 2010, 56 patients (aged $56.6{\pm}13.4$ years, 43 males) received venovenous ECMO for the treatment of ARDS. The detailed clinical records were retrospectively reviewed. Results: Before the institution of ECMO support, 35 patients (55.4%) required nitric oxide inhalation, 35 patients (55.4%) received continuous renal replacement therapy, and 20 patients (35.7%) were in shock status. The median duration of ECMO support was 164 hours (range, 5 to 1,413 hours). 27 (48%) patients could be successfully weaned from ECMO. Of them, 7 (13%) survived to discharge. On logistic regression analysis, a requirement for higher inspiratory pressure before ECMO support was the only significant factor that could predict ECMO weaning failure. Conclusion: The outcome of venovenous ECMO support for the treatment of ARDS was suboptimal. Further improvements in outcomes should be made through the accumulation of experience and establishment of a standardized protocol for the management of ECMO.

• 대한수의학회지
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• 제23권2호
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• pp.193-198
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• 1983

A servey on bovine fascioliasis in 52,876 cattle of Euiseong, Andong, Yecheon, Wolseong areas in Gyeongbug Province was carried out by the intradermal test, and the clinical side action of the positive cattle administered with DS-6 intramuscularly was observed. In addition pathological examination of 2 cattle died with side action of DS-6 was also conducted. The results of the studies are summarized as follows; 1. The average infestation rate of bovine fascioliasis was 31.1% and regional infestation rates were 35.1% in Eiseong, 34.5% in Yecheon, 32.2% in Andong, 26.9% in Wolseong, respectively. 2. The side actions were occurred in 1.5%(115/7,667) cf cattle administered with DS-6 and the clinical observations were salivation, dyspnea, hyperamia of conjunctiva, lacrimation, perspiration, urticaria, tremor, diarrhea, staggering, convulsion, edema and abortion. 3. Within 1 hour after the injection, side actions were occurred in 61.7% of the 115 cattle while they were observed in 37.4% of the 115 catte from 1 hour to 2 hours post injection. 4. The duration of the side action was less than 2 hours in 29.5%, 2 to 10 hours in 47.0% and more than 10 hours in 23.5% of the 115 cattle. 5. Autopsy findings and histopathological observations indicate that the death of cattle is caused by anaphylactic shock.

• Journal of Korean Neurosurgical Society
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• 제46권3호
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• pp.221-225
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• 2009

Objective : Surgical treatment of posterior inferior cerebellar artery (PICA) aneurysms is challenging due to limited surgical accessibility. Endovascular approach has a benefit of avoiding direct injury to the brainstem or lower cranial nerves. Therefore, it has recently been considered an alternative or primary modality for PICA aneurysms. We retrospectively assessed outcomes following detachable coil embolization of saccular PICA aneurysms. Methods : From February 1997 to December 2007, we performed endovascular procedures to treat 15 patients with 15 PICA aneurysms. Fourteen patients with 14 PICA aneurysms morphology of which was saccular were reviewed retrospectively. Twelve patients had ruptured aneurysms. The aneurysms arose from the PICA origin site (n=12), the PICA lateral medullary segment (n=1), or the PICA tonsilomedullary segment (n=1). Results : Complete aneurysm occlusion was achieved in 10 patients, residual neck in 3, and residual sac in one. Radiological follow-up was performed in 7 patients with mean duration of 34.7 months (range, 1-97 months) and showed stable or complete occlusion in 6 patients. There were no rebleeding or retreatment after endovascular treatment. Thromboembolism was the only procedure-related complication (n=4 ; 28.6%). Asymptomatic PICA infarction occurred in two patients and symptomatic PICA infarction in two elderly patients with poor clinical grade. Of these procedural PICA infarction cases, 1 symptomatic PICA infarction patient developed ventriculitis and septic shock leading to death. The clinical outcome was good in 10 patients (71.4%). Conclusions : In the present study, detachable coil embolization has shown as an efficient modality for PICA saccular aneurysms challenging indications of microsurgery. However, thromboembolic complications should be considered, especially in poor clinical elderly patients with ruptured aneurysms.