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Diagnostic Methods of Traumatic Tracheobronchial Injury (외상성 기관-기관지 손상의 진단 방법)

  • Son, Shin-Ah;Cho, Suk-Ki;Do, Young-Woo;Lee, Hong-Kyu;Lee, Eung-Bae
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.675-680
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    • 2010
  • Background: The aim of this study was to identify the distinguishing clinicoradiologic findings of traumatic tracheobronchial injury. Material and Method: Between January 2003 and December 2009, six patients who underwent surgical repair for traumatic tracheobronchial injury due to blunt trauma were included in this study. We evaluated the mechanism of the injury, the coexisting injuries, the time until the making diagnosis and treatment, the diagnostic methods, the anatomic location of the injury and the surgical outcomes. Result: The mechanisms of injury were traffic accident and crushing forces. The frequent symptoms were subcutaneous emphysema, dyspnea and pain, and the common radiologic findings were pneumothorax, mediastinal emphysema, rib fracture and lung contusion. Only 2 patients were diagnosed by chest CT and the others were not diagnosed preoperatively. The location of injury was the trachea in 2 patients and the bronchial tree in 4 patients. There was no postoperative mortality or anastomotic leak; however, vocal cord palsy occurred in one patient. The most distinguishing sign was persistent lung collapse even though the chest tube was connected with negative pressure. Conclusion: Although it was not easy to diagnose traumatic tracheobronchial injury without a clinical suspicion, the distinguishing clinical symptoms and CT findings could help to make an early diagnosis without performing bronchoscopy.

Reconsideration of decision making for third molar extraction (하악 제3대구치 발치의 결정에 관한 재고찰 - 발치 현황과 영향 인자를 중심으로)

  • Park, Won-Se;Kim, Jin-Hak;Kang, Sang-Hoon;Kim, Moon-Key;Kim, Bong-Chul;Choi, Ji-Wook;Lee, Sang-Hwy
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.37 no.5
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    • pp.343-348
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    • 2011
  • Introduction: Third molar extraction is one of the most common procedures in oral and maxillofacial surgery. The impacted third molar causes many pathological conditions, such as pericoronitis, caries, periodontitis, resorption of adjacent teeth, and cyst or tumors associated with impacted teeth. Extraction is often considered the treatment of choice for impacted lower third molars. On the other hand, imprudent extraction of deeply impacted third molars can cause permanent complications, such as inferior alveolar nerve damage. Therefore, guidelines for the extraction of lower third molars should be set to prevent embarrassing complications. This study examined the indication and current trends of the extracted lower third molars in the dental hospital of a dental college. Materials and Methods: 557 extracted third molars were evaluated at the department of oral and maxillofacial surgery of Yonsei University. The chief complaint, diagnosis, age and degree of impaction were analyzed to determine the tendency for the extraction of asymptomatic lower third molars. Results: The percentage of asymptomatic third molars was 40.8%. In cases of full impacted tooth or full erupted tooth, the percentage of asymptomatic teeth was more than 50% (52.4% and 54.3, respectively). Among those partially impacted teeth, 73.1% of them showed symptoms, such as pain, tenderness and swelling. In terms of age, pericoronitis was evident at a younger age, and dental caries/periodontitis was the main cause of removal in those aged over 50. Twenty nine cases (1.6%) had teeth associated with pathological changes Conclusion: The incidence of pathological changes to the lower third molar was relatively low. Surgical extraction is recommended in cases of partially impacted teeth. In Korea, the incidence of asymptomatic third molar extraction was relatively higher than in European countries. More careful attention would be desirable to consider the risks and benefits of lower third molar extraction.

Severity-Adjusted LOS Model of AMI patients based on the Korean National Hospital Discharge in-depth Injury Survey Data (퇴원손상심층조사 자료를 기반으로 한 급성심근경색환자 재원일수의 중증도 보정 모형 개발)

  • Kim, Won-Joong;Kim, Sung-Soo;Kim, Eun-Ju;Kang, Sung-Hong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.10
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    • pp.4910-4918
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    • 2013
  • This study aims to design a Severity-Adjusted LOS(Length of Stay) Model in order to efficiently manage LOS of AMI(Acute Myocardial Infarction) patients. We designed a Severity-Adjusted LOS Model with using data-mining methods(multiple regression analysis, decision trees, and neural network) which covered 6,074 AMI patients who showed the diagnosis of I21 from 2004-2009 Korean National Hospital Discharge in-depth Injury Survey. A decision tree model was chosen for the final model that produced superior results. This study discovered that the execution of CABG, status at discharge(alive or dead), comorbidity index, etc. were major factors affecting a Sevirity-Adjustment of LOS of AMI patients. The difference between real LOS and adjusted LOS resulted from hospital location and bed size. The efficient management of LOS of AMI patients requires that we need to perform various activities after identifying differentiating factors. These factors can be specified by applying each hospital's data into this newly designed Severity-Adjusted LOS Model.

Molecular Description of Macroorchis spinulosus (Digenea: Nanophyetidae) Based on ITS1 Sequences

  • Won, Eun Jeong;Kim, Deok-Gyu;Cho, Jaeeun;Jung, Bong-Kwang;Kim, Min-Jae;Yun, Yong Woon;Chai, Jong-Yil;Ryang, Dong Wook
    • Parasites, Hosts and Diseases
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    • v.54 no.1
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    • pp.109-112
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    • 2016
  • We performed a molecular genetic study on the sequences of 18S ribosomal RNA (ITS1 region) gene in 4-day-old adult worms of Macroorchis spinulosus recovered in mice experimentally infected with metacercariae from crayfish in Jeollanam-do Province, Korea. The metacercariae were round, $180{\mu}m$ in average diameter, encysted with 2 layers of thick walls, but the stylet on the oral sucker was not clearly seen. The adult flukes were oval shape, and $760-820{\mu}m$ long and $320-450{\mu}m$ wide, with anterolateral location of 2 large testes. The phylogenetic tree based on ITS1 sequences of 6 M. spinulosus samples showed their distinguished position from other trematode species in GenBank. The most closely resembled group was Paragonimus spp. which also take crayfish or crabs as the second intermediate host. The present study is the first molecular characterization of M. spinulosus and provided a basis for further phylogenetic studies to compare with other trematode fauna in Korea.

Alveolar Cleft Reconstruction Using Chin Bone and Autogenous Tooth Bone Graft Material: Reports of 5 Cases

  • Jeong, Kyung-In;Lee, Junho;Kim, Kyung-Wook;Um, In-Woong;Hara, Shingo;Mitsugi, Masaharu;Kim, Young-Kyun
    • Journal of Korean Dental Science
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    • v.6 no.1
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    • pp.13-21
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    • 2013
  • Purpose: To report the successful results of using chin bone graft and autogenous tooth bone graft material (AutoBT) in alveolar cleft patients. Materials and Methods: Five patients with alveolar cleft defects underwent alveolar bone grafting. Three patients were treated using chin bone graft, and the other two patients underwent AutoBT graft. After implant site development using chin bone graft in the fi rst three cases, endosseous implant restorations were placed. In case #4 and 5, AutoBT graft material was placed to guide the normal eruption of partially impacted maxillary right canine and to the upper docking site after distraction osteogenesis. Result: Successful implant restorations with closure of the oronasal fistula were achieved in alveolar cleft defect reconstruction using either chin bone graft (Case #1, 2, 3) or AutoBT graft material (Case #4, 5). Case #4 showed enlarged follicle of the right maxillary canine, indicating a normal eruption guide pattern. Conclusion: Both chin bone graft and AutoBT graft showed favorable outcomes in reconstructing alveolar cleft defects. Autogenous tooth bone graft opens up the possibility of avoiding harvesting autogenous bone graft with complications and morbidities.

Korean Medicine, Complementary and Alternative Medicines (CAM) Therapy after Gastrectomy of Gastric Cancer in a Hospital (위암 환자의 위 절제수술 후 한의학과 대체요법 사용실태 - 지방소재 일개병원의 경험 -)

  • Kim, Chan-Young;Yang, Doo-Hyun;Kang, Jun-Won;Hwang, Eui-Hyoung
    • The Journal of Korean Medicine
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    • v.28 no.3 s.71
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    • pp.86-99
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    • 2007
  • Objectives : Cancer patients who are afraid of unpleasant therapy and doubt a perfect cure often seek out traditional Korean medicine or many other kinds of complementary and alterative medicine (CAM) instead. This study was carried out in order to learn the prevalence and kinds of the traditional Korean medicine and CAM to evaluate awareness of and attitude toward it. Methods : 213 patients with gastric cancer who had undergone surgery in the department of gastrointestinal surgery and visited for routine follow-up from November to December of 2004 were included. A questionnaire survey was done by trained interviewers for CAM and demographic information. Results : 96.7% of patients had experience with CAM. The kinds and frequencies of CAM were diet and nutrition 21.0%, folk remedy 21.0%, pharmacological treatment 13.5%, oriental medicine 5.3% and mind-body intervention 1.4%. 56.8% of patients had experienced 2-6 kinds of CAM, 37.4% more than 7. Among diet and nutrition, ginseng (62.9%) was highest, followed by ox leg bone soup (50.8%) and pumpkin (31.5%). Among the folk remedies, elm tree was highest at 46.5%, followed by phellinus linteus (Sang-Whang) at 26.8% and ganoderma lucidum (Young-Gee) 20.7%.satisfaction with CAM was relatively low (43.2%), many patients (78.2%) replied that they would use it continuously. Conclusion : Most patients had experience with many kinds of CAM, but didn't discuss it with medical doctors. If scientific study proves whether or not each kind of CAM is actually effective ondisease, it will help to improve the health of patients and prevent the inappropriate usage and cost.

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Effects of Electrotherapy on the Deactivation of Trigger points (전기치료가 발통점 비활성화에 미치는 효과)

  • Joung, Ho-Bal;Bang, Sang-Bun
    • Journal of Korean Physical Therapy Science
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    • v.9 no.2
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    • pp.123-131
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    • 2002
  • The purpose of this study is to compare Ultra Sound(U-S), Silver Spike Point(SSP) and Electro-Acupuncture(E-A) with each other and to objectively analyze their concrete validities and their effects on the deactivation of trigger points in patients with myofascial pain syndrome, and to provide basic necessary principles for clinical therapists. Sixty patients were randomly distributed into three groups of twenty persons each and the U-S, the SSP and the E-A were applied to each group respectively. Tree pain evaluation methods of VAS(Visual Analogue Scale), Electrical Stimulation Scale and Pressure Algometer were adopted to measure the effectiveness of each therapy. The results were as follows: The U-S and E-A groups demonstrated statistically significant decrease on the VAS. The pain thresholds by Electrical Stimulation Scale method was increased for all the groups of U-S, SSP and E-A with no statistical significance. however, Pressure Algometer method was found to increase the pain thresholds for both SSP and E-A groups with statistically significance. Statistically significant improvement was found for all the groups together after the administration of the U-S, the SSP and the E-A. From the above results, three methods of U-S, SSP and E-A are found to be effective tools for the deactivation of trigger points in patients with upper trapezius muscle of Myofascial Pain Syndrome. The E-A method was found to be the most effective among three methods.

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The Post-occupancy Evaluation of Roofgarden at Hospital - A Case Study of Asan Medical Center - (병원 옥상정원의 이용후 평가 - 서울아산병원을 대상으로 -)

  • 김인혜;허근영;최아현;김유일
    • Journal of the Korean Institute of Landscape Architecture
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    • v.31 no.5
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    • pp.58-72
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    • 2003
  • Rooftop greenery has been used as a way to solve urban environmental problems by creating green space in densely populated cities. This study was carried out to suggest more effective designs for roof-garden at hospitals through a post-occupancy evaluation. The roofgarden of Asan Medical Center was evaluated with regards to setting, proximate environmental context, users, and design activity by a multi-method including plan investigations, observations, in-depth interviews and questionnaires. The results are summarized as follows; the users' main activities included resting, walking, and talking. A number of users were observed at shaded spaces sitting on such things as benches, pergolas, and shelters. The satisfaction of the users showed high satisfaction level except in the amount of shade, facilities, and shelter. The variables affecting a overall satisfaction were ‘accessibility’, ‘safety’, ‘quality of surroundings’, and ‘suitability for speculation’. By comparing the design concept with using pattern, designer's intention was not reflected sufficiently in several aspects such as ‘event deck for therapy programs’, ‘grove and path’, and ‘low planters’. This study suggests some design implications; it is necessary to furnish shaded sitting places for passive behaviors and pathways for walking or a light exercise. A wind-break wall with glass windows could widen the users' views in a limited space. Natural shade like tree shade or pergola are more desirable than artificial shades. As for the vertical location of the roofgarden, the middle floor could be better than top area for accessibility. Characteristics of building and users should be considered in detail to provide distinct spaces. Proper technical standards for the greening of artificial ground should be established.

Seasonal distribution of airborne pollen in Ulsan, Korea in 2009-2010

  • Choi, Seung-Hyeok;Jung, In-Yong;Kim, Dong-Yeop;Kim, Yang-Ho;Lee, Ji-Ho;Oh, In-Bo;Choi, Kee-Ryong
    • Journal of Ecology and Environment
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    • v.34 no.4
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    • pp.371-379
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    • 2011
  • To determine the peak dispersal times of allergenic pollen grains in Ulsan, Korea, we performed continuous airborne pollen counts at three stations (Sts. A, B, and C) in Ulsan from August 2009 to November 2010. Pollen grains were sampled using a Durham sampler. Two peak pollen dispersal seasons were observed per year. The peak seasons generally coincided with the flowering period of anemophilous trees: Taxodiaceae (February), Alnus (March), Cupressaceae (April), Quercus, and Pinus (May), and with the flowering phase of herbs from August to November, e.g., Humulus, Artemisia, Gramineae, and Ambrosia from August through September. The highest concentration of airborne pollen was from Pinus (68%), followed by Quercus (15%), Alnus (6%), and Humulus (2%); whereas very low pollen concentrations were from Taxodiaceae, Cupressaceae, Artemisia, Gramineae, and Ambrosia (${\leq}$ 1% of the annual total airborne pollen concentration). Our findings indicate that Alnus and Humulus pollen are major allergens whereas those of Pinus and Quercus are minor allergens. The concentration of Alnus pollen grains at St. C was over five times that at Sts. A and B. This finding implies that individuals living at or near St. C are exposed to high concentrations of Alnus pollen before and after March, which is the flowering period of the alder tree. From August to September, individuals living at or near St. B are exposed to high concentrations of Humulus pollen. Our study suggests that Alnus pollen may be the major aeroallergen causing pollinosis in the spring at St. C and Humulus pollen may be the major aeroallergen in autumn at St. B.

A Study on Radiological Image Retrieval System (방사선 의료영상 검색 시스템에 관한 연구)

  • Park, Byung-Rae;Shin, Yong-Won
    • Journal of radiological science and technology
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    • v.28 no.1
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    • pp.19-24
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    • 2005
  • The purpose of this study was to design and implement a useful annotation-based Radiological image retrieval system to accurately determine on education and image information for Radiological technologists. For better retrieval performance based on large image databases, we presented an indexing technique that integrated $B^+-tree$ proposed by Bayer for indexing simple attributes and inverted file structure for text medical keywords acquired from additional description information about Radiological images. In our results, we implemented proposed retrieval system with Delphi under Windows XP environment. End users, Radiological technologists, are able to store simple attributes information such as doctor name, operator name, body parts, disease and so on, additional text-based description information, and Radiological image itself as well as to retrieve wanted results by using simple attributes and text keywords from large image databases by graphic user interface. Consequently proposed system can be used for effective clinical decision on Radiological image, reduction of education time by organizing the knowledge, and well organized education in the clinical fields. In addition, It can be expected to develop as decision support system by constructing web-based integrated imaging system included general image and special contrast image for the future.

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