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Risk Factors of Neurologic Complications After Coronary Artery Bypass Grafting (관상동맥 우회수술후 신경계 합병증의 위험인자)

  • Park, Kay-Hyun;Chae, Hurn;Park, Choong-Kyu;Jun, Tae-Gook;Park, Pyo-Won
    • Journal of Chest Surgery
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    • v.32 no.9
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    • pp.790-798
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    • 1999
  • Background: As the early outcome after coronary artery bypass grafting(CABG) has been stabilized, neurologic complication has now become one of the most important morbidity. The aim of this study was to find out the risk factors associated with the neurologic complications after CABG. Material and Method: In 351 patients who underwent CABG, the incidence and features of neurologic complications, with associated perioperative risk factors, were retrospectively reviewed. Neurologic complication was defined as a new cerebral infarction confirmed by postoperative neurologic examination and radiologic studies, or delayed recovery of consciousness and orientation for more than 24 hours after the operation. Result: Neurologic complications occurred in 18 patients(5.1%), of these nine(2.6%) were diagnosed as having new cerebral infarctions(stroke). Stroke was manifested as motor paralysis in four patients, mental retardation or orientation abnormality in four, and brain death in one. Statistical analysis revealed the following variables as significant risk factors for neurologic complications by both univariate and multivariate analyses: cardiopulmonary bypass longer than 180 minutes, atheroma of the ascending aorta, carotid artery stenosis detected by Duplex sonography, and past history of cerebrovascular accident or transient ischemic attack. Age over 65 years, aortic calcification detected by simple X-ray, and intraoperative myocardial infarction were significant risk factors by univariate analysis only. Neither the severity of carotid artery stenosis nor technical modifications such as cannulation of the aortic arch or single clamp technique, which were expected to affect the inciden e of neurologic complications, had significant relationship with the incidence. Conclusion: This study confirmed the strong association between neurologic complications after CABG and atherosclerosis of the arterial system. Therefore, to minimize the incidence of neurologic complications, systematic evaluation focused on atherosclerotic lesions of the arterial system followed by adequate alteration of operative strategy is needed.

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A Study on the Determination of Applicable law to Liability for the compensation of Damage in a plane accident (항공기사고 손해배상청구에 있어서 준거법의 결정에 관한 소고)

  • So, Jae-Seon
    • The Korean Journal of Air & Space Law and Policy
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    • v.25 no.2
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    • pp.3-42
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    • 2010
  • This study shows that the Warsaw Convention in Article 1 is not an international transport, origin, destination and all the Contracting Parties is not a purely domestic shipping does not apply to this Treaty. Therefore, in this case, liability and damages for the governing law is selected according to international law should be. In addition, in the case of international shipping and passenger air carrier of this treaty to govern the relationship, not all of which aim is the unification of certain rules. Product liability is the most important thing of all. As for the aircraft manufacturer's responsibility according to international law also does not select the applicable law is not. The Warsaw Convention Article 17 apply for the passenger's personal damages Article 2 Section 2 leads to the most prestigious type of damages, and subjective and objective with regard to the scope of international law are being committed. In this regard, Governing Law-related aircraft accidents leading to serious accidents in China of an aircraft crash in Nagoya, Japan, the airport can be. China Airlines accident of the aircraft are operated for the unification of the rules for international air transport on the Warsaw Convention as amended by Article 17, Article 18 of damages by the tort claims and claims based on damages caused by, or this cause of aircraft accidents air bus maker by the Corporation for damages in tort claims for damages claimed on the basis of solidarity is the case. In the case of these grand scale claim responsibility for the airline, air transport agreements to determine the applicable law of the contract is very complex. There for the contracts based on individual circumstances or origin, and by considering because each must be determined.

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Evaluation of Etiological Factors for Injuries at Oral and Maxillofacial Area (구강악안면부 외상발생의 역학적 평가)

  • Bae, Sung-Suk;Hwang, Soon-Jung
    • Journal of dental hygiene science
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    • v.12 no.4
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    • pp.310-319
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    • 2012
  • In this study, 1,495 cases of computerized data collected as disease entities of oral and maxillofacial injuries among patient visiting S university hospital located in Seoul in 2009 were analyzed and following results were obtained. It was found that the injury incidence in male was greater than in female (1.49:1), it occurred most frequently in the age of 7~14 years old (19.6%), and its most frequent cause was falling down (25.9%). Injuries occurred in other place including beach and open-air (24.7%) most frequently, often developed in anterior teeth (43.2%) and posterior teeth (43.1%), their incidence was relatively higher between 15:00~17:00 (10.4%) and 19:00~23:00 (7.1%) O'clock. In the relationship between causes of the injury and the diagnosis based on the international classification of disease), falling, fall, impingement, violence, traffic accident, sports and own making accident caused most frequently lip and oral open injuries (S01.5), open fracture of tooth (S02.51), close fracture of tooth (S02.50), close fracture of mandible (S02.60), close fracture of tooth (S02.50), respectively. From the above results, it is necessary to understand general characteristics of oral and maxillofacial injuries and to consider their trends for the establishment of systematic complement policies and for the performing safety training and public relations activities.

Behavior Analysis of Fill Slope by Vehicle Collision on Guardrail (가드레일에 차량 충돌 시 성토사면의 거동분석)

  • Park, Hyunseob;Ahn, Kwangkuk
    • Journal of the Korean GEO-environmental Society
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    • v.15 no.2
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    • pp.67-74
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    • 2014
  • Recently, the number of road construction is increasing by industrial development. According to this industrial tendency, the number of traffic accidents are consistently increasing due to increasing number of vehicle on the road. This is mainly because traffic accidents are occurred by various parameter such as negligence of driver, vehicle defects, state of unstable road, natural environment etc. Lane department of vehicles from guardrail is occurring frequently. This type of accident is caused by vehicle performance improvement and shape of vehicle, weak guardrail installation and maintenance. Guardrail has the purpose on prevention such as prevention of traffic accident and prevention of deviating out of road, minimizing damage of driver and vehicle by collision as well as entry into the road through guardrail. Stability evaluation test of guardrail verifies the behavior of guardrail through the crash of truck. At this time, the crash condition has 100 km/h of velocity and $15^{\circ}$ of impact angle. In the case of ground condition, filling slope condition has relatively high bearing capacity of infinite ground towards the test. Guardrail is generally installed on road of shoulder in fill slope in korea. It is possible for stability problem to deteriorate ground bearing capacity in Guardrail in fill slope. The existed study towards stability of guardrail has been carried out in the infinite ground. However, the study on the behavior of fill slope with guardrail is not performed by vehicle collision. Therefore, In this study, the numerical analysis using LS-DYNA was executed for verification on behavior of fill slope with guardrail through vehicle collision. This numerical analysis was carried out with change of embedded depth on installed guardrail post in shoulder of fill slope by vehicle collision and 8 tonf truck crash providing at NCAN (National Crash Analysis Center). As the result, displacement and stress on fill slope are decreased in accordance with the increase of embedded depth of guardrail post. Ground bearing capacity is deteriorated at depth of 450 mm form shoulder of road on fill slope.

The influence of wearing helmet and cervical spine injury in skiers and snowboarders (스키와 스노우 보드에서 헬멧의 착용이 경추부 손상에 미치는 영향)

  • Kim, Sung Hun;Kim, Tae Kyun;Chun, Keun Churl;Hwang, Jae Sun
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.10 no.2
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    • pp.94-99
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    • 2011
  • Purpose: As the number of people enjoying skiing and snowboarding which are two popular winter sports has been increasing, wearing helmet during doing these sports has been needed for safety. The rates of head or face injury have decreased after using helmet. However the effect that wearing helmet has on cervical damage is not yet to be known. So through this research we intend to be helpful in developing effective program and safety equipment. Materials and Methods: During two seasons from December 2009 to march 2011, cased 658 cervical injuries within 14538 admittance in medical center of major resort due to skiing and snow-boarding injuries. For survey and research model, one year before the research year conducted a pilot study. Admittance were 432 male and 226 female, advanced 273 and 385 novice. We divided them into two groups depending on wearing helmet, measured cervical damage ratio and injury mechanism, and researched the severity of damage and diagnosed injury. Each group used SPSS 12.0 (SPSS Inc., Chicago, IL, USA) to process data statistically. Results: The number of patients was 312 in skier and 346 in snow boarder. Patients wearing helmet were 146 in skier and 127 in snow boarder. Classification of each injuries were confirmed as 292 cases of simple sprain, 359 bruising, 6 cervical fractures and 1 case of dislocation. Classification of injury mechanisms were 287 of human collision, 212 material collision, 108 of slip down by oneself, 39 of falling and 12 cases of etc. In cases wearing helmet ski 78/ snow board 70 were simple sprain, ski 64/ snowboard 68 were shown as bruising, ski 1/ snow board 2 had cervical fracture or dislocation. The ratio of cervical sprain increased in cases of wearing helmet compared to non-wearing cases and there was a statistical significance (p<0.001). The ratio of cervical contusion increased significantly in non-wearing helmet user (p<0.05). However, there was no significant increase in fracture and dislocation compared between helmet user and non-user (p> 0.05). Conclusion: In this study, wearing helmet had no relation to additional cervical injury occurrence or severity among skiers and snow boarders. The ratio of cervical sprain increased significantly in helmet user with person to person accident. However, the cervical contusion decreased. On this ground, further biomechanical studies are required and modified helmet will be necessary.

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A RETROSPECTIVE STUDY OF THE TRAUMATIC INJURIES IN THE PRIMARY AND PERMANENT TEETH (유치와 영구치의 외상에 관한 연구)

  • Heo, Su-Kyung;Choi, Nam-Ki;Kim, Seon-Mi;Yang, Kyu-Ho;Park, Ji-il
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.4
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    • pp.642-651
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    • 2008
  • This study was carried out to give basic information of traumatic injuries of primary and permanent teeth which can be used for diagnosis and management of injured teeth. From January 2003 to July 2007, 570 children with 1394 teeth who came to pediatric dentistry and emergency center of Chonnam National University Hospital due to the traumatized teeth participated in this study. The following data were investigated. : age, sex, causes and places of trauma, position of injured teeth, types of injury, and treatment at the first visit. 1. Trauma prevailed at the age of 1, $6{\sim}8$, $17{\sim}18$ and the rate of males was more likely to be higher than the rate of females(1.9 : 1). 2. The main cause of injury is a fall-down injury for primary and mixed dentition, but is a traffic accident and fighting for permanent dentition, respectably. The place of injury for primary dentition is mainly home(45.3%), while street for mixed and permanent dentition. 3. The position of injured teeth according to the area in the mouth is mainly maxillary anterior teeth in both case of primary and permanent teeth and especially, the ratio of central incisors is high. 4. The periodontal tissue injury occurred the most frequently in the primary and the permanent teeth, but the ratio of hard tissue injury in the permanent teeth increased, compared with the primary teeth. 5. Among treatments at the first visit, observation without actual treatment comprised 75.6% in the primary teeth and 55.4% in the permanent teeth, respectably. The pulp necrosis occurred in 20.3% of the primary teeth and 26.6% of the permanent teeth in the case of the periodontal tissue injuries, respectably.

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A study on the extraction of risk factor and its application for senile dementia patient at home based on accidental cases (사고사례를 통한 재가치매환자의 위험요소 추출 및 그 활용에 관한 연구)

  • Lee, Hang-Woon;Eom, Jin-Sup;Choi, Mi-Hyun;Lee, Soo-Jeong;Choi, Jin-Seung;Moon, Seok-Woo;Tack, Gye-Rae;Chung, Soon-Cheol
    • Science of Emotion and Sensibility
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    • v.12 no.1
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    • pp.11-18
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    • 2009
  • The purpose of this study was, first, to extract the risk factor by investigating several cases of accident of senile dementia patient at home, and second, based on these results to provide basic information for the determination of monitoring factor for the care of senile dementia patient. Basic and behavioral characteristics, Short form of Samsung Dementia Questionnaire (S-SDQ), Activities of Daily Living (ADL), and cases of accident were investigated with 55 senile dementia patient at home (16 male, 39 female). Based on these questionnaires, risk factors were extracted and frequency, cooccurrence frequency, and occurring place of risk factors, presence or not, region, and degree of injury were investigated. Frequency between risk factors and behavioral characteristics, ADL, and S-SDQ was analyzed by crosstabulation frequency analysis. Results showed that 12 risk factors were extracted, and the frequency of 'going out' was the highest, and risk factors for injury were 'tumble', 'bump', 'slip', and 'fall'. Cooccurrence frequency analysis showed that the occurrence of 'fall', 'going out', 'fire of gas', and 'violence' with other factors was relatively higher than others. The occurring place of risk factor was the highest in home neighborhood, and the region of injury in knee, and the degree of injury with bruise. Crosstabulation frequency analysis showed that factors which had difference in frequency of risk factor were behavioral disorder, disorder of daily living and ADL. Factor which had difference in frequency due to the degree of behavioral disorder and disorder of daily living was 'going out', and factors which had difference in frequency due to the degree of ADL were 'slip' and 'fire of gas'.

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Current State of Occupational Health in Small-Scale-Enterprises of Korea (50인 미만 소규모사업장의 보건관리 실태)

  • Yun, Soon-Nyung;Kim, Young-Im;Jung, Hye-Sun;Kim, Soon-Lae;Yoo, Kyung-Hae;Song, Young-Sook;Kim, Hwa-Joong
    • Research in Community and Public Health Nursing
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    • v.11 no.1
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    • pp.90-104
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    • 2000
  • This study was carried out to investigate the current state of occupational health management and characteristics of employees working in small-scale-enterprises (SSE) employing less than 50 workers. Samples were chosen among the two thousands employees working in 838 factories where located in Youngdungpo-Ku, Seoul, Korea. The study results were as followed: 1. Most factories investigated in the study were manufactures (68.6%) which were established in 5 to 10 years ago (29.2%), employing less than 5 workers (72.9%) and registered in accident compensation insurance (23.0%). 2. Health screening was undertaken in 24.9% workplaces for periodic health examination and in 1.5% for special health examination. Environmental monitoring was done in 3.3% factories. Very few factories displayed Material Substance Data Sheet (MSDS) in 3.1% among the total factories. 3. Workplaces usually had their own toilets in 75.9% and washing basin in 58.6% as types of sociowelfare facilities. 4. Employees responded in the study were mostly in the range of age from 30 to 39 in 34.7%. male in 84.8%. the married in 70.3%. manual workers in 42.0%. mostly working regularly 51 hours per a week in 48.2% and earned 710.000 Won to 1.000.000 Won per month in 35.0%. Medical utilization for employees were covered by factories sponsored medical insurance in 12.7% and by provincial sponsored medical insurance in 83.4%. 5. Two point six percents of employees were suffered by diseases. The health complaints indicated were mainly digestive problems in 46.7% and hypertension in 24.4%. 6. Employees wore personal protective equipments for work such as gloves in 48.1%. safety shoes in 30.5%. ear plug in 5.5% and mask in 6.9%. Based on the results of study, we recommend that various types of occupational health management should be developed according to workplace working condition of each factory. In addition to the development of occupational health strategies. we think that it is more important to monitor and to allocate how effectively they operate each other on the basis of longitudinal continuity. Besides, we would like to insist that these all management effort should be focused on prevention of disease and occupational health education of employees.

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Correlation Between Knowledge and Educational Needs Related to Recurrent in Coronary Artery bypass graft patients (관상동맥 우회술환자의 수술 후 재발 관련 지식과 교육요구도와의 상관관계)

  • 김희승;박민정
    • Journal of Korean Academy of Nursing
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    • v.30 no.3
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    • pp.549-559
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    • 2000
  • The purpose of this study was to investigate the correlation between the knowledge and educational needs related to recurrent in coronary artery bypass graft patients as a basis to provide an individual nursing education for the population. The subjects consisted of 110 patients who had coronary artery bypass graft(CABG) at Asan Medical Center in Seoul and Sechong hospital in Buchon. Data was obtained from a knowledge questionnaire and a learning needs questionnaire between November 1998 and February 1999. Data were analyzed using SAS program for Wilcoxon rank sum test and Spearman correlation coefficient. The results were as follows : 1. With regard to the 18 items to measure knowledge, the mean (median) of items 'don't know' was 4.9(4) items. The mean (median) of items answered wrong was 3.2(3) items. The number of items answered 'don't know' tend to show higher in those who had less education, blue color jobs and myocardiac infarction history than in their counter parts. There were higher frequency of items answered 'don't know' in those who had no hypertension 2. With regard to the level of knowledge by questionnaire about CABG, The most "I dont know" (59.1%) highly response was 'He has to be treated with anticoagulant drug to prevent revasculized vessel from obstructing.' The seond highest response (56.4%) was 'If you were hypotensive, the coronary attack would collapse. 'During the hospitalized day, the patient has complete bedrest.' The highest error probability was cholesterol has not to intake.', 'After surgery, the sexual life is need controlled for 1 year. 3. The mean of educational needs was 3.38. With regard to the level of learning needs by sentence about CABG, 'Food that benefit heart disease', 'Recurrence possibility of heart disease', 'Management method of operation site', 'Risk symptom that visit hospital or report immediately' were higher than other sentenses. With regard to the level of learning needs by factor 'food(5 items)', 'disease(9 items)' and 'exercise(3 items)' showed the highest than other factors. The educational needs by patients characteristics tend to show higher in males, under the age of 49, middle or high school degree, previous experience of admission with coronary artery disease, history of myocardial infarction, expierience of PTCA, history of cerebro-vascular accident, previous expierience of smoking than in their counter parts. 4. The number of items answered 'don't know', wrong and correct weren't correlated with the level educational needs. As the results, the number of items answered 'don't know' tend to show higher in those who had less educated, blue color jobs and myocardiac infarction history than in their counter parts. There were higher frequency of items answered 'don't know' in those who had no hypertension .There were higher frequency of items answered 'don't know' on anti-thrombolitic theraphy, hypotension and pain relief. Also there were higher frequency of items answered wrong on bed rest period, cholesterol intake, and sexual life. Educational needs were higher in young age group, had previous experience of procesure and history of other disease. And when we educate CABG patients, education for diet, recurrence possibility of disease, management methods of operation site and risk symptom should be emphasized.

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A Survey on the Knowledge and Attitude of Workers Concerning Occupational Health (근로자의 산업보건 지식과 태도에 관한 조사연구)

  • 박영식;조수열;남철현
    • Journal of Environmental Health Sciences
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    • v.18 no.2
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    • pp.3-18
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    • 1992
  • This research was carried out on 1,017 production workers for four months from May to August, 1991, to search more effective management method of their health by grasping their knowledge and attitude on industrial health. The results of this study can be summarized as follows: 1. As for general characteristics, 74.2% were male and 25.8% were female among the 1,017 workers. The two largest age groups were 30~39, 38.7%. As for education level, graduation from high school was 58.6%, 61.2% were married, 35.9% owned their house, and workers who worked more than 1 year less than 5 years was 52.9%, workers who worked 8 hours a day was 46.7%, the largest group income level was 60~69 thousand won 21.2%, and the degree of satisfaction with work was ordinary, 45.6%. 2. The degree of recognition concerning occupational diseases was 92.5% at a very high rate. Causes of occupational diseases under the present work field were in order of noise, dust, heavy metal. The largest group of the counterplan for prevention was an improvement of working environment, 62.0%. 3. The major cause that threatens worker's health was poor working environment, 31.4%. As the best method for workers' health management, working environment management was pointed. 4. As for health examination result, the response that it is of use to health management was 53.8%. As for examination method and result, 42.7% responded that they are formal. The practice period was more than once every six months as the largest group, and the highest desire for improvement was that they wants an exact information of the result. 5. 49.3% of the respondents know about the measurement of working environment an the response that the measurement is necessary to improve working environment was 57.9%, and that the results from the measurement were reflected on improvement an management 57.5%. Appropriate period to take a measurement was more than once per six months, 40.2% and per three months, 29.1%. 6. As for safety and halth instruction, 34.5% were educated for both, 38.2% for only safety education and just 4.6% for only health education. 51.9% responded that they had never been educated out of work place. The period of its practice was more than once a month, 39.5% and every three months, 21.3%. 7. The importance of safety and health showed that the one is equal to the other, 59.8%, that the one is more important, 29.6%, and that other is more important, 7.6%. 67.7% said the necessity of a safety and health manager. 8. In spite of more or less health obstacle of work environment, 14.9% of the respondents wanted to overwork to gain an allowance for over-time work, 39.9% didn't, and 40.2% according to condition and state. 9. As the most important cause of industrial accident, 40.2% indicated unsafe behavior. As for the individual protective instrument, 66.1% of all the respondents said they have worn it to protect industrial diseases. 10. As for the degree of understanding of the contents in Industrial Safety and Health Law and Industrial Law of Accident Insurance, an affirmative response was respectively 49.3% and 50.8% and the sources of safety-health information were televisions and radios, 28.0%. Therefore, it is necessary that we do positive working environmental improvement, continuous management and health education's inforcement to increase their health and prevent occupational diseases.

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