• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.4
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• pp.181-189
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• 2019

Local anesthetic systemic toxicity (LAST) refers to the complication affecting the central nervous system (CNS) and cardiovascular system (CVS) due to the overdose of local anesthesia. Its reported prevalence is 0.27/1000, and the representative symptoms range from dizziness to unconsciousness in the CNS and from arrhythmias to cardiac arrest in the CVS. Predisposing factors of LAST include extremes of age, pregnancy, renal disease, cardiac disease, hepatic dysfunction, and drug-associated factors. To prevent the LAST, it is necessary to recognize the risk factors for each patient, choose a safe drug and dose of local anesthesia, use vasoconstrictor, confirm aspiration and use incremental injection techniques. According to the treatment guidelines for LAST, immediate application of lipid emulsion plays an important role. Although lipid emulsion is commonly used for parenteral nutrition, it has recently been widely used as a non-specific antidote for various types of drug toxicity, such as LAST treatment. According to the recently published guidelines, 20% lipid emulsion is to be intravenously injected at 1.5 mL/kg. After bolus injection, 15 mL/kg/h of lipid emulsion is to be continuously injected for LAST. However, caution must be observed for >1000 mL of injection, which is the maximum dose. We reviewed the incidence, mechanism, prevention, and treatment guidelines, and a serious complication of LAST occurring due to dental anesthesia. Furthermore, we introduced lipid emulsion that has recently been in the spotlight as the therapeutic strategy for LAST.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.25 no.1
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• pp.61-69
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• 2022

Purpose: Studies in adults have shown an increasing incidence of Clostridioides difficile infection (CDI) in patients hospitalized with acute pancreatitis (AP). There is lack of epidemiological data on CDI and its impact on hospitalized pediatric patients with AP. Methods: We analyzed the National Inpatient Sample and Kids' Inpatient Database between the years 2003 and 2016 and included all patients (age <21 years) with a primary diagnosis of AP using specific International Classification of Diseases codes. We compared clinical outcomes between children with CDI and those without CDI. Our primary outcome was severe AP and secondary outcomes included length of stay and hospital charges. Results: A total of 123,240 hospitalizations related to AP were analyzed and CDI was noted in 0.6% of the hospital. The prevalence rate of CDI doubled from 0.4% (2003) to 0.8% (2016), p=0.03. AP patients with CDI had increased comorbidities, and also underwent more invasive surgical procedures, p<0.05. AP patients with CDI had a higher in-hospital mortality rate and increased prevalence of severe AP, p<0.001. Multivariate regression models showed that CDI was associated with 2.4 times (confidence interval [CI]: 1.91 to 3.01, p<0.001) increased odds of severe AP. CDI patients had 7.24 (CI: 6.81 to 7.67, p<0.001) additional hospital days while incurring $59,032 (CI: 54,050 to 64,014, p<0.001) additional hospitalization charges. Conclusion: CDI in pediatric patients with AP is associated with adverse clinical outcomes and increased healthcare resource utilization. Further studies are needed to elucidate this association to prevent the development of CDI and to improve outcomes.

• Journal of the Korean Arthroscopy Society
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• v.5 no.2
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• pp.124-130
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• 2001

Purpose : To identify occult intra-articular pathologies in the acute ankle fracture using arthroscopy and to investigate the factors to predict its possibility of occult injuries that could be occurred. Materials and Methods : This prospective study included fifty patients who got operation for the ankle fractures. Ankle arthroscopy was performed to document the type and anatomical location of occult lesion. We investigated the correlation between incidence of occult injuries and specific fracture type. Results : Of fifty ankles, 37 ankles had occult lesion. Twenty five loose bodies including displaced fragments were found and various cartilage lesions were found in 31 ankles. Tibial avulsion fragment by anterior inferior tibiofibular ligament was occurred in 6 cases. There was no correlation between the incidence of occult lesion and various factors including age, sex, injury mechanism and fracture type(p>0.05). Conclusion : The ankle arthroscopy had an effective role for the detection and treatment of occult injuries and it was difficult to predict the occurrence or associated accurately in all of th ankle fractures.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.1
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• pp.34-42
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• 2004

The appropriate care to the dental emergency patients is much important in the aspect of community dental service. To attain such a purpose, the sacred duty of the training of oral and maxillofacial surgeons is required. So, a retrospective study on the characteristics of dental injuries and diseases in emergency care unit will be very meaningful. This study was carried by reviewing the charts and radiographic films of 3,394 patients, treated for dental emergency at Wonju Christian Hospital, Republic of Korea, from January 1, 1993 to December 31, 2002. All patients were classified to 6 groups including trauma, toothache, infection, hemorrhage, TMJ disorder and the others. The clinical characteristics of diseases and treatment modalities according to each group were analyzed. The trauma (73.9%) was the most frequent cause in dental emergency patients, and acute toothache, odontogenic infection, oral hemorrhage, and TMJ disorder were next in order. Gender prediction was male (68%), there were many patients on May and December in the monthly frequency, and the most frequent age group was from 0 to 9 years. In the trauma group, male (68.6%) was predominant, and soft tissue injuries and primary closures were the most frequent type of injury and treatment. In jaw fractures, traffic accidents were the most cause and the weakest site was mandibular symphysis area, and mandibular angle, condyle, and body area were next in order. In the acute toothache group, the cause was dental pulpitis mostly and treatment for that was drug administration mainly. Buccal space abscess in infection group had the largest incidence (24.5%), and common treatments were incision and drainage and medications. In the hemorrhage group, a major cause was postoperative bleeding (60.3%) and hemostasis was obtained by pressure dressing, curettage and suture. For the TMJ disorder group, the peak incidence (63.8%) was shown in the post-traumatic myofascial pain dysfunction syndrome and its primary care was medication such as analgesics and sedatives. In the other group, the various specific symptoms were complained due to acute sialadenitis, trigeminal neuralgia, acute stomatitis, chemical burn, terminal stage neuritis of head and neck cancer, and foreign body aspiration. In conclusion, for the rapid and proper care of the emergency dental diseases, well-trained education should be presented to the intern and resident course of oral and maxillofacial surgery. And it is demanded that oral and maxillofacial surgeons must be prepared in knowledge and skill for such emergency care.

• Proceedings of the Korean Environmental Health Society Conference
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• 2005.06a
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• pp.45-72
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• 2005

C. neoformans-associated cryptococcosis is primarily a disease of immunocompromised persons, has a world-wide distribution, and is often spread by pigeons in the urban environment. In contrast, C. gattii causes infection in normal hosts, has only been described in tropical and semi-tropical areas of the world, and has a unique niche in river gum Eucalyptus trees. Cryptococcosis is acquired through inhalation of the yeast propagules from the environment. C. gattii has been identified as the cause of an emerging infectious disease centered on Vancouver Island, British Columbia, Canada. No cases of C. gattii-disease were diagnosed prior to 1999; the current incidence rate is 36 cases per million population. A search was initiated in 2001 to find the ecological niche of this basidiomycetous yeast. C. gaftii was found in the environment in treed areas of Vancouver Island. The highest percentage of colonized-tree clusters were found around central Vancouver Island, with decreasing rates of colonization to the north and south. Climate, soil and vegetation cover of this area, called the Coastal Douglas fir biogeoclimatic zone, is unique to British Columbia and Canada. The concentration of airborne C. gattii was highest in the dry summer months, and lowest during late fall, winter, and early spring, months which have heavy rainfall. The study of the emerging colonization of this organism and subsequent cases of environmentally acquired disease will be informative in planning public health management of new routes of exposure to exotic agents in areas impacted by changing climate and land use patterns. Cryptococcosis is an infection associated with an encapsulated, basidiomycetous yeast Cryptococcus neoformans. The route of entry for this organism is through the lungs, with possible systemic spread via the circulatory system to the brain and meninges. There are four cryptococcal serogroups associated with disease in humans and animals, distinguished by capsular polysaccharide antigens. Cryptococcus neoformans: variety grubii (serotype A), variety neoformans (serotype D), and variety gattii (serotypes B and C) (Franzot et at. 1999). C. neoformans variety gattii has recently been elevated to species status, C. gattii. C. neoformans val. grubii and var. neoformans have a world-wide distribution, and are particularly associated with soil and weathered bird droppings. In contrast, C. gattii (CG) is not associated with bird excrement, is primarily found in tropical and subtropical climates, and has a restricted environmental niche associated with specific tree species. (Ellis & Pfiffer 1990) Ellis and Pfeiffer theorize that, as a basidiomycete, CG requires an association with a tree in order to become pathogenic to mammals. In Australia, CG has been found to be associated with five species of Eucalypts, Eucalyptus camaldulensis, E. tereticornis, E. blakelyi, E. gomphocephala, and E. rudis. Eucalypts, although originally native to Australia, now have a world-wide distribution. CG has been found associated with imported eucalypts in India, California, Brazil, and Egypt. In addition, in Brazil and Columbia, where eucalypts have been naturalized, native trees have been shown to harbour CG (Callejas et al. 1998; Montenegro et al. 2000). In British Columbia, Canada, since the beginning of 1999, there have been 120 confirmed cases of cryptococcal mycoses associated with CG in humans, including 4 fatalities (data from British Columbia Centre for Disease Control), and over 200 cases in animal pets in BC (data from Central Laboratory for Veterinarians). What is remarkable about the BC outbreak of C. gattii-cryptococcosis is that all of the cases have been residents of, or visitors to, a narrow area along the eastern coast of Vancouver Island, BC, from the tip of the island in the south (Victoria) to Courtenay on the north-central island as illustrated in Figure 1. Of the first 38 human cases, 58% were male with a mean age of 59.7 years (range 20 - 82): 36 cases (95%) were Caucasian. Ten cases (26%) presented with meningitis, the remainder presented with respiratory symptoms. Cultures recovered from cases of cryptococcosis associated with the outbreak were typed as serogroup B, which is specific to CG (Bartlett et al. 2003). This was the first reported outbreak of CVG in Canada, or indeed, the world. Where infection with CG is endemic, for example, Australia, the incidence of cryptococcosis ranges from 1.8 - 4.7 per million between the southern and northern states (Sorrell 2001). However, the overall incidence of cryptococcosis in immunocompenent individuals has been estimated at 0.2 per million population per year (Kwon-Chung et al. 1984). The population of Vancouver Island is approximately 720,000,consequently, even if the organism were endemic, one would expect a maximum of 0.15 cases of cryptococcal disease annually.

• Korean Journal of Remote Sensing
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• v.23 no.2
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• pp.145-152
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• 2007

The polarimetric backscattering coefficients of a wet-land rice field which is an experimental plot belong to National Institute of Agricultural Science and Technology in Suwon are measured using ground-based polarimetric scatterometers at 1.8 and 5.3 GHz throughout a growth year from transplanting period to harvest period (May to October in 2006). The polarimetric scatterometers consist of a vector network analyzer with time-gating function and polarimetric antenna set, and are well calibrated to get VV-, HV-, VH-, HH-polarized backscattering coefficients from the measurements, based on single target calibration technique using a trihedral corner reflector. The polarimetric backscattering coefficients are measured at $30^{\circ},\;40^{\circ},\;50^{\circ}\;and\;60^{\circ}$ with 30 independent samples for each incidence angle at each frequency. In the measurement periods the ground truth data including fresh and dry biomass, plant height, stem density, leaf area, specific leaf area, and moisture contents are also collected for each measurement. The temporal variations of the measured backscattering coefficients as well as the measured plant height, LAI (leaf area index) and biomass are analyzed. Then, the measured polarimetric backscattering coefficients are compared with the rice growth parameters. The measured plant height increases monotonically while the measured LAI increases only till the ripening period and decreases after the ripening period. The measured backscattering coefficientsare fitted with polynomial expressions as functions of growth age, plant LAI and plant height for each polarization, frequency, and incidence angle. As the incidence angle is bigger, correlations of L band signature to the rice growth was higher than that of C band signatures. It is found that the HH-polarized backscattering coefficients are more sensitive than the VV-polarized backscattering coefficients to growth age and other input parameters. It is necessary to divide the data according to the growth period which shows the qualitative changes of growth such as panicale initiation, flowering or heading to derive functions to estimate rice growth.

• Clinical and Experimental Pediatrics
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• v.45 no.7
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• pp.828-835
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• 2002

Purpose : The outcomes of infants weighing less than 1,500 gm(very low birth weight infant : VLBWI) reflect recent progress in neonatal intensive care. In this study, we analyzed changes over time in survival rate and morbidity of VLBWIs during the past seven years. Methods : A retrospective review of medical records was analyzed for VLBWIs admitted to the neonatal intensive care unit of Samsung Medical Center within three days from birth. We compared the outcomes of previous corresponding data(period I : Oct. 1994 to Sept. 1996), with the outcomes of period II(Oct. 1996 to Dec. 1998) and period III(Jan. 1999 to Dec. 2000). Results : As shown in Tables 1 and 3, the distribution of birth weight, gestational age(GA), gender, and inborn admissions did not change during the 7-year study. The overall survival rate of VLBWI increased significantly over time(period I : 72% vs period III : 88.3%, P<0.05). Between period I and period II, the birth weight-specific survival rate increased by 23.6%(75% vs 92.7%, P<0.05) for infants 1,000 to 1,249 gm. Between period II and period III, the birth weight-specific survival rate increased three times(20% vs 66.7%, P<0.05) for infants <750 gm. The survivors of lowest birth weight included infants at 624 gm(GA : $26^{+5}$ weeks), 667 gm(GA : $25^{+6}$ weeks) and 480 gm(GA : $26^{+2}$ weeks) in each period. The gestational age-specific survival rate in period III increased significantly in GA 25-26 weeks and 29-30 weeks(vs period I & period II, P<0.05). The survivors of lowest gestational age included infants at GA 26 weeks(970 gm), GA $23^{+5}$ weeks(791 gm) and GA $24^{+1}$ weeks(740 gm) in each period. The incidence of severe IVH(grade III, IV) and the early death rate(< seven days) decreased in period III(vs period I; P<0.05), reflecting improvements in neonatal intensive care. Conclusion : The survival rate of VLBWI continues to increase, particularly for BW < 750 gm, GA < 26 weeks. This increase in survival is not associated by any increase in major morbidities.

• Journal of Preventive Medicine and Public Health
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• v.14 no.1
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• pp.81-88
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• 1981

The present study was conducted to investigate the status of industrial injuries through a prospective study for a year from August 1980 to July 1981. The subjects were 15 textile industries which were selected by random sampling in Daegu. The results obtained are as follows: Anual over-all incidence rate of industrial injuries was 3.3 percent and the rate showed 6.7 percent in male and 2 percent in female. The rate showed decreasing tendency with larger scale of industries. By the age group, $15{\sim}19$ age group was the highest as 49.3 percent. Age specific incidence rate of industrial injuries revealed highest as 4.7 precent among the group the group of 30 years old and over. By the years of service, 57.1 percent of the total cases belonged to the the group less than 1 year and the rate revealed increasing tendency with shorter period of service. The highest frequency of industrial injuries was observed at the point of 3 hours after the beginning of the work in a day as 18.1 percent. Frequency of industrial injuries showed highest as 20.3 percent on Monday. Frequency of industrial injuries was highest as 27.7 percent in winter time and showed 14 percent and 11.8 percent in January and August, respectively. By the cause of injuries, machinery accidents showed the highest as 39.2 percent and followed by the accidents due to striking against object as 17.8 percent, fall of ground as 16.3 percent and hand tool as 7.2 percent. Frequency of injured parts of body was highest as 43.9 percent in fingers. The frequency was much higher in upper extremities (66.9%) than in lower extremities (17.6%). By the kind of injuries, laceration wound was highestas 35.7 percent and the next was superficial injury and contusion as 35.1 percent. By the duration of treatment, most of the cases was belonged to the group less than 1 month as 79.1 percent and the duration showed prolonging tendency with larger scale of industries.

• Journal of Korean Neurosurgical Society
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• v.63 no.5
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• pp.607-613
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• 2020

Objective : Spontaneous intracranial hemorrhage is a life-threatening disease, and non-lesional spontaneous intraparenchymal hemorrhage (nIPH) and aneurysmal subarachnoid hemorrhage (aSAH) are the leading causes of spontaneous intracranial hemorrhage. Only a few studies have assessed the association between prior physical activity or triggering events and the occurrence of nIPH or aSAH. The purpose of this study is to investigate the role of specific physical activities and triggering events in the occurrence of nIPH and aSAH. Methods : We retrospectively reviewed 824 consecutive patients with spontaneous intracranial hemorrhage between January 2010 and December 2018. Among the 824 patients, 132 patients were excluded due to insufficient clinical data and other etiologies of spontaneous intracranial hemorrhage. The medical records of 692 patients were reviewed, and the following parameters were assessed : age, sex, history of hypertension, smoking, history of stroke, use of antiplatelet or anticoagulation agents, season and time of onset, physical activities performed according to the metabolic equivalents, and triggering event at onset. Events that suddenly raised the blood pressure such as sudden postural changes, defecation or urination, sexual intercourse, unexpected emotional stress, sauna bath, and medical examination were defined as triggering events. These clinical data were compared between the nIPH and aSAH groups. Results : Both nIPH and aSAH most commonly occurred during non-strenuous physical activity, and there was no significant difference between the two groups (p=0.524). Thirty-two patients (6.6%) in the nIPH group and 39 patients (8.1%) in the aSAH group experienced triggering events at onset, and there was a significant difference between the two groups (p=0.034). The most common triggering events were defecation or urination in both groups. Conclusion : Specific physical activity dose no affect the incidence of nIPH and aSAH. The relationship between the occurrence of intracranial hemorrhage and triggering events is higher in aSAH than nIPH.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.5
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• pp.2835-2838
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• 2013

Background: Prostate cancer features a substantial incidence and mortality burden, similarly to breast cancer, and it ranks among the top ten specific causes of death in males. Objective: To explore the situation of prostate cancer in a healthy population cohort in Eastern Nepal. Materials and Methods: This study was conducted in the Department of General Surgery at B. P. Koirala Institute of Health Sciences, Dharan, Nepal from July 2010 to June 2011. Males above 50 years visiting the Surgical Outpatient Department in BPKIHS were enrolled in the study and screening camps were organized in four Teaching District Hospitals of BPKIHS, all in Eastern Nepal. Digital rectal examination (DRE) was conducted by trained professionals after collecting blood for assessment of serum prostatic specific antigen (PSA). Trucut biopsies were performed for all individuals with abnormal PSA/DRE findings. Results: A total of 1,521 males more than 50 years of age were assessed and screened after meeting the inclusion criteria. The vast majority of individuals, 1,452 (96.2%), had PSA ${\leq}4.0$ ng/ml. Abnormal PSA (>4 ng/ml) was found in 58 (3.8%). Abnormal DRE was found in 26 (1.72%). DRE and PSA were both abnormal in 26 (1.72%) individuals. On the basis of raised PSA or abnormal DRE 58 (3.84%) individuals were subjected to digitally guided trucut biopsy. Biopsy report revealed benign prostatic hyperplasia in 47 (3.11%) and adenocarcinoma prostate in 11 (0.73%). The specificity of DRE was 66.0%with a sensitivity of 90.9% and a positive predictive value of 38.5%. The sensitivity of PSA more than 4ng/ml in detecting carcinoma prostate was 100% and the positive predictive value for serum PSA was 19.0% Conclusions: The overall cancer detection rate in this study was 0.73% and those detected were locally advanced. Larger community-based studies are highly warranted specially among high-risk groups.