• Journal of Trauma and Injury
• /
• 제35권3호
• /
• pp.215-218
• /
• 2022

The rectum is the least frequently injured organ in trauma, with an incidence of about 1% to 3% in trauma cases involving civilians. Most rectal injuries are caused by gunshot wounds, blunt force trauma, and stab wounds. A 46-year-old male patient was crushed between two vehicles while he was working. He was hemodynamically unstable, and the Focused Assessment with Sonography for Trauma showed hemoperitoneum and hemoretroperitoneum; therefore, damage control surgery with pelvic packing was performed. A subsequent whole-body computed tomography scan showed a displaced pelvic bone and sacrum fracture. There was evidence of an anorectal full-thickness laceration and urethral laceration. In second-look surgery performed 48 hours later, the pelvis was stabilized with external fixators, and it was decided to proceed with loop sigmoid colostomy. A tractioned rectal probe with an internal balloon was positioned in order to approach the flaps of the rectal wall laceration. On postoperative day 13, a radiological examination with endoluminal contrast injected from the stoma after removal of the balloon was performed and showed no evidence of extraluminal leak. Rectosigmoidoscopy, rectal manometry, anal sphincter electromyography, and trans-stomic transit examinations showed normal findings, indicating that it was appropriate to proceed with the closure of the colostomy. The postoperative course was uneventful. The optimal management for extraperitoneal penetrating rectal injuries continues to evolve. Primary repair with fecal diversion is the mainstay of treatment, and a conservative approach to rectal lacerations with an internal balloon in a rectal probe could provide a possibility for healing with a lower risk of complications.

• 대한두개안면성형외과학회지
• /
• 제23권4호
• /
• pp.183-186
• /
• 2022

Plastic surgery around the eyes is usually performed under local anesthesia, using a mixture of lidocaine and epinephrine. Blindness is a rare but devastating complication after the injection of local anesthesia in this region. Most cases reported to date have been caused by occlusion of the ophthalmic artery or central retinal artery. In this case report, however, we present a highly unusual case of blindness caused by corneal edema after a local anesthetic injection. A patient visited the emergency room with a laceration on the eyebrow, and local anesthesia was injected before suturing. Immediately after the injection, severe corneal edema developed, making it impossible to observe the structures in the anterior chamber in detail or check the light reflex and visual acuity of the naked eye. An antibiotic (moxifloxacin hydrochloride) and high-concentration steroid eyedrops were promptly applied. High-concentration steroids were also administered orally. On day 13 post-injury, the visual acuity of the naked eye improved to 1.0, and no recurrence of corneal lesions was observed. Although the cause of corneal edema after the local injection could not be conclusively identified, we hope that this report will help raise clinicians' awareness of this complication and appropriate treatment methods.

• The Korean Journal of Pain
• /
• 제35권1호
• /
• pp.97-105
• /
• 2022

Background: Percutaneous transforaminal endoscopic discectomy (PTED) has been widely used in the treatment of lumbar degenerative diseases. Epidural injection of steroids can reduce the incidence and duration of postoperative pain in a short period of time. Although steroids are widely believed to reduce the effect of surgical trauma, the observation indicators are not uniform, especially the long-term effects, so the problem remains controversial. Therefore, the purpose of this paper was to evaluate the efficacy of epidural steroids following PTED. Methods: We searched PubMed, Embase, and the Cochrane Database from 1980 to June 2021 to identify randomized and non-randomized controlled trials comparing epidural steroids and saline alone following PTED. The primary outcomes included postoperative pain at least 6 months as assessed using a visual analogue scale (VAS) and the Oswestry Disability Index (ODI). The secondary outcomes included length of hospital stay and the time of return to work. Results: A total of 451 patients were included in three randomized and two non-randomized controlled trials. The primary outcomes, including VAS and ODI scores, did not differ significantly between epidural steroids following PTED and saline alone. There were no significant intergroup differences in length of hospital stay. Epidural steroids were shown to be superior in terms of the time to return to work (P < 0.001). Conclusions: Intraoperative epidural steroids did not provide significant benefits, leg pain control, improvement in ODI scores, and length of stay in the hospital, but it can enable the patient to return to work faster.

• 대한통합의학회지
• /
• 제10권2호
• /
• pp.49-59
• /
• 2022

Purpose : The purpose of this study is to directly understand the health condition of residents of mental health sanatoriums nationwide, which has been difficult to ascertain in surveys conducted to date. The study presents specific measures for improving the health of these residents. Methods : A "physical examination questionnaire for residents of mental health sanatoriums" was developed to check the basic physical condition of residents, and 20 out of 59 mental health sanatoriums nationwide were randomly selected. Medical personnel visited the sanatoriums, interviewing and examining the residents in person. A total of 396 health surveys were completed. Results : Many of the residents were underweight but had abdominal obesity. It was confirmed that chronic diseases among the residents were not diagnosed early or were not properly managed. Among the subjective symptoms complained of by the residents, musculoskeletal symptoms were the most common. Oral examinations revealed a serious level of oral health problems among the residents, including dental caries and missing teeth. Basic physical examinations found health problems that required additional examination or medical treatment. Blood pressure abnormalities made up the highest percentage of the health problems. Conclusion : Regular health surveys are needed to determine the health condition of residents of mental health sanatoriums. Access to and quality of primary medical services within the sanatoriums need to be dramatically improved. A delivery system for severe diseases and emergency medical care in the sanatoriums should also be specifically presented. The residents should be notified upon admission and during their stay that they have the right to the enjoyment of the highest attainable standard of mental and physical health. The issue of health rights should be addressed within a larger framework of reorganizing management plans for people in the community - not only residents - with chronic mental illness.

• 한국의학물리학회지:의학물리
• /
• 제32권4호
• /
• pp.145-152
• /
• 2021

Purpose: During the treatments of cancer patients with a linear accelerator (LINAC) using photon beams with energies ≥8 MV, the components inside the LINAC head get activated through the interaction of photonuclear reaction (γ, n) and neutron capture (n, γ). We used spectroscopy and measured the dose rate for the LINAC in operation after the treatment ended. Methods: We performed spectroscopy and dose rate measurements for three units of LINACs with a portable high-purity Germanium (HPGe) detector and a survey meter. The spectra were obtained after the beams were turned off. Spectroscopy was conducted for 3,600 seconds, and the dose rate was measured three times. We identified the radionuclides for each LINAC. Results: According to gamma spectroscopy results, most of the nuclides were short-lived radionuclides with half-lives of 100 days, except for ⁶⁰Co, ⁶⁵Zn, and ¹⁸¹W nuclides. The dose rate for three LINACs obtained immediately in front of the crosshair was in the range of 0.113 to 0.129 µSv/h. The maximum and minimum dose rates measured on weekends were 0.097 µSv/h and 0.092 µSv/h, respectively. Compared with the differences in weekday data, there was no significant difference between the data measured on Saturday and Sunday. Conclusions: Most of the detected radionuclides had half-lives <100 days, and the dose rate decreased rapidly. For equipment that primarily used energies ≤10 MV, when the equipment was transferred after at least 10 minutes after shutting it down, it is expected that there will be little effect on the workers' exposure.

• 디지털융복합연구
• /
• 제19권11호
• /
• pp.381-389
• /
• 2021

본 연구의 목적은 대학생들의 성인 애착 불안과 스마트폰중독의 관계에서 지각된 스트레스의 매개효과를 검증하는데 있다. 본 연구에서는 연구 변인들 사이의 관계를 검증하기 위하여 대학교 재학생 272명(남학생 132명, 여학생 139명)의 수집된 자료를 SPSS와 AMOS 프로그램을 사용하여 분석하였다. 연구 결과, 애착 불안과 스마트폰중독의 관계에서 지각된 스트레스는 부분매개효과를 나타내는 것으로 확인되었다. 이러한 연구결과는 애착 불안이 스트레스의 지각과정을 통해 스마트폰중독을 야기하는 것을 의미한다. 본 연구결과는 성인초기에 해당하는 대학생의 스마트폰중독의 위험요인에 대해서 살펴봄으로써 대학생의 정신건강의 이해를 돕는데 그 의의가 있다. 이러한 연구결과는 대학생의 스마트폰중독 예방과 치료에 도움을 제공하여 대학생의 정신건강 증진을 도울 수 있을 것이다.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
• /
• 제28권1호
• /
• pp.31-39
• /
• 2022

Purpose: The study aimed to extract the space mentioned in the criteria for evaluation and certification of psychiatric institutions in which the most specific standards for medical services of psychiatric institutions are prepared, and to organize and analyze the requirements. Method: The implied space is derived by analyzing the evaluation and certification criteria. The derived space is re-classified by departments of the hospital, and the requirements are organized and analyzed. Results: First, a total of 41 spaces were derived. The derived spaces can be considered as spaces to be treated as important in psychiatric institutions. Second, as a result of reclassifying the derived space by department, 10 spaced for the hospital as a whole, 10 for wards, 12 for central/outpatient departments, 5 for pharmaceutical departments, 2 for catering facilities, and 2 for facilities. Third, if organized by psychiatric institution, there is a total of 40 spaces for psychiatric hospitals according to certification criteria, and according to evaluation criteria, there is 38 spaces for psychiatric hospitals and departments and 19 spaces for the clinics. The difference between the certification and evaluation criteria of psychiatric hospitals is insignificant. In order to promote the qualitative improvement of psychiatric institutions, it is necessary to gradually strengthen from the certification criteria. Fourth, the requirements reflecting the characteristics of a psychiatric institution were very limited to emergency exits and treatment rooms. It is necessary to prepare the space requirements for other rooms in consideration of the behavior of the mentally ill. Implications: The derived spaces and requirements can serve as practical reference materials for practitioners preparing to receive certification and evaluation of psychiatric institutions. In addition, it has meaning as a basic data for estimating the level of space and requirements of psychiatric institutions that are currently required in Korea.

• Journal of Hospice and Palliative Care
• /
• 제24권4호
• /
• pp.226-234
• /
• 2021

Purpose: The accessibility of medical facilities for cancer patients affects both their comfort and survival. Patients in rural areas have a higher socioeconomic burden and are more vulnerable to emergency situations than urban dwellers. This study examined the feasibility and effectiveness of a cancer care model integrating a regional cancer center (RCC) and public health center (PHC). Methods: This study analyzed the construction of a safety care network for cancer patients that integrated an RCC and PHC. Two public health institutions (an RCC in Gyeongnam and a PHC in Geochang County) collaborated on the development of the community care model. The study lasted 13 months beginning in February 2019 to February 2020. Results: The RCC developed the protocol for evaluating and measuring 27 cancer-related symptoms, conducted education for PHC nurses, and administered case counseling. The staff at the PHC registered, evaluated, and routinely monitored patients through home visits. A smartphone application and regular video conferences were incorporated to facilitate mutual communication. In total, 177 patients (mean age: 70.9 years; men: 59%) were enrolled from February 2019 to February 2020. Patients' greatest unmet need was the presence of a nearby cancer treatment hospital (83%). In total, 28 (33%) and 44 (52%) participants answered that the care model was very helpful or helpful, respectively. Conclusion: We confirmed that a combined RCC-PHC program for cancer patients in rural areas is feasible and can bring satisfaction to patients as a safety care network. This program could mitigate health inequalities caused by accessibility issues.

• 한국초지조사료학회지
• /
• 제43권4호
• /
• pp.199-205
• /
• 2023

Pasture formation and management are crucial to avoid yield reduction. This experiment aimed to examine the effects of tall fescue-centered mixed-seeding combinations on yield and vegetation changes in perennial pastures in the central region for two years, from September 2020 to October 2022. The treatments were arranged in three replications in a randomized block design: control (C), tall fescue-based mixture-1 (T-1), and tall fescue-based mixture-2 (T-2). The tall fescue (TF), orchard grass (OG), perennial ryegrass (PRG), Kentucky bluegrass (KBG), and white clover (WC) were used. The emergency rate of grasses (70.0 to 73.3%) did not differ among mixed seeding combinations. Overwintering rates (81.7 to 83.3%) were similar among treatments. The plant height of grasses was similar at each harvest date, with the highest height (86.2 cm) recorded in the second harvest of the first year, followed by that (58.4 cm) in the third harvest of the first year; it was least (38.9 cm) in the fourth harvest of the second year. There was no significant difference in the dry matter yield of grasses among the mixed seeding combination treatments in the first, third, or fourth harvests of the first year (p>0.05). For second-year grasses, dry matter yield was not significantly different in harvest date among the treatments (p>0.05). Based on mixed seeding ratio, orchard grass showed the highest yield at 70% in the C treatment, followed by tall fescue at 80% and 60% in the T-1 and T-2 treatments, respectively, in the first harvest after seeding. There was no significant difference in feed value between treatments (p>0.05), but a significant difference was observed between the third and fourth harvest (p<0.05). Therefore, it indicated that it is important to create perennial pastures in the central region through mixed seeding combinations centered on tall fescue.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제49권6호
• /
• pp.332-338
• /
• 2023

Objectives: This study aimed to compare the effectiveness of a hybrid arch bar (hAB) with the conventional Erich arch bar (EAB) for the management of jaw fractures, focusing on their use for temporary fixation in patients undergoing open reduction and internal fixation (ORIF). Materials and Methods: Patients presenting with maxillary and mandibular fractures at our institution were included in this prospective, comparative study. Placement time and ease of occlusal reproducibility were recorded intraoperatively for Group A (hAB patients) and Group B (EAB patients). The primary outcome was comparison of the postoperative stability of the two arch bars. Postoperative measurements also included mucosal overgrowth, screw loosening or wire retightening, and replacement rates. The data were tabulated and computed with a P<0.05 considered statistically significant. Results: The study included 41 patients. A statistically significant difference was observed in postoperative stability scores (3) between Group A and Group B (85.0% vs 9.5%, P=0.001). The mean placement time in Group A (23.3 minutes) significantly differed from that in Group B (86.4 minutes) (P<0.001). The ease of intraoperative occlusion was not different between the two groups (P=0.413). Mucosal overgrowth was observed in 75.0% of patients (15 of 20) in Group A. Conclusion: The hAB was superior to EAB in clinical efficiency, maxillomandibular fixation time reduction, stability, versatility, and safety. Despite temporary mucosal overgrowth, the benefits of hAB outweigh the disadvantages. The choice between hAB and EAB should be based on specific clinical requirements.