• Title/Summary/Keyword: general treatment

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Analysis of the Risk Factors Influencing the Severity of Injury in Pediatric Multiple Trauma Patients (소아 다발성 외상 환자의 중증도에 영향을 미치는 위험인자에 관한 분석)

  • Lee, Gang-Wook;Kim, Sun-Pyo;Kim, Seong-Jung;Cho, Soo-Hyung;Cho, Nam-Soo
    • Journal of Trauma and Injury
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    • v.23 no.2
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    • pp.68-74
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    • 2010
  • Purpose: The purpose of this study is, first, to analyze the risk factors that influence the severity of injury in pediatric multiple trauma patients and, second, to present solutions for the problems related to the treatment of such patients. Our living situations are so complicated that the danger of accidents is truly open to children who are not prepared. We need to draw attention to the increased numbers of various accidents involving children. Methods: We studied patients who visited the Emergency Medical Center at Chosun University Hospital from January 1, 2006, to December 31, 2008. Using medical records, we evaluated the general characteristics: the mechanism of injury, the vital signs, the revised trauma score (RTS), the injury severity score (ISS), and the hemoglibin value, which was checked at the time of visit, and the presence or the absence of emergent on regular surgery. We divided the level of injury as follows: light level (1-8 points), mid level (9-15 points), and serious level (above 16 points). We analyzed the medical data by using SPSS 17.0 for windows. Results: The average age of the patients examined was 8.6 years. The number of 6- to 11-year-old patients was 96, which was the largest, but the degree of injury severity was the highest among infant (0-2 years), according to ISS 7.95(${\pm}6.85$). The frequency of accidents was highest on sunny days, and most accidents occurred from 16:00 to 20:00. The cause of multiple trauma for children was the greatest in the traffic accident, (95 patients, 49.0%). In addition, the trauma caused by traffic accidents showed the highest ISS value ($9.02{\pm}6.42$) and the most serious degree (P=0.004). The ISS level of injury ($8.40{\pm}6.64$) for patients moved from a secondary hospital was higher than that ($6.49{\pm}5.57$) for patients who visited the medical center directly. The severity of injury was highest for patients who used a 119 ambulance ($8.84{\pm}5.80$). According to the injured parts of body, Injuries to the arms and the feet most frequent (79 patients, 40.7%), but the level of injury was the highest for internal organs and chest, $16.42{\pm}8.56$ and $11.23{\pm}6.97$, respectively. Conclusion: We used Abbreviated Injury Scale (AIS) in order to examine the characteristics by injured body part for pediatric multiple trauma patients. Because the degree of injury was the highest for internal organs or the chest, we need to more seriously examine and provide for patients who are suspected of having injuries to the internal organs or the chest. We need to quickly determine the need for surgery in patients with serious injuries to the arms and the feet, which is the greatest in frequency. In particular, we need to consider the surgical care of patients who are not very high in the severity of injury to their brains.

Heart Transplantation: the Seiong General Hospital Experience (심장이식 환자의 임상적 고찰)

  • 박국양;박철현
    • Journal of Chest Surgery
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    • v.29 no.6
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    • pp.606-613
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    • 1996
  • Cardiac transplantation has been the treatment of patients with end-stage heart disease since it was first performed in 1967. In Korea the first case was performed in 1992 and 42 patients underwent heart trans- plantation so far. The purpose of this article is to report short-term result of cardiac transplantation at our center. Between April 1994 and September 1995, 14 patients had undergone orthotopic heart transplantations. There was 12 male and 2 female patients. Mea recipient age was 34 years(range 11 to 54 years) and mean donor age was 28.4 years(16 to 50 years). Mean graft ischemic time was 120.7minutes(80 to 280 minutes). The follow-up period after transplantation was 11 months(3 to 17 months). Recipient diagnosis included dilated cardiomyopathy in 10, ischemic cardiomyopathy in 2, valvular cardiomyopathy in 1, congenital complex heart disease in 1 patient. The preoperative status of the recipients were state I (50%) and ll (50%) by UNOS classification and class 111 (5 patients) and class IV (9) by NYHA functional class. All patients were treated with triple-drug immunosuppression (cyclosporine, azathioprine, steroid) and induction with RATG. The rejection episodes were 5 times in 3 patients during the follow-up. Causes of infection were aspergillosis (2), and hepes zoster (1), CMV pneumonitis (1). Permanent pace- maker was inserted in 1 patient. Currently 9 patients are alive with seven patients in WYHA functional class I and two in class l . The ejection fraction increased from preoperative value of 19.9 $\pm$ 3.4% to postoperative value of 69.0 $\pm$ 5.6%. The causes of death were cellular rejection (1),chronic graft failure due to size-mismatching (1),respirat- oxy insufficiency due to asthma attack (1), subarachnoid hemorrhage (1), and RIO humoral rejection (1).

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Physicochemical and Sensory Characteristics of Vanilla Ice Cream Treated by Gamma Irradiation (감마선 조사에 의한 바닐라 아이스크림의 물리화학적 및 관능적 특성 평가)

  • Kim, Hyun-Joo;Han, In-Jun;Choi, Jong-Il;Song, Beom-Seok;Kim, Jae-Hun;Ham, Jun-Sang;Lee, Wan-Gyu;Yook, Hong-Sun;Shin, Mee-Hye;Byun, Myung-Woo;Lee, Ju-Woon
    • Food Science of Animal Resources
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    • v.28 no.1
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    • pp.69-75
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    • 2008
  • This study evaluated the physicochemical and sensory characteristics of vanilla ice cream treated with gamma irradiation. The general composition of the vanilla ice cream used for the study was 45.4-53.3% moisture, 5.5-5.9% fat and 3.9-4.1% protein, and these values did not change following gamma irradiation. The Hunter L, a and b values were slightly decreased following gamma irradiation. The fatty acid composition of the ice cream included caprylic acid, capric acid, lauric acid, myristic acid, palmitic acid and stearic acid, and there was no detectable change following irradiation. There was no significant difference in TBARS (2-thiobarbituric acid reactive substances) values between non-irradiated and irradiated samples at a dose of 3 kGy or less (p<0.05). Sensory evaluation indicated that gamma-irradiated vanilla ice cream did not show any difference in color relative to non-irradiated ice cream. However, gamma irradiation did affect the flavor, taste and overall acceptability of ice cream at doses above 3 kGy. These results indicate that gamma irradiation at 3 kGy is an effective treatment for sustaining the physicochemical characteristics of vanilla ice cream with minimal changes in sensory characteristics, though further studies should be carried out to reduce the deterioration of sensory qualities induced by gamma irradiation.

A Study on the Dental Service Statifation of Cityizens in Deajeon (대전시 시민의 치과의료서비스에 관한 만족도 조사연구)

  • Sung, Bo-Kyun
    • Journal of Korean society of Dental Hygiene
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    • v.8 no.4
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    • pp.19-30
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    • 2008
  • This study reached the following conclusions as a result of carrying out the questionnaire survey of self-descriptions for the satisfaction after the citizens of Daejon uses the dental clinics, in order to identify the factors of satisfaction to the medical services of such dental clinics to be utilized in the patient management by dental hygienists, provide the basic data to provide the medical services desired by patients. 1. 43.9% men responded to the facilities and 56.1% women to the atmosphere for the standards of selection of dental clinics by general characteristic, and the college graduates or more to the kindness (38.2%), high-school graduates (43.2%) and middle-school graduates (25.9%) or less to the close distance for the level of educational attainment (p=0.009), which was meant to have a statistical significance. 2. The execution of reservation system for the dental clinics showed 54.7%, the reserved time was observed upon the execution of such reservation system, the dental clinics where they practice such system were 40.6%, and the confirmation methods was done through the telephone with 62.5%. 3. The experience of fear upon the dental treatment showed 74.6%. The type of fear showed the machine sound (48.7%) for men and cry of others for women (70.8%) at the highest. 70% of those under 30 at the age responded to the sharp instruments at the highest. 83.3% of Yousung-gu showed the highest by responding to the cry of others for the residential areas. The statistically significant difference was shown in both the age and residential area (p=0.000). 4. Women showed higher in the distribution of gender for the sterilization of instruments for the external satisfaction of dental clinics(p=0.000) and those under 30 at the age showed the highest with 2.98${\pm}$0.95(p=0.001). Seo-gu (3.48${\pm}$0.77) was the highest for the residential area (p=0.000), and there was statistically significant differences in the gender, age and residential area. 5. Men showed higher satisfaction than women in the clean state and the statistically significant differences were shown (p=0.000) at the age as the high satisfaction was shown for those under 30 at the age (2.35${\pm}$0.79), those having the income not less than 10 million won and not more than 20 million won (2.43${\pm}$0.78), and Seo-gu (2.63 ${\pm}$0.69) for the residential area. 6. For the internal satisfaction of dental clinic by users for the medical services in the dental clinics, 61.1% women responded to no in the ability of solving the inconvenience in the service process, and showed low ability of solving the inconvenience from 30 at the age (26.2%) and by responding to Dong-gu (22.1%) for the residential area, showing statically significant differences(p=0.000). For the re-use of dental clinics, 46.6% men (p=0.043) for the gender, 24.3% under 30 at the age and 22.9% of Dong-gu for the residential area responded to the re-use, showing statistically significant differences for the gender and residential area (p=0.000). 7. The dissatisfaction showed a high rate of 69.5% for the satisfaction to the medical services of dental clinics. 46.2% men responded to the pain and women to the feeling of foreign substance for the reason of dissatisfaction while those under 30 at the age showed 55.6% for others, those between 50 and 59 41.7% for the feeling of foreign substance. 86.3% carried out the education for cautions after the treatments and most people turned out that they do not carry out the continuous health management of mouth as 20.5% responded to that they carry out such health management.

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A Study on the Dietary Habit and Health of Office Workers in Seoul (서울시내 직장인의 식습관과 건강에 관한 연구)

  • Choi, Mi-Kyung;Kim, Jong-Goon;Kim, Jeong-Mee
    • Journal of the Korean Society of Food Culture
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    • v.18 no.1
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    • pp.45-55
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    • 2003
  • To investigate the relationship between dietary attitude and healthy status of office workers in Seoul was to be researched for 389 subjects (male: 224 and female: 165). As a result showed 69.4% of them moderately healthy state and 55.0% had a great interest in health. About 41.6% of the respondents was nonsmoker and 74.8% of them drunk alcohol once or twice a week. Only 28.0% of them responded to have breakfast three to four times a week. About 71.0% responded to skip breakfast'. The main reasons for it were 'the lack of time'(46.5%) and 'habitually'(22.6%). The usually preferred taste of food was showed to be 'hot' for 40.3%, the highest percentage. An attempt of supplemental food was 66.0%. The reason for it was shown to be 'for relaxation'(51.7%), followed by 'for prevention and treatment of diseases (23.1%). On dietary habit showed the groups of married and professional people won the hish scores on it. And the groups of those doing exercise once or twice a week, those having a sufficient sleep and those kept in a good food habit showed the high scores on it. The older age group showed the good dietary attitude regardless of occupation.

Pulp Response of Mineral Trioxide Aggregate, Calcium Sulfate or Calcium Hydroxide (Mineral trioxide aggregate, calcium sulfate와 calcium hydroxide의 치수에 대한 반응)

  • Yun, Young-ran;Yang, In-Seok;Hwang, Yun-Chan;Hwang, In-Nam;Choi, Hong-Ran;Yoon, Suk-Ja;Kim, Sun-Hun;Oh, Won-Mann
    • Restorative Dentistry and Endodontics
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    • v.32 no.2
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    • pp.95-101
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    • 2007
  • This study was performed to verify the possibility of MTA and calcium sulfate as a pulp capping agent through comparing the dental pulp response in dogs after capping with MTA, calcium sulfate, and calcium hydroxide. 24 teeth of 2 dogs, 8 month old, were used in this study. Under general anesthesia, cervical cavities were prepared and pulp was exposed with sterilized #2 round bur in a high speed handpiece. MTA calcium hydroxide, and calcium sulfate were applied on the exposed pulp. Then the coronal openin,fs were sealed with IRM and light-cured composite. Two months after treatment, the animals were sacrificed. The extracted teeth were fixed in 10% neutral-buffered formalin solution and were decalcified in formic acid-sodium citrate. They were prepared for histological examination in the usual manner. The sections were stained with haematoxylin and eosin. In MTA group, a hard tissue bridges formation and newly formed odontoblasts layer was observed. There was no sign of pulp inflammatory reaction in pulp tissue. In calcium hydroxide group, there was no odontoblast layer below the dentin bridge. In pulpal tissue, chronic inflammatory reaction with variable intensity and extension occurred in all samples. In calcium sulfate group, newly formed odontoblast layer was observed below the bridge. Mild chronic inflammation with a few neutrophil infiltrations was observed on pulp tissue. These results suggest that MTA is more biocompatible on pulp tissue than calcium hydroxide or calcium sulfate.

The Clinical and Cost Effectiveness of Medical Nutrition Therapy for Patients with Type 2 Diabetes Mellitus (제2형 당뇨병환자에서 임상영앙치료의 임상적 효과와 비용효과 연구)

  • Cho, Youn-Yun;Lee, Moon-Kyu;Jang, Hak-Chul;Rha, Mi-Yong;Kim, Ji-Young;Park, Young-Mi;Sohn, Cheong-Min
    • Journal of Nutrition and Health
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    • v.41 no.2
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    • pp.147-155
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    • 2008
  • Medical nutrition therapy (MNT) is considered a keystone of medical treatment of chronic diseases. However, only few studies have evaluated medical and economical outcome of MNT. The study was performed on the patient with type 2 diabetes mellitus to evaluate the effect of clinical and cost-effective outcomes of MNT. Subjects from two general hospitals were randomly assigned to two different groups; One receiving basic nutritional education (BE) (n = 35), and the other receiving intensive nutritional education (IE) (n = 32) for a 6-month clinical trial. The group which received BE had a single visit with a dietitian, while the other group which received IE had an initial visit with a dietitian addition to two visits during the first 4 weeks of the study periods. Anthropometric parameters, blood components, and dietary intake were measures at the beginning of study period and after 6 month. Cost-effective analysis included direct labor costs, educational materials and medication cost difference during 6 months. After 6 month, subjects from IE group showed significant reduction of body weight (p <0.05) and systolic blood pressure (p <0.05), whereas BE group did not show any significant changes. Result from biochemical indices showed glycated hemoglobin concentration was significantly reduced by 0.7% (p <0.05) only in the IE group. The ratio of energy intake to prescribed energy intake decreased significantly in both groups (p <0.05). Mean time taken for a dietitian to educate the subject was 67.9 ${\pm}$ 9.3 min/person for BE group, while 96.4 ${\pm}$ 12.2 min/person for IE group. Mean number of educational materials was 1.9 ${\pm}$ 0.7/person for BE group and 2.5 ${\pm}$ 0.7/person for IE group. Change in glycated hemoglobin level along the 6 month period of study can be achieved with an investment of \88,510/% by implementing BE and \53,691/% by implementing IE. Considering the net cost-effect of blood glucose control and HbA Ic, IE which provides MNT by dietitian had a cost efficiency advantage than that of BE. According to this study, MNT provided by dietitian had a significant improvements in medical and clinical outcomes compared to that of BE intervention. Therefore, MNT protocol should be performed by systemic intensive nutrition care by dietitian in clinical setting to achieve good therapeutic results of DM with lower cost.

Effect of Fermented Cirsium japonicum Extract on Testosterone Deficiency Syndrome (엉겅퀴 발효 추출물을 통한 남성 갱년기 증상 개선 효과)

  • Jeong, Byung Seo;Kim, Seong Hoon;Kim, Hyun Pyo
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.46 no.7
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    • pp.790-800
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    • 2017
  • As men get older, total testosterone levels decline gradually, and concentrations of free and bioavailable testosterone decline sharply with each decade beyond their 30s. Andropause or testosterone deficiency syndrome (TDS) is defined as a decrease in sexual satisfaction or decline in general well-being accompanied by low levels of testosterone in older men. This male climacteric is characterized by nervousness, reduced potency, decreased libido, irritability, fatigue, depression, memory problems, sleep disturbances, and hot flushes. Cirsium japonicum (CJ) is used as a traditional medicine for hemorrhage, blood congestion, and inflammation in Korea. However, there is no report on the efficacy of CJ treatment for TDS. In this study, we observed the mitigating effect of CJ extract (CE) and fermented CJ extract (FCE) on symptoms of TDS. In elderly male rats, total and testosterone levels, hind limbs muscles, forced swimming time, and total and motile sperm counts significantly increased after daily intake of CE and FCE for 6 weeks. In contrast, sex hormone binding globulin, retroperitoneal fat, total serum cholesterol, and triglyceride levels were significantly reduced in CE and FCE groups. However, there was no difference in prostate specific antigen, aspartate aminotransferase, and alanine aminotransferase levels among all groups, which means CE and FCE did not have putative adverse effects. In a cell experiment, we also observed that CE and FCE enhanced expression of genes related to testosterone biosynthesis but reduced genes involved in testosterone conversion. On the whole, these positive effects on TDS were greater in FCE compared to CE. Thus, these results suggest the potential of FCE as a promising natural product for recovering testosterone levels and alleviating TDS.

Passenger's Right to Compensation in relation to Delayed Flights - From the perspective of EU case law - (운항지연에 따른 승객의 보상청구권 - EU 및 프랑스 판례를 중심으로 -)

  • Lee, Chang-Jae
    • The Korean Journal of Air & Space Law and Policy
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    • v.30 no.2
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    • pp.249-277
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    • 2015
  • Regulation (EC) No 261/2004 ("Regulation") is a common rule on compensation and assistance to passengers in the event of denied boarding and of cancellation or long delay of flights. In some recent cases of European nations, passengers sued the air carrier in order to obtain monetary compensation under Article 7(1) of the Regulation. Some courts dismissed the actions on the grounds that, unlike denied boarding or cancellation of the flight, the Regulation provides no compensation in relation to delayed flights. However, Court of Justice of the European Union(CJEU) ruled that Regulation 261/2004 must be interpreted to mean that passengers whose flights are delayed have a right to compensation in cases when the loss of time is equivalent to, or is in excess of three hours - where the passengers eventually reached their final destination three hours or more later than the originally scheduled arrival time. It is true that a strict interpretation of the regulation would suggest that passengers whose flight has merely been delayed are not entitled to compensation. They should only be offered assistance in accordance with the Articles 6 and 9. Nevertheless, the Court recognized the same right to the same compensation for passengers of flights delayed by more than three hours as that explicitly provided for passengers of cancelled flights. On the one hand, the Court bases this ruling on the recitals of the Regulation, in which the legislature links the question of compensation to that of a long delay, while indicating that the Regulations seek to ensure a high level of protection for passengers regardless of whether they are denied boarding or their flight is cancelled or delayed. On the other hand, the Court interprets the relevant provisions of the Regulation in light of the general principle of equal treatment. Furthermore, the Court delivered a ruling that the loss of time inherent in a flight delay, which constitutes an inconvenience within the intention of Regulation No 261/2004 and which cannot be categorized as 'damage occasioned by delay' within the meaning of Article 19 of the Montreal Convention, cannot come within the scope of Article 29 of that convention. Consequently, under this view, the obligation under Regulation No 261/2004 intended to compensate passengers whose flights are subject to a long delay is in line with Article 29 of the Montreal Convention. Although the above interpretation of the Court can be a analogical interpretation, the progressive attitude of the Regulation and the view of Court forward to protect passengers' interest is a leading role in the area of international air passenger transportation. Hopefully, after the model of the positive support in Europe, Korea can establish a concrete rule for protecting passengers' right and interest.

Comparison of Size Criteria in Mediastinal Lymph Node Involvement of Adenocarcinoma of Lungs (폐 선암의 종격동 림프절 전이에 있어서 림프절 크기 기준의 비교)

  • Gu, Ki-Seon;Kuk, Hiang;Koh, Hyeck-Jae;Yang, Sei-Hun;Jeong, Eun-Taik
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.4
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    • pp.542-547
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    • 1999
  • Background: Decision in mediastinal lymph node involvement of lung cancer by CT scan is very important and valuable for the treatment planning and prognosis prediction. In general, long diameter of mediastinal lymph node more than 15mm is used as criterion of lung cancer involvement. Adenocarci-noma has a tendency of early distant metastasis and micrometastasis, so adenocarcinoma may involve lymph node earlier and cannot be detected before lymph nodes are enlarged enough. The authors tried to determine the difference between two size criteria(15mm, 10mm) in adenocarcinoma for the detection of cancer involvement. Methods: Numbers of sample are 60 cases(male 46, female 14, median age: 61.5 years). According to pathology, squamous cancer 41, large cell cancer 2, adenocarcinoma 17. According to TNM stage, I 23, III 24, IIIA 13. Results : Mean long diameter of lymph node involvement is 16.0($\pm8.0$) mm in non-adenocarcinoma group, and that of adenocarcinoma group is 12.0($\pm3.2$) mm(p<0.05). If long diameter of lymph node larger than 15mm as involvement criterion is applied, sensitivity, specificity, positive predictive index, negative predictive index, accuracy of nonadenocarcinoma group are 54%, 100%, 100%, 83%, 86%, and those of adenocarcinoma group are 43%, 90%, 75%, 69%, 71%. If long diameter of lymph node larger than 10mm as involvement criterion is applied, sensitivity, specificity, positive predictive index. negative predictive index. accuracy of nonadenocarcinoma group are 65%, 77%, 61%, 92%, 79%, and those of adenocarcinoma group are 100%, 80%, 78%, 100%, 88%. Conclusion: Long diameter of lymph node larger than 10mm is more valuable criterion as lymph node involvement in adenocarcinoma of lungs.

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