• Tuberculosis and Respiratory Diseases
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• v.78 no.4
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• pp.445-449
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• 2015

Occupational lung diseases are caused by several toxic substances including heavy metals; however, the exact pathologic mechanisms remain unknown. In the workplace, dental technicians are often exposed to heavy metals such as cobalt, nickel, or beryllium and occasionally develop occupational lung diseases. We described a case of occupational lung disease in a patient who was employed as a dental technician for over a decade. A 31-year-old, non-smoking woman presented with productive cough and shortness of breath of several weeks duration. Chest computed tomography revealed a large number of scattered, bilateral small pulmonary nodules throughout the lung field, and multiple mediastinal lymph nodes enlargement. Percutaneous needle biopsy showed multifocal small granulomas with foreign body type giant cells suggestive of heavy metals inhalation. The patient's condition improved on simple avoidance strategy for several months. This case highlighted the importance of proper workplace safety.

• Tuberculosis and Respiratory Diseases
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• v.84 no.3
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• pp.217-225
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• 2021

Background: Despite the proven benefits of dexamethasone in hospitalized coronavirus disease 2019 (COVID-19) patients, the optimum time for the administration of dexamethasone is unknown. We investigated the progression of COVID-19 pneumonia based on the timing of dexamethasone administration. Methods: A single-center, retrospective cohort study based on medical record reviews was conducted between June 10 and September 21, 2020. We compared the risk of severe COVID-19, defined as the use of a high-flow nasal cannula or a mechanical ventilator, between groups that received dexamethasone either within 24 hours of hypoxemia (early dexamethasone group) or 24 hours after hypoxemia (late dexamethasone group). Hypoxemia was defined as room-air SpO₂ <90%. Results: Among 59 patients treated with dexamethasone for COVID-19 pneumonia, 30 were in the early dexamethasone group and 29 were in the late dexamethasone group. There was no significant difference in baseline characteristics, the time interval from symptom onset to diagnosis or hospitalization, or the use of antiviral or antibacterial agents between the two groups. The early dexamethasone group showed a significantly lower rate of severe COVID-19 compared to the control group (75.9% vs. 40.0%, p=0.012). Further, the early dexamethasone group showed a significantly shorter total duration of oxygen supplementation (10.45 days vs. 21.61 days, p=0.003) and length of stay in the hospital (19.76 days vs. 27.21 days, p=0.013). However, extracorporeal membrane oxygenation and in-hospital mortality rates were not significantly different between the two groups. Conclusion: Early administration of dexamethasone may prevent the progression of COVID-19 to a severe disease, without increased mortality.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.14 no.2
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• pp.71-77
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• 2018

This study was designed to evaluate basic data about dental treatment under general anesthesia in pediatric dentistry of Wonju Severance Christian Hospital. Sex, Age, location, preoperative physical status, intubation methods, inhalation agents, duration of anesthesia and treatment, performed treatment and postoperative follow-up period and frequency were collected based on electronic medical records of 239 patients who visited pediatric dentistry at Wonju Severance Christian Hospital from March 2011 to February 2017. There were the most patients between the ages of 5 - 9, and there was no significant difference between male and female. The largest number of patients visited the hospital from Wonju, where the hospital was located. Most of preoperative status was ASA Class I. Orotracheal intubation was used in 169 of patients (70.7%). As an anesthesia maintenance agent, drug containing sevoflurane was used in 153 of patients (64.0%). In performed treatment, dental restoration, sealant and stainless steel crowns were performed 3.8, 1.8 and 1.1 times per person. 129 patients (54.0%) attended follow-up appointments under 6 months and those of the number of appointments were 1 - 4 times in average. General anesthesia as a behavior guidance in pediatric dentistry is increasing. Clinical guidelines for pediatric patients under general anesthesia are required through follow-up studies.

• Journal of Chest Surgery
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• v.55 no.1
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• pp.30-36
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• 2022

Background: No consensus exists regarding whether volatile anesthetics are superior to intravenous anesthetics for reducing postoperative pulmonary complications (PPCs) in patients undergoing general anesthesia for surgery. Studies of this issue focused on anatomic pulmonary resection are lacking. This study compared the effects of total intravenous anesthesia (TIVA) versus volatile anesthesia on PPCs after anatomic pulmonary resection in patients with lung cancer. Methods: This retrospective study examined the medical records of patients with lung cancer who underwent lung resection at our center between January 2018 and October 2020. The primary outcome was the incidence of PPCs, which included prolonged air leak, pneumonia, acute respiratory distress syndrome, empyema, atelectasis requiring bronchofiberscopy (BFS), acute lung injury (ALI), bronchopleural fistula (BPF), pulmonary embolism, and pulmonary edema. Propensity score matching (PSM) was used to balance the 2 groups. In total, 579 anatomic pulmonary resection cases were included in the final analysis. Results: The analysis showed no statistically significant difference between the volatile anesthesia and TIVA groups in terms of PPCs, except for prolonged air leak. Neither of the groups showed atelectasis requiring BFS, ALI, BPF, pulmonary embolism, or pulmonary edema after PSM. However, the length of hospitalization, intensive care unit stay, and duration of chest tube indwelling were shorter in the TIVA group. Conclusion: Volatile anesthetics showed no superiority compared to TIVA in terms of PPCs after anatomical pulmonary resection in patients with lung cancer. Considering the advantages of each anesthetic modality, appropriate anesthetic modalities should be used in patients with different risk factors and situations.

• Journal of Trauma and Injury
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• v.36 no.4
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• pp.376-384
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• 2023

Purpose: The Armed Forces Trauma Center of Korea was established in April 2022. This study was conducted to report our 1-year experience of treating soldiers with open fractures of the lower extremity. Methods: In this case series, we reviewed the medical records of 51 Korean soldiers with open fractures of the lower extremity between April 2022 and March 2023 at a trauma center. We analyzed patients with Gustilo-Anderson type II and III fractures and reported the duration of transportation, injury mechanisms, injured sites, and associated injuries. We also presented laboratory findings, surgery types, intensive care unit stays, hospital stays, rehabilitation results, and reasons for psychiatric consultation. Additionally, we described patients' mode of transport. Results: This study enrolled nine male patients who were between 21 and 26 years old. Six patients had type II and three had type III fractures. Transport from the accident scene to the emergency room ranged from 75 to 455 minutes, and from the emergency room to the operating room ranged from 35 to 200 minutes. Injury mechanisms included gunshot wounds, landmine explosions, grenade explosions, and entrapment by ship mooring ropes. One case had serious associated injuries (inhalation burn, open facial bone fractures, and hemopneumothorax). No cases with serious blood loss or coagulopathies were found, but most cases had a significant elevation of creatinine kinase. Two patients underwent vascular reconstruction, whereas four patients received flap surgery. After rehabilitation, six patients could walk, one patient could move their joints actively, and two patients performed active assistive movement. Eight patients were referred to the psychiatry department due to suicidal attempts and posttraumatic stress disorder. Conclusions: This study provides insights into how to improve treatment for patients with military trauma, as well as medical services such as the transport system, by revising treatment protocols and systematizing treatment.

• Clinical and Experimental Pediatrics
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• v.48 no.5
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• pp.518-522
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• 2005

Purpose : To evaluate the effect of inhaled hypertonic saline solution in hospitalized infants with bronchiolitis. Methods : A randomized double blind trial was performed from October 2003 to May 2004. A total of eighty patients <1 year of age with a clinical diagnosis of acute viral bronchiolitis were enrolled and assigned to receive either of the following : inhalation of 2 mL(0.5 mg) fenoterol added to 2 mL of 0.9 percent saline solution(group 1; n=40) or 2 mL(0.5 mg) fenoterol added to 2 mL of 3 percent saline solution(group 2; n=40). This therapy was repeated at six hours interval after admission. They were evaluated daily just before and 20 minutes after nebulization. The outcome measures included changes in clinical severity score(based on respiratory rate, presence of wheezing, retraction, and general condition) after nebulization and duration of hospitalization. Results : In the clinical severity score, a significant improvement was observed during the 72 hours of hospitalization in both groups(P<0.05). The basic clinical severity scores before inhalation were decreased significantly faster in group 2 as compared to group 1 on each day of treatment(P<0.05). The mean duration of hospital stay was significantly reduced in group 2 than group 1($5.9{\pm}1.9days$ versus $7.4{\pm}2.0days$, P<0.05). No adverse effects were associated with inhaled therapy. Conclusion : These results suggest that a nebulized 3 percent saline solution plus 0.5 mg fenoterol may be more effective than a 0.9 percent saline solution plus 0.5 mg fenoterol in accelerating the clinical recovery of infants with viral bronchiolitis.

• Environmental Analysis Health and Toxicology
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• v.14 no.4
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• pp.189-201
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• 1999

Lead (Pb) is ubiquitous in the urban environment and is a well-known toxic element. It may cause adverse health effects on hematopoietic system, peripheral and central nervous systems, kidney functions, and others. In recent decades, lead concentration in blood has been widely used one of indicators for lead exposure and risk evaluation. In this study, we determined the blood-lead levels in general populations of Korea, and investigated the relationship among blood-lead levels, sociobehavioral factors, and lead concentrations in the contacted environments such as ambient air, drinking water, and foods. The study subjects consisted of volunteers who had lived in the residential or industrial area in Korea. Information about gender, age, living area, occupation, smoking, heat system, and dietary habits, etc was collected using a self-reported questionnaires. The lead concentrations of environments were collected by literature search to the study area. Participated subjects in industrial area were 726 and their blood-lead levels were 8.58 $\mu\textrm{g}$/dl for males and 6.26 $\mu\textrm{g}$/dl for female in average. The other subjects in residential area were 317 and their blood-lead levels were 4.58 $\mu\textrm{g}$/dl for males and 3.49 $\mu\textrm{g}$/dl for female in average. The distribution of blood-lead level in the industrial subjects was well fitted to the log -normal distribution and that in the residential subjects was well fitted to the normal distribution. Blood-lead levels in both area were affected by gender, smoking habit, age and residence duration except age in industrial area and residence duration in residential area. It was identified that 30% of blood-lead level was contributed from the inhalation of ambient air in the industrial area, and 8.4% of blood-lead level was from that in the residential area. from this study, it would be suggested for the health risk assessment and management of lead pollution concerns in urban, industrial and rural areas.

• Journal of The Korean Dental Society of Anesthesiology
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• v.7 no.2
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• pp.114-119
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• 2007

Background: Dental disabilities mean the poor cooperation for dental treatment because of patient's inherent disability, severe fear and anxiety, and communication problem. Sedation and general anesthesia are usually used for behavioral control in dentally disabled patients. In particular, sedation (conscious and deep) can help them to tolerate the proper dental treatment effectively and safely. Methods: From March 2002 to September 2007, total 35 sedation were carried out in 33 patients (male : female = 20 : 13) with dental disabilities at Seoul National University Dental Hospital and Hanyang University Medical Center. Patients' dental charts and sedation records were retrospectively reviewed. Results: Tooth extraction (19 cases) was the most common dental treatment performed under intravenous sedation (30 cases). Occasionally, inhalation sedation using Sevoflurane 1-2% was adapted (5 cases). Deep sedation (28 cases) was carried out using midazolam 2-3 mg bolus injection and propofol infusion via TCI (4.2 ${\pm}$ 0.9 mg/kg/h), and conscious sedation (7 cases) was carried out using midazolam bolus onlywithout severe complications. The duration of dental treatment was 25.5 ${\pm}$ 12.3 min and that of sedation was 43.2 ${\pm}$ 9.7 min. Conclusion: Sedation for dentally disabledpatients should be selected for effective behavioral control in conjunction with general anesthesia, considering the duration and pain-evoking potentials of dental treatment, the type and severity of patients' disabilities, and the experience of dental anesthesiologists altogether.

• Journal of Preventive Medicine and Public Health
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• v.27 no.3 s.47
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• pp.597-608
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• 1994

This study was conducted to evaluate the relationships between the environmental exposure and biological monitoring among workers exposed to metallic mercury We interviewed each workers to get the medical history including previous hazardous occupational history. We measured the respiration rate and tidal volume of each worker in order to calculate the 8-hour inhaled mercury of workers. And we wafted to evaluate the effect of exposure duration to mercury concentrations in blood and urine as biologic exposure indices of metallic mercury. The regression and correlation analysis were done to the relationships of 8-hour inhaled mercury and mercury in blood and urine. The results were as follows; 1. The subjects were 35 fluorescent lamp manufacturing workers. The mean age of subjects was .24.8 years old, and the mean work careers of workers was 1.19 years. 89% of the total was consisted man. 2. The correlation coefficients between 8-hour inhaled mercury and mercury in blood and urine were higher than that of only considered air mercury concentration. 3. The correlation coefficients of 8-hour inhaled mercury and mercury in blood and urine were above 0.9 in workers who had exposed to mercury more than 1 year 4. The R-square value and -value of regression analysis between the 8-hour inhaled mercury and mercury in blood and urine was also higher in workers who had exposed to mercury over 1 year than in workers who had less than 1 year working experience. The important results of this study were that relationships between the 8hr-inhaled mercury and mercury in blood and urine was very high than that with air mercury concentration only. And the results were very apparent when considering workers 1 year or more. Therefore we concluded that the work career and respiratory volume of each individuals should be considered in evaluation the, results of biological monitoring of workers exposed to metallic mercury.

• Pediatric Infection and Vaccine
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• v.14 no.1
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• pp.47-54
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• 2007

Purpose : Viral respiratory tract infection is most common cause for admission to hospital in children. There are many cases with elevated transaminase level in patients with viral lower respiratory tract infection (LRTI). The aim of this study was to compare indexes of disease severity such as duration of assisted ventilation, length of hospital stay and Respiratory Distress Assessment Instrument (RDAI) score in children with viral LRTI with and without elevated transaminase levels and to determine the etiology related to elevated transaminase levels in this patients group. Methods : Virological analysis was done from respiratory specimens obtained from patients with LRTI admitted to Kangnam Sacred Heart Hospital from Jan. 2003 to Jun. 2005. Viral diagnosis was made by isolation of viruses employing HEp-2 cell culture from nasopharyngeal aspiration. Medical records of children were reviewed retrospectively. We compared age, sex, RDAI score, Respiratory Rate (RR) score and mean duration of hospital stay between patients with elevated transaminase levels (Patient Group) and patients with normal transaminase levels (Control Group). Results : Viruses were isolated from 181 children with LRTI. 16 cases were excluded according to criteria. 28 cases (17.0%) had elevated transaminase levels (Patient group) and 137 cases (83.0%) had normal transaminase levels (Control group). There were no significant difference in duration of fever, RR score, RDAI score, incidence of $O_2$ inhalation and duration of hospital stay between patient group and control group. We found 17 (60.7%) cases of RSV, 4 cases (14.3%) of parainfluenza, 4 cases (14.3%) of influenza B virus, 3 cases (10.7%) of adenovirus and 1 case (3.6%) of influenza A virus infection in patient group and 78 cases (56.9%) of RSV, 28 cases (20.4%) of parainfluenza virus, 13 cases (9.5%) of influenza A virus, 9 cases (6.6%) of influenza B virus, 6 cases (4.4%) of adenovirus and 3 cases (2.2%) of coxsackie virus infection in control group. Conclusion : There were 28 cases (17.0%) with elevated transaminase level among patients with virus isolated LRTI. There was no relation between elevated transaminase level and severity of disease. The viral etiologies in two groups were not significantly different. There was no significant difference of age distribution between two groups.