• Journal of Trauma and Injury
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• v.34 no.2
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• pp.105-111
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• 2021

Purpose: Open extremity fractures require prompt antibiotic medication and initial debridement surgery to reduce the infection rate and restore functional stabilization. We aimed to report the effects and positive outcomes of a trauma team approach on the management of open extremity fractures in polytrauma patients. Methods: This retrospective review included all polytrauma patients with open extremity fractures admitted between March 2009 and December 2019. Patients were divided into two groups according to whether they were treated before or after the implementation of the trauma team approach (March 2014). We analyzed the outcomes in each group with respect to the time interval until the doctor's arrival, total length of stay in the emergency department, the time interval until initial antibiotic treatment and operation, whether the initial operation was performed within 24 hours, and the rate of deep infections. Results: A total of 123 patients met the inclusion criteria. There were no statistically significant differences in demographic characteristics. The time interval until the doctor's arrival (64.12±49.2 minutes vs. 19.82±15.23 minutes; p=0.035) and initial antibiotic treatment (115.47±72.12 minutes vs. 48.78±30.12 minutes; p=0.023) significantly improved after implementing the trauma team approach. The union rate was not significantly different. However, the time interval until initial debridement, opportunity for initial debridement within 24 hours, and the rate of deep infections demonstrated better results. Conclusions: The reduced time interval until initial antibiotic treatment and debridement could be attributed to the positive effect of the trauma team approach on the management of open extremity fractures in polytrauma patients.

• Journal of Preventive Medicine and Public Health
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• v.15 no.1
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• pp.125-130
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• 1982

In order to investigate the relation of subjective complaints to objective course of treatment in pulmonary tuberculosis, one hundred and seventy four cases registered at the University Health Center in Chonnam University were divided into two groups, complaint group and non-complaint group. By analysing the record at the University Health Center during these seven years from 1973 to 1979, following results were obtained: 1. In complaint group who had subjective symtoms, thirty eight cases(77.6%) among forty nine cases were detected. at clinic visit. In non-complaint group who had not any symtoms, one hundred and twenty one cases (96.8%) among one hundred and twenty five cases were detected at compulsive physical examination. 2. Comparisons of complaint group with non-complaint group were not statistically significant in many aspects, but significantly higher cases were discharged at the University Health Center to receive other medical service in complaint group than in non-complaint group. (6.1% vs 0.8%, respectively) On the contrary, non-complaint group refused medication more than two times compared with complaint group in the course of treatment (29.9% vs 12.2%, respectively). 3. In the average time lag from initial diagnosis to initial treatment, comparisons between complaint vs non-complaint group were significant (7.8 vs 28.3 days, respectively). 4. Subjective symptoms were thought to create motivation to receive therapy, and influence of motivation to therapy was strong at initial stage but it become weaker as time passed.

• Journal of Trauma and Injury
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• v.30 no.1
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• pp.1-5
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• 2017

Purpose: Nefopam is a centrally acting non-narcotic analgesic that has mostly been used for postoperative pain. We examined the efficacy of nefopam analgesia (alone and in combination with ketorolac) for trauma patients in the emergency department. Methods: We performed a retrospective chart review to select trauma patients who received nefopam at the emergency department of Korea University Medical Center Guro Hospital between January 2012 and December 2012. Patients younger than 15 years were excluded. The primary outcome measure was change of pain score (numeric rating scale) from baseline (before medication) to 30 min after medication. The secondary outcome measure was requirement for additional analgesia (pethidine). Results: Records of 1465 trauma patients who received analgesics in the emergency department from January 2012 to December 2012 were examined. Patients were classified into five groups according to initial analgesic: nefopam (n=112), ketorolac (n=867), pethidine (n=365), nefopam+ketorolac (92), and nefopam+pethidine (22). There were no significant differences in pain score reductions among the five groups. Twenty-two patients in the nefopam group, 141 in the ketorolac group, and 29 in the nefopam+ketorolac group required rescue analgesia with pethidine; these rates were not significantly different. Conclusion: The efficacy of nefopam analgesia for trauma patients in the emergency department is comparable to that of more commonly used agents, including ketorolac and pethidine.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.26 no.2
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• pp.127-133
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• 2023

Purpose: Dyssynergic defecation (DSD) is one of the important causes of chronic constipation in children. We aimed to analyze the clinical features, diagnostic test results, and treatments for DSD in children. Methods: Children diagnosed with DSD using fluoroscopic defecography were enrolled in this study. Clinical data, including the results of colon transit time (CTT) test and biofeedback (BF) therapy, were collected from medical records retrospectively. Results: Nineteen children were enrolled. The median age was 9 years (6-18 years), the median frequency of bowel movement was 1/7 days (1-10 days), the median duration of constipation was 7.0 years (2-18 years), the median age of onset of constipation was 2.5 years (1-11 years). In the CTT test, outlet obstruction type was noted in 10/18 (55.6%), slow transit type in 5/18 (27.8%), and normal transit in 1/18 (5.6%). The median CTT was 52 hours (40-142 hours). Initial medical therapy was performed with the polyethylene glycol 4000, and the response was good in 9/19 (47.4%), fair in 9/19 (47.4%), and poor in 1/19 (5.0%). BF was performed in 8/19, with good results in 6/8 (75.0%) children and failure in 2/8 (25.0%) children. After long-term medical therapy (11/19), 3/5 showed good response with medication alone, 6/8 showed good response with BF and medication combined. Conclusion: DSD should be considered as a cause of chronic constipation in children, especially in those with abnormal CTT test results. BF combined with medical therapy is effective even with age-limited cooperation.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.39
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• pp.1.1-1.7
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• 2017

Background: Multiple myeloma (MM) is characterized by a neoplastic proliferation of plasma cells primarily in the bone marrow. Bisphosphonates (BP) are used as supportive therapy in the management of MM. This study aimed to analyze the incidence, risk factors, and clinical outcomes of medication-related necrosis of the jaw (MRONJ) in MM patients. Methods: One hundred thirty MM patients who had previous dental evaluations were retrospectively reviewed. Based on several findings, we applied the staging and treatment strategies on MRONJ. We analyzed gender, age, type of BP, incidence, and local etiological factors and assessed the relationship between these factors and the clinical findings at the first oral examination. Results: MRONJ was found in nine male patients (6.9%). The mean patient age was 62.2 years. The median BP administration time was 19 months. Seven patients were treated with a combination of IV zoledronate and pamidronate, and two patients received single-agent therapy. The lesions were predominantly located in the mandible (n = 8), and the most common predisposing dental factor was a history of prior extraction (n = 6). Half of the MRONJ were related to diseases found on the initial dental screen. Patients with MRONJ were treated with infection control and antibiotic therapy. When comparing between the MRONJ stage and each factor (sign, location, etiologic factor, BP type, treatment, and outcome), there were no significant differences between stages, except for between the stage and sign (with or without purulence). Conclusions: For prevention of MRONJ, we recommend routine dental examinations and treatment prior to starting BP therapy.

• The Korean Journal of Pain
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• v.4 no.2
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• pp.127-132
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• 1991

Recently a non-electronic, disposable and portable infusor(Baxter infusor with patient control module, Baxter health care Co., Deerfield IL 60015 USA: BI $\bar{c}$ PCM) has been developed that will deliver both a continuous drug infusion as well as allow the patient to deliver extra doses of medication on a demand basis under predetermined limitation of analgesics. Patients may also not require as high analgesic dose rate to control pain when the acceptable and tolerable level of pain relief can be maintained by this device. From April l99l, we have used a total l93 units of BI $\bar{c}$ PCM. These units consisting of two components which one made by a balloon reservoir(capacity 65 ml, flow rate 0.5 ml/hr) to store medication and to regulate the pump power(490 torr), and another two PCMs to regulate additional analgesic administration by patients demand at intervals of 1S minutes and 60 minutes. The dose administered to the patient can be varied by changing the concentration of the infusate within the balloon reservoir. These devices were utilized for the pain control of 44 patients. These patients were divided into two groups. Twenty seven cases had cancer pain and 17 cases had non-cancer pain. The Touhy needle(No. l8 G.) tip was inserted into the epidural space and was used to guide the catheter to the spinal nerve level corresponding to the most painful area. The device was connected to the opposite site of the catheter tip and was filled with 60 ml of mixture solution such as 0.5% bupivacaine 15 ml, morphine HCl 10 mg, trazodone 10 ml, Tridol 3 ml and normal saline 31 ml were administed as the initial dose. When the initial dose was less effective, the next dose could be varied by increasing the concentration of bupivacaine, by adding more morphine (5~10 mg), and by reducing the volume of normal saline. Using these modules of drug self administration, we experienced the following: 1) Improvement of patient's self titration of analgesic requirement was provided. 2) The patients anxiety with pain recurrence resulting from delays in administering pain control medication was decreased significantly. 3) The working load accompanying with the single bolus injection as the usual method was reduced remarkably. 4) There was urinary retention in 5 cases and pruritus in 4 eases which developed as side effects but respiratory depression and vomiting was not encountered in a single case.

• Herbal Formula Science
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• v.18 no.1
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• pp.181-189
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• 2010

Objectives : In order to confirm a remedial effect and related influence of the clinic treatment by prescribing Samchuljojung-tang(蔘朮調中湯), Bojungikqi-tang(補中益氣湯) and Samso-um(蔘蘇飮) to patients who suffering from a chronic cough and rhinorrhea. Methods : 1. In a clinical observation and analysis method, we have selected the 23 patients who have visited National Oriental Medical Center, date from 2007.8.21 to 2008.7.31 and suffering from a chronic cough and rhinorrhea caused by the common cold sequelae. 2. Separated them into three types(I: cough type, II: rhinorrhea type, III: cough & rhinorrhea type). 3. Observed thoroughly the level of symptom and recorded it for each type with questionnaire survey at the beginning set 4. Prescribed Samchuljojung-tang, Bojungikqi-tang and Samso-um for type I, II, III respectively. 5. Observed the level of symptom and treatment afterwards affect, and recorded movements of intensity level for 3 types with same questionnaires. Results : 1. Type I : The survey turned out to be from 9 patients, initial level recorded 31.89 at the entry diagnosis, and next level that means changing of symptoms, recorded to 12.67 after prescribing herb medication. 2. Type II : From 11 patients, initial level was 32.82 and next level was 13.45. 3. Type III : From 3 patients, initial level was 37.67 and next one was 16.00. Conclusions : It is concluded that there is a significant remedial effect and related influence of the clinic treatment for each type of patients who suffering from a chronic cough and rhinorrhea caused by the common cold sequelae.

• Childhood Kidney Diseases
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• v.8 no.1
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• pp.33-42
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• 2004

Purpose : Children with nephrotic syndrome(NS) are under high risk for metabolic bone disease(MBD) as a complication of long-term glucocorticoid therapy. We prospectively evaluated the effect of oral bisphosphonate(alendronate) therapy in children with NS, which has proven efficacy in adult patients with glucocorticoid induced MBD. Methods : Among 58 children with NS, aged 5 to 8 years and haying a disease duration of more than 2 years, 30(51.7%) were enrolled to meet the selection criteria, less than -1.0 Z-scores of lumbar spine bone mineral density(BMD) by dual energy X-ray absorptiometry (DEXA). These 30 children were divided into three groups and each were assigned to receive alendronate, calcitriol, and no-medication, respectively for one year. Lumbar spine BMD was followed up every 6 months and the biochemical indexes were measured before and 1 year after the treatment. There were no significant difference among groups with respect to the average age, the initial BMD, and the cumulative steroid doses. Analysis of the treatment efficacy was done by the % change of BMD and by the changes in Z-scores of lumbar spine BMD. Results : Mean age and disease duration of patients at the initial lumbar spine BMD evaluation was $7.4{\pm}1.7$ years and $2.2{\pm}1.2$ years, respectively. Twenty-three of 30 children(76%) had osteopenia, and seven(23%) had osteoporosis. There was no difference in the biochemical values among the groups, before and 1 year after the treatment(P<0.05). Twenty two children(73.3%) with frequent relapsing or steroid dependant NS had more frequent MBD, compared to the 8 children(26.6%) with infrequent relapsing NS. The one year % changes of BMD were 8.56 in alendronate group, 5.79 in calcitriol group, and 1.9 in no-medication group. The changes in Z-score of lumbar spine BMD increased in the alendronate group and the calcitriol group, but not in the no-medication group. One year % changes of BMD were different among groups(P=0.0002). Significant differences were found between the alendronate and the no-medication group, and between the calcitriol and the no-medication group(P<0.05). There was no difference between the alendronate and the calcitriol group. No serious adverse effect was observed in the alendronate group. Conclusion : Children with NS receiving high dose steroids are under the high risk of BMD and should undergo regular BMD evaluation. Z-score of lumbar spine BMD was a useful parameter in diagnosing low bone mass in children. Alendronate weekly oral therapy was effective and relatively safe in increasing the lumbar spine BMD in children with NS having steroid induced MBD.

• Journal of Dental Rehabilitation and Applied Science
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• v.33 no.1
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• pp.34-41
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• 2017

Anticonvulsants, calcium channel blockers and immunosuppressants are representative drugs related with gingival enlargement. Clinical signs and symptoms caused by drug-induced gingival enlargment frequently appear within 1 to 3 months after medication. At initial stage, it is limited to attached gingiva but may extend coronally and interfere with esthetics, mastication and speech. Interproximal spaces are common beginning area and pathologic teeth migration could be occurred by the lesion. Withdrawal or substitution of medication would be the most effective treatment of drug-induced gingival enlargement. However, periodontal treatment and further supportive periodontal therapy should be provided where change in medication is impossible. The present study reports the cases which show the resolution of inflammation with spontaneous teeth migration without change in medication. In all cases discussed in this report could be efficiently managed with proper periodontal treatment and further supportive periodontal therapy.

• Korean Journal of Veterinary Research
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• v.46 no.1
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• pp.27-34
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• 2006

This paper describes the slaughter check results of breeding pigs from the Korean Swine Testing Station for the control of endemic diseases. Gross lesions monitored in the present study included those conditions commonly associated with economically significant subclinical herd infections: enzootic pneumonia, pleuropneumonia, pleuritis, atrophic rhinitis, liver white spots, papular dermatitis and ileitis. A total of 128 slaughter pigs were investigated at 4 subsequent tests according to the slaughter check procedures established. The prevalence of enzootic pneumonia, pleuropneumonia and pleuritis in the initial test was 67.9%, 28.6% and 17.9%, respectively. However, these were decreased to 46.7%, 6.7% and 6.7%, respectively, in the last test after implementation of counter measures including clean-up protocols and medication programs (p > 0.05). The mean pneumonic score also significantly decreased from 6.8 in the initial test to 2.8 in the last test. The prevalence of atrophic rhinitis (${\geq}score\;2$) was 32.2% and mean atrophic rhinitis score of 1.1 were recorded. However, no significant improvement of conditions was achieved with the counter measures indicating that atrophic rhinitis was originated from the source herds and lesions developed early in the life. In the initial test, prevalence of liver white spots and papular dermatitis lesions was 21.4% and 25.0%, respectively. These conditions were cleaned by the implementation of parasite control measures with all-in all-out, strict clean-up protocols and proper medications adopted in the present study (liver white spots, p = 0.0124; papular dermatitis lesions, p = 0.0055). The prevalence of ileitis lesions in slaughter pigs from the initial test was 28.6%, it could be gradually reduced by the use of repeated treatments and control measures but the effect was not so significant (p > 0.05). In conclusion, slaughter check procedures were successfully established and applied for the control of endemic diseases in the Korean Swine Testing Station.