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Epidemiologic Study of Frostbites and Its Current Managements in Community Hospital (지역 병원에서 동상 환자에 대한 역학에 관한 연구 및 최근 치료)

  • Kim, Dong Chul;Min, Byung Duk;Kim, Ji Hoon;Chung, Chang Eun;Lee, Chong Kun;Yu, Sung Hoon
    • Journal of the Korean Burn Society
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    • v.24 no.2
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    • pp.21-29
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    • 2021
  • Purpose: Frostbite is a hazard to people exposed to cold environments. With the progression of modern industrial development and change of leisure behavior encountering cold environments, frequent accidental exposure to frostbite injury during work and human behavior is increasing, and the predisposing factors of frostbite were greatly changed than before. The purpose of this study was to make epidemiological analysis, and to review the treatment outcomes of frostbite. Methods: From March 2010 to February 2021, this study has included 27 patients with second- to third-degree frostbite injuries in Advanced Burn Reconstruction Center, Bundang Jesaeng Hosptial. A retrospective study was made about the distribution of age, gender, predisposing factors, prevalent area, type of managements, and the length of treatment period. Results: In our institution, acute management of frostbite patients has included rewarming, anticoagulation therapy (acetylsalicylic acid), and agents to improve vascular perfusion (lipo-prostaglandin E1 [Eglandin®]). The 25 frostbite patients with second-degree frostbite (92.6%) were successfully managed by the conservative treatment alone with a mean of 20.3 days healing time. Two patients with third-degree frostbite (7.4%) also showed good outcomes after surgical reconstruction with a mean of 59 days healing time. In our clinical experiences of third-degree frostbite, definitive surgical reconstruction should be recommended to wait for more than 4~6 weeks for identification of clear demarcation of necrotic tissue caused by frostbite. In this study, 43 frostbite injuries site in 27 frostbite patients occurred. Among them, 15 patients (55.6%) had multiple-site frostbite injury. The most common predisposing cause of frostbite was refrigerant gas accidents (44.4%), followed by outdoor activity in cold environments (40.8%), misapplying ice pack for treatment purposes (7.4%), barefoot walking on the cold ground (3.7%), and loss of consciousness in cold grounds (3.7%). The most prevalent sites of frostbite injuries revealed as the hand (58.1%), followed by the foot (32.6%), face (7.0%), and abdomen (2.3%). And in the winter season from the November to March, the incidence rate of frostbite injuries was high at 74.1%. Conclusion: This study included 27 frostbite patients with 43 frostbite sites since last decade in a single institution at the community hospital. The frostbite patients with second-degree frostbite (92.6%) were successfully healed by the conservative treatment alone with a mean of 20.3 days healing time. The most common predisposing cause of frostbite was refrigerant gas accidents (44.4%), followed by outdoor activity in cold environments, etc. The most prevalent site of frostbite injuries was the hand (58.1%). And the most prevalent seasonal incidence of frostbite was from November to March (74.1%).

Surgical Treatment for Longitudinal Epiphyseal Bracket of the Finger (수지의 종적 Bracket 골단에 대한 수술적 치료)

  • Kim, Sung Soo;Kim, Ki Woong;Kim, Jung Ho;Lee, Chan Soo
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.2
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    • pp.154-161
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    • 2020
  • Purpose: To describe the clinical and radiology results of a surgical treatment for clinodactyly due to a longitudinal epiphyseal bracket. Materials and Methods: This study analyzed the records of 11 patients (27 case) with clinodactyly due to a longitudinal epiphyseal bracket who underwent an osteotomy or physiolysis between March 1999 and April 2017. The preoperative range of motion of the proximal and distal interphalangeal joints, the subjective satisfaction of the patient, and the degree of angulation to the ulnar side were examined. The patients were classified into two groups: osteotomy and physiolysis. The results were reviewed retrospectively and compared according to the surgical method. Results: The mean age of the patients who underwent osteotomy was 10.3 years. The average preoperative angle was 25.7° and the average postoperative angle was 13.5° the mean correction rate was 47.4%. The mean age of the patients who underwent physiolysis was 6.0 years the mean preoperative angle was 24.5° and the postoperative angle was 10.7°. The average correction rate was 59.4%. No significant difference in the correction angles was observed between the group who underwent the correction osteotomy and the group who underwent the osteotomy. In each group, the postoperative correction was statistically significant. The range of motion at the last follow-up was not significantly different from the preoperative range of motion. Conclusion: In patients with clinodactyly due to longitudinal epiphyseal bracket, osteotomy or physiolysis may be performed selectively according to age, bone age, and radiological progression. Both surgical methods showed good clinical results and deformity correction.

Correlation Analysis between the Factors Associated with Osteoporosis and the Fat Infiltration Rate of the Multifidus and Erector Spinae Muscles in Osteoporotic Vertebral Compression Fracture Patients (골다공증성 척추 압박 골절 환자에서 다열근과 척추기립근의 지방 침투율과 골다공증 관련 인자의 상관 관계 분석)

  • Jun, Deuk Soo;Baik, Jong-Min;Choi, Ji Uk
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.4
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    • pp.318-323
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    • 2020
  • Purpose: To examine the relationship between total fat infiltration (TFI) rate, which quantifies the reduction of muscles around the spine and is an important factor for sarcopenia, and the factors affecting osteoporotic vertebral compression fracture. Materials and Methods: Patients treated for osteoporotic compression fractures of the lumber spine from January 2012 to December 2016 were analyzed retrospectively. Among them, this study included ninety-eight patients who were 1) diagnosed with osteoporosis with a bone mineral density (BMD) T score of less than 2.5 g/cm2, 2) received vertebroplasty or kyphoplasty for lumbar fractures, 3) involved one segment of the lumbar spine, and 4) were followed-up for more than one year. The TFI rate confirmed by analyzing magnetic resonance imagings with the Image J program was studied. Based on this, the relationship between the TFI of the multifidus and erector spinae muscles and the factors of osteoporosis were analyzed. Results: The mean TFI of the multifidus and erector spinae was 14.66±10.16. The spine BMD showed a positive correlation with the hip BMD, but a negative correlation with the TFI. A positive correlation was observed between the hip BMD and body mass index. In addition, vitamin D was positively correlated with both the hip and spine BMD but negatively correlated with the TFI rate. Conclusion: Muscle growth helps treat osteoporosis, and can prevent fractures that occur frequently in osteoporosis patients. Increasing the vitamin intake can also slow the progression of muscle atrophy.

Differential Effects of Transforming Growth Factor-β on NKG2D Ligands Expression and NK Cell-mediated Immune Responses in Primary and Metastatic Colon Cancer (원발성 및 전이성 대장암에서 TGF-beta가 NKG2D 리간드 발현과 NK 세포 매개 면역반응에 미치는 영향)

  • Eun-Jung Yun;Yu-Rim Kim;Seong Jun Park;Sang-Yull Lee;Jaeho Bae
    • Journal of Life Science
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    • v.33 no.2
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    • pp.149-157
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    • 2023
  • Transforming growth factor-β (TGF-β) is a multifunctional cytokine that affects not only the survival and growth of cancer cells but also the activity of immune cells. Although it has been generally accepted that cancer cell-derived TGF-β could promote the survival and growth of early cancer cells and have immunosuppressive roles, it has been known that TGF-β has differential effects according to the type or stage of cancer cells. Therefore, it is hard to clearly define its role in cancer progression and immune responses. This study investigated the effects of TGF-β signaling on the expression of five NKG2D ligands and the NK cell-mediated anticancer immune response in the primary colon cancer cell line KM12C and its two metastatic cell lines, KM12SM and KM12L4A. At the surface protein level, exogenous TGF-β decreased the expression of MICA, MICB, ULBP1, and ULBP2, and galunisertib increased the expression of MICA, MIAB, ULBP1, ULBP2, and ULBP3 in KM12C. However, KM12SM and KM12L4A showed no significant changes in the expression of NKG2DLs after treatment with TGF-β or galunisertib. TGF-β signaling inhibition via galunisertib improved the NK cell-mediated anticancer immune response against KM12C but did not show a significant response to KM12SM and KM12L4A. Therefore, the suppression of TGF-β signaling could improve the NK cell-mediated anticancer immune response against KM12C. However, an increase in NKG2DLs expression and an enhanced NK cell-mediated cancer immune response is hard to expect due to the alteration of TGF-β signaling in KM12SM and KM12L4A.

Reconsideration of the Formation Process of Current Nagyangchun (현행 낙양춘의 형성과정 재고)

  • Yim, Hyun-taek
    • (The) Research of the performance art and culture
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    • no.43
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    • pp.79-120
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    • 2021
  • Nagyangchun is a Dangak that has been handed down to the present time with Boheoja as a Saak of the Song Dynasty which was introduced in the Goryeo Dynasty. The title and lyrics of Nagyangchun are conveyed in the Dangakjo of Goryeosa-akji and the Jeungbomunheonbigo. The remaining scores containing Nagyangchun include Akjangyoram, Sogagwonbo Vol.4 and Vol.6 of the Joseon Dynasty and Aakbu-akbo, the 6th Aaksaeng-gyogwacheol, Leewangjikaakbu-oseonakbo during the Japanese colonial period. Besides, the current melody of Nagyangchun is based on Hangugeumak and Gugakjeonjib published by the National Gugak Center. This paper aims to examine how Nagyangchun, which is currently being performed at the National Gugak Center, went through the process of change to have the same structure and form as it is now using these scores as a research subject. The study results are summarized as follows. First, the song of Nagyangchun, which was originally Saak but transmitted as an instrumental piece without lyrics, first appeared in the Hangugeumak Vol.16 and Gugakjeonjib Vol.7 published by the National Gugak Center in 1978 and 1979. In this process, the Janggu added by Kim Ki-soo is now disappearing and is replaced by Jwago. Second, though the five notes of 黃, 太, 仲, 林, and 南 have been maintained unchanged since the Akjangyoram, the pitch of 無/應 and 夾/姑, which appear once each, gradually rises and is unified into 應 and 姑 during the period of Aaksaeng-gyogwacheol or at the latest Leewangjikaakbu-oseonakbo, and reached the present. Third, the current melody of Nagyangchun consists of a structure in which the tones and range of each phrase rises within the form of Mijeonsa (a·b·c·d) and Mihusa (e·b'·c'·d'). Particularly, except for the a-type and e-type melodies, which are the introduction for the Mijeonsa and Mihusa, the remaining melodic types show a gradually descending structure within the corresponding phrase, so the structure of ascending and descending is generally in harmony. Forth, the Ganeum that appeared from Aakbu-akbo are currently classified into seven types, and they appear in ascending pitches of 2nd, 3rd, 4th, and 5th and play a role in smoothly or fluently connecting melodic progression. Fifth, after Akjangyoram, Nagyangchun, which had been handed down as an instrumental piece without lyrics, was restored in 1960 by Lee Hye-gu, and is being passed down as the form of male and female vocals added to the instrumental accompaniment. As a result of examining the current Nagyangchun, which was formed through the process of change after Akjangyoram, it was found that there were tasks that required reconsideration of the current Nagyangchun, which is being played at the National Gugak Center, such as the arrangement of Janggu, the identification of the key, and the investigation of the lyrics. When follow-up studies are continued in the future, it will be able to contribute to the cultural transmission of Nagyangchun.

Inhibitory Effect of Potato Sprouting Inhibitor Chlorpropham on Dry Rot (감자 맹아억제제 Chlorpropham의 마른썩음병 억제 효과)

  • Kyusuk Han;Byung Sup Kim;Sae Jin Hong;Nam Sook Kim
    • Journal of Bio-Environment Control
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    • v.32 no.2
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    • pp.165-171
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    • 2023
  • Potato dry rot is one of the potato storage diseases caused by Fusarium species and is a representative pathological disorder that induced post-harvest loss during storage. Chlorpropham treatment for sprouting inhibition is mainly used for room temperature storage of potatoes for processing. In this study, the inhibitory effect of chlorpropham on Fusarium-induced dry rot of potato 'Dano'. To investigate the mycelial growth rate of the dry rot fungus (Fusarium solani Appel & Wollenw), mycelial growth was investigated in a chlorpropham (5.0, 50.4, 503.8, and 5,038 ppm) and prochloraz (0.1, 1.0, 10.0, and 100.0 ppm) medium containing F. oxysporum mycelia. Mycelia were more inhibited as the concentration of chlorpropham and prochloraz increased during incubation at 20℃, and the inhibition rate was 98.2% and 100% when treated with 503.8 ppm of chlorpropham and 10ppm of prochloraz in 14 days, respectively. Potato Dano tubers inoculated with F. oxysporum were dipped in chlorpropham (5.0, 50.4, and 503.8 ppm) and prochloraz (100 ppm) to investigate the effect of preventing dry rot during cold storage at 20℃ and 4℃ in vivo. The disease diameter of potatoes stored at room temperature (about 20℃) was reduced to 13.0 mm in the prochloraz 100 ppm teatment, and 10.7 mm in the chlorpropham 50.4 ppm treatment compared to 13.7 mm in the control tuber at 70 days of storage. The disease progression in all treatments including control was similar with no statistically significant difference at 4℃ air temperature. From the results of this study, it is considered that treatment with 50.4 ppm of chlorpropham after harvest will be useful for suppressing dry rot of stored potatoes.

The Clinical Outcome of Dedifferentiated Chondrosarcoma (역분화 연골육종의 임상 결과)

  • Kong, Chang-Bae;Lee, Seung Yong;Song, Won-Seok;Cho, Wan-Hyeong;Koh, Jae-Soo;Jeon, Dae-Geun
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.2
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    • pp.164-171
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    • 2019
  • Purpose: A dedifferentiated chondrosarcoma is a rare lethal tumor characterized by a low grade chondrosarcoma juxtaposed with a high grade dedifferentiated sarcoma, such as osteosarcoma, fibrosarcoma. The aim of our study was to document the clinical manifestation and oncologic outcomes of a dedifferentiated chondrosarcoma. Materials and Methods: This study identified 11 patients who were diagnosed and treated for dedifferentiated chondrosarcoma between January 2007 and December 2016. The identified cohort was then reviewed regarding age, sex, symptom onset, tumor location, magnetic resonance imagings (MRIs), surgical margin, and pathologic diagnosis. The time to local recurrence and/or metastasis, follow-up duration, and the patients' final status were analyzed. Results: The patients were comprised of 7 males and 4 females with a mean age of 54 years (range, 33-80 years). The location of the tumor was in the femur in 6 cases, pelvis in 4 cases, and metatarsal in 1 case. The average tumor diameter was 12.7 cm (range, 6.0-26.1 cm). At the time of diagnosis, 2 patients showed pathologic fracture; 1 patient was Enecking stage IIA, 9 patients were stage IIB, and 1 patient was stage III. Eight patients were classified as a primary dedifferentiated chondrosarcoma and 3 patients were secondary. One of the primary lesions was misinterpreted initially as a low grade chondroid lesion by MRI and underwent curettage. Local recurrence occurred in 8 cases and distant metastasis occurred in 10 cases with a mean duration of 8 months (range, 2-23 months) and 7 months (range, 1-32 months), respectively. The three-year overall survival of patients with dedifferentiated chondrosarcoma was 18%, and 10 patients died due to disease progression. Conclusion: Dedifferentiated chondrosarcoma developed lung metastases in the early period of the clinical courses and the prognosis was dismal.

The Effect of Distal Hooks in Thoracolumbar Fusion Using a Pedicle Screw in Elderly Patients (척추경 나사못을 이용한 고령 환자의 흉요추부 유합에서 원위부 갈고리의 효과)

  • Lee, Dong-Hyun;Kim, Sung-Soo;Kim, Jung-Hoon;Lim, Dong-Ju;Choi, Byung-Wan;Kim, Jin-Hwan;Kim, Jin-Hyok;Park, Byung-Ook
    • Journal of the Korean Orthopaedic Association
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    • v.52 no.1
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    • pp.83-91
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    • 2017
  • Purpose: To investigate the clinical outcomes of distal hook augmentation using a pedicle screw in thoracolumbar fusion in elderly patients. Materials and Methods: This retrospective multicenter study recruited 20 patients aged 65 years or older, who underwent anterior support and long level posterior fusion in the thoracolumbar junction with a follow-up of one year. To assess the effect of distal hook augmentation, the patients were divided into two groups; the pedicle screw with hook group (PH group, n=10) and the pedicle screw alone group (PA group, n=10). Results: The average age was 72.4 years (65-83 years). The average fusion segment was 4.6 segments (3-6 segments). There were no significant differences in age, sex, causative diseases, bone mineral density of lumbar and proximal femur, number of patients with osteoporosis, and number of fused segments between the two groups (p≥0.05). At 1 year follow-up after surgery, parameters related with distal screw pullout were significantly worse in the PA group. No patients in the PH group had distal screw pullout. However, six patients (60%, 6/10) in the PA group had distal screw pullout. There were no significant differences in the progression of distal junctional kyphosis between the two groups. Conclusion: Distal hook augmentation is an effective procedure in protecting distal pedicle screws against the pullout when long level thoracolumbar fusion was performed in elderly patients aged 65 years or older.

A Study on the Interactive Narrative - Focusing on the analysis of VR animation <Wolves in the Walls> (인터랙티브 내러티브에 관한 연구 - VR 애니메이션 <Wolves in the Walls>의 분석을 중심으로)

  • Zhuang Sheng
    • Trans-
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    • v.15
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    • pp.25-56
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    • 2023
  • VR is a dynamic image simulation technology with very high information density. Among them, spatial depth, temporality, and realism bring an unprecedented sense of immersion to the experience. However, due to its high information density, the information contained in it is very easy to be manipulated, creating an illusion of objectivity. Users need guidance to help them interpret the high density of dynamic image information. Just like setting up navigation interfaces and interactivity in games, interactivity in virtual reality is a way to interpret virtual content. At present, domestic research on VR content is mainly focused on technology exploration and visual aesthetic experience. However, there is still a lack of research on interactive storytelling design, which is an important part of VR content creation. In order to explore a better interactive storytelling model in virtual reality content, this paper analyzes the interactive storytelling features of the VR animated version of <Wolves in the walls> through the methods of literature review and case study. We find that the following rules can be followed when creating VR content: 1. the VR environment should fully utilize the advantages of free movement for users, and users should not be viewed as mere observers. The user's sense of presence should be fully considered when designing interaction modules. Break down the "fourth wall" to encourage audience interaction in the virtual reality environment, and make the hot media of VR "cool". 2.Provide developer-driven narrative in the early stages of the work so that users are not confused about the ambiguous world situation when they first enter a virtual environment with a high degree of freedom. 1.Unlike some games that guide users through text, you can guide them through a more natural interactive approach that adds natural dialog between the user and story characters (NPC). Also, since gaze guidance is an important part of story progression, you should set up spatial scene user gaze guidance elements within it. For example, you can provide eye-following cues, motion cues, language cues, and more. By analyzing the interactive storytelling features and innovations of the VR animation <Wolves in the walls>, I hope to summarize the main elements of interactive storytelling from its content. Based on this, I hope to explore how to better showcase interactive storytelling in virtual reality content and provide thoughts on future VR content creation.

Safety and Efficacy of Gemcitabine Based Chemotherapy in Elderly Patients with Advanced Pancreatic Cancer - Safety of Gemcitabine in Elderly (진행성 췌장암을 가진 노인환자에서 Gemcitabine 항암화학요법의 안정성과 효과 - 노인에서 Gemcitabine의 안정성 -)

  • You Ie Choi;Dong Uk Kim;Jae Hoon Cheong;Bong Eun Lee;Gwang Ha Kim;Geun Am Song
    • Journal of Digestive Cancer Research
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    • v.1 no.1
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    • pp.36-42
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    • 2013
  • Background/Aims: Gemcitabine is regarded as a reference regimen for advanced pancreatic cancer and shows relatively safe toxicity profiles compared with other cytotoxic agents. However, many oncologists are appeared to be still reluctant to treat elderly pancreatic cancer patients with cytotoxic chemotherapy because of predicted low response rate and potential adverse events. Methods: All patients who were received gemcitabine based chemotherapy between 2007 and 2010 were identified and clinical, laboratory, radiographic data were retrospectively reviewed. Patients were divided into two groups based on their ages: less than 65, and equal or more than 65 years old. Gemcitabine, at a dose of 1,000 mg per square meter of body surface area, was administered by intravenously over 30 minutes weekly for 3 weeks followed by 1 week rest, alone or along with other chemotherapeutic agents including cisplatin, capecitabine and erlotinib. Results: A total of 61 patients were identified and all patients were not eligible to receive operation because of advanced stage at diagnosis. Twenty three patients (37.7%) were equal or more than 65 year of age. Mean age was 56 years old and 71 years old in each group. Laboratory data including CA 19-9 were not significantly different. More gemcitabine monotherapy was delivered (56.5% vs. 26.3%, p=0.029) and less second or third line therapy was adminis- tered (17.4% vs. 50.0%, p=0.014) in elderly group. Cholangitis occurred and stent placement were performed similarly in both groups. Conclusion: Gemcitabine based chemotherapy can be administered safely to elderly pancreatic cancer patients and comparable response rate and progression free survival can be expected as young patients.

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