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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.

The Evaluation of Radiation Therapy and Combined-modality Therapy for Non-small-cell Lung Cancer in Elderly (고령의 비소세포성폐암 환자의 방사선 및 병용치료에 대한 효과 평가)

  • Yoon, Won-Sup;Yang, Dae-Sik;Kim, Chul-Yong
    • Radiation Oncology Journal
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    • v.25 no.2
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    • pp.101-108
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    • 2007
  • [ $\underline{Purpose}$ ]: To compare radiation therapy alone to combined modality therapy about survival rate and tolerance of elderly patients ($70=or{\geq}$) with non-small-cell lung cancer (NSCLC). $\underline{Materials\;and\;Methods}$: Between 1998 and 2002, 57 patients given radiation therapy due to NSCLC (Stage III) were analysed retrospectively. Radiation therapy alone (RT), concurrent chemoradiation (CRT), and sequential chemoradiation (SCRT) was done to 33, 16 and 8 patients, respectively. Patients' median age was 74 (range $70{\sim}85$). Male and female are 51 patients and 6 patients, respectively. 23 patients were stage IIIa and 34 were stage IIIb. Patients' characteristic distribution of RT and CRT was not significantly different except mass size that RT has a bigger than CRT. The fraction size of radiation therapy was 1.8 Gy in CRT and $1.8{\sim}3\;Gy$ in other groups. Total radiation dose was $51{\sim}63\;Gy$ according to the fraction size. If the prescribed total radiation dose was successfully irradiated, we stated that it was completion of radiation therapy. $\underline{Results}$: 52 patients were dead. Median period of radiation therapy was as follow: RT, 35 days, CRT, 60.5 days and SCRT, 35 days. Overall median survival time (MST) was 10.1 months. The 1 yr- and 2 yr-overall survival rate was 39.8% and 17.6%, respectively. MST of RT, CRT and SCRT was 8.9, 8.2 and 11.7 months, respectively. The 1 yr survival rate of RT, CRT and SCRT was 38.4%, 37.5% and 50% (not significant). Patients given incomplete radiation therapy were 12 (RT, 5 CRT, 6 SCRT, 1). N stage (p=0.081) and the difference of treatment methods (p=0.079) were the factors affecting incompletion of radiation therapy, but it was not significant. In case of combined-agents chemotherapy, 4 of 8 ceased radiation therapy. T stage ($T{\geq}3$), mass size (${\geq}5\;cm$), Karnofsky performance scale (${\leq}70$) and completion of radiation therapy were the prognostic factors in uni- and multi-variate analysis. $\underline{Conclusion}$: In elderly patients with NSCLC, radiation therapy alone was a treatment method with similar survival period compared with other methods. Generally, patients given radiation therapy alone was tolerable to a treatment. Before planning concurrent chemoirradiation in elderly patients with NSCLC, physicians pay attention to a selection of patients and chemotherapy agents considering general condition and toxicity.

Comparing Farming Methods in Pollutant runoff loads from Paddy Fields using the CREAMS-PADDY Model (영농방법에 따른 논에서의 배출부하량 모의)

  • Song, Jung-Hun;Kang, Moon-Seong;Song, In-Hong;Jang, Jeong-Ryeol
    • Korean Journal of Environmental Agriculture
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    • v.31 no.4
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    • pp.318-327
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    • 2012
  • BACKGROUND: For Non-Point Source(NPS) loads reduction, pollutant loads need to be quantified for major farming methods. The objective of this study was to evaluate impacts of farming methods on NPS pollutant loads from a paddy rice field during the growing season. METHODS AND RESULTS: The height of drainage outlet, amount of fertilizer, irrigation water quality were considered as farming factors for scenarios development. The control was derived from conventional farming methods and four different scenarios were developed based combination of farming factors. A field scale model, CREAMS-PADDY(Chemicals, Runoff, and Erosion from Agricultural Management Systems for PADDY), was used to calculate pollutant nutrient loads. The data collected from an experimental plot located downstream of the Idong reservoir were used for model calibration and validation. The simulation results agreed well with observed values during the calibration and validation periods. The calibrated model was used to evaluate farming scenarios in terms of NPS loads. Pollutant loads for T-N, T-P were reduced by 5~62%, 8~37% with increasing the height of drainage outlet from 100 mm of 100 mm, respectively. When amount of fertilizer was changed from standard to conventional, T-N, T-P pollutant loads were reduced by 0~22%, 0~24%. Irrigation water quality below water criteria IV of reservoir increased T-N of 9~65%, T-P of 9~47% in comparison with conventional. CONCLUSION(S): The results indicated that applying increased the height of drainage after midsummer drainage, standard fertilization level during non-rainy seasons, irrigation water quality below water criteria IV of reservoir were effective farming methods to reduce NPS pollutant loads from paddy in Korea.

Management and Supporting System on the Occupational Health Nursing Services Provided in Group Occupational Health Agencies of Korea (소규모 사업장 보건관리대행기관의 간호업무 운영관리 지원체계)

  • Yoo, Kyung-Hae
    • Korean Journal of Occupational Health Nursing
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    • v.8 no.2
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    • pp.193-211
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    • 1999
  • This study was carried out to investigate the management and support system affecting to the occupational health nursing services(OHNS) provided in group occupational health agencies(GOHA). Questionnaire was developed and distributed to 82 nurses who were working in GOHA and who agreed to participate in the survey. The results were as follow: 1. OH nurses responded were mostly in the age of twenty to thirties(89%), married(73.7%), technical college graduates(88.9%), worked in hospital(85.4%) and participated more than 1 year in group occupational health services (96.3%). 2. Fifty eight point four percent of the OH nurses worked in number of workplace more than 30 to less than 60 in the OHNS form. The figure of workplaces undertaken by nurses was ranged greatly from 9 to more than 100. Number of employees who cared by nurses were mostly under 5,000 peoples in 93.3%. The types of industry was mostly manufacturing and located in the order of factory complex area, suburban, urban and others. 3. Most OH nurses(87.8%) were fully involved in the OHNS for the SSE. Their working days to visit SSE was 5 days per week(77.8%) and one day in the GOHA at 41.3%. 4. The OH documents using by nurses were found in more than 23 different types. However, they were largely summarized in the types of 'Workplace Health Management Card', 'Personal Health Counselling Card', 'Daily Health Management Report', 'Visiting List of Workplace' and 'Sick Employee List'. 5. The items of laboratory test provided by GOHA were mostly achieved in the purpose of basic health examination. They were used to be the blood pressure check(98.8%), blood sugar test (98.8%), urine sugar and protein(91.4%), SGOT and SGPT(85.3% each), cholesterol (82.9%), hepa vaccine immunization(82.9%), r-GPT(81.7%), hemoglobin(79.3%) and triglyceride(75.5%). 6. The OH nurses(92.7%) followed the work pattern to visit the GOHA before and after small-scale enterprises(SSE) visit by car driven by nurses in 74.3%. They were payed by GOHA for transportation fees in certain amounts. However, nurse is the main person(75.0%) who covers up in case of traffic accident. If the GOHA has no transportation regulation for the formal workplace visit, data showed that nurses had been responsible to take charge(31.7%). 7. The personnel manager who takes in charge for nursing services was 'nurse' in 61.7% and 41.2% worked as the final decision maker related to nursing work. The OH nurses' opinions about factors affecting to the management were classified in the four areas such as 'Nature(Quality) of health professional'. 'Content of OHNS', 'Delivery system of the GOHS', and 'Others'. The factors were indicated highly in 'Authority as health professional', 'Level of perception of director on the OH' and 'Physical work condition for OHNS'. The things that this study suggests in the recommendation would be summarized in such as the management and supporting system working for SSE in the OHNS is necessary to reform thoroughly. The reconsidered aspects might be in the matters of number of workplaces undertaken by nurses, development of effectively practical health documents, preparation for guideline of the laboratory test in the workpleces, establishment of convenient and encouraging support system and cooperation between other health professionals with respect and skill.

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The Effects of Emotional Perception on Major Satisfaction among Students at the Department of Dental Hygiene (치위생과 학생의 정서적 인식이 전공만족도에 미치는 영향)

  • Yu, Ji-Su;Choi, Su-Young
    • Journal of dental hygiene science
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    • v.10 no.5
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    • pp.307-314
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    • 2010
  • This study aimed to measure such features of emotional responses perceived by students as learning climate, department living stress, and perceived helplessness to analyze their effects on major satisfaction among students at the department of dental hygiene; to do this, a survey was conducted with 431 students, regardless of college year, who were at the department of dental hygiene in four colleges in Gyeonggi Province, Daejeon, and Chungcheong Province. An existing emotion scale which went through the generalization process was used to draw a multiple model in the combination form in order to collect emotional factors affecting college students' satisfaction with their major, which had existed as a hypothetical proposition, and make overall interpretation of relevance through the explainable, predictable modeling process by measuring emotional factors and phenomenal description of the level of general perception. The results showed that major satisfaction was very significantly affected by emotional features among students at the department of dental hygiene, which needs to be treated as an important factor to enhance expertise related to major learning and improve students' living.

CHARACTERISTICS OF DETAINED DELINQUENT ADOLESCENTS AND VARIABLES RELATED TO THE REPEATED CRIME DURING 6 MONTHS AFTER RELEASE (구속된 비행 청소년들의 특성 및 석방 후 6개월간 재범여부와 관련된 변인)

  • Kim, Won-Sik;Koh, Seung-Hee;Koo, Yong-Jin;Kim, Hong-Chang;Suh, Dong-Hyuck;Chung, Sun-Ju
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.10 no.2
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    • pp.201-211
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    • 1999
  • Objectives:This study investigated the characteristics of detained delinquent adolescents and variables related to the repeated crime during 6 months after release. Methods:The socio-demographic and crime-related characteristics of 73 detained adolescents were evaluated by semi-structured interviews and police records, and the psychological characteristics of them measured by the MMPI. We also compared the characteristics between subjects with and without repeated crime during 6 months after release. Results:1) Most of detained adolescents had families with low socioeconomic status(77%) and broken families(48%). Sixty-six percent of them were dropped out of school. The most frequent crime pattern was theft(49%), and with accomplice(77%). Seventy-five percent of total subjects had the records of previous conviction. Of the previous convictions, seventy-eight percent was same with the present crimes. 2) Subjects with repeated crime during 6 months after release were younger and had higher T-score on Pa scale of MMPI than the subjects without repeated crime. More adolescents with repeated crime had broken families than those without repeated crime. They also showed the crime-related characteristics of higher percent of theft among crime patterns, higher incidence of previous conviction, younger age of the first crime, and shorter crime-free duration from the last to present crime. Conclusion:These results of present study suggest that the development and the persistence of adolescent delinquency would be resulted from interaction of factors of individual, family, school, and community. By the comparison between subjects with and without repeated crime, it was found that familial dysfunction, younger age at first crime, presence of previous conviction might be the risk factors for repeated delinquency. To prevent repeated crime of delinquent adolescents more effectively, early therapeutic intervention and the development of programs to help adaptation in school and community would be essential.

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Regional Variations in the Cesarean Section Rate and It's Determinants in Korea (제왕절개 분만율의 지역간 변이와 관련요인에 대한 연구)

  • Kim, Hye-Kyung;Lee, Jeon-Un;Park, Kang-Won;Moon, Ok-Ryun
    • Journal of Preventive Medicine and Public Health
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    • v.25 no.3 s.39
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    • pp.312-329
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    • 1992
  • The purpose of this study is to estimate cesarean section rate in Korea and analyze the socioeconomic variables and health resources which affect regional variation in the rate. Samples were drawn from the record of vaginal and cesarean section deliveries based upon insurance claim bills which have been submitted to the National Federation of Medical Insurance for the first three months, January through March, 1991. The results are obtained as follows : It was found that. cesarean section rate was increasing rapidly up to 23.1% in 1991. Cesarean section per 10 thousand insured people was 4.8 and the number of cesarean section per 10 thousand insured eligible($15{\sim}49$ years old) female was 7.6. The fee for normal delivery was 109,489 won and that for cesarean section was 390,024 won. The average days of hospitalization in normal delivery was 2.3 days, and those in cesarean section was 7.6 days. On the average cesarean section has a longer of stay as much as by 4.3 days and cost 3.6 times more than normal deliveries. Cesarean section rates vary among medical facilities 19.8% at clinics 37.6% in small-scale hospitals, and 29.1% in general hospitals. The regional variation of cesarean section rates was also fairly prominent. The South Cheju Gun has the highest rate of cesarean section, 56.2%. Meanwhile no cesarean section cases has been reported in Sunchang Gun during the period of this study. The variation is noted among provinces. The rate for Cheju province has been 3.4 times higher than that for Chunnam. The number of cesarean section per 10 thousand insured people vary greatly among regions, too. This study has found that there exists significant regional variations among various geographic units in terms of average length of stay, average cost, number of obsretricians and number of beds. Multiple regression analysis was done to identify factors explaining the regional variance of various cesarean section rates : In the urban areas, no significant explaining variables were noted except the number of beds for the dependent variable of cesarean section cases per 10 thousand insured eligible females. The smaller the number of bed, the more cases of cesarean section was noted for an urban area. The is mostly because the rate of cesarean section is higher in medium-size hospitals than in large general hospitals. In the rural areas, the factor of education has been found significant for all three deplendent variables. The higher the educational level, the rate of cesarean section is most likely to rise. An income variable measured by the amount of monthly insurance contribution has been identified a powerful predictor in explaining the valiance of cesarean section rates. The same has been noted for the number of obstetricians. Similar findings are observed for the country as a whole. The income level has veen found as the most powerful explaining factor in the regional variance of cesarean section rates. In general the rate is higher in the urban areas, and lower in the area with more small hospitals. As this is the initial attempt to identify the factors relevant to the regional difference in the rates of cesarean section, more elaborated study is urgently required.

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Production Medium Optimization for Monascus Biomass Containing High Content of Monacolin-K by Using Soybean Flour Substrates (기능성 원료를 기질로 이용하는 Monacolin-K 고함유 모나스커스 균주의 생산배지 최적화)

  • Lee, Sun-Kyu;Chun, Gie-Taek;Jeong, Yong-Seob
    • KSBB Journal
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    • v.23 no.6
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    • pp.463-469
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    • 2008
  • During the last decade, monacolin-K biosynthesized by fermentation of red yeast rice (Monascus strains) was proved to have an efficient cholesterol lowering capability, leading to rapid increase in the market demand for the functional red yeast rice. In this study, the production medium composition and components were optimized on a shake flask scale for monacolin-K production by Monascus pilosus (KCCM 60160). The effect of three different soybean flours on the monacolin-K production were studied in order to replace the nitrogen sources of basic production medium (yeast extract, malt extract and beef extract). Among the several experiments, the production medium with dietary soybean flour to replace a half of yeast extract was very good for monacolin-K production. Plackett-Burman experimental design was used to determine the key factors which are critical to produce the biological products in the fermentation. According to the result of Plackett-Burman experimental design, a second order response surface design was applied using yeast extract, beef extract and $(NH_4)_2SO_4$ as factors. Applying this model, the optimum concentration of the three variables was obtained. The maximum monacolin-K production (369.6 mg/L) predicted by model agrees well with the experimental value (418 mg/L) obtained from the experimental verification at the optimal medium. The yield of monacolin-K was increased by 67% as compared to that obtained with basic production medium in shake flasks.

An Experimental Study on Establishing Criteria of Gripping Work in Construction Site (건설 현장 악력 작업안전 기준 설정에 관한 실험적 연구)

  • 손기상;이인홍;최만진;안병준
    • Journal of the Korean Society of Safety
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    • v.10 no.3
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    • pp.81-95
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    • 1995
  • Now, safety assurance in construction sites should be accomplished by its own organization rather than control of the code or government. It is believed that the safety assurance can be considerably improved by a lecture or an education using the existing theories or literatures up to now, but it is thought that fundamental safety assurance we not able to be accomplished without developing safety devices '||'&'||' equipment or taking fundamental measures, based on the result analyzed from workers behaviors. There are various behaviors of the workers showed in construction site, but only tests for hammerusing works such as form, re-bar, stone workers directly related to the grip strength are mainly performed, investigated and measured here for the study. The above works are similar to power grip, 7th picture on seven items which are categorized for hand grip types(Ammermin 1956 ; Jones ; Kobrick 1958). Measurements of grip strength are commonly taken in anthropometric surveys. They are easy to administer but unfortunately it is rather dubious whether they yield any data that are of interest to the engineer. Very fewer controls of tools are grasped and squeesed studies showed very little overall correlation between grip strength and other measures of bodily strength (Laubach, Kromer, and Thordsen 1972), but hammer-using work which is practically progressed in construction site are mainly influenced with grip strength. According to the investigation on work measurement, it is shown that 77% of form worker are using hammer to be related to grip strength. In this study, it is particularly noticed that wearing safety gloves in construction site is required for workers safety but 20% difference between grip strength with safety gloves and without ones are commonly neglected in the site(Fig. 1). Nevertheless, safety operation with consideration of the above 20% difference is not considered in the construction site. Factors of age, kinds of work, working time, with or without safety gloves are in vestigated '||'&'||' collected at the sites for this study. Test, not at each working hour but at 14 : 00 when the almost all of the workers think the most tired, resulting from the questionaires, also when it is shown on the research report has been performed and compared for main kinds of works : form '||'&'||' re-bar work. Tests were performed with both left SE rightand of the workers simultaneously in construction site using Rand Dynamometer(Model 78010, Lafayette Instrument Co., Indiana, U.S.A) by reading grip strength on the gauge while they are pulling, and then by interviewing on their ages, works, experiences and etc., directly. The above tests have been performed for the dates of 15th march-26th May '95 with consideration of site condition. And even if various factors of ambient temperature on the testing date, working condition, individual worker's habit and worker's condition of the previous ate are concerned with the study. Those are considered as constants in this study. Samples are formwork 53, rebar 62, electrician 5, plumber 4, welding 1 from D construction Co., Ltd, ; formwork 12, re-bar 5, electrician 2, from S construction Co., Ltd, , formwork 78, re-bar 18, plumber 31, electrician 13, labor 48, plumber 31, plasterer 15, concrete placer 6, water proof worker 3, maisony 5 from B construction Co., Ltd. As In the previously mentioned, main aspect to be investigated in this study will be from '||'&'||' re-bar work because grip strength will be directly applied to these two kinds of works ; form '||'&'||' re-bar work, eventhough there are total 405 samples taken. It is thought that a frequency of accident occurrence will be mainly two work postures "looking up '||'&'||' looking down" to be mainly sorted, but this factor is not clarified in this study because It will be needed a lot of work more. Tests has been done at possible large scale of horizontally work-extended sites within one hour in order to prevent or decrease errors '||'&'||' discrepancies from time lag of the test. Additionally, the statistical package computer program SPSS PC+has been used for the study.

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The Factors for Food Service Satisfaction of the Elderly Welfare Center Free Lunch Program Participants in Busan (부산 일부지역 복지관 무료급식 이용노인들의 급식만족도에 영향을 미치는 요인)

  • Lee, Jeong-Sook
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.40 no.1
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    • pp.128-136
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    • 2011
  • This study was carried out to investigate the factors of food service satisfaction of the elderly in Busan. The survey was conducted from September 1 to October 15, 2009 by questionnaires and data analyzed by SPSS program. Fifty point nine percent of the subjects lived alone and the source of living expenses of 70.5% of the subjects was subsidy from government. The most important reason for the elderly to participate in meal service was 'economic difficulty' and 'to meet friend'. The subjects had various chronic degenerative diseases, such as arthritis, hypertension, diabetes, osteoporosis and cardiac disease. Sixty-six point eight percent of the subjects needed diet therapy for their diseases, but 87.1% of them don't want to pay the extra fee. Thirty six point five percent of the subjects attained information about lunch program because it was 'close to home' but 20.7% was 'from public officials'. The reasons for the use of the meal service were 'economic difficulty' (40.0%), 'to meet friends' (22.6%), and 'bother to prepare meal' (16.50%). The services provided by welfare center were health care, physical exam and haircut. The score given by the subjects on the satisfaction of meal service was 3.84 on the 5-point maximum scale. Higher satisfaction on kindness of staff, satisfaction of social support and awareness of support resulted in higher satisfaction of food service. It would be effective to provide food service models that meet specific needs of the elderly according to social welfare service and social community activities.