Purpose : The purpose of this study is to find out the changing pattern of drug or foreign body ingestion between 1990s and 2000s in Wonju Christian Hospital, which is located in one of the most rapidly urbanizing cities in Korea. Methods : We retrospectively reviewed the medical records of patients with acute drug intoxication and foreign body ingestion from January 1991 to December 1994 and from January 2001 to December 2004. We performed clinical analysis and compared the results of the 1990s and 2000s. Results : There were 43 cases of acute drug intoxication in the 1990s, and 35 cases in the 2000s. Foreign body ingestion was 47 cases in the 1990s and 22 cases in the 2000s. The ingested foreign bodies were chiefly coins (46.8 percent), Weiqi chips (14.9 percent), plastic toys (6.4 percent) and others (31.9 percent) in the 1990s. In the 2000s, others (58.2 percent) were the most commonly ingested foreign body with mercury batteries (23.8 percent), nails (9 percent), pins (9 percent) following. The most common cause of drug intoxication was medical drugs (37.2 percent) others (23.2 percent), agricultural agents (13.9 percent), carbon monoxide (11.6 percent), rodenticide (9.3 percent), insecticide (9.3 percent) in the 1990s. In the 2000s the most common causes were others (34.3 percent), medical drug (31.4 percent), agriculture agents (20 percent), detergent (11.4 percent), insecticide (2.9 percent) and carbon monoxide (2.9 percent). The highest incidence age group was the 1-3 year old group, both in acute drug intoxication and foreign body ingestion. There were no changes in the incidence age group between the 1990s and the 2000s. Conclusion : There were some significant changes in the cause of acute drug intoxication and foreign body ingestion between the 1990s and 2000s. New education programs for preventing acute drug intoxication and foreign body ingestion are important and necessary.
Objects : This study was carried out to investigate characteristics of patients who need hypnotics on the night before elective surgery as well as contributing variables for the necessity of hypnotics. Methods : After reviewing the clinical charts of patients who were scheduled to receive surgery by general anesthesia the following day, researchers had semi structural interviews with patients. In addition, Spielberger's State-Trait Anxiety Inventory(SSTAI), Beck Depression Inventory(BDI), Zung's Self-Rating Pain and Distress Scale(ZPDS), and Presleep and Postsleep Questionnaires were administered to patients. A total of 167 patients, who gave reliable information, were divided into two groups based on subjective judgement regarding the necessity for hypnotics on the night before surgery; 29 eligibles for hypnotics and 138 non-eligibles for hypnotics. Demographic and clinical characteristics of patients, some possible factors affecting sleep, psychological characteristics of patients and daytime status and nighttime sleep before surgery were compared between the two groups. In addition, discriminant function analysis was done to find the variables which would best discriminate among patients who differ in terms of necessity for hypnotics on the night before surgery. Results : There was no difference in demographic and clinical characteristics between the two groups; however, the satisfaction level with ward environment was significantly lower in the eligible group for hypnotics than the non-eligible group. Psychologically, the eligible group for hypnotics, compared to the non-eligible group, showed significantly more severe depression, pain, and distress; whereas anxiety level was not different between the two groups. For nighttime sleep before surgery, the eligible group for hypnotics, compared to the non-eligible group, expected poorer sleep before retiring and in fact, reported poorer sleep the following morning. In discriminant function analysis, 'expectation for sleep' and 'pain and distress' were the most potent contributors to discriminate the necessity of hypnotics. Conclusion : For the improvement of the patient's sleep on the night before elective surgery, giving hypnotics and/or analgesics should be determined by patient's opinion about the necessity of the drugs rather than by the therapist's own judgement or any other objective indices.
This experiment was performed to evaluate the morphological responses of the gastric epithelial cells of the mouse, inoculated with Ehrlich carcinoma cells in the inguinal area, following administration of BCG. Healthy adult ICR mice weighing 25 gm each were divided into normal and experimental groups (tumor control group and BCG-treated group). In the experimental groups, each mouse was inoculated with $1{\times}10^7$ Ehrlich carcinoma cells subcutaneously in the inguinal area. From next day after inoculations, 0.2 mL of saline or BCG (0.5 mL/25 g B.W.: $0.03{\times}10^8{\sim}0.32{\times}10^8$ CFU) were injected subcutaneously to the animals every other day, respectively. The day following the 7th injection of saline or BCG, each mouse was injected with a single dose of 0.7 ${\mu}Ci/g$ of methyl-$^3H$-thymidine (25 Ci/mmol, Amersham Lab., England) through tail vein. Seventy minutes after the thymidine injection, animals were sacrificed, and gastric tissues were taken and fixed in 10% neutral formalin. Deparaffinized sections were coated with autoradiographic emulsion EM-1 (Amersham Lab., England) in a dark room. The number of labeled epithelial cells in the gastric mucosae (mean number of labeled epithelial cells per 3.5 mm length of mucosa) were observed and calculated. And for electron microscopic observation, gastric tissues were prefixed with 2.5% glutaraldehyde-1.5% paraformaldehyde solution, followed by post-fixation with 1% osmium tetroxide solution. On the light microscopic study, gastric mucosae had no morphological changes following the injection of BCG. On the electron microscopic study, in the BCG-treated mice, myelin figures and multivesicular bodies within the gastric epithelial cells were observed more frequently than in those of the normal control ones. On the autoradiographic study, number of the labeled cells of normal control, tumor control and BCG-treated mice were 380.2 (${\pm}31.35$), 426.1 (${\pm}28.43$) and 301.8 (${\pm}34.63$), respectively. In the BCG-treated mice, poorly-labeled cells containing only a few silver grains of 3H-thymidine were observed more frequently as compared in those of the normal control and tumor control ones. From the above results, BCG may suppress the DNA synthesis of the gastric epithelial cells, but does not results severe fine structural defect on the gastric epithelial cells. These results suggest that BCG is expected as one of the effective supplemental anticancer drugs.
In spite of the establishment of chemotherapy and the gradual decrease in prevalence, pulmonary tuberculosis is still mainly treated with an operation. Through analyzing and examining some cases of surgical treatment, we hope to provide some help in treating of pulmonary tuberculosis in the future. Material and Method: By comparing four journals previously published in our department with 144 cases of lung surgery during ten years from January of 1991 to December of 2000 performed by the department of thoracic and cardiovascular surgery of the National Medical Center, we analyzed and reviewed the most recent trends and the results of the surgical treatment. Annual frequency of the operation, distribution of age, examination of sputum, adaptability and types of techniques, complications, and results of the postoperative follow-up were used as methods. Result: It was found that the annual frequency of operations had decreased. The ratio of men to women, 2:1 indicates that there are more incidences in men. Aging of patients could be speculated by the .results that the decrease in the incidence rate in the 20s age range and increase rate in the 50s age range. The range of preoperative lesions belonged mostly to far advanced and moderately advanced tuberculosis. By monitoring the period of use in preoperative antituberculosis drugs, cases for more than 3 years remarkably increased from 16.0 % to 55.6 %. The positive reactive rate for preoperative sputum examinations were drastically decreased from 91 % to 27 %. Total pulmonary destruction and partial destruction were the most common cases in terms of adaptability to the operations and there were significant increases in forming empyema accompanied by parenchymal lesions from 4.0 % to 20.1 %. Pneumonectomy and pulmonary lobectomy were the major type of operations. Especially, there were increases in the incident rate of empyema and recurrence of tuberculosis resulted. Post operative follow-up indicates that the rate of complete recovery was more than 70 % and the rate of gradual increase in treating with persistent antituberculosis drug was from 5.8 % to 18.0 %. Conclusion: In recent cases, there is an increasing number of patients showing tolerance to chemotherapy. Patients with pleural tuberculosis and severe lesions were typically increased. It is important to accurately analyze those complaints accurately that are mostly difficult to be treated medically. Surgical treatment is strongly recommended Before multiple drug resistance occurs.
Purpose : The purpose of this study was to identify pediatric nurses's knowledge related to children's pain and pediatric nurses' career including educational experience and to examine whether there is a difference of their knowledge according to their career. Method : Subjects of this study was 115 pediatric nurses of one university hospital who understood purpose of this study and accepted to participate in this study. Subjects responded questionnaire by self report. The data were gathered for 7 days during the period from October 20 to October '2:7, 2003. The pediatric nurses' knowledge and attitude survey regarding pain developed by Manworren(2001) was used to identify the knowledge related to children's pain of pediatric nurses. Nurses' career consisted of level of education, presently working ward, duration of experience at clinic, pediatric clinic and presently working ward and educational experience related to children's pain during undergraduate courses, ward orientation and continuing education. Educational experience regarding children's pain was measured by whether they had education related to children's pain during undergraduate courses, ward orientation and continuing education or not and their perception on the contents of education was measured by 5 point Likert type scale. SPSS Windows was used to analyze the data. Scores of the knowledge regarding children's pain and career including educational experience of pediatric nurses were presented as mean and standard deviation. Mean percentage of correct answers responded by the subjects was presented under the category of introduction, assessment, pharmacological and nonpharmacological intervention for children's pain. The difference of scores of the knowledge regarding children's pain according to nurses' career was analyzed using t-test, ANOVA and Tukey as a post hoc. Statistical significance was accepted at the level of p<.05. Result : Pediatric nurses had deficient knowledge related to children's pain on the whole and did not trust pain complaint and underestimated the pain. They were short of concrete practical knowledge about pain assessment and pharmacological and nonpharmacological intervention for children's pain. They were excessively concerned with side effect and addiction of analgesic drugs and had a negative view point on nonpharmacological pain intervention. About 50% of the subjects received education regarding children's pain while their undergraduate courses. The number of nurses who received education regarding children's pain while their undergraduate courses was found to be greater among the recently graduated nurses. In ward orientation and continuing education, only less than 10% of the nurses received education regarding children's pain. Nurses perceived their experienced educational content deficient; experienced educational content consisted of pain introduction, assessment and pharmacological and nonpharmacological intervention for children's pain while their undergraduate course, ward orientation and continuing education. There were no significant differences of the knowledge regarding children's pain of pediatric nurses according to level of education, duration of experience at clinic, pediatric clinic and presently working ward. Scores of the knowledge regarding children's pain of nurses at neonatal ward were significantly greater than those of nurses at pediatric intensive care unit. Scores of the knowledge regarding children's pain of pediatric nurses who received education during their undergraduate course were significantly greater than those who did not receive it during their undergraduate courses. Also scores of the knowledge regarding children's pain of pediatric nurses who received one kind of educational experience were significantly greater than those who had no educational experience. Conclusion : Pediatric nurses had deficient knowledge of children's pain and underestimated the pain of children. Also they were short of concrete practical knowledge on pain assessment and intervention for children's pain.
This paper finds a solution in the social context which cannot be explained thoroughly by well-timed release date, revival of comedy films, and the attraction of Lee Byeong-heon's comedy etc. while it throws question of how the film, Extreme Job captivated 16 million audience. The incredible hits of Extreme Job cannot be explained by analyzing the text alone. After this essay investigates a function and a role of comedy as a public sphere, it examines people's desires and wishes in the comedy and other genres since 2008 when the conservative government has seized power. Since 2008 a series of dark tone's action thriller, social problem film, and disaster film have emerged, these genres showed absence of public security, crisis of democracy and criticism against rulling class. On the other hand, hit comedy films have showed escapism such as weepie, nostalgia, and fantasy at the same time, generally. Although Veteran (2015) is not full-blown comedy, after this film's big success, "comic mode" has gradually revived. A light tone's films which are truer to genre rules has started representing the wishes of people toward social reforms and changes. Meanwhile, "Candlelight Protest" served as a momentum to recover the democracy which has been in crisis, but it could not lead changes in economic and daily lives. Exreme Job can be read as a question how we will survive since "Candlight Protest." The lives of detectives as self-employed workers who has taken over a fried chicken restaurant for going undercover are appearances of ordinary persons who must survive in the edless conpetition. Furthermore, this film shows a dream of a "great success myth" which becomes well-known as a famous restaurant and a self-management such as brand-naming and an exapansion of franchise business. We can read ganster's chicken franchises as a huge distribution industry which disturbs market system by delivering drugs secretly. While applauses that we give to the police having identities of self-employed workers which sweeps the ganster are giving support to oridinary neighborhood like us, they are also wishes of people who long for the restoration of publicness of police in the market which is becoming increasingly privatized today. A significance of this essay is to examine Extreme Job in terms of the geography of film genres and the revival of comic mode sicne 2008 at the macro level, and is to read the film in the perspective of the problems of economic and daily lives which has been still unsolved since "Candlelight Protest" at the micro level.
Pulmonary aspergillosis usually results from the colonization of the existing lung lesions by chronic pulmonary diseases, such as tuberculosis. Most cases of pulmonary aspergilloma have been treated surgically for many years because it is a potentially life-threatening disease causing massive hemoptysis. Here we reviewed our results from the last 10 years. Material and Method: We reviewed 31 cases surgically treated from Aug. 1992 to Jul. 2002. retrospectively. This investigation is designed to illustrate the peak age incidence, sex ratio, chief complaints, preoperative study, anatomic location of operative site, postoperative pathologic finding and postoperative complications. Result: The peak age Incidence laid in the 3rd and 4th decade of 20 cases (64.5%). The most common complaint was hemoptysis in 27 cases (87.1%). The 31 cases had a history of treatment with anti-tuberculous drugs under impression of pulmonary tuberculosis. The 19 cases (61.3%) showed the so-called “Air-meniscus sign” on the preoperative chest X-ray. In the 31 cases (100%) on the chest computed tomography. as a preoperative diagnostic modality, positivity was shown in 37.9%, 83.3% was shown on the fungus culture of sputum for Aspergillus, serum immunodiffusion test for A. fumigatus, respectively. The anatomical location of aspergilloma was mainly in the upper lobe in 19 cases (61.3%) and the majority of cases were managed by lobectomy. The postoperative pathologic findings showed that 31 cases (100%) were combined with tuberculosis. The postoperative complications include empyema, prolonged air leakage, remained dead space, postoperative bleeding and these numbers of cases is 3 cases (9.7%), 2 cases (6.45%), 2 cases (6.45%), 1 case (3.23%), respectively. one case was died postoperatively due to massive beeding, and asphyxia. Conclusion: Compared with the previous study, there is no significant difference in results. Preoperative chest computed tomography and immunodiffusion test were more commonly available and showed high positivity. Operations often became technically difficult because of pleural space obliteration, indurated hilar structures, and poor expansion of the remaining lung, which were more prominent in the patients with complex aspergillosis. In such cases, medical treatments and interventional procedures like bronchial artery embolization are preferred. However, cavernostomy is also recommanded with few additional morbidity because of its relatively less invassiveness. Early surgical intervention is the recommended management for patients with simple aspergilloma considering the Row surgical mortality and morbidity in recent days.
Journal of the korean academy of Pediatric Dentistry
/
v.42
no.4
/
pp.331-339
/
2015
The first priority of sedation for incorporative children in pediatric dentistry is a safety. Therefore, evidence-based practices in health care are needed for preventing medical accidents. In accordance with the rise of the evidence based medicine, the interest in Evidence-Based Dentistry is increasing in the field of dentistry. However, systematic research about Evidence-Based sedation in Korea has rarely been done. As such, the purpose of this systematic review is to critically analyze the available scientific literature regarding dental sedation and to seek the next developmental strategies about evidence based pediatric dental sedation. A broad search of the 5 databases of the systematic reviews manual of the National Evidence-based Healthcare Collaborating Agency in Korea were referenced: 1) Core search database- KMbase, KISS; 2) Academic information and portal; 3) the National Assembly Library; 4) DBpia, and 5) RISS. Of a total 470 themes limited to the search term of "dental sedation", in accordance with the PRISMA statement for reporting systematic reviews of health sciences interventions, a literature selection process, which includes the removal of overlapping down the flow chart, was performed. Of the remaining 31 articles, two authors read through articles independently and added or removed articles using the exclusion criteria. Finally, twenty published papers of acceptable quality were identified and reviewed. This systemic review of Korean pediatric dental sedation practices for the last twenty-five years was based on the objective criteria defined in the GRADE process and identified consistent evidence. The results were evidence of moderate quality. Therefore, more systemically well-designed clinical studies are needed about the safe use of a sedative medicines (drugs).
Background: Ischemic preconditioning(IP) is known to be effective in the protection of myocardial necrosis, arrhythmia, and the restoration of the myocardial function in the ischemia-reperfusion state of the heart. However the exact mechanism is not clearly understood. The purpose of this study was to elucidate the trigger mechanism 7f IP on the restoration of the myocardial function after ischemia-reperfusion. Material and Method: By connecting a Langendorff perfusion apparatus with an isolated heart of a rat, the normal temperature of the heart was maintained. The experiment was conducted in seven groups, which were divided according to the preconditioning stimuli and blockage methods Group I(n=10) was a group without IP, Group II(n=10) a group of three-minute IP, Group III(n=10) a group of PEIP, Group IV(n=10) a group of clonidine IP, Group V(n=10) a group of If after reserpine, Group Vl(n=10) a group of PE & prazosin IP, and Group Vll(n=10) a group of clonidine & yohimbine IP. Hemodynamic parameters of DP, LVEDP, $\pm$dP/dT and the changes of perfusion in the coronary artery were evaluated. Result: Developed pressure and +dP/dT changed per unit time. After 20 minutes of reperfusion, those of Group II and III were 63.1$\pm$3.7%, 64.8$\pm$4.6% and 64.5$\pm$4.6%, 63.8$\pm$4.4%, which improved more significantly than those of Group I(P<0.05), However, there were no significant differences between the Groups V and Vl, and Group I. Conclusion: The Brief ischemic preconditioning and pharmacological preconditioning using $\alpha$-receptor sympatho-mimetics have protecting effects on the restoration of myocardial function after reperfusion. And the protecting effect of preconditioning seems to be related to sympathetic neurotransmitters and to the selective action of the $\alpha$$_1$-adrenergic receptor.
Influence of the blockade of the three major pressor systems-sympathetic nervous system (SNS), renin-angiotensin system (RAS) and vasopressin system-on the pressor responsiveness to norepinephrine (NE), angiotensin II (AII), and vasopressin (VP) as well as on basal blood pressure (BP) levels was investigated in urethane-anesthetized rabbits. To block the SNS and RAS, chlorisondamine (CS) and pirenzepine (PZ), sympathetic ganglionic blockers, and enalapril (ENAL), an inhibitor of angiotensin converting enzyme, respectively were used. And for suppressing the VP system bremazocine (BREM), a kappa opiate receptor agonist shown to suppress plasma levels of VP, was employed. Each of CS (0.4 mg/kg), ENAL (2 mg/kg), and BREM (0.25 mg/kg) produced almost same levels of steady hypotensive state. The hypotensive effect of BREM was significantly attenuated by desmopressin, a synthetic VP-like analogue, suggesting the hypotension being at least in part due to suppression of plasma levels of VP. CS, ENAL and BREM elicited further fall of the BP which had been lowered by ENAL or BREM, CS or BREM, and CS or ENAL, respectively. The hypotension produced by both CS and PZ together with either of ENAL or BREM was more marked than that produced by the three drugs other than CS. CS potentiated the pressor response not only to NE but to AII and VP. The pressor effect of AII was increased by ENAL and BREM, too. The pressor response to VP was also enhanced by BREM. Blockade of ${\alpha}-adrenergic$ receptors with phentolamine or phenoxybenzamine potentiated the pressor response to AII and that to VP. The results on basal BP levels indicate that the three major pressor systems are all participating in control of BP, but SNS has the greatest potential for supporting BP. The finding that blockade of one of the pressor systems induced enhanced pressor responsiveness to the pressor hormone of that particular system as well as to the pressor hormone(s) of the other systems(s) provides evidence for important interactions among the three major pressor systems.
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