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Clinical Analysis of Patients with Abdomen or Neck-penetrating Trauma (복부와 경부 관통상 환자에 대한 임상적 고찰)

  • Noh, Ha-Ny;Kim, Kwang-Min;Park, Joon-Beom;Ryu, Hoon;Bae, Keum-Seok;Kang, Seong-Joon
    • Journal of Trauma and Injury
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    • v.23 no.2
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    • pp.107-112
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    • 2010
  • Purpose: Recently, the change to a more complex social structure has led to an increased frequency of traumas due to violence, accident and so on. In addition, the severity of the traumas and the frequency of penetrating injuries have also increased. Traumas to cervical and abdominal areas, what are commonly seen by general surgeons, can have mild to fatal consequences because in these areas, various organs that are vital to sustaining life are located. The exact location and characteristics of the injury are vital to treating patients with the trauma to these areas. Thus, with this background in mind, we studied, compared, and analyzed clinical manifestations of patients who were admitted to Wonju Christian hospital for penetrating injuries inflicted by themselves or others. Methods: We selected and performed a retrospective study of 64 patients who had been admitted to Wonju Christian Hospital from January 2005 to December 2009 and who had cervical or abdominal penetrating injuries clearly inflicted by themselves or others. Results: There were 51 male (79.7%) and 13 female (20.3%) patients, and the number of male patients was more dominant in this study, having a sex ratio of 3.9 to 1. The range of ages was between 20 and 86 years, and mean age was 43.2 years. There were 5 self-inflicted cervical injuries, and 19 self-inflicted abdominal injuries, making the total number of self-inflicted injury 24. Cervical and abdominal injuries caused by others were found in 11 and 29 patients, respectively. The most common area involved in self-inflicted injuries to the abdomen was the epigastric area, nine cases, and the right-side zone II was the most commonly involved area. On the other hand, in injuries inflicted by others, the left upper quadrant of the abdomen was the most common site of the injury, 14 cases. In the neck, the left-side zone II was the most injured site. In cases of self-inflicted neck injury, jugular vein damage and cervical muscle damage without deep organ injury were observed in two cases each, making them the most common. In cases with abdominal injuries, seven cases had limited abdominal wall injury, making it the most common injury. The most common deep organ injury was small bowel wounds, five cases. In patients with injuries caused by others, six had cervical muscle damage, making it the most common injury found in that area. In the abdomen, small bowel injury was found to be the most common injury, being evidenced in 13 cases. In self-inflicted injuries, a statistical analysis discovered that the total duration of admission and the number of patients admitted to the intensive care unit were significantly shorter and smaller, retrospectively, than in the patient group that had injuries caused by others. No statistically significant difference was found when the injury sequels were compared between the self-inflicted-injury and the injury-inflicted-by-others groups. Conclusion: This study revealed that, in self-inflicted abdominal injuries, injuries limited to the abdominal wall were found to be the most common, and in injuries to the cervical area inflicted by others, injuries restricted to the cervical muscle were found to be the most common. As a whole, the total duration of admission and the ICU admission time were significantly shorter in cases of self-inflicted injury. Especially, in cases of self inflicted injuries, abdominal injuries generally had a limited degree of injury. Thus, in our consideration, accurate injury assessment and an ideal treatment plan are necessary to treat these patients, and minimally invasive equipment, such as laparoscope, should be used. Also, further studies that persistently utilize aggressive surgical observations, such as abdominal ultrasound and computed tomography, for patients with penetrating injuries are needed.

Evaluation of Pollutant Removal Efficiency in Environmentally Friendly Full-scale Constructed Wetlands for Treating Domestic Sewage during Long-term Monitoring (장기 모니터링을 통한 환경친화형 인공습지 하수처리장의 수질정화효율 평가)

  • Seo, Dong-Cheol;Jo, In-Seong;Lim, Seok-Cheon;Lee, Byeong-Ju;Park, Seong-Kyu;Cheon, Yeong-Seok;Park, Jong-Hwan;Lee, Hong-Jae;Cho, Ju-Sik;Heo, Jong-Soo
    • Korean Journal of Environmental Agriculture
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    • v.28 no.2
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    • pp.97-105
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    • 2009
  • A constructed wetland which was composed of aerobic and anaerobic areas was evaluated for 3 years to effectively treat the sewage produced in farming and fishing communities. For 3 years in a constructed wetland, biochemical oxygen demand(BOD), chemical oxygen demand(COD), suspended solids(SS), total nitrogen(T-N), and total phosphorus(T-P) in effluent were 0.2${\sim}$11.8, 1.0${\sim}$41.9, 1.1${\sim}$6.5, 4${\sim}$60 and 0.02${\sim}$3.51 mg/L, respectively. Removal rate of BOD, COD and SS in effluent were 97, 92 and 99%, respectively, in the third year. As time goes by, removal rate of T-N and T-P in treated water in aerobic area and effluent were gradually increased in a constructed wetland. In the third year, removal rate in effluent were 62 and 73%, respectively. By the seasons, removal rate of BOD, COD, SS, T-N and T-P were 97${\sim}$98, 87${\sim}$91, 99, 43${\sim}$61 and 76${\sim}$86%, respectively. Removal rate of BOD, COD, SS and T-P were not affected by the seasons, but that of T-N in winter and spring were decreased than the other seasons.

Gemcitabine-induced Cell Death in Lung Cancer Cells : the Role of p53 (폐암 세포에서 Gemcitabine에 의한 세포 사멸과 p53의 역할)

  • Kim, Doh-Hyung;Bae, Gang-U;Yong, Wha-Shim;Choi, Eun-Kyung;Kim, Youn-Seup;Park, Jae-Seuk;Jee, Young-Koo;Lee, Kye-Young
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.3
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    • pp.275-284
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    • 2002
  • Background : Gemcitabine is a new anti-cancer agent for treating non-small cell lung cancer. Functioning as an antimetabolite, it induces anti-cancer effects by suppressing DNA synthesis after being incorporated into the DNA as a cytosine arabinoside analogue. When Gemcitabine is incorporated into the DNA, the p53 gene may be activated by induction of the DNA defect. However, there are a few studies on the molecular mechanisms of Gemcitabine-induced cell death. This study examined the role of p53 in Gemcitabine-induced cell death. Methods : A549 and NCl-H358 lung cancer cells were used in this study. The cell viability test was done using a MTT assay at Gemcitabine concentrations of 10nM, 100nM, 1uM, 10uM and 100uM. A FACScan analysis with propium iodide staining was used for the cell cycle analysis. Western blot analysis was done to investigate the extent of p53 activation. For the functional knock-out of p53, stable A549-E6 cells and H358-E6 cells were transfected pLXSN-16E6SD which is over expresses the human papilloma virus E6 protein that constantly degrades p53 protein. The functional knock out of p53 was confirmed by Western blot analysis after treatment with a DNA damaging agent, doxorubicine. Results : Gemcitabine exhibited cell toxicity in dose-dependent fashion. The cell cycle analysis resulted in an S phase arrest. Western blot analysis significant p53 activation in time-dependent manner. Gemcitabine-induced cytotoxicity was reduced by 20-30% in the A549-E6 cells and the 30-40% in H358-E6 cells when compared with the A549-neo and H358-neo control cells. Conclusion : Gemcitabine induces an S phase arrest, as expected for the anti-metabolite, and activates the p53 gene, Furthermore, p53 might play an important role in Gemcitabine-induced cell death. Further investigation into the molecular mechanisms on how Gemcitabine activates the p53 gene and its signaling pathway are recommended.

The Effects of Female Wage on Fertility in Korea (여성의 임금수준이 출산율에 미치는 영향 분석)

  • Kim, Jungho
    • KDI Journal of Economic Policy
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    • v.31 no.1
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    • pp.105-138
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    • 2009
  • Although the decline in fertility rate is generally observed along the history of economic development throughout the world, the continuing decline hitting below the replacement level in Korea over the recent years gathered serious social concerns on the ground that it accelerates the process of population aging. The total fertility rate in Koreareached 2.08 in 1983, and gradually fell to the levels of 1.08 in 2005 and 1.26 in 2007. The policy debate over the role of the government has been focused mainly on the level of theoretical discussion without substantial basis on firm empirical evidence and the determinants of fertility. The objective of the paper is to empirically investigate the fertility effect of the female wage, which is understood as one of the most important determinants of fertility in Koreasince 1980 focusing on one aspect of fertility, namely birth spacing. Using the Korean National Fertility Survey conducted in 2006, I estimate a duration model of first and second births taking into account individual heterogeneity, which turned out to be an important factor to control for. Compared with previous studies in the literature on the Korean fertility, the study has an advantage of using the complete pregnancy history of women in a more representative sample. Unlike the previous studies, the analysis also deals with the endogeneity of marriage by treating a certain age, rather than age at marriage, as the time in which a woman becomes exposed to the risk of pregnancy. The study shares the common problem in the literature on birth spacing of lacking relevant wage information for respondents in a retrospective survey. I estimate the wage series as a function of the basic characteristics using the annual Wage Structure Survey from 1980 to 2005, which is considered as a nationally representative sample for wage information of employees. The results suggest that the increase in female wage by 10 percent leads to a decrease in second birth hazard by 0.56~0.92 percentage points and that the increase in spouse's wage by the equal amount is accompanied by the increase in second birth hazard by 0.36~1.13 percentage points. These estimates are more precisely estimated and of smaller magnitude than those presented by the previous studies. The results are robust to the different specifications of the wage equation. The simulation analysis based on the predicted values shows that about 17% of the change in the second birth hazard over the period 1980 to 2005 was due to the change in the female wage. Although there is some limitation in data, the results can be viewed as one estimate of the role of female wage on the recent fertility decline in Korea. The question raised by the paper is not a normative one of whether a government should promote childbearing but a positive one thatexplains fertility decline. Therefore, if there is a wide consensus on promoting childbearing, the finding suggests that the policies designed to reduce the opportunity cost of women in the labor market would be effective. The recent movement of implementing a wide range of family-friendly policies including child care support, maternity leave, parental leave and tax benefit in developed countries should be understood in this context.

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Effects of Agarum cribrosum on the Improvements in Treating Constipation and Plasma lipid Profiles (구멍쇠 미역의 변비 완화 효과 및 혈액지방에 미치는 영향)

  • Park, Sung-Jin;Kim, Bom;Kim, Min-Jeong;Kim, Young-Eon;Park, Sung-Hye;Park, Tae-Gil
    • Korean journal of food and cookery science
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    • v.29 no.2
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    • pp.185-192
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    • 2013
  • The present study was conducted to evaluate the effects of Agarum cribrosum on weight change and defecation states in rats with constipation induced by loperamide. Food intake and body weight both decreased in the 5% Agarum cribrosum and loperamide-treated group (SD5) and 10% Agarum cribrosum and loperamide-treated group (SD10), whereas fecal water contents increased by 1.6 and 2.1-fold in the SD5 and SD10 groups, respectively. The concentrations of total-cholesterol, HDL-cholesterol and triglyceride in the sera of the SD5 and SD10 groups were lower than those in the control (C) group. However, the biochemical parameters, GOT (glutamic oxaloacetic transaminase), GPT (glutamic pyruvic transaminase), and glucose levels, were not affected by the level of Agarum cribrosum. In addition, the concentrations of total-cholesterol and triglyceride in the livers of the SD5 and SD10 groups were also lower than those in the control group. The results of the present study demonstrated that Agarum cribrosum might ameliorate constipation symptoms, and lower lipid concentrations in the blood and liver.

Operating Status and Improvement Plans of Ten Wetlands Constructed in Dam Reservoirs in Korea (국내 10개 댐저수지 인공습지의 운영현황 및 개선방안)

  • Choi, Kwangsoon;Kim, Sea Won;Kim, Dong Sup;Lee, Yosang
    • Journal of Wetlands Research
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    • v.16 no.3
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    • pp.431-440
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    • 2014
  • To propose the improvement and management plans to strengthen the pollutant removal efficiency of dam reservoir's constructed wetlands(CWs), the operation status and configuration of CWs (including water depth, operational flow, water flow distribution, residence time, and pollutant removal efficiency, aspect ratio, open water/vegetation ratio etc.) were analyzed in 10 major wetlands constructed in dam reservoirs. The pollutant concentrations in the inflows of the studied CWs were lower than those of American and European constructed wetlands. Especially, organic matter concentrations in all of inflows were below 3 mg/L(as BOD) due to advanced treatment of sewage disposal plant and an intake of low concentration water during dry and normal seasons. The average removal efficiency of total nitrogen(TN) and total phosphorus(TP) for 10 CWs ranged from 7.6~67.6%(mean 24.9%) and -4.9~74.5%(mean 23.7%), respectively, showing high in wetlands treating municipal wastewater. On the other hand, the removal efficiency of BOD was generally low or negative with ranging from -133.3 to 41.7%. From the analysis of the operation status and configuration of CWs, it is suggested that the low removal efficiency of dam reservoir's CWs were caused by both structural (inappropriate aspect ratio, excessive open water area) and operational (neglecting water-level management, lack of facilities and operation for first flush treatment, lake of monitoring during rainy events) problems. Therefore, to enable to play a role as a reduction facility of non-point source(NPS) pollutants, an appropriate design and operation manuals for dam reservoir's CW is urgently needed. In addition, the monitoring during rainy events, when NPS runoff occur, must be included in operation manual of CW, and then the data obtained from the monitoring is considered in estimation of the pollutant removal efficiency by dam reservoir's CW.

An Evaluation of Solid Removal Efficiency in Coagulation System for Treating Combined Sewer Overflows by Return Sludge (CSOs처리를 위한 응집침전시스템에서 슬러지 반송에 의한 고형물 처리효율평가)

  • Ha, Sung-Ryong;Lee, Seung-Chul
    • Journal of Korean Society of Environmental Engineers
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    • v.35 no.3
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    • pp.171-178
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    • 2013
  • In this study, the sludge that occurs in the initial operation of coagulation system developed for the treatment of CSOs were returned to the flocculation reactor. The purposes of this study were to analyze the Characteristics of flocs that are generated through the recycling sludge and settling characteristics of sludge, and to evaluate the possibility that high concentrations of particulate matter in the initial inflow of CSOs could be used as an weighted coagulant additive. As a result, the concentration of treated CSOs pollutants at the beginning of the CSOs influent with a large amount of particulate matter over 20 ${\mu}m$ was low, after gradually increasing the concentrations of them. The flocs generated from the sludge return were similar in size compared to flocs generated through injection of micro sands, and settling velocity in case of return sludge injection was decreased from 55.1 cm/min to 21.5 cm/min. SVI value of the sludge accumulated at the bottom of the sedimentation tank was 72, and settled sludge volume decreased rapidly due to the consolidation of sludge to the time it takes to 10 minutes. these mean that sludge used for recycling has good settling characteristic. A condition of returned sludge which is 0.1% return of 0.3% extraction was formed in the balance of settlement and extraction. In this case, This condition was to be adequate to maintain the proper concentration such as 100~200 mg/L of TS and 50~100 mg/L of VS in the flocculation reactor. The usage of the return sludge containing particulate matters of CSOs as an weighted coagulant additive was able to secure a stable treated water quality despite the change of influent water quality dynamically. Furthermore, it can be expected to reduce the alum dosage along with the sludge production.

A Clinical Inquiry into 200 Cases of Children Coming to the Clinic Due to the Symptom of Growth Deficiency (성장장애(成長障碍)를 주소(主訴)로 내원(來院)한 환아(患兒) 200례(例)에 대(對)한 임상적(臨床的) 관찰(觀察))

  • Na, Dong-Gyu
    • Journal of Haehwa Medicine
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    • v.7 no.2
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    • pp.609-620
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    • 1999
  • Over the period between January 1997 and December 1998, herbal medicine was more than three times administered to the patients coming to Na dong gyu's Oriental Medical Clinic on account of the symptom of growth deficiency. According to radiological opinions about the patients providing cooperation for measuring their height and weight as well as their bone age every three months, it was found that the growth plates were not closed. A research was conducted for 200 children randomly selected of patients in prepuberty (they grew by less than 5cm a year before treatment at a age of 12years for female children and 14years for male children). As a result, the following conclusion was drawn: 1. The randomly selected subjects were made up of 116 male and 84 female children in terms of gender. The age direstribution was most 10 to 12 years in 86 children(34.00%), followed by 8-10 years(27.50%) and 12 to 14 years(19.50%). 2. Considering the distribution of sick children's parental height, the fathers of 141 children(70.50%) measured less than 170cm high, the subaverage height, while the mothers of 172 children(86%) measured less than 160cm high, the subaverage height. It was shown that sick childen's height was genetically influenced by their parents. 3. Children patients's weight at a time of birth was most 3.1-3.5kg for 85 children(44%) and less than 2.5kg which came under the range of growth dificiency for 19 children(9.5%). 4. The highest proportian of the children patients with growth dificiency(56.33%) had the symptom of digestive disorders, of which 77 children patients(18.78%) had anorexia, 16.59% of children patients had the high level of respiratory disorders. Both the digestive disorder and the respiratory disorder put together, they had the high rate of 72.92%. Therefore, this indicates that both the digestive disorder and the respiratory disorder have a great effect on children's growth dificiency. 10.74% of chilren patients were shown to have allergic disorders, which indicates that they also exert an effect on growth deficiency. Specifically, 7.07% of the children patients had the high level of obesity, which shows that an excessive uptake of nutrition may rather induce children to have growth dificiency though an appropriate amount of nutritional uptake is necessary. 5. Comparing their bone age and their chronological age, 58 children patients(29.00%) showed that they were the same at the highest percent. 79 children patients(39.50%) showed that thier bone age was lower than their chronological age. And 63 children patients(31.50%) showed that their bone age was higher than their chronological age. 6. As regards the prescription administered to children patients for treating their growth dificiency, Growth tang A related to the kidney, the congenital factor, of the causes for growth dificiency in traditional Oriental Medicine was administered to 108 children patients(54%), whereas the Growth tang B related to the spleen, the acquired factor, was administered to 92 children patients(46%). 7. 116 male children patients with growth dificiency had the average value of growth for one year before treatment, 4.39cm, while 84 female children patients had the average value of growth for one year before treatment, 4.24cm. A total of 200 children had the average value of growth for one year before treatment, 4.33cm. The annual average value of growth in growth curve surveyed by the Korea Pediatrics Society was 5.79cm. Compared to this value, the one year average value of growth for 108 male and female children patients taking Growth tang A was shown be 8.44cm, which indicates a greater growth by 4.12cm(95.37%) in comparison with the average value of growth before treatment, 4.32cm, and a greater growth by 2.65cm(45.77%) compared to 5.79cm, the average value of growth in growth curve surveyed by the Korea Pediatrics Society. Also, the average value of growth before treatment for 92 male and female children patients taking Growth tang B was shown to be 8.47cm, which indicates a greater increase by 4.15cm(96.06%) compared to 4.32cm, the average value of growth before treatment and a greater increase by 2.67cm(46.29%) in comparison with 5.79cm, the average value of growth in growth curve surveyed by the Korea Pediatrics Society. Considering the average value of growth for male and female children patients taking Growth tang A and B, it was shown to be 8.46cm, which indicates a greater increase by 4.14cm(95.81%) compared to 4.32cm, the average value of growth before treatment, and a greater increase by 2.67cm(46.11%) compared to 5.79cm, the average value of growth in growth curve surveyed by the Korea Pediatrics Society.

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A Study on rural middle and high school students' Recognition Degree of harmful environment around Schools (지방소재 중 . 고등학생들의 학교주변 유해환경에 대한 인지도 조사연구)

  • 이명선
    • Korean Journal of Health Education and Promotion
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    • v.18 no.1
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    • pp.109-125
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    • 2001
  • The purpose of this study was to provide the basic data for establishing school education environment protection measures, on the basis of comparing and analyzing the realities and students' recognition degree of the environment and hygiene around the middle and high schools located in the rural areas. These study data were investigated by the self-administered questionnaires, taking as subject the 805 students in the middle and high schools located rural areas. And the results were as follows: First, as the result of having investigated the distribution degree of harmful environment within the purification zone around schools, it was found out that students responded: within the purification zone around the middle school, there were cartoon rooms (46.2%), electronic game rooms (45.9%), and singing rooms (45.0%). within the purification zone around the high school, there were electronic game rooms (46.3%), singing rooms (42.3%), billiard halls (41.4%), PC rooms (40.1 %), and Soju-room (35.2%). Secondly, as having analyzed student's recognition degree of the harmful environment around the school, it was found out that middle school students responded that sexual utensils-treating shops (3.74 points) were most harmful, and next corrupted bathhouses (3.52 points), and Soju-room (3.47 points), and high school students also responded relating to harmfulness in a similar sequence. Thirdly, in case of students' recognition degree of the harmful environment around the school according to general characteristics, 1) girl students had a higher ratio of recognition that the environment around the school was harmful than boy students (p〈0.001). 2) groups of students whose living standard was high had a higher ratio of recognition that the environment around the school was harmful than groups of students whose living standard was low (p〈0.05). 3) groups of students whose school was located near the park or the residential street had a higher degree of recognition that the environment around the school was harmful than groups of students whose school was located near the factory or the shopping area (p〈0.01). 4) groups of students whose school was located near the park or the residential street had a higher degree of recognition that the environment around the school was harmful than groups of students whose school was located near the amusement area or the shopping area (p〈0.05). Fourthly, 1) relating to the harmful shops where they experienced most highly the behavior of drinking and smoking, middle school students responded that they did so in the electronic game room (22.5%) and high school students did so in the singing room (31.4%), and high school students had a very high experience ratio of drinking and smoking, compared with middle school students (p〈0.001). 2) relating to the harmful shops where they could get in contact with lewd articles, both of middle school students (5.3%) and high school students (8.3%) responded that they could do so in the video room. 3) relating to the harmful shops where they experienced unsound opposite sex acquaintance, both of middle school students (5.8%) and high school students (16.6%) responded that they did so most highly in hotels, and high school students had a remarkably high experience ratio of unsound opposite sex acquaintance, compared with middle school students (p〈0.05). 4) relating to the harmful shops where they experienced violence, middle school students responded that they did so in the electronic game room (14.0%) and then in the singing room (3.7%), and high school students responded that they did so in the electronic game room (9.3%), the nightclub (4.6%), Soju-room (4.1 %), and high school students had a remarkably high experience ratio of violence, compared with middle school students (p〈0.05). 5) relating to the harmful places where they experienced drugs both of middle school students (0.8%) and high school students (2.4%) responded that they did so in the hotels. Fifthly, when going to the harmful shops, students had the experience of being guided and regulated roughly 1 time - 2 times, and middle school students (16.4%) and high school students (16.7%) had almost similar experience ratios of being guided and regulated. Conclusively, there was a limit in controlling the environment and purification zone only by legal regulations and institutional controls, the self-control purification effort for the school and the surrounding environment was required greatly, in order to protect students from harmful environment. In addition, the constant study to establish the educational environment purification measures must be carried out.

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Results of Arthroscopic Debridement of the Elbow Osteoarthritis (주관절 골관절염에서 관절경적 변연절제술 후 결과)

  • Chun, Churl-Hong;Kim, Jung-Woo;Lim, Jae-Chang
    • Clinics in Shoulder and Elbow
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    • v.12 no.1
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    • pp.53-60
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    • 2009
  • Purpose: Primary osteoarthritis on the elbow is the result of the growth of osteophytes and contracture of the capsule. It often causes disability on joint motion and pain while exercising. As arthroscopy has developed, the arthroscopic diagnosis and treatment of the elbow have recently become more generalized as well. Therefore, we like to report on arthroscopy for treating elbow arthritis and its results. Materials and Methods: This study includes 23 cases of elbow arthritis that were seen between 2005 June to 2007 June and these patients didn't response to conservative treatment. From this we excluded 18 cases that underwent arthroscopic surgery and among these 18 cases, 6 cases underwent ulnar nerve transfer. The average observation time was 21.3 months and the average age was 48.4 years (range: 22-66 years). The pre and post operative pain was evaluated with using the Visual Analogue Scale (VAS) and functional evaluation was done with using the Mayo elbow Performance Score (MEPS) with the range of joint motion. Results: The VAS score at the last follow up was significantly decreased from 3.4 to 1.9 compare to the preoperative score. The range of joint motion was improved by 25 (0-40) to 8.5 (0-20) in extension and 101.7 (80-140) to 125.2 (85-140) in flexion (p<0.05). The MEPS always showed significant improvement by showing an increase from 65.4 (40-85) to 87.9 (55-100). However, 3 cases showed a decreased range of motion after the operation. One case showed ulnar nerve symptoms after surgery. Conclusion: An arthroscopic procedure can treat the pathologic processes associated with arthritis of the elbow and it was safe and effective in this series.