• Journal of The Korean Society of Integrative Medicine
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• v.9 no.1
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• pp.23-31
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• 2021

Purpose : To compare the immediate effects of air stacking maneuver using resuscitator bags and balloons. Methods : Twenty healthy young adults participated in this study. Forced vital capacity (FVC) and peak cough flow (PCF) tests were performed at pre-intervention, and then, the maximum insufflation capacity (MIC), forced expiratory volume in 1 s (FEV1), FEV1/FVC, peak expiratory flow (PEF), and peak cough flow (PCF) were measured using the air stacking maneuver via resuscitator bags and balloons. Interventions were randomly performed, and a 40-min break was provided between interventions. The evaluation process in this study was conducted in accordance with the guidelines of the American Thoracic Society (ATS) 2019. To compare the three outcomes measured at pre-and post-interventions, repeated measures analysis of variance was performed. Results : A significant difference was found in the MIC, FEV1, PEF, and PCF after the air stacking maneuver using resuscitator bags and balloons, whereas no significant difference was observed between resuscitator bags and balloons. Conclusion : No significant difference was found in the immediate effect of the air stacking maneuver using resuscitator bags and balloons in this study. Air stacking maneuver using balloons can increase the success rate of the techniques by providing visual feedback on the amount of air insufflation when performed with balloon blowing exercise. Balloons are cheaper and easier to buy compared to manual resuscitator bags; therefore, education on the air stacking maneuver using balloons will have a positive effect on pulmonary rehabilitation.

• Knowledge Management Research
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• v.21 no.4
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• pp.265-285
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• 2020

The inbound tourism market is recognized as a vital sector of the tourism industry today, but it is highly volatile due to each country's economic, social, and cultural variables. The causes of volatility vary according to the inbound country, and we intend to revitalize the stabilized tourism industry by minimizing risks. In this study, the portfolio theory was applied to derive the optimal combination for each country to achieve the minimum risk level's maximum growth rate. The number of inbound travelers and the average expenditure per person was simultaneously applied. As a result of the analysis, the best mix by country based on the number of inbound travelers was the UK, the United States, Germany, China, and Japan. Based on average spending, each country's best combinations were Thailand, Middle East, Singapore, Japan, Russia, Hong Kong, and Germany. It is expected to be able to establish a plan to operate the Korean inbound tourism market strategically.

• Journal of Trauma and Injury
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• v.34 no.2
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• pp.81-86
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• 2021

Purpose: This study investigated the clinical outcomes of trauma patients with blunt thoracic aortic injuries at a single institution. Methods: During the study period, 9,501 patients with traumatic aortic injuries presented to Trauma Center of Gil Medical Center. Among them, 1,594 patients had severe trauma, with an Injury Severity Score (ISS) of >15. Demographics, physiological data, injury mechanism, hemodynamic parameters associated with the thoracic injury according to chest computed tomography (CT) findings, the timing of the intervention, and clinical outcomes were reviewed. Results: Twenty-eight patients had blunt aortic injuries (75% male, mean age, 45.9±16.3 years). The majority (82.1%, n=23/28) of these patients were involved in traffic accidents. The median ISS was 35.0 (interquartile range 21.0-41.0). The injuries were found in the ascending aorta (n=1, 3.6%) aortic arch (n=8, 28.6%) aortic isthmus (n=18, 64.3%), and descending aorta (n=1, 3.6%). The severity of aortic injuries on chest CT was categorized as intramural hematoma (n=1, 3.6%), dissection (n=3, 10.7%), transection (n=9, 32.2%), pseudoaneurysm (n=12, 42.8%), and rupture (n=3, 10.7%). Endovascular repair was performed in 71.4% of patients (45% within 24 hours), and two patients received surgical management. The mortality rate was 25% (n=7). Conclusions: Traumatic thoracic aortic injuries are life-threatening. In our experience, however, if there is no rupture and extravasation from an aortic injury, resuscitation and stabilization of vital signs are more important than an intervention for an aortic injury in patients with multiple traumas. Further study is required to optimize the timing of the intervention and explore management strategies for blunt thoracic aortic injuries in severe trauma patients needing resuscitation.

• Journal of Korean Neurosurgical Society
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• v.64 no.4
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• pp.543-551
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• 2021

Objective : Hemorrhagic stroke (HS) and hypertensive retinopathy are known end organ damage of the brain and eye respectively, with HS having deleterious consequence to the patients. This study is to correlate between hypertensive retinopathy and HS in hypertensive disease. Methods : A control group of hypertensive patients only, and an investigated group of hypertensive HS patients. Fundoscopic examination to determine the grade of retinopathy was performed and then divided into low or high severity hypertensive retinopathy. Clinical and radiological parameter included are demography, vital signs, Glasgow coma scale (GCS) on admission, clot volume, site of clot, Intracerebral hemorrhage (ICH) score and Glasgow outcome scale (GOS). Data were correlated with the severity of hypertensive retinopathy. Results : Fifty patient in the control group and 51 patients in the investigated group were recruited. In the hypertensive HS group, 21 had low severity retinopathy (no or mild retinopathy) accounting for 41.2% and 30 patients had high severity (moderate or severe retinopathy). In the hypertensive patients 49 had low severity and one had high severity (p-value of 0.001). In HS group low severity showed better GCS score of 9-15 on admission (p-value of 0.003), clot volume less than 30 mL (p-value 0.001), and also a better 30 days mortality rate by using the ICH score (p-value 0.006), GOS score of 4 and 5 the low severity retinopathy fair better than the high severity retinopathy (p-value of 0.001), and the relative risk to develop HS in low severity and high severity retinopathy was 0.42 and 29.4, respectively. Conclusion : Hypertensive retinopathy screening could be used as an indicator in hypertensive patient, to evaluate the risk of developing hypertensive HS in the future.

• Journal of Veterinary Clinics
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• v.38 no.4
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• pp.204-209
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• 2021

A seven-month-old castrated male Chihuahua weighing 1.6 kg presented with generalized tonic-clonic seizure following ingestion of isoniazid. Emergency treatment with three doses of diazepam (total 1.5 mg/kg, intravenous [IV]) and phenobarbital (15 mg/kg IV) was administered. The seizure stopped after administration of propofol (constant rate infusion [CRI]; 0.2 mg/kg/min). Blood analyses showed mildly increased serum blood glucose concentration, hyperkalemia, and hyperphosphatemia. On suspicion of isoniazid toxicity, activated charcoal (1 g/kg, orally), lipid emulsion (CRI; 9 mL/hr), and pyridoxine hydrochloride (70 mg/kg IV) were added to the treatment regimen. Twelve hours after presentation, the dog showed increased serum liver enzyme activities, serum blood urea nitrogen, and creatinine concentrations indicating hepatic and renal failure. Twenty-two hours after presentation, blood analysis still revealed increased liver enzyme activities, blood urea nitrogen, and creatinine concentrations with low blood glucose concentration. Twenty-six hours after presentation, the dog's vital signs deteriorated and the owner elected for the dog to be euthanized. This is the first report of the clinical course of isoniazid toxicosis in a dog in South Korea. Furthermore, to our best knowledge, this is the first report where secondary multiple organ failure was observed due to isoniazid toxicosis. Clinicians should be aware of the possibility of isoniazid toxicosis in dogs. Rapid initiation of treatment after clinical recognition is warranted in such cases.

• The Journal of the Convergence on Culture Technology
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• v.7 no.4
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• pp.203-210
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• 2021

This study examined the effect of the respiratory training centered at forced breathing exercise of blowing out a candle on the improvement of adults' respiratory ability, which means the increased muscle strength of body trunk. After the four-week candle-blowing breathing training, the forced vital capacity (FVC) increased statistically significantly (p<.05). The forced expiratory volume in one second (FEV1) did not show a statistically significant difference before and after the four-week intervention(p>.05). The peak expiratory flow rate (PEF) statistically significantly increased after the four-week blowing-out-the-candle training (p<.05). This study examined the relationship between forced breathing training and pulmonary function of healthy adults including FVC, FEV1, and PEF, which means the increased muscle strength of body trunk, by implementing blowing-out-the-candle breathing exercise centered at forced respiratory exercise and obtained significant results. Further studies that use a sample of patients with advanced respiratory system disease for whom physical therapy is absolutely necessary will be required in the future.

• Journal of The Korean Society of Integrative Medicine
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• v.10 no.1
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• pp.149-155
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• 2022

Purpose : This study investigated the effects of wearing a mask and different mask filters on the respiratory function of stroke patients. Methods : A total of 15 stroke patients were selected according to the inclusion and exclusion criteria. The respiratory functions were compared between participants with and without masks and among respiratory functions with three different mask filters. The order of using masks was non-wearing masks, Dental masks, KF80 masks, and KF94 masks; the difference in respiratory volumes among these conditions were measured. For accuracy of the measurement, sufficient education on the respiratory measurement method was provided to the researcher, and the heart rate of the participants was estimated to confirm their stability before the measurements. To ensure accuracy, the subjects were educated on the researchers' respiratory measurement methods. Each measurement was followed by 10 min breathing stability before replacing the next mask. Results : The results of this study showed that the difference in respiratory functions, including forced vital capacity (FVC), forced expiratory volume in the first second (FEV₁), and maximal voluntary ventilation (MVV), in stroke patients was statistically significant among different masks (p<.05). Afterwards, the values of FVC, FEV₁, and MVV in stroke patients wearing masks were significantly lower than those of the non-masked control group (p<.05). The difference in respiratory functions with different mask filters showed no statistical significance (p<.05). Conclusion : This study showed that participants wearing any of the masks presented a lower respiratory function than that of those without using masks; additionally, no difference in respiratory functions was observed with differences in mask filters. Therefore, wearing a mask for a prolonged period is confirmed to affect breathing in stroke patients with weak respiratory function.

• Computers and Concrete
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• v.29 no.1
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• pp.15-29
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• 2022

Concrete-filled steel tubes (CFSTs) are increasingly used as composite sections in structures owing to their excellent load bearing capacity. Therefore, predicting the mechanical behavior of CFST sections under axial compression loading is vital for design purposes. This paper presents the first study on the nonlinear analysis of heated CFSTs with high-strength concrete core containing steel fiber and waste tire rubber under axial compression loading. CFSTs had steel fibers with 0, 1, and 1.5% volume fractions and 0, 5, and 10% rubber particles as sand alternative material. They were subjected to 20, 250, 500, and 750℃ temperatures. Using flow rule and analytical analysis, a model is developed to predict the load bearing capacity of steel tube, and hoop strain-axial strain relationship, and axial stress-volumetric strain relationship of CFSTs. An elastic-plastic analysis method is applied to determine the axial and hoop stresses of the steel tube, considering elastic, yield, and strain hardening stages of steel in its stress-strain curve. The axial stress in the concrete core is determined as the difference between the total experimental axial stress and the axial stress of steel tube obtained from modeling. The results show that steel tube in CFSTs under 750℃ exhibits a higher load bearing contribution compared to those under 20, 250, and 500℃. It is also found that the ratio of load bearing capacity of steel tube at peak point to the load bearing capacity of CFST at peak load is noticeable such that this ratio is in the ranges of 0.21-0.33 and 0.31-0.38 for the CFST specimens with a steel tube thickness of 2 and 3.5 mm, respectively. In addition, after the steel tube yielding, the load bearing capacity of the tube decreases due to the reduction of its axial stiffness and the increase of hoop strain rate, which is in the range of about 20 to 40%.

• Archives of Plastic Surgery
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• v.48 no.4
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• pp.417-426
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• 2021

Background Soft tissue coverage plays a vital role in replacing the vascularity of the underlying bone in Gustilo type IIIB fractures. The aim of this article was to evaluate the feasibility of local pedicled flaps in type IIIB fractures at a tertiary care center. Methods We included all cases of open Gustilo-Anderson type IIIB fractures of the tibia treated with local flap coverage from January 2017 to February 2019. We carried out a retrospective analysis to investigate the relationships of complications, hospital stay, and cost-effectiveness with the choice of flap, infective foci, site and size of the defect, and type of fixation. Results Out of 138 Gustilo type IIIB fractures analyzed in our study, 27 cases had complications, of which 19 (13.76%) involved flap necrosis, four (2.89%) were infections, three (2.17%) involved partial necrosis, and one (0.72%) was related to bone spur development. Flap complications showed a statistically significant association with the perforator flap category (propeller flaps in particular) (P=0.001). Flap necrosis showed a significant positive correlation with cases treated within 3 weeks after trauma (P=0.046). A significant positive correlation was also found between defect size and the duration of hospital stay (P=0.03). Conclusions Although local flaps are harvested from the same leg that underwent trauma, their success rate is at least as high as microvascular flaps as reported from other centers. Amidst the local flaps, complications were predominantly associated with perforator flaps.

• Geomechanics and Engineering
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• v.27 no.6
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• pp.605-614
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• 2021

Water inrush from fault is one of the most severe hazards during tunnel excavation. However, the traditional evaluation methods are deficient in both quantitative evaluation and uncertainty handling. In this paper, a comprehensive methodology method combined intuitionistic fuzzy AHP with a Bayesian network for the risk assessment of water inrush from fault in the subsea tunnel was proposed. Through the intuitionistic fuzzy analytic hierarchy process to replace the traditional expert scoring method to determine the prior probability of the node in the Bayesian network. After the field data is normalized, it is classified according to the data range. Then, using obtained results into the Bayesian network, conduct a risk assessment with field data which have processed of water inrush disaster on the tunnel. Simultaneously, a sensitivity analysis technique was utilized to investigate each factor's contribution rate to determine the most critical factor affecting tunnel water inrush risk. Taking Qingdao Kiaochow Bay Tunnel as an example, by predictive analysis of fifteen fault zones, thirteen of them are consistent with the actual situation which shows that the IFAHP-Bayesian Network method is feasible and applicable. Through sensitivity analysis, it is shown that the Fissure development and Apparent resistivity are more critical comparing than other factor especially the Permeability coefficient and Fault dip. The method can provide planners and engineers with adequate decision-making support, which is vital to prevent and control tunnel water inrush.