• Quality Improvement in Health Care
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• v.10 no.2
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• pp.190-203
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• 2003

Background: Dental hygienists are at risk of acquiring infections through exposure to infectious agents. This study explores the frequency of exposure to infectious agents and infection control practices among dental hygienists. Methods: We undertook a cross-sectional survey to examine the exposure to infectious agents and infection control practices among dental hygienists through questionnaire. Data were obtained from 124 dental hygienists attending educational conferences. A multiple logistic regression analysis was conducted to determine the factors that effect infection control practices in relation to age, completion of infection control education, recognition of their own serum hepatitis Ag/Ab status, the number of one day patients, location of clinics, type of clinics, and career years. Result: Of the 124 dental hygienists, 91.7% were exposed to at least one accident such as needle stick injuries during their practices periods. The health screening coverage rate in dental hygienists was 16.5%. The number of one day patients and career years were important in relation to infection control practices among dental hygienists. The adjusted odds ratio estimates for career years were 5.049 times greater(95% Cl 1.238-20.597) for groups with over 4 career years than under 2 career years. That for the number of one day patients were 0.261(95% Cl 0.071-0.955) lower for through 20 up to 30 patients, 0.531(95% Cl 0.102-2.78) lower for through 30 up to 40 patients and 0.498(95% Cl 0.123-2.017) lower for more than 40 patients than under 20 patients. Conclusion: From these results, prevalence of infection control practices among dental hygienists is related to the number of one day patients and career years. Prevention of cross infection and reduction of future transmission should be a priority to dental hygienists for promotion of infection control and further efforts to educate newcomers on infection prevention should be made.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.19 no.4
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• pp.367-376
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• 1997

The 234 patients who received treatment of midfacial fractures at the Department of Oral and Maxillofacial Surgery of Chonnam University Hospital from Jan. 1, 1992 to Dec. 31, 1996 were analyzed clinicostastically. Results obtained were as follows ; Male predominated over females by a ratio of 5.3 to 1. The frequently developing age groups were first 3rd (25%), 4th (21%) and the 2nd (18%) decade on succession. The peakest month was the August (16%), and May (11%), September (9%), October (9%). When it comes to the reasons for in-patients, traffic accident was predominant to 38%. In the 234 cases of midfacial fractures, zygomaticomaxillary complex fracture was the most by 37%. The most common with injury show that facial laceration marked by 49%, neurologic injury 24%, and mandibular fracture 20% each by each. About the time from injury onset to operation, 55% of cases were less than a week while the others (45%) more than a week. 3 plates were used for operation : 2 for zygoma or maxilla fracture and 3 for zygomatiomaxillary complex fracture. especially 4 for Le Fort I fracture, 5.5 for Le Fort I, II ; I, III ; II, III fracture, 7 for Le Fort I,II,III fracture were used. 20 patients (8%) appealed their complication and the most common was reported as infection. Above results suggest that early diagnosis and treatment of fracture site, systemic condition and associated injuries are necessary, and coorperative treatment with medical department should be performed.

• Journal of Korean Neurosurgical Society
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• v.51 no.4
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• pp.215-218
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• 2012

Objective: Traumatic epidural hematomas (EDHs) in children are a relatively unusual occurrence. The cause and outcome vary depending on period and reg ion of study. The aims of this analysis were to review the cause and outcome of pediatric EDHs nowadays and to discuss outcome-related variables in a large consecutive series of surgically treated EDH in children. Methods: This is a retrospective review of 29 patients with surgically treated EDHs between Jan 2000 and February 2010. Patients' medical records, computed tomographic (Cl) scans, and, if performed, magnetic resonance imaging (MRI) were reviewed to define variables associated with outcome. Variables included in the analysis were age, associated severe intracranial injury, abnormal pupillary response, hematoma thickness, severity of head injury (Glasgow Coma Scale score), parenchymal brain injury, and diffuse axonal injury. Results: The mean (SO) age of the patients was 109 months (0-185 months). Most of the injuries with EDHs occurred in traffic accident (14 cases, 48.2%) and followed by slip down in 6 cases and falls in 6 cases. There were one birth injury and one unknown cause. EDHs in traffic accidents occurred in pedestrians hit by a motor vehicle, 9 cases; motorbike and car accidents, 5 cases and bicycle accidents, 1 case. The locations of hematoma were almost same in both sides (left side in 15 cases). Temporal lobe is the most common site of hematomas (13 cases, 44%). The mean size of the EDHs was 18 mm (range, 5-40 mm). Heterogeneous hematomas in CT scans were 20 cases (67%). Two patients were referred with unilateral or bilateral dilated pupil(s). There was enlargement of EDH in 5 patients (17%). All of them were heterogeneous hematomas in CT scans. Except for 4 patients, all EDHs were associated with skull fracture(s) (87%). There was no case of patient with major organ injury. CT or MRI revealed brain contusion in 5 patients, and diffuse axonal injury in one patient The mortality was zero, and the outcomes were excellent in 26 and good in 2 patients. None of the tested variables were found to have a prognostic relevance. Conclusion: Regardless of the EDH size, the clinical status of the patients, the abnormal pupillary findings, or the cause of injury, the outcome and prognosis of the patients with EDH were excellent.

• Journal of Acupuncture Research
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• v.33 no.4
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• pp.149-163
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• 2016

Objectives : The purpose of this study is to determine the effect of Functional Cerebrospinal Therapy(FCST) on patients from traffic accidents with Temporomandibular Joint Disorder. Methods : We reviewed the medical records of 33 patients who were treated for injuries stemming from traffic accidents at the Dong-Eui University Korean Medicine Hospital from December 29th, 2015 to August 29th, 2016. The patients were divided into 2 groups: Group A(n = 15) and Group B(n = 18). In Group A, patients received Korean medical treatments with FCST using an Accurate Balancing Appliance(ABA) - a standard intra-oral appliance. In Group B, patients received Korean medical treatments without FCST. To estimate the efficacy of the treatments in decreasing pain, we analyzed the Visual Analogue Scale(VAS), Neck Disability Index(NDI) and Oswestry Disability Index(ODI). Results : In Group A, VAS of headache(VAS H), VAS of neck & nuchal pain(VAS N), VAS of shoulder pain(VAS S), and VAS of low back pain(VAS L) were significantly improved during each period. In Group B, VAS H was significantly improved during each period, except the period from the first visit to two weeks later. VAS N, S, L were significantly improved during each period, except the period from the first visit to one week later. The total VAS improvement during each period in Group A was significantly higher than Group B. In both groups, NDI and ODI were improved significantly during each period. The improvement of NDI and ODI during each period in Group A was significantly higher than Group B. Conclusion : According to the results, FCST using ABA may be an effective treatment for patients from traffic accidents.

• Journal of Preventive Medicine and Public Health
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• v.1 no.1
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• pp.1-8
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• 1968

This paper describes the incidence of transport accident for the period, 1955-1965. Transport accidents were classified into three categories, viz. railway(WHO Classification of Diseases, E-802), watercraft (E 550-E 858) and motor vehicle accidents(E810-E835, E840-E841, E844-E845). Crude data on the subject were collected from the various souces of Government Statistical Books including Statistical Year Books edited by the Central Office of Economic Planning Board, Annual Police Reports by the Ministry of Home Affairs, and the national and local associations for road traffic safety. From the data incidence and mortality rates by year, month and local province were computed and other variables relevant to the epidemiology of accidents were observed. The following summary could be drawn: 1. Death rates due to transport accidents per 100,000 population were 12.3 for 1955 and 9.7 for 1965. The incidence of injury due to the same cause were 34.0 for 1955 and 35.9 for 1965. 2. Death rates by transportation vehicle showed 9.0 due to motor vehicle accidents, 1.7 due to water-crafts, and 1.6 due to railway trains for 1955. In 1965 death rates were 6.0 due to motor vehicles, 1.2 to water-crafts and 2.4 to railway. 3. Seasonal distribution of transport accidents revealed that car accidents occur more frequently in spring and fall fall seasons while ship accidents do in winter and train accidents more in summer. 4. Both car and ship accidents slightly decreased during the past decade, 1955-1965, whereas the accidents of railway trains showed a tendency of increase. 5. Although the survey on railway accidents excluded the injuries of passengers or railway employees corresponding to WHO classification of diseases, E 801, due to inaccuracy of data, it is roughly estimated that the same number of casualities as the incidence among pedestrians or any other than passengers or employees assumed to be at work(E 802).

• Journal of Preventive Medicine and Public Health
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• v.1 no.1
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• pp.43-49
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• 1968

Epidemiological and statistical observations were made of fire hazards that occurred during the past 18 years, 1948 to 1965. Injury and mortality rates for all ages were computed chronologically. For the years of 1955, 1961 and 1965, all fire accidents were epidemiologically analysed to draw characteristic patterns in relation to the seasonal and 24 hour distribution, causes and sites of accidents etc.. Fire hazards observed herein are the categorys E 916 of the International Classification of Causes of Death, 1955, and includes all accidents caused by fire and explosion of combustible materials. The following conclusion was made: 1. The average number of annual deaths due to fire was 183 and the number of the in jured due to the same cause was 335. The mortality rate per 100,000 population was 0.8 and the ratio of injuries per death was 1.83. 2. The casually rate including both the dead and injured was 5.0 per 100,000 in Seoul, the highest among the provinces and followed by 3.4 in Cheju -Do, 2.1 in Kangwon-Do, 1.7 in Kyunggi-Do accordingly. The other provinces had a range of 0.6 to 1.2. 3. The monthly distribution of fro accidents showed that the winter months, December through February, had more frequent accidents, while the summer season, June through August had less. The 24 hour distribution of accidents showed more cases from 12:00 to 18:00 and less from 4:00 to 10:00 hours. 4. The per cent distribution of causes of accidents showed; 90.0% for careless, 10.0% for arson. The cause of carelessness was further breakdown into; 15.0% for kitchen fire places, 13.8% for fire playing, 9,4% for electrical heating and wires, 8.3% for fuels, 6.3% for matches, 5.2% for ash dumps and the remaining for others. 5. The accidents as classified by place revealed that 56.8% of the total occurred at the common dwelling houses, 11.3 at various industrial workshops, 9.3% at the street shops and the remaining at the miscellaneous places.

• Journal of Chest Surgery
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• v.43 no.1
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• pp.104-107
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• 2010

Acute respiratory distress syndrome (ARDS) is difficult to treat and it is often fatal. If the medical treatment for ARDS is not effective, then extracorporeal membrane oxygenation (ECMO) can be applied to the patient. A 22-year-old female who suffered multiple traumatic injuries due to a car accident presented with acute respiratory distress syndrome. Veinarterial extracorporeal membrane oxygenation (VA ECMO) was started to treat her respiratory failure. With the VA ECMO, the systemic oxygen saturation remained at only 84%, and so the ECMO system was switched to V-VA ECMO via an additional venous outflow through the right jugular vein to increase both the systemic and pulmonary oxygen saturation. After conversion to the V-VA type ECMO, the systemic oxygen saturation increased to 94% and the partial pressure of oxygen ($PaO_2$) increased to 65 mmHg. We report here on a successful case of ECMO conversion from the VA type to the V-VA type in a patient with severely hypoxic respiratory failure.

• Fire Science and Engineering
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• v.29 no.6
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• pp.57-64
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• 2015

Carbon dioxide extinguishing systems are broadly used for onshore and offshore fire accidents because of excellent performance and low cost. However, there is risk with carbon dioxide systems, which have caused many injuries and deaths by suffocation associated with industrial and marine fire protection applications. In this study, a numerical analysis was performed to predict the fire suppression characteristics of a carbon dioxide system in the compressor room of ships. A double protection safety system is suggested to prevent suffocation accidents from carbon dioxide extinguishing systems. Four scenarios were selected to study the variation of the heat release rate, maximum temperature, a $CO_2$ and $O_2$ mole fraction, and fire suppression characteristics with the carbon dioxide system. The importance of proper design is suggested for a ventilation system in the compressor room of ships.

• Journal of Trauma and Injury
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• v.27 no.4
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• pp.126-132
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• 2014

Purpose: The field trauma triage for injured patients is essential for trauma care system. In this study, agreement of patient evaluation between by prehospital EMS personnel and by hospital staffs and the appropriateness of prehospital triage were evaluated. Methods: This observational study was conducted from September to October 2012 for 5 weeks. During this period, EMT evaluated patient's severity according to guideline for field triage and recorded. Same guideline was applied in 26 hospitals for patients with EMS use. Kappa statistics were used to measure agreement for each item of guideline. Finally, over-triage and under-triage rate of EMT were calculated. Results: During study period, total 3,106 patients were transferred to 26 hospital emergency departments with EMS use. Kappa statistics for "vital signs" items were 0.45 for mentality lower than V and 0.44 for systolic blood pressure lower than 90 mmHg as a moderate agreement. In "anatomy of injury" items Kappa statistics were very low. In "mechanism of injury" items Kappa statistics were 0.28 for high-rise fall down and 0.27 for high energy traffic accident but in other items Kappa statistics were very low. 362 patients (12.0%) were over-triaged and 281 patients (9.3%) were under-triaged. Conclusion: Field triage can be applied but need to evaluate and modify in order to become accurate and sensitive for decision of transportation.

• Archives of Reconstructive Microsurgery
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• v.18 no.2
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• pp.62-66
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• 2009

Purpose: Despite the free tissue transfer using microsurgical technique being the current trend of soft tissue reconstruction of the hand, the pedicled groin flap has the advantage to provide coverage for the mangled hand without necessitating the use of a damaged arterial system and also providing the benefit of saving the arterial system for later free tissue transfer. This report presents the author's experience using pedicled groin flap in four cases of mangled hands with massive bone and soft tissue defects requiring later thumb reconstruction with the free wrap around flap. Materials and methods: The patients' age ranged from 30 to 51 years; three patients were male and one was female. The causes of mangled hand included two machinery crush injuries, one laboratory explosion and one motor vehicle accident. While evaluating the post-operative results, factors like flap survival, complications, stability in opposition, pinch power and 2 point discrimination were taken into account. Results: All massive soft tissue defects of the hands were completely covered with pedicled groin flap successfully. The reconstructed thumb using free wrap around flap did not have any limitation in opposition. There was no occurrence of post-operative infection and all the flaps survived completely. The average pinch power was 70% of the contralateral intact thumb and average 2 point discrimination was 10 mm. Conclusion: The pedicled groin flap for the reconstruction of the massive soft tissue defects of the hand with subsequent reconstruction of the thumb with a wrap around flap is a very useful procedure. The combined use of pedicled groin flap and wrap around flap allows adequate coverage of sizable soft tissue defects and functional thumb opposition in cases of reconstruction of the mangled hands.