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Characteristics of Nasal Trauma in the Implanted Nasal Prosthesis (실리콘 코높임술 후 코 부위 외상의 특징)

  • Choi, Seok Min;Choi, Hwan Jun;Kim, Cheol Hann;Ahn, Hyung Sik;Kang, Sang Gue;Jung, Sung Gyun
    • Archives of Plastic Surgery
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    • v.35 no.5
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    • pp.597-602
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    • 2008
  • Purpose: Presently, silicone rubber is chosen most frequently for nasal augmentation. However, there is a possibility of extrusion with this material. Sometimes, noses are prone to be traumatized, and then silicone rubber has a possibility of deformity or deviation resulting in trauma. We experienced cases with complications and traumatic deformities after the augmentation rhinoplasty. Methods: A retrospective review was performed to determine the characteristics of the implanted nasal silicone prosthesis after trauma. The patients' data such as deviation of implant, shape of fracture, age and sex of the patient, time of treatment, operative methods were reviewed. From March 2001 to March 2008, this study was performed in 30 patients. The patients were 25 females and 5 males, from 24 to 60 years of age, with an average of 42. All patients had previous augmentation rhinoplasty with silicone implant. Results: All of the 30 patients were confirmed as deviation of silicone and nasal bone fractures in the facial bone CT scan. The most common cause of fracture was traffic accident. The classification of nasal trauma after augmentation was done by facial bone CT. Class I: Deviation of silicone without nasal bone fracture without extrusion(12 cases, 40%), Class II: Deviation of silicone without nasal bone fracture and with extrusion(4 cases, 13%), Class III: Deviation of silicone with nasal bone fracture and without extrusion(8 cases, 27%), Class IV: Deviation of silicone with nasal bone fracture and with extrusion(3 cases, 10%), Class V: Mild deviation of silicone with nasal bone fracture(3cases, 3%). Specially, the comminuted or trapezoid nasal fracture was confirmed in 11 cases(Class III, IV). Conclusion: The problems of silicone implant have generally been related to foreign body reactions, rigidity of the material, encapsulation, infections, and extrusion. We experienced 11 cases of comminuted or comminuted trapezoid shaped fracture below nasal implant. So, we think this phenomenon could be used in late problem of silicone implant.

Epidemiologic Characteristics of Carbon Monoxide Poisoning: Emergency Department Based Injury In-depth Surveillance of Twenty Hospitals (일산화탄소 중독의 역학적 특징: 전국 20개 병원 응급실 손상환자 표본 심층조사)

  • Bae, Sohyun;Lee, Jisook;Kim, Kyunghwan;Park, Junseok;Shin, Dongwun;Kim, Hyunjong;Park, Joonmin;Kim, Hoon;Jeon, Woochan
    • Journal of The Korean Society of Clinical Toxicology
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    • v.14 no.2
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    • pp.122-128
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    • 2016
  • Purpose: This study was conducted to describe the characteristics of patients with carbon monoxide (CO) poisoning. Methods: We retrospectively surveyed data from the Emergency Department based Injury In-depth Surveillance of 20 hospitals (2011-2014). We included patients whose mechanism of injury was acute CO poisoning caused by inhalation of gases from charcoal or briquettes. We surveyed the annual frequency, gender, age, result of emergency treatment, rate of intensive care unit (ICU) admission, result of admission, association with alcohol, and place of accident. We also surveyed the cause and experience of past suicide attempts by intentional poisoning. Results: A total of 3,405 patients were included (2,015 (59.2%) and 1,390 (40.8%) males and females, respectively) with a mean age of $39.83{\pm}18.51$ year old. The results revealed that the annual frequency of CO poisoning had increased and the frequency of unintentional CO poisoning was higher than that of intentional CO poisoning in January, February and December. The mean age of intentional CO poisoning was younger than that of unintentional CO poisoning ($38.41{\pm}13.03$ vs $40.95{\pm}21.83$) (p<0.001). The rates of discharge against medical advice (DAMA), ICU care and alcohol association for intentional CO poisoning were higher than for unintentional CO poisoning (36.4% vs 14.0%, 17.8% vs 4.7%, 45.2% vs 5.6%) (p<0.001). The most common place of CO poisoning was in one's residence. Conclusion: The annual frequency of total CO poisoning has increased, and unintentional CO poisoning showed seasonal variation. DAMA, ICU care, and alcohol association of intentional CO poisoning were higher than those of unintentional CO poisoning.

Reduction of Fall Incidence through Operation of the Staff Nurse-Centered Peer Review Group (낙상 peer review group 운영을 통한 낙상발생률 감소)

  • Sung, Il Soon;Song, Mi Ra;Kim, Hee Sun;Kim, Eun Sook;Jung, Mi A;Lee, Su Mi;Sung, Young Hee;Ha, Kook Hee;Kim, Seong Hwa;Lee, Hye Ran;An, Kyoung Jin;Shim, Mi Ok;Kim, Nag Hee;Sung, Young Hee
    • Quality Improvement in Health Care
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    • v.14 no.1
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    • pp.49-54
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    • 2008
  • Background : This study was to reduce incidence of falls by analyzing actual problem and drawing out improvement plan applicable to the clinical practice through operation of the staff nurses-centered fall peer review group. Method : The fall peer review group was composed of 8 nurses having patient nursing experience for over 5 years, and each of fall cases was reviewed and the root cause was analyzed. As a result, it was found that the patients and their families did not fully understandthe content of the education, and the staff nurses did not completely inspect the risk factors of falls and perform immediate intervention when patient's condition changed. Based on the above-mentioned results, improvement activity was conducted for the purposes of consolidating patients education method and supplementing computerized system to support nurses' decision making as well as devices and facilities. Result : As a result of conducting improvement activity in the aspects of education for patients, support of nurse's decision-making, and devices and facilities through operation of the staff nurses-centered fall peer review group, falls decreased by 9.5% compared to before improvement activity. Conclusion : It is concluded that operation of the clinical nurses-centered fall peer review group played a role of promoter to draw out practical and applicable improvement plan to the clinical practice and apply directions of the field-centered, and increased nurses' interest in falls and ultimately, reduced incidence of falls. Therefore the Center will continue to operate the staff nurses-centered peer review group, and recommends participation of nurses who actually take the charge of nursing patients in further analysis of patients' safety accidents.

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A Study on the Ultrastructural Changes of Cardiac Muscle in Dichlorvos Treated Albino Rat (Dichlorvos가 흰쥐 심근의 미세구조에 미치는 영향)

  • Baik, Tai-Kyoung;Lee, Wha-Mo;Chung, Ho-Sam
    • Applied Microscopy
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    • v.24 no.3
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    • pp.23-33
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    • 1994
  • It is well known that dichlorvos (DDVP), an organophosphate insecticide in common use, is so easily and rapidly hydrolyzed and excreted that it has usually little toxic effect on human body. In these days, however, it is widely used as an industrial and domestic insecticide and as an anthelmintic agent for animals, so that the accident of chemical poisoning occurs frequently. DDVP acts as a powerful inhibitor of carboxylic esterase, which can cause accumulation of acetylcholine at the synapses so paralysis of muscle and the transmission failure in cholinergic synapses dueing to desensitization of acetylcholin receptor may occure. Moreover accumulation of the acetylcholine brings about the elevation of the cyclic-AMP, which alters the cellular metabolisms of nucleic acid, carbohydrate, protein and lipid. Present study has undertaken to investigate the cardiotoxic effect of DDVP by electron microscopic study. A total of 30 Sprague-Dawley strain rats, weighing about 250gm were used as experimental animals. 2mg/kg/day of DDVP is intraperitonealy injected 3 times with intervals of every other day. On 1 day, 3 days, 5 days, 7 days and 14 days after drug administration, the animals were sacrified by cervical dislocation. Left ventricular cardiac muscles were resected and sliced into $1mm^3$. The specimens were embedded with Epon 812 and prepared by routine methods for electron microscopical observation. All preparations were stained with lead citrate and uranyl acetate and then observed with Hitachi-600 transmission electron microscope. The results were as follows: 1. In the cardiac muscle of DDVP treated rats, mitochondria with disorganized double membrane and mitochondrial crista, and vacuole formation in mitochondrial matrix were observed. But structures of mitochondria were recovered to normal in 14 days group. 2. In the cardiac muscle of DDVP treated rats, cisternae of sarcoplasmic reticulum were dilated and sacculated. But these changes were recovered to normal in 14 days group. 3. In the cardiac muscle of DDVP treated rats, glycogen particles around damaged myofibrils were decreased. But amount of glycogen particles were restored in 14 days group. 4. In the cardiac muscle of DDVP treated rats, disruption and discontinuation of myofilaments and disorganization of Z-disc were observed. But the structures of myofibrils were recovered to normal in 14 days group. It is consequently suggested that DDVP would induce the reversible degenerative changes on the ultrastructures in cardiac muscle of rat.

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A Ship-Wake Joint Detection Using Sentinel-2 Imagery

  • Woojin, Jeon;Donghyun, Jin;Noh-hun, Seong;Daeseong, Jung;Suyoung, Sim;Jongho, Woo;Yugyeong, Byeon;Nayeon, Kim;Kyung-Soo, Han
    • Korean Journal of Remote Sensing
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    • v.39 no.1
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    • pp.77-86
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    • 2023
  • Ship detection is widely used in areas such as maritime security, maritime traffic, fisheries management, illegal fishing, and border control, and ship detection is important for rapid response and damage minimization as ship accident rates increase due to recent increases in international maritime traffic. Currently, according to a number of global and national regulations, ships must be equipped with automatic identification system (AIS), which provide information such as the location and speed of the ship periodically at regular intervals. However, most small vessels (less than 300 tons) are not obligated to install the transponder and may not be transmitted intentionally or accidentally. There is even a case of misuse of the ship'slocation information. Therefore, in this study, ship detection was performed using high-resolution optical satellite images that can periodically remotely detect a wide range and detectsmallships. However, optical images can cause false-alarm due to noise on the surface of the sea, such as waves, or factors indicating ship-like brightness, such as clouds and wakes. So, it is important to remove these factors to improve the accuracy of ship detection. In this study, false alarm wasreduced, and the accuracy ofship detection wasimproved by removing wake.As a ship detection method, ship detection was performed using machine learning-based random forest (RF), and convolutional neural network (CNN) techniquesthat have been widely used in object detection fieldsrecently, and ship detection results by the model were compared and analyzed. In addition, in this study, the results of RF and CNN were combined to improve the phenomenon of ship disconnection and the phenomenon of small detection. The ship detection results of thisstudy are significant in that they improved the limitations of each model while maintaining accuracy. In addition, if satellite images with improved spatial resolution are utilized in the future, it is expected that ship and wake simultaneous detection with higher accuracy will be performed.

A study on the Development of Surveillance System for Agricultural Injuries in Korea (농작업재해 감시체계 개발)

  • Koh, Jae-Woo;Kwon, Soon-Chan;Kim, Kyung-Ran;Lee, Kyung-Suk;Jang, Eun-Chul;Kwon, Young-Jun;Ryu, Seung-Ho;Lee, Soo-Jin;Song, Jae-Chul
    • Journal of agricultural medicine and community health
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    • v.32 no.3
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    • pp.139-153
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    • 2007
  • Injury in agriculture is a serious public health issue with a major impact on the lives of Korean farmers. It is one of the leading causes of death and is also a major cause of longand short-term disability. In 2001, the social cost of one accident in agricultural machinery was estimated as 97.7-97.8 million won that is 4 fold of farm household income in Korea. Effective prevention and control of injuries requires a system of surveillance that monitors the incidence of injuries, their causes, treatment and outcomes. This requires an integrated system of data collection, analysis and interpretation and communication. Creating effective injury surveillance system in Korea requires to establish a framework for a national agenda. Discussions regarding the development of the framework should address, but not be limited to issues related to Data Holdings and Linkages; Capacity and Skills; Communication; Interconnection; and Surveillance Products. Ideally, an injury surveillance system would meet the information requirements across all sectors, while allowing each to have the ongoing information it needs for its policy and programming needs. This study was carried out to develop a surveillance system of agricultural injuries in Korea. Study subjects were residents who lived in a typical agricultural area (Yangpyung area in Kyung-gi province). The main data sources were reports of village headmen, compared with data of 'National Emergency Management Agency', 'National Health Insurance Corporation', 'Insurance of National Agricultural Cooperative', and 'Emergency Medical Centers'. Each data were reviewed to validate the strengths and weaknesses.

A Study on Occupational Hydrofluoric Acid Burns in a Hydrofluoric Acid Manufacturing Factory (불산제조업체에서 발생한 불산화상에 관한 조사연구)

  • Lim, Hyun-Sul;Cheong, Hae-Kwan;Kim, Ji-Young
    • Journal of Preventive Medicine and Public Health
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    • v.26 no.4 s.44
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    • pp.587-598
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    • 1993
  • Hydrofluoric acid is one of the strongest irritating, corrosive and poisonous inorganic chemicals. Hydrofluoric acid burns are occurring with ever-increasing frequency due to the wide use of this acid in industries. Hydrofluoric acid burns are characterized by severe progressive tissue destruction and excruciating pain due to the unique properties of the freely dissolvable fluoride ion. The authors reviewed medical records of 32 cases (36 spells) of hydrofluoric acid burns which occurred in a hydrofluoric acid manufacturing factory from Sep. 1, 1990 to June 30, 1993. The results are as follows; 1. Eleven measurements of air concentrations of hydrofluoric acid by detection tube method from 1990 to 1992 were all below TLV (Department of Labor, R.O. K). 2. There were 19 cases (22 spells) of hydrofluoric acid burns which occurred during the study period among regular employees. The overall incidence density of hydrofluoric acid was 17.8 cases (20.6 spells) per 100 person-year. Incidence density was 19.0 cases (22.0 spells) per 100 person-year among male workers and there were no female cases. Incidence density was 32.9 cases (38.3 spells) per 100 person-year among production workers and 1.9 cases (1.9 spells) per 100 person-years among management workers with the difference being statistically significant (P<0.01). 3. Of 32 cases (36 spells) of hydrofluoric acid burns among workers who were regularly employed or temporarily employed, 26 spells (81.2%) were between age 20 to 39. In 15 spells(41.7%) burns occurred between 12:00 and 17:59 with 16 spells(44.3%) having arrived at hospital within 2 hours after the accident. 4. Of 36 spells, the main cause of hydrofluoric acid burns were by splashes (8 spells, 22.2 %). The most frequent site of burns were fingers and pain was the most frequent symptom. Thirty spells (83.3%) of the hydrofluoric acid burns were treated with local injection of antidote (calcium gluconate). Complete recovery without scarring were observed in most of the cases (34 out of 36 cases, 94.4%). The study results suggest that to prevent hydrofluoric acid burns, environmental control and the wearing of hydrofluoric acid resistant protective clothes and gloves are important. It is also stressed that establishment of an emergency management and a transfer system for hydrofluoric acid burn victims is necessary.

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A Clinical Study of Patients with Headache Founded on DongEuiBoGam (동의보감(東醫寶鑑)에 따른 편(偏), 담궐(痰厥) 몇 기궐두통(氣厥頭痛) 환자의 임상적 고찰)

  • Kim, Ji-Yun;Hong, Hyun-Woo;Kim, Jae-Yeon;Kim, Ki-Tak;Heo, Tae-Yool;Park, Dong-Il;Gam, Chul-Woo
    • The Journal of Internal Korean Medicine
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    • v.26 no.4
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    • pp.806-819
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    • 2005
  • Objective : The purpose of this study is to investigate clinical characteristics and remedial value oriental medical therapy for sufferers of severe headache. Methods : On the authority of DongEuiBoCam, patients were classified into three groups: migraine, qi-syncope headache and phlegm-headache. All patients wert treated with acupuncture therapy and herb medicines. After that inquiry was made into the extent of improvement of headache. Results : 1. In accordance with the statistics, 56 cases(50.5%) had phlegm-syncope headache, 28 cases(25.2%) had qi-syncope headache and 27 cases(24.3%) had migraine. 2. The ratio between males and females was about 1:4. Most patients were in their forties. 3. 12 cases(31.6%) with migraine had pain only on the right side of the head, 20 cases(26.3%) with phlegm-syncope and 17 cases(45.6%) with qi-syncope headache suffered from the frontal lobe headache. 4. 8 cases(29.6%) with migraine had been suffering for a week or less, 12 cases(21.4%) with phlegm-syncope headache had been suffering for over six months and under one year and 6 cases(21.4%) with qi-syncupe headache had suffered over one year and under five. 5. Overwork and stress was deemed the main cause of migraine. Phlegm-syncope headache was also attributed to stress and tense situations. Qi-syncope headache was believed to be variously caused by traffic accident, noise, blood pressure and other reasons. 6. 46 cases(30%) felt dull headache and 32 cases(20.9%) felt dizzy. The common associated symptoms of migraine and qi-syncope headache included back, neck and shoulder pain and other pains. Dizziness was an especially prevalent symptom of phlegm-syncope headache. 7. After the oriental medical therapy, 12 cases(10.8%) almost entirely recovered, 50 cases(45%) were in about half as much pain, 45 cases(40.5%) improved little and 4 cases(3.6%) felt no improvement. Conclusions : The results support a role for oriental medical therapy in treatment of headache.

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The characteristics of nuclear powered submarine and the use of enriched uranium (원자력 추진 잠수함의 특성과 농축우라늄 사용)

  • Jang, Jun-Seop
    • Strategy21
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    • s.41
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    • pp.261-293
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    • 2017
  • Nuclear power is a way of attaining an enormous amount of energy with relatively small amount of resources and after it has been introduced to the submarine since 1954, there are approximately 150 of nuclear powered submarine currently on a mission around the world. This is due to the maneuverability, mountability and covertness of nuclear submarines. However, there are other tasks, not only the high level of nuclear technology that are needed to be dealt with in order to construct nuclear powered submarine. The biggest task of all is to secure the enriched uranium. Accordingly, this research is about the way of enriching and securing the nuclear fuel that are used in the nuclear submarine with the characteristics, merits and demerits of the nuclear submarine. Due to the fact that the pressurized water reactor in South Korea is the reactor that was originally built for the development of nuclear powered submarine, many parts is designed to be suitable for the submarine propulsion. However, in order to apply this to submarine it is needed to consider additional requests such as the position of reactor, accident-coping system, radioactive covering, reactor output adjustment and ship's pitch and roll in order to apply this to submarine. Nuclear submarines have much higher speed based on the powerful propulsion in comparison with diesel-electric submarine and also have bigger loading area. Besides, there is no need to snorkel and they also have advantages in covertness with the multi-noise proof system. The nuclear technology in South Korea has seen the dramatic development since 1962 and in 1998 reached to the level that we have succeeded in the localization of nuclear plant and exported the world-class one-piece small-sized reactor (SMART) to UAE. To operate these reactors, we import the whole quantity of low-enriched uranium and having our own uranium enrich facility is not probable because of the budget and international regulations. With the ROK/US nuclear agreement revised on 2015 November, the enrichment of uranium that are available without special permission has changed up to 20%. According to the assumption that we use the 20% enrichment of Uranium on U.S. virginia class submarine, it is necessary to change the fuel after 11 years and it will cause additional cost of 1 billion dollars. But the replace period by the uranium's enrichment rate is not fixed so that it is possible to change according to the design of reactor. Therefore, I would like to make a suggestion on two types of design concepts of nuclear submarine that can be operated for 30 years without nuclear fuel change by using the 20% enriched uranium from ONNp.First of all, it is possible by increasing the size of reactor by 3 times and it results in the 1,000t increase of the weight. And secondly, it is by designing the one piece reactor to insert devices such as steam turbine, condenser into the inside of nuclear core like the Rubis class submarines of France.

A Case of Fat Embolism Syndrome of Fat Globules Found in BAL Fluid after Recovery from Acute Respiratory Failure (급성호흡부전 호전 후 기관지폐포세척에서 지방과립구가 확인된 지방색전증후군 1예)

  • Park, Song Ree;Kim, Hyun Soo;Lee, Jae Hyung;Kim, Sang Heon;Kim, Tae Hyung;Yoon, Ho Joo;Park, Sung Soo;Shin, Dong Ho;Park, Chan Kum
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.6
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    • pp.562-566
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    • 2006
  • Fat embolism syndrome is a rare clinical diagnosis of dyspnea with acute respiratory failure and neurological signs caused by a traumatic long bone fracture. We report a case of fat embolism in a 22 year-old man after a traffic accident. Dyspnea and stuporous mental changes developed on the $1^{st}$ day after the external fixation operation of a left metaphyseal femur fracture. On the following day, he was transferred from a hospital to this one because of acute respiratory failure. After recovery, macrophages with fat droplets were found in the bronchoalveolar lavage fluid 1. It is important to diagnose a fat embolism as the correct cause of acute respiratory failure through the BAL in the acute state of fat embolism syndrome It is believed that clinically apparent or sometimes hidden fat embolism syndrome can be diagnosed from the BAL during the recovery state.