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Resuscitative Endovascular Balloon Occlusion of the Aorta in Impending Traumatic Arrest: Is It Effective?

  • Chung, Jae Sik;Kim, Oh Hyun;Kim, Seongyup;Jang, Ji Young;An, Gyo Jin;Jung, Pil Young
    • Journal of Trauma and Injury
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    • v.33 no.1
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    • pp.23-30
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    • 2020
  • Purpose: Hemorrhagic shock is the leading cause of death in trauma patients worldwide. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a technique used to improve the hemodynamic stability of patients with traumatic shock and to temporarily control arterial hemorrhage. However, further research is required to determine whether REBOA with cardiopulmonary resuscitation (CPR) in near-arrest or arrest trauma patients can help resuscitation. We analyzed trauma patients who underwent REBOA according to their CPR status and evaluated the effects of REBOA in arrest situations. Methods: This study was a retrospective single-regional trauma center study conducted at a tertiary medical institution from February 2017 to November 2019. We evaluated the mortality of severely injured patients who underwent REBOA and analyzed the factors that influenced the outcome. Patients were divided into CPR and non-CPR groups. Results: We reviewed 1,596 trauma patients with shock, of whom 23 patients underwent REBOA (1.4%). Two patients were excluded due to failure and a repeated attempt of REBOA. The Glasgow Coma Scale score was lower in the CPR group than in the non-CPR group (p=0.009). Blood pressure readings at the emergency room were lower in the CPR group than in the non-CPR group, including systolic blood pressure (p=0.012), diastolic blood pressure (p=0.002), and mean arterial pressure (p=0.008). In addition, the mortality rate was higher in the CPR group (100%) than in the non-CPR group (50%) (p=0.012). The overall mortality rate was 76.2%. Conclusions: Our study suggests that if REBOA is deemed necessary in a timely manner, it is better to perform REBOA before an arrest occurs. Therefore, appropriate protocols, including pre-hospital REBOA, should be constructed to demonstrate the effectiveness of REBOA in reducing mortality in arrest or impending arrest patients.

Arthroscopic Reconstrucion in Megafrequency of Recurrent Anterior Shoulder Dislocations (관절경을 이용한 고 빈도 재발성 전방 견관절 탈구의 재건술)

  • Ko, Sang-Hun;You, Chong-Il;Cho, Sung-Do;Choi, Chang-Hyuk;Cheon, In-Ho;Woo, Jong-Keun;Kwag, Chang-Yul;Yun, Dong-Jin;Choe, Seong-Won
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.2
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    • pp.194-200
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    • 2005
  • Purpose: To evaluate the short-term follow up outcome and the effectiveness of arthroscopic vertical shift of anteroinferior capsulolabral complex, plication of AIGHLC (anterior band of inferior glenohumeral ligament complex) and thermal capulorraphy, posteroinferior suture plication, rotator interval closure as an adjuncts in recurrent instability of megafrequency with night time dislocation. Materials & Methods: From March 1998 to February 2004, we have had 18 shoulders out of 156. All of the cases have been night time dislocation above more one time. The age were average 29.4$(21{\sim}37)$ year old. The average follow up were 21.1 $(12{\sim}45)$months We checked Rowe score and ROM at pre-operation, post-operation 6 months,1 year & last follow up period. Results: Above good results were 16 cases(88.9%). The excellent were 6 cases, good were 10, fair 1, poor 1. Conclusions: In recurrent anterior shoulder dislocation in greater than 50 frequency, arthroscopic stabilization can be an alternative technique for selected patients against open inferior capsular shift. But more long ter n follow up and large materials will be needed in the future study.

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A Study on the Comparison for Energy Consumption Characteristics between G-SEED certified and non-certified Office Buildings in Korea (G-SEED 인증 건축물과 비인증 건축물의 에너지 소비량 특성에 관한 연구 : 업무시설을 대상으로)

  • Kim, Jong-Hyun;Kim, Jin-Ho
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.11
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    • pp.33-43
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    • 2019
  • Considerable efforts have been made to reduce greenhouse gas emission around the world to cope with climate change. The government is implementing G-SEED certification to promote energy efficient building design. This study aims to verify the effectiveness of the G-SEED certification system by analyzing the actual energy use of certified and non-certified office buildings. For this purpose, the energy consumption of 135 certified and 142 non-certified office buildings was analyzed according to the seasonal characteristics, building size and number of floors, approval year, and certification grade. The energy saving effects of certified buildings was about 50% higher than that of non-certified buildings. The seasonal energy consumption of buildings is closely related to the heating degree-days. The energy consumption of certified and non-certified buildings decreases with increasing approval year. On the other hand, the energy consumption according to building size and certification grade is not related. This study provides meaningful basic data of G-SEED certification system for future improvement. As the building energy performance standards are strengthened over the years, it is necessary to make the individual score of G-SEED certified projects open to the public to configure the factors of energy efficiency.

A Study on the Environmental Improvement of National Parks' Public Space Design - Focusing on Trail Entry Areas - (공공디자인 측면에서의 국립공원 환경개선의 효과성 및 만족도 분석 - 탐방로 진입부 공간을 중심으로 -)

  • Lee, Sook-Hyang;Sim, Kyu-Won;Lee, Ho-Seung;Lee, Jea-Kyu;Jeong, Jeong-Kwon
    • Journal of Korean Society of Rural Planning
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    • v.22 no.3
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    • pp.49-61
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    • 2016
  • This study examined the effectiveness of and satisfaction of visitors with the Environmental Improvement Project on national parks' trail entry areas. A survey was conducted to improve the proposal framework based on the data. Data for the study were obtained from 6400 respondents who used 28 national park offices at 32 national park trail entry areas. The field research was collected in 3200 surveys, divided between pre- and post-implementation of the Environmental Improvement Project. The study variables consisted of socio-demographics, visitors' perceptions on the environmental improvement of trail entries, effects of the environmental improvement, and visitor satisfaction. Several important results were found. First, the environment of trail entries has a significant impact on the formation of images and user satisfaction of national parks. Second, the influence of the trail entry improvement showed that 71.8% of visitors rated the trail entry as environmentally friendly after the Environmental Improvement Project, compared to 48.5% of visitors rated the trail entry as environmentally friendly before the Environmental Improvement Project. The findings indicated that a top priority of environmental improvement of the trail entries needs to be the installation of convenience facilities such as rest areas, restrooms, and direction boards (pre: 34.5%, post: 32.6%). Third, functionality and the other nine variables were shown to enhance the effect of the environmental improvement of the trail entries at the 1% statistical significance level. Finally, results indicated that the overall satisfaction of the visitors with the park was significantly higher after the environmental improvement (t-value=25.741, p=.000), showing the satisfaction score was higher after the environmental improvement (pre: 3.51, post: 4.12), with a statistically significant difference at the 1 % level. This study helps to understand trail entries, which have influenced the image of the national park and satisfaction. These findings can be utilized to manage and design a national park as a public space.

Moxibustion for Benign Prostatic Hyperplasia: A Systematic Review and Meta-analysis (전립선 비대증에 대한 뜸치료의 효과 : 체계적 문헌고찰과 메타분석)

  • Bae, Go-eun;Lee, Seung-hwan;Hong, Jin-woo;Lee, In;Kim, So-yeon;Choi, Jun-young;Han, Chang-woo;Yun, Young-ju;Park, Seong-ha;Kwon, Jung-nam
    • The Journal of Internal Korean Medicine
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    • v.39 no.3
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    • pp.372-388
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    • 2018
  • Objective: This study evaluates the effectiveness and safety of moxibustion for benign prostatic hyperplasia (BPH). Methods: Using the keywords "benign prostatic hyperplasia", "benign prostatic hypertrophy", "benign prostatic enlargement", "prostatic hyperplasia", and "moxibustion", we searched papers in numerous databases, including National Discovery for Science Leaders (NDSL), Korean Traditional Knowledge Portal (KTKP), Oriental Medicine Advanced Searching Integrated System (OASIS), Research Information Sharing Service (RISS), PubMed, Embase, and CENTRAL. The search range included randomized controlled trials (RCTs). Papers not matched with inclusion criteria were excluded. The methodological quality of each RCT was assessed using the Cochrane risk-of-bias tool. Where appropriate, meta-analyses were performed. Results: Initially, 77 studies were found. Of these, 11 duplicate studies were removed and 27 were excluded following title and abstract screening. After the remaining 39 papers were scanned, 13 RCTs were selected and analyzed. Among these 13 RCTs, five compared moxibustion therapy and oral medication, seven compared moxibustion plus acupuncture therapy and oral medication, and one compared moxibustion plus acupuncture therapy and sham-moxibustion. The meta-analysis showed positive results for the use of moxibustion therapy in terms of International Prostate Symptom Score (IPSS), Quality Of Life (QOL), Maximum Flow Rate (Qmax), Prostate Volume (PV), and the efficacy rate. The meta-analysis showed positive results for the use of moxibustion plus acupuncture therapy in terms of IPSS, QOL, and the efficacy rate. Conclusions: This meta-analysis of clinical trials suggests that moxibustion is effective intreating BPH patients. The results of this study could be applied to clinical treatment of BPH. However, additional large-scale clinical researches should be conducted.

Analysis of Quantitative Electroencephalography (QEEG) Following Acupuncture Treatment in Patients with Insomnia: Z Scored Absolute Power and sLORETA (불면증 환자에 대한 침치료 전후 정량화 뇌파 분석: Z Scored Absolute Power and sLORETA)

  • Lee, Go Eun;Mun, Su Jeong;Lee, Sung Ik;Lim, Jung Hwa;We, Young Man;Moon, Kwang Su;Lyu, Yeoung Su;Kang, Hyung Won
    • Journal of Oriental Neuropsychiatry
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    • v.27 no.3
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    • pp.169-184
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    • 2016
  • Objectives: To investigate the neurophysiological effect of acupuncture treatment on insomnia patients using quantitative electroencephalography (QEEG) and standardized Low Resolution Brain Electromagnetic Tomography method (sLORETA).Background: Insomnia is one of the commonly encountered symptoms in primary medical care. Recent studies of acupuncture for insomnia reported that the acupuncture groups showed significant improvements compared with the control groups. However, the neurophysiological mechanism of acupuncture in the treatment of insomnia has not been revealed and a few studies have measured the effect of acupuncture treatment using QEEG.Methods: Participants who had some problems in initiating or maintaining sleep, or had non-restorative sleep for more than 3 days a week and ISI scores above 8 and below 21 were treated by acupuncture for 2 weeks (3 times a week, total 6 times). We assessed the effectiveness of acupuncture for insomnia by the PSQI (Pittsburgh Sleep Quality Index) at baseline and at 2 weeks after the end of treatment (4th week). Also, we performed EEG and analysed the EEG data at baseline and at the end of treatment (2nd week) on the linked ears montage using the Neuroguide software program and sLORETA.Results: Thirty-two participants were enrolled and 2 participants dropped out because of personal reasons. Among the 30 participants, EEGs of 12 participants were included in the analysis of QEEG and sLORETA. Total score on the ISI and PSQI was significantly decreased after acupuncture treatment. The number of electrodes exceeding the range of 90% (±1.65) or 95% (±1.96) in the z scored absolute power of beta was significantly decreased after acupuncture treatment. There was no significant change in brain activation between pre- and post-acupuncture using sLORETA.Conclusions: The deviation of absolute power compared to the normative database was significantly decreased after acupuncture treatment in the alpha and beta ranges. Therefore, we suggest that acupuncture treatment for insomnia might be effective through the central nervous system especially in the brain. There are many limitations to drawing any conclusion. Further studies are needed in the future to overcome these limitations.

Intermediate Term Follow Up for R3 Sympathicotomy in Palmar Hyperhidrosis (수장부 다한증에서의 제3번 늑골 위 교감 신경(R3) 차단술의 중기 결과)

  • 손국희;김광호;백완기;김정택;김현태;김영삼;윤용한
    • Journal of Chest Surgery
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    • v.37 no.6
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    • pp.530-535
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    • 2004
  • Background: Thoracoscopic R3 (above the third rib)sympathicotomy has been performed as an effective method in treating palmar hyperhidrosis because it is effective in eliminating the symptoms of hyperhidrosis and has lower degree of compensatory hyperhidrosis than that of sympathectomy. Most of the results published were based on the short-term follow up. So we evaluated the intermediate term follow up results of the R3 sympathicotomy. Material and Method: From April 1999 to August 2001, ninety-four patients with palmar hyperhidrosis had been treated by R3 sympathicotomy at the Inha University Hospital. Follow-up study was completed for 76 patients (male 38, female 38) and average follow-up period were 25$\pm$9.1 (15∼50) months. The sympathetic trunk passing above the upper border of third rib was divided by electric cautery. The patient's satisfaction after surgery was estimated using the analogue scale from score 0 to 100 (100 means perfect satisfaction). Result. The scale of patient's satisfaction immediately after operation was 92.36$\pm$9.93. After 15 months, the scale of satisfaction was decreased to average 71.80$\pm$20.24 and it is statiscally significant. The cause of dissatisfaction were compensatory hyper-hidrosis and recurrence of symptom. The degree of sweating immediately after operation was mean 0 and after 15 months it increased to mean 1.5. The degree of the compensatory hyperhidrosis immediately after operation was mean 1 and it increased to mean 5 after 15 months. Conclusion: R3 sympathicotomy has excellent therapeutic results immediately after operation but therapeutic effectiveness is becoming to decrease 15 months after operation. The common causes of dissatisfaction are compensatory hyperhidrosis and recurrence of hyperhidrosis.

Development and Effect of Creative Convergence HTE-STEAM Program using Natural Disaster (자연재해 주제를 활용한 창의융합 HTE-STEAM(융합인재교육) 프로그램 개발 및 효과)

  • Han, Shin;Kim, Yonggi;Kim, Hyoungbum
    • Journal of the Korean Society of Earth Science Education
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    • v.12 no.3
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    • pp.291-301
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    • 2019
  • The purpose of this study is to develop HTE-STEAM program using natural disasters for high school students and to verify their attitude and satisfaction with STEAM. We developed the HTE-STEAM program utilizing natural disasters and tested the effectiveness of 243 students from G High School and N High School. For data analysis, a single group pretest and post response t-test were conducted to verify the effects on attitudes and satisfaction with STEAM. The research results are as follows. First, we developed STEAM education programs for high school students by selecting the topic of "natural disasters" in the area of earth science and flying drones as lifesaving drones. The six-hour program was designed to give students the experience to solve problems by applying essential knowledge related to natural disasters and drones, and what they learned in other situations. Second, there was a significant statistical test result in the t-test of the corresponding sample by the difference between the pre and post score of the STEAM attitude test (p <.05). The drone-based HTE-STEAM program had a significant improvement in the overall attitude toward STEAM education, which consists of seven subfactors. Third, in the HTE-STEAM satisfaction test, the average value of the lower job offer was 3.64 ~ 3.76, which showed a positive response overall. It is judged that the students' satisfaction is improved through the students' understanding of the problem situation and the design of creative convergence and production process.

Medial Anterior-inferior Capsular Shift in Multidirectional Shoulder Instability (내측 전하방 관절낭 이동술을 이용한 다방향 견관절 불안정성의 치료)

  • Chung, Soo-Tai;Park, Jai-Hyung;Kim, Hyoung-Soo;Yoo, Jeong-Hyun;Kim, Joo-Hak;Ji, Jeong-Min;Jo, Hwan-Hee
    • Clinics in Shoulder and Elbow
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    • v.10 no.1
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    • pp.33-41
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    • 2007
  • Purpose: The purpose of this study was to prove the effectiveness of the open medial (glenoid-based) anterior-inferior capsular shift in patients with multidirectional shoulder instability. Materials and Methods: We reviewed 19 patients treated by medial anterior-inferior capsular shift for multidirectional shoulder instability from March, 1998 to December, 2003. 15 patients of them have experienced recurrent dislocation. 8 patients(42%) showed bilateral laxity and 11 patients(58%) generalized ligamentous laxity, and 2 patients(10.5%) voluntary subluxation. An average follow-up was 24 months (range : $9{\sim}32$ months). Results: Pain improved in 18 patients of all. There was an average loss of 10 degree of external rotation, but no limitation of activity of daily living. There was no redislocation and subluxation, but two patients had some apprehension in sports activity. With Rowe score, the result was excellent or good in all patients. There were hematoma and local skin problem in 1 patient, but all had healed up. Conclusion: Medial anterior-inferior capsular shift in multidirectional shoulder instability provided satisfactory results in pain relief, patient's satisfactions and stability of glenohumeral joint. Though some of them have anterior gleniod deformities and large Hill-Sachs lesions, we could get good stabilities.

Extracorporeal Shock Wave Therapy for Postoperative Pain after Ankle Surgery (족관절 수술 후 발생한 통증에 대한 체외충격파의 치료 효과)

  • Young, Ki Won;Kim, Jin Su;Jeon, Sung Han;Lee, Do Hyun
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.8 no.1
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    • pp.6-10
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    • 2015
  • Purpose: To evaluate the effectiveness of extracorporeal shock wave therapy (ESWT) for postoperative pain after surgery around ankle. Materials and Methods: We included 21 patients who performed an operation around ankle from 2009 to 2013. 4 times ESWT were applied to the patients who have tenderness more than visual analog scale (VAS) point 4. We evaluated the VAS at each sessions and final follow-up, and American Orthopedic Foot and Ankle Society ankle-hindfoot score (AFOAS) was checked at preoperative and final follow-up. Patient's satisfaction and complications were surveyed. Results: Preoperative VAS was mean 4.7, postoperative pain VAS was mean 6.0 at 4.5 months follow-up. The VAS after ESWT each session at 1, 2, 3 weeks and final follow-up were 4.8, 3.2, 2.3, 2.9, respectively. Mean final follow-up period was 9.4 months. Final VAS were significantly decreased (p<0.001). Final VAS were increased from VAS at last session of ESWT, however, not significant (p=0.189). AOFAS significantly improved from preoperative 60 to final follow-up 86 (p<0.001). Excellent was 12 patients (57%), good was 4 patients (19%), no change was 3 patients (14%) and poor was 2 patients (9%). 1 patient complained a dizziness and nausea during ESWT. Conclusion: ESWT for postoperative pain after ankle surgery shows satisfactory pain reduction in 76% of all patients without severe complication.

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