• Journal of The Korean Society of Emergency Medicine
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• v.29 no.5
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• pp.500-508
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• 2018

Objective: The aim of this study was to evaluate the clinical characteristics of heat stroke in a bath facility and investigate predictive factors of multiple major complications in heat stroke patients. Methods: This was a retrospective study on heat stroke patients who visited an urban emergency center from January 2010 to March 2018. We compared clinical characteristics, complication, and outcomes of heat stroke patients in bath and non-bath facilities. Multivariate logistic regression analysis were performed to identify independent predictors of multiple major complications in heat stroke patients. Results: A total of 67 heat stroke patients with heat stroke were enrolled, of which 42 (62.6%) were in a bath facility and 25 (37.3%) were in a non-bath facility. Patients with heat stroke in the bath facility were characterized by old age, past medical history of hypertension and diabetes mellitus, and high incidence of hypotension compared with those in the non-bath facility but also low incidence of acute renal failure, seizure, and multiple major complications. In the multivariate analysis, predictive factors of multiple major complications in heat stroke patients were non-bath facility (odds ratio [OR], 5.4; 95% confidence interval [CI], 1.2-29.9), Glasgow Coma Scale (GCS)${\leq}8$ (OR, 8.2; 95% CI, 1.3-49.4), and mean arterial pressure (MAP), body temperature above $40.5^{\circ}C$ (OR, 8.1; 95% CI, 1.1-58.8) <60 mmHg (OR, 14.8; 95% CI, 1.8-122.9). Conclusion: Heat stroke in the bath facility resulted in less major complications, and high body temperature, GCS ${\leq}8$, and MAP <60 mmHg were independent predictive factors of multiple major complications in heat stroke patients.

• Journal of Korea Water Resources Association
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• v.54 no.3
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• pp.181-190
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• 2021

In this study, a large-scale levee breach experiment from lateral overflow was conducted to verify the effect of the new reinforcement method applied to the levee's surface. The new method could prevent levee failure and minimize damage caused by overflow in rivers. The levee was designed at the height of 2.5 m, a length of 12 m, and a slope of 1:2. A new material mixed with biopolymer powder, water, weathered granite, and loess in an appropriate ratio was sprayed on the levee body's surface at a thickness of about 5 cm, and vegetation recruitment was also monitored. At the Andong River Experiment Center, a flow (4 ㎥/s) was introduced from the upstream of the A3 channel to induce the lateral overflow. The change of lateral overflow was measured using an acoustic doppler current profiler in the upstream and downstream. Additionally, cameras and drones were used to analyze the process of the levee breach. Also, a new method using 3D point cloud for calculating the surface loss rate of the levee over time was suggested to evaluate the performance of the levee reinforcement method. It was compared to existing method based on image analysis and the result was reasonable. The proposed 3D point cloud methodology could be a solution for evaluating the performance of levee reinforcement methods.

• Journal of The Korean Society of Clinical Toxicology
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• v.18 no.2
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• pp.78-84
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• 2020

Purpose: In acute acetaminophen poisoning, the administration of N-acetylcysteine (NAC) can effectively treat the main complications, such as kidney injury and liver failure. In the current situation, measurements of the acetaminophen concentration are not checked in the usual medical facilities. Therefore, this study examined the factors of determining the administration of NAC in addition to the stated amount of intake. Methods: The medical records of patients who visited Ajou University Hospital emergency center with acetaminophen poisoning from January 2015 to December 2019 were reviewed retrospectively. One hundred and seventy-nine patients were initially included. Among these patients, 82 patients were finally selected according to the inclusion criteria in the study. The inclusion criteria were as follows: patients who were 15 years of age or older; those whose ingested dose, ingested time, and body weight were clearly identified; and patients whose acetaminophen sampling time was within 24 hours. Patients were divided into two groups: NAC administered vs. non-NAC administered. The following variables were compared in these two groups: ingested dose, ingested dose per body weight, hospital arrival time after ingestion, suicide attempt history, psychiatric disease history, classification of toxic/non-toxic groups, duration of hospitalization, and laboratory results. Results: Univariate analysis revealed the ingested dose per body weight, hospital arrival time after ingestion, suicide attempt history, and psychiatric disease history to be the determining factors in administering NAC. Logistic regression analysis confirmed that the ingested dose per body weight was the only significant factor leading to an NAC treatment decision. (Odds ratio=1.039, 95% Confidential interval=1.009-1.070, p=0.009) Conclusion: The ingested dose per body weight was the only determining factor for administering NAC in patients with acute acetaminophen poisoning. On the other hand, additional criteria or indicators for the NAC administration decision will be necessary considering the inaccuracy of the ingested dose per body weight and the efficiency of NAC administration.

• Journal of Wetlands Research
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• v.23 no.2
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• pp.189-200
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• 2021

To improve the water quality of agricultural reservoirs, constructed wetlands are applied in many places. These are technologies that establish ecosystems and important design factors include water depth distribution, inflow and outflow, water flow distribution, hydraulic residence time, water quality treatment efficiency, aspect ratio, and the distribution of open water and covered water surfaces. For high efficiency during the operation of a constructed wetland, the design needs to be optimized and this requires consideration of the different types and length of the intake dam as well as the type and connection of wetland cells. Therefore, this study was conducted to investigate and suggest factors that needs to be considered during the design and for efficient operation measures through field surveys of 23 constructed wetlands that have been established and operated in agricultural reservoirs. Results of the field investigation shows that several sites were being operated improperly due to the malfunctioning or failure of the water level sensors, sedimentation in the intake dam, and clogging of the mechanical sluice frames. In addition, it was found that as the length of the inlet channel increases, the ecological disconnection between the intake dam upstream and the wetland outlet downstream also increases and was identified as a problem. Most of the wetlands are composed of 2 to 5 cells which can result to poor hydraulic efficiency and difficulty in management if they are too large. Moreover, it was found that the flow through a small wetland can be inadequate when there are too many cells due to excessive amounts of headloss.

• Quality Improvement in Health Care
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• v.27 no.2
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• pp.18-29
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• 2021

Purpose: Patients with hematologic malignancy (HM) typically have a high mortality rate when their condition deteriorates. The chronic progressive course of the disease makes it difficult to assess the effect of intervention on acute events. We investigated the effectiveness of a rapid response team (RRT) on in-hospital mortality in patients with HM. Methods: We retrospectively analyzed the data of patients with HM who admitted to the medical intensive care unit between 2006 and 2015. Clinical outcomes before and after RRT implementation were evaluated. Results: A total of 228 patients in the pre-RRT period and 781 patients in the post-RRT period were included. The overall in-hospital mortality was 55.4%. Patients in the post-RRT period had improved survival; however, they required more vasopressor therapy, continuous renal replacement therapy, and extracorporeal membrane oxygenation. Multivariate analysis revealed that in-hospital mortality was associated with RRT activation (hazard ratio [HR], 0.634; 95% confidence interval [CI], 0.498-0.807; p < .001), neurological disease (HR, 2.007; 95% CI, 1.439-2.800; p < .001), sequential organ failure assessment score (HR, 1.085; 95% CI, 1.057-1.112; p < .001), need for continuous renal replacement therapy (HR, 1.608; 95% CI, 1.206-1.895; p< .001), mechanical ventilation (HR, 1.512; 95% CI, 1.206-1.895; p< .001), vasopressor (HR, 1.598; 95% CI, 1.105-2.311; p = .013), and extracorporeal membrane oxygenation (HR, 1.728; 95% CI, 1.105-2.311; p = .030). Conclusion: RRT activation may be associated with improved survival in patients with HM.

• Journal of Chest Surgery
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• v.55 no.6
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• pp.435-441
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• 2022

Background: This study aimed to evaluate the impact of the treatment modality on post-procedural acute kidney injury (AKI) and other clinical outcomes in patients with advanced chronic kidney disease who underwent surgical or transcatheter aortic valve replacement (AVR). Methods: A total of 147 patients with advanced chronic kidney disease (stage 3 to 5) who underwent isolated surgical AVR (SAVR group; n=70) or transcatheter AVR (TAVR group; n=77) were retrospectively studied. Postprocedural AKI was defined according to the RIFLE definition (an acronym corresponding to the risk of renal dysfunction, injury to the kidney, failure of kidney function, loss of kidney function, and end-stage kidney disease). Factors associated with postoperative complications and mortality were analyzed using multivariable logistic regression models and Cox proportional hazard models. Results: Postprocedural AKI occurred in 17 (24.3%) and 6 (7.8%) patients in the SAVR and TAVR groups, respectively (p=0.006). Multivariable analyses demonstrated that the SAVR group had higher risks of AKI (odds ratio [OR], 5.63; 95% confidence interval [CI], 1.85-17.73; p=0.002) and atrial fibrillation (OR, 16.65; 95% CI, 4.44-62.50; p<0.001), whereas the TAVR group had a higher risk of permanent pacemaker insertion (OR, 5.67; 95% CI, 1.21-26.55; p=0.028). The Cox proportional hazard models showed that the occurrence of AKI, contrary to the treatment modality, was associated with overall survival. Conclusion: In patients with chronic kidney disease, the risk of postprocedural AKI might be higher after SAVR than after TAVR.

• Journal of The Korean Society of Clinical Toxicology
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• v.19 no.2
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• pp.83-92
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• 2021

Purpose: Glyphosate herbicide (GH) is a widely used herbicide and has been associated with significant mortality as poisoned cases increases. One of the reasons for high toxicity is thought to be toxic effect of its ingredient with glyphosate. This study was designed to determine differences in the clinical course with the salt-type contained in GH. Methods: This was a retrospective study conducted at a single hospital between January 2013 and December 2017. We enrolled GH-poisoned patients visited the emergency department. According to salt-type, patients were divided into 4 groups: isopropylamine (IPA), ammonium (Am), potassium (Po), and mixed salts (Mi) groups. The demographics, laboratory variables, complications, and their mortality were analyzed to determine clinical differences associated with each salt-type. Addtionally, we subdivided patients into survivor and non-survivor groups for investigating predictive factors for the mortality. Results: Total of 348 GH-poisoned patients were divided as follows: IPA 248, Am 41, Po 10, and Mi 49 patients. There was no difference in demographic or underlying disease history, but systolic blood pressure (SBP) was low in Po group. The ratio of intentional ingestion was higher in Po and Mi groups. Metabolic acidosis and relatively high lactate level were presented in Po group. As the primary outcome, the mortality rates were as follows: IPA, 26 (10.5%); Am, 2 (4.9%); Po, 1 (10%); and Mi, 1 (2%). There was no statistically significant difference in the mortality and the incidence of complications. Additionally, age, low SBP, low pH, corrected QT (QTc) prolongation, and respiratory failure requiring mechanical ventilation were analyzed as independent predictors for mortality in a regression analysis. Conclusion: There was no statistical difference in their complications and the mortality across the GH-salt groups in this study.

• Journal of the Korean Geotechnical Society
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• v.37 no.11
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• pp.23-36
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• 2021

In this paper, the effect of shear rate on internal friction angle and unconfined compressive strength of non-cemented and cemented sand was investigated. A dry Jumunjin sand was prepared at loose, medium, and dense conditions with a relative density of 40, 60 and 80%. Then, series of direct shear tests were conducted at shear rates of 0.32, 0.64, and 2.54 mm/min. In addition, a cemented sand with cement ratio of 8% and 12% was compacted into a cylindrical specimen with 50 mm in diameter and 100 mm in height. Unconfined compression tests on the cemented sand were performed with various shear rates such as 0.1, 0.5, 1, 5 and 10%/min. Regardless of a degree of cementation, the unconfined compressive strength of the cemented sand and the angle of internal friction of the non-cemented sand tended to increase as the shear rate increased. For the non-cemented sand, the angle of internal friction increased by 4° at maximum as the shear rate increased. The unconfined compressive strength of the cemented sand also increased as the shear rate increased. However, its increasing pattern declined after the standard shear rate (1 mm/min). A discrete element method was also used to analyze the crack initiation and its development for the cemented sand with shear rate. Numerical results of unconfined compressive strength and failure pattern were similar to the experimental results.

• Korean Journal of Culture and Social Issue
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• v.27 no.4
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• pp.475-503
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• 2021

The purpose of this study is to clarify the constructs of emotion suppression and help understanding on the multidimensional nature of emotion suppression by classifying constructs for suppression according to the KMW model. Also, this study examined the gender differences of emotion suppression. For this purpose, 657 adult male and female subjects were evaluated for attitude toward emotions, and difficulty in emotional regulation, as well as depression, state anger and daily stress scale. As a result of the exploratory factor analysis on the scales related to the emotion suppression factors, the emotion suppression factors corresponding to each stage of the KMW model were found to be 'distraction against emotional information, 'difficulty in understanding and interpretation of emotions', 'emotion control beliefs', 'vulnerability on emotional expression beliefs'. Next, the study participants were classified by performing a cluster analysis based on each emotion suppression factor. As a result, four clusters were extracted and named 'emotional control belief cluster', 'emotional expression cluster', 'emotional attention failure cluster', and 'general emotional suppression cluster'. As a result of examining the average difference of male depression, depression, state anger, and daily stress for each group, significant differences were found in all dependent variables. As a result of examining whether there is a difference in the frequency of emotional suppression clusters according to gender, the frequency of emotional suppression clusters was high in men, and the ratio of emotional expression clusters was high in women. Finally, it was analyzed whether there was a gender difference in the effect of the emotional suppression cluster on psychosocial adaptation, and the implications were discussed based on the results of this study.

• Journal of Chest Surgery
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• v.56 no.3
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• pp.155-161
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• 2023

Background: Surgical closure of an atrial septal defect (ASD) is infrequently indicated during infancy. We evaluated the clinical characteristics and outcomes of patients who underwent surgical ASD closure during infancy. Methods: A single-center retrospective review was performed for 39 patients (19 males) who underwent surgical ASD closure during infancy between 1993 and 2020. The median body weight percentile at the time of operation was 9.3. Results: During a median follow-up of 60.9 months, 4 late deaths occurred due to chronic respiratory failure. A preoperative history of bronchopulmonary dysplasia (BPD) was the only risk factor for late mortality identified in Cox regression (hazard ratio, 3.54; 95% confidence interval [CI], 1.75-163.04; p=0.015). The 5-year survival rate was significantly lower in patients with preoperative history of BPD (97.0% vs. 50.0%, p<0.001) and preoperative ventilatory support (97.1% vs. 40.4%, p<0.001). There were significant postoperative increases in left ventricular end-diastolic (p=0.017), end-systolic (p=0.014), and stroke volume (p=0.013) indices. A generalized estimated equation model showed significantly better postoperative improvement in body weight percentiles in patients with lower weight percentiles at the time of operation (<10th percentile, p=0.01) and larger indexed ASD diameter (≥45 mm/m², p=0.025). Conclusion: Patients with ASD necessitating surgical closure during infancy are extremely small preoperatively and remain small even after surgical closure. However, postoperative somatic growth was more prominent in smaller patients with larger defects, which may be attributable to an increase in postoperative cardiac output due to changes in ventricular septal configuration. The benefits of ASD closure in patients with BPD are undetermined.