• Title/Summary/Keyword: Medical Treatment

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Musculoskeletal Injuries by Weapons in Korean Soldiers: Four-Year Follow-Up (총기 및 폭발물에 의한 군인의 근골격계 손상: 최근 4년간 분석)

  • Yang, Hanbual;Hwang, Il-Ung;Song, Daeguen;Moon, Gi Ho;Lee, Na Rae;Kim, Kyoung-Nam
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.3
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    • pp.234-244
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    • 2021
  • Purpose: To date, studies of firearm and explosive injuries in the Korean military have been limited compared to its importance. To overcome this, this study examined the characteristics of musculoskeletal damages in soldiers who have suffered firearm and explosive injuries over the past four years. Materials and Methods: From January 2015 to July 2019, military forces who had suffered musculoskeletal injuries from firearms or explosive substances were included. The medical records and radiographs were reviewed retrospectively, and telephone surveys about Short Musculoskeletal Functional Assessment (SMFA) for this group were conducted. To compare the functional outcomes, statistical analysis was performed using a t-test for the types of weapons, and ANOVA for others. Results: Of the 61 patients treated for firearms and explosives injuries, 30 patients (49.2%) were included after undergoing orthopedic treatment due to musculoskeletal injury. The average age at injury was 26.4 years old (21-52 years old). The number of officers and soldiers was similar. Eleven were injured by gunshot and 19 by an explosive device. Sixteen were treated in the Armed Forces Capital Hospital and 10 at private hospitals. More than half of the 16 patients (53.3%) with a fracture had multiple fractures. The most common injury site was the hand (33.3%), followed by the lower leg (30.0%). There were 14 patients (46.7%) with Gustilo-Anderson classification 3B or higher who required a soft tissue reconstruction. Fifteen patients agreed to join the SMFA survey for the functional outcomes. Between officers and soldiers, officers had better scores in the Bother Index compared to soldiers (p=0.0045). Patients treated in the Armed Forces Capital Hospital had better scores in both the Dysfunction and Bother Index compared to private hospitals (p=0.0008, p=0.0149). Conclusion: This is the first study to analyze of weapons injuries in the Korean military. As a result of the study, the orthopedic burden was high in the treating patients with military weapon injuries. In addition, it is necessary to build a military trauma registry, including firearm and explosive injuries, for trauma treatment evaluation and development of military trauma system.

A Study on Human Rights in North Korea in terms of Haewon-sangsaeng (해원상생 관점에서의 북한인권문제 고찰)

  • Kim Young-jin
    • Journal of the Daesoon Academy of Sciences
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    • v.43
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    • pp.67-102
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    • 2022
  • The purpose of this study is to analyze the human rights found in the North Korean Constitution and their core problem by focusing on elements of human rights suggested by Daesoon Jinrihoe's doctrine of Haewon-sangsaeng (解冤相生 the Resolution of Grievances for Mutual Beneficence). Haewon-sangsaeng is seemingly the only natural law that could resolve human resentment lingering from the Mutual Contention of the Former World while leading humans work for the betterment of one another. Haewon-sangsaeng, as a natural law, includes the right to life, the right to autonomous decision-making, and duty to act according to human dignity (physical freedom, the freedom of conscience, freedom of religion, freedom of speech, freedom of press, etc.), the right to equal treatment in one's social environment, and the right to ensure the highest level of health through treatment. The North Korean Constitution does not have a character as an institutional device to guarantee natural human rights, the fundamental principle of the Constitution, and stipulates the right of revolutionary warriors to defend dictators and dictatorships. The right to life is specified so that an individual's life belongs to the life of the group according to their socio-political theory of life. Rights to freedom are stipulated to prioritize group interests over individual interests in accordance with the principle of collectivism. The right to equality and the right to health justify discrimination through class discrimination. The right to life provided to North Koreans is not guaranteed due to the death penalty system found within the North Korean Criminal Code and the Criminal Code Supplementary Provisions. The North Korean regime deprives North Koreans of their right to die with dignity through public executions. The North Korean regime places due process under the direction of the Korea Worker's Party, recognizes religion as superstition or opium, and the Korea Worker's Party acknowledge the freedoms of bodily autonomy, religion, media, or press. North Koreans are classified according to their status, and their rights to equality are not guaranteed because they are forced to live a pre-modern lifestyle according to the patriarchal order. In addition, health rights are not guaranteed due biased availability selection and accessibility in the medical field as well as the frequent shortages of free treatments.

Heavy concrete shielding properties for carbon therapy

  • Jin-Long Wang;Jiade J Lu;Da-Jun Ding;Wen-Hua Jiang;Ya-Dong Li;Rui Qiu;Hui Zhang;Xiao-Zhong Wang;Huo-Sheng Ruan;Yan-Bing Teng;Xiao-Guang Wu;Yun Zheng;Zi-Hao Zhao;Kai-Zhong Liao;Huan-Cheng Mai;Xiao-Dong Wang;Ke Peng;Wei Wang;Zhan Tang;Zhao-Yan Yu;Zhen Wu;Hong-Hu Song;Shuo-Yang Wei;Sen-Lin Mao;Jun Xu;Jing Tao;Min-Qiang Zhang;Xi-Qiang Xue;Ming Wang
    • Nuclear Engineering and Technology
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    • v.55 no.6
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    • pp.2335-2347
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    • 2023
  • As medical facilities are usually built at urban areas, special concrete aggregates and evaluation methods are needed to optimize the design of concrete walls by balancing density, thickness, material composition, cost, and other factors. Carbon treatment rooms require a high radiation shielding requirement, as the neutron yield from carbon therapy is much higher than the neutron yield of protons. In this case study, the maximum carbon energy is 430 MeV/u and the maximum current is 0.27 nA from a hybrid particle therapy system. Hospital or facility construction should consider this requirement to design a special heavy concrete. In this work, magnetite is adopted as the major aggregate. Density is determined mainly by the major aggregate content of magnetite, and a heavy concrete test block was constructed for structural tests. The compressive strength is 35.7 MPa. The density ranges from 3.65 g/cm3 to 4.14 g/cm3, and the iron mass content ranges from 53.78% to 60.38% from the 12 cored sample measurements. It was found that there is a linear relationship between density and iron content, and mixing impurities should be the major reason leading to the nonuniform element and density distribution. The effect of this nonuniformity on radiation shielding properties for a carbon treatment room is investigated by three groups of Monte Carlo simulations. Higher density dominates to reduce shielding thickness. However, a higher content of high-Z elements will weaken the shielding strength, especially at a lower dose rate threshold and vice versa. The weakened side effect of a high iron content on the shielding property is obvious at 2.5 µSv=h. Therefore, we should not blindly pursue high Z content in engineering. If the thickness is constrained to 2 m, then the density can be reduced to 3.3 g/cm3, which will save cost by reducing the magnetite composition with 50.44% iron content. If a higher density of 3.9 g/cm3 with 57.65% iron content is selected for construction, then the thickness of the wall can be reduced to 174.2 cm, which will save space for equipment installation.

Image Evaluation for Optimization of Radiological Protection in CBCT during Image-Guided Radiation Therapy (영상유도 방사선 치료 시 CBCT에서 방사선 방호최적화를 위한 영상평가)

  • Min-Ho Choi;Kyung-Wan Kim;Dong-Yeon Lee
    • Journal of the Korean Society of Radiology
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    • v.17 no.3
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    • pp.305-314
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    • 2023
  • With the development of medical technology and radiation treatment equipment, the frequency of high-precision radiation therapy such as intensity modulation radiation therapy has increased. Image-guided radiation therapy has become essential for radiation therapy in precise and complex treatment plans. In particular, with the introduction of imaging equipment for diagnosis in a linear accelerator, CBCT scanning became possible, which made it possible to calibrate and correct the patient's posture through 3D images. Although more precise reproduction of the patient's posture has become possible, the exposure dose delivered to the patient during the image acquisition process cannot be ignored. Radiation optimization is necessary in the field of radiation therapy, and efforts to reduce exposure are necessary. However, when acquiring 3D CBCT images by changing the imaging conditions to reduce exposure, there should be no image quality or artefacts that would make it impossible to align the patient's position. In this study, Rando phantom was used to scan and evaluate images for each shooting condition. The highest SNR was obtained at 100 kV 80 mA 25 ms F1 filter 180°. As the tube voltage and tube current increased, the noise decreased, and the bowtie filter showed the optimal effect at high tube current. Based on the actual scanned images, it was confirmed that patient alignment was possible under all imaging conditions, and that image-guided radiation therapy for patient alignment was possible under the condition of 70 kV 10 mA 20 ms F0 filter 180°, which showed the lowest SNR. In this study, image evaluation was conducted according to the imaging conditions, and low tube voltage, tube current, and small rotation angle scan are expected to be effective in reducing radiation exposure. Based on this, the patient's exposure dose should be kept as low as possible during CBCT imaging.

Relation between Ablation Execution Time and Radiation Exposure Effect in the Treatment of Atrial-fibrillation using Cryo-balloon and 3D Radio-frequency Ablation (냉각 풍선 절제술과 3D 고주파 절제술을 이용한 심방세동 치료 시 절제술 시행 시간과 방사선 피폭 영향과의 연관성)

  • Seo, Young-Hyun
    • Journal of the Korean Society of Radiology
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    • v.16 no.4
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    • pp.427-434
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    • 2022
  • Atrial fibrillation treatment includes 3D RFCA and Cryo-balloon ablation. Both procedures have in common that they enter after understanding the structure of the heart using angiography equipment. Therefore, there is a disadvantage that the effect of exposure according to the procedure time can be a threat to both the patient and the operator, so this study aims to confirm the relationship between the total ablation time and the effect of radiation exposure. We used follow-up data (retrospective) from 41 patients who underwent coronary angiography and arrhythmia at the same time from March 2019 to July 2022. The range for total ablation time was based on the recorded data from the start to the end of the total ablation. The end point of 3D RFCA was when the ablation was completed for 4 pulmonary veins, and in the case of Cryo-balloon ablation, the data that succeeded in electrical insulation were included. As a result of analyzing the total ablation time, the time taken for Cryo-balloon ablation was 1037.29±103.66 s, which was 2448.61 s faster than 3D RFCA using 3485.9±405.71 s, and was statistically significant. (p<0.05) As a result of analyzing the total fluoroscopy time, the exposure time for 3D RFCA was 2573.75±239.08 s, which was less by 1717.15 s than the exposure time for Cryo-balloon ablation, 4290.9±420.42 s, and was statistically significant. In the case of total area dose product, 3D RFCA was 59.04±13.1 uGy/m2, which was lower than Cryo-balloon ablation 980.6±658.07 uGy/m2 by 921.56 uGy/m2, which was statistically significant. As the insulation time of the Cryo-balloon ablation is shorter than that of the 3D RFCA, the method using the Cryo-balloon ablation is considered to be effective when the patient's condition is not good and a quick procedure is required. However, in patients with permanent Atrial fibrillation, there is a high probability of structural changes in the heart, so it is considered that 3D RFCA is better than Cryo-balloon ablation, which is difficult to manipulate.

Evaluation of Shielding Performance of Tungsten Containing 3D Printing Materials for High-energy Electron Radiation Therapy (고에너지 전자선 치료 시 텅스텐 함유 3D 프린팅 물질의 차폐 성능 평가)

  • Yong-In Cho;Jung-Hoon Kim;Sang-Il Bae
    • Journal of the Korean Society of Radiology
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    • v.17 no.5
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    • pp.641-649
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    • 2023
  • This study compares and analyzes the performance of a shield manufactured using 3D printing technology to find out its applicability as a shield in high-energy electron beam therapy. Actual measurement and monte carlo simulations were performed to evaluate the shielding performance of 3D printing materials for high-energy electron beams. First, in order to secure reliability for the simulation, a source term evaluation was conducted by referring to the IAEA's TRS-398 recommendation. Second, to analyze the shielding performance of PLA+W (93%), a specimen was manufactured using a 3D printer, and the shielding rate by thickness according to electron beam energy was evaluated. Third, the shielding thickness required for electron beam treatment was calculated through a comparative analysis of shielding performance between PLA+W (93%) and existing shielding bodies. First, as a result of the evaluation of the source term through actual measurement and simulation, the TRS-398 recommendation was satisfied with an error of less than 1%, thereby securing the reliability of the simulation. Second, as a result of the shielding performance analysis for PLA+W (93%), 6 MeV electron beams showed a shielding rate of more than 95% at 3.12 mm, and 15 MeV electron beams showed a shielding rate of more than 90% at 10 mm thickness. Third, through simulations, comparative analysis between PLA+W (93%) materials and existing shields showed high shielding rates within the same thickness in the order of tungsten, lead, copper, PLA+W (93%), and aluminum. 6 MeV electron beams showed almost similar shielding rates at 5 mm or more and 15 MeV electron beams. Through this study in the future, it is judged that it can be used as basic data for the production and application of shielding bodies using PLA+W (93%) materials in high-energy electron beam treatment.

Isoalantolactone Inhibits the Formation of Multicellular Tumor Spheroids Derived From Human Hepatocellular Carcinoma Hep3B Cells Through the Induction of ROS-dependent Apoptosis (ROS 의존적 세포사멸 유도를 통한 isoalantolactone의 인간 간세포암종 Hep3B 세포 유래 다세포 종양 spheroid 형성의 억제)

  • Min Yeong Kim;Byunwoo Son;Sang-Hyup Lee;Sang Eun Park;Su Hyun Hong;Sang Hoon Hong;Eunjeong Kim;Yung Hyun Choi;Hyun Hwangbo
    • Journal of Life Science
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    • v.34 no.7
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    • pp.476-484
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    • 2024
  • Although two-dimensional (2D) monolayer cell culture models are still widely used as the optimal models for anticancer activity research, three-dimensional (3D) multicellular tumor spheroid (3D MTS) models that can better approximate the tumor environment can offer an alternative to bridge the gap between in vitro and animal model studies. Isoalantolactone is among the sesquiterpene lactones found in medicinal plants, including the roots of Elecampane (Inula helenium L.), and is known to have various pharmacological activities, including anticancer activity. In this study, we investigated whether the anticancer activity of isoalantolactone observed in 2D models could be reproduced in a 3D MTS model derived from human hepatocellular carcinoma (HCC) Hep3B cells. According to our results, isoalantolactone inhibited the formation of MTSs in a manner dependent on the treatment concentration, which was accompanied by an increase in reactive oxygen species (ROS) generation. In particular, as isoalantolactone treatment and the culture time increased, the area of proliferating cells was replaced by cells in which apoptosis was induced. Additionally, in MTSs, isoalantolactone increased the expression of death-receptor-related proteins and the activity of caspase-3, and it decreased the expression of the Bax/Bcl-2 expression ratio and total poly(ADP-ribose) polymerase. However, when the production of ROS was artificially blocked, all these changes caused by isoalantolactone were attenuated and the cell survival rate of MTS cells was restored. Therefore, the results of this study suggest that the induction of apoptosis in Hep3B cell-derived MTSs by isoalantolactone is achieved through the activation of extrinsic and intrinsic pathways and is ROS-dependent.

Seed and Germination Characteristics of Allium koreanum H.J. Choi & B.U. Oh for Effective Propagation (효과적인 번식을 위한 돌부추의 종자 및 발아 특성)

  • Hee Sung Hwang;Jeong Hun Hwang;Ji Hye Yun;So Yeong Hwang;Ji Eun Park;Hyeon Eui Oh;Sang Jun Lee;Jeong Mi Park;Seung Jae Hwang
    • Journal of Bio-Environment Control
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    • v.32 no.4
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    • pp.359-365
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    • 2023
  • Native plants are unique genetic resources that have the potential to be used as ornamental, medical, and food resources. Allium koreanum H.J. Choi & B.U. Oh is one of the native plants distributed in the coastal rocky land of Korea, which has high conservation value due to climate change and reduction of its habitat. This study was conducted to investigate the effects of temperature and hydrogen peroxide on the germination of A. koreanum. The seeds were prepared as untreated (control) or those treated with 1% hydrogen peroxide for 90 minutes (H2O2), and the treatments were placed in plant growth chambers set at 15, 20, and 25℃. Regardless of the H2O2 treatment, the germination percentage at 15℃, which was 42%, was more than two times higher than that at 20℃ and 25℃, which were 18% and 0%, respectively, 23 days after sowing. The number of days to attain 50% of the final germination percentage (T50) was the shortest at 20℃, but the mean daily germination (MDG) was the highest at 15℃. Therefore, 1% of H2O2 treatment did not have a significant effect on the germination percentage of A. koreanum, and a temperature of 15℃ was considered to be optimum to increase the germination percentage of A. koreanum. The results of this study can be used as basic research data for the germination of A. koreanum.

Application of a Modified Triple Pelvic Osteotomy for Treatment of Hip Dysplasia in Dogs (개의 고관절 이형성 치료를 위한 변형 3중 골반 절골술의 적용)

  • Kim Young-Sam;Lim Ji Hey;Jung Chang-soo;Byeon Ye-eun;Kanaya Tomohiro;Nagaoka Katsuyoshi;Kweon Oh-kyeong
    • Journal of Veterinary Clinics
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    • v.22 no.4
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    • pp.328-335
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    • 2005
  • The objective of this study was to evaluate tire effects of modified triple pelvic osteotomy(TPO). The procedures of modified TPO were composed of two iliac osteotomies and a pubic symphysiotomy at a tittle. Medical records of modified TPO treatment on 36 dogs and of unilateral TPO on 7 dogs were reviewed on the basis of signalment, body weight, operation time, Healing time of osteotomy sites and complications from October 2002 to September 2004. The values of clinical status and hip dysplasia, Norberg angle, percentage of femoral head coverage and pelvic diameter from radiographs taken preoperative, immediately postoperative, 2, 4, 8, 12 and 24 weeks after operation, respectively, were measured. In .unilateral TPO, the dogs could start standing without assistance from $3.0\pm1.0days$ and walking from $8.3\pm0.6days$ (n=3). Mean clinical grade before and 24 weeks after surgery were $2.2\pm0.42$(n=6) and $3.5\pm0.7$ (n=2), respectively. Mean operation time was $107.3\pm38.9$ minutes (n=4). In modified TPO, the dogs were seen to staff standing without assistance from $4.9\pm3.7$ days and walking from $7.3\pm4.8days$ (n=25). Mean clinical grade before surgery and 24 weeks after surgery were $2.3\pm1.5$ (n=27) and $3.2\pm0.7$)(n=9), respectively. Postoperative clinical grade significantly improved against preoperative clinical grade (P<0.01). Mean operation time was $143\pm42.8$ minutes (n=24). This was shorter than time f3r twice unilateral TPO. By comparison with preoperative values, postoperative mean radiographic grade, percentage of femoral head coverage and Norberg angle measured at the recheck time point significantly increased (P<0.01). Mean postoperative pelvic diameter was significantly larger than preoperative pelvic diameter in modified TPO (P<0.01) but not in unilateral TPO. These results indicated that modified TPO was effective technique for the treatment of hip dysplasia in dogs.

Surgical Treatment of Anomalous Origin of Coronary Artery from the Pulmonary Artery: Postoperative Changes of Ventricular Dimensions and Mitral Regurgitation (관상동맥-폐동맥 이상기시증(Anomalous Origin of Coronary Artery from Pulmonary Artery)의 수술적 치료: 중기 성적과 좌심실 및 승모판 기능의 변화 양상에 대한 연구)

  • Kang, Chang-Hyun;Kim, Woong-Han;Seo, Hong-Joo;Kim, Jae-Hyun;Lee, Cheul;Chang, Yoon-Hee;Hwang, Seong-Wook;Back, Man-Jong;Oh, Sam-Se;Na, Chan-Young;Han, Jae-Jin;Lee, Young-Tak;Kim, Chong-Whan
    • Journal of Chest Surgery
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    • v.37 no.1
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    • pp.19-26
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    • 2004
  • Background: The aims of this study are to verify the result of the surgical treatment of ALCAPA and to identify the postoperative changes of left ventricular dimensions and mitral regurgitation (MR), Material and Method: Fifteen patients operated on since 1985 were included in the study. The patients operated on before 1998 (n=9) showed heterogeneous properties with various surgical strategies and cardiopulmonary bypass techniques. However, six patients were operated on with the established surgical strategy since 1998; 1) Dual perfusion and dual cardioplegic solution delivery through ascending aorta and main pulmonary artery, 2) Coronary transfer by rolled-conduit made of pulmonary artery wall flap, and 3) Additional mitral valvular procedure was not peformed. Result: Median age of the study group was 6 months (1 month to 34 years). The operative methods were left subclavian artery to left coronary artery anastomosis in 1, simple ligation in 2, Takeuchi operation in 2, and coronary reimplantation in 10 patients. The mean follow up period was 5.5<5.8 years (2 months 14 years), There were one early death (6.7%) and one late death. Overall 5-year survival rate was 85.6$\pm$9.6%. The Z-value of left ventricular end-diastolic and end-systolic dimensions were 6.4$\pm$3.0 and 5.1 $\pm$3.6 preoperatively, and decreased to 1.7$\pm$ 1.9 and 0.8$\pm$ 1.6 in 3 months (p<0.05). Significant preoperative MR was identified in 6 patients (40%) and all the patients showed immediate improvement of MR within f month postoperatively. There were 3 cases of reoperation due to coronary anastomosis site stenosis and recurrence of MR. However, there was no mortality nor late reoperation in the patients operated on after 1998. Conclusion: The surgical treatment of ALCAPA showed favorable survival and early recovery of ventricular dimensions and mitral valvular function. Although long-term reintervention was required in some cases of earlier period, all the cases after 1998 showed excellent surgical outcome without long-term problem.