• Journal of Medicine and Life Science
• /
• v.15 no.2
• /
• pp.108-111
• /
• 2018

Extra-corporeal membrane oxygenation (ECMO) has the potential to rescue patients in cardiac arrest or respiratory failure. ECMO has two systems such as veno-arterial and veno-venous circulation. In cardiac arrest resulting from acute myocardial infarction, veno-arterial ECMO is mandatory for systemic circulation and oxygenation. A 75-year old female patient underwent primary coronary intervention for acute myocardial infarction. Despite successful revascularization, recurrent ventricular tachycardia and heart failure were progressing. We performed a veno-arterial ECMO through the femoral artery and vein, then the patient seemed to be stable clinically. However, laboratory studies, echocardiography, and vital signs indicated multi-organ failure and decreasing cardiac function. We found out an error that we performed veno-venous ECMO instead of veno-arterial ECMO. We added a femoral artery cannula and exchange the circuit system to veno-arterial ECMO. While the systemic circulation seemed to be recovered, the left ventricular function was decreased persistently. A hypovolemia resulting from pulmonary hemorrhage was occurred, which lead to ECMO failure. The patient died of cardiac arrest and multi-organ failure 23 hours after ECMO. Because the color of arterial and venous circuits represent the position and efficacy of ECMO, if unexpected or abnormal circuit colors are detected, prompt and aggressive evaluation for ECMO function is mandatory.

• Safety and Health at Work
• /
• v.10 no.1
• /
• pp.87-94
• /
• 2019

Background: Lead (Pb) exposure in shooting ranges has been reduced by various measures such as jacketed ammunition and lead-free primers. Nevertheless, this may lead to exposure to other metals, potentially resulting in adverse health effects. Methods: In a cross-sectional study, 35 subjects from seven different shooting ranges were studied: four shooting instructors, 10 police officers, 15 Special Forces, and six maintenance staff members. Metals and metalloids were determined in blood and urine by inductively coupled plasma-mass spectrometry. Results: The concentrations of most elements did not differ significantly between groups or compared to reference values, except for Sb and Pt in urine and Pb in blood. Mean values for Sb were considerably higher in urine from the Special Forces ($0.34{\mu}g/L$), the maintenance staff ($0.13{\mu}g/L$), and shooting instructors ($0.32{\mu}g/L$) compared to the police officers before shooting ($0.06{\mu}g/L$) and a Belgian reference value ($0.04{\mu}g/L$). For Pt, the Special Forces showed higher mean urinary concentrations ($0.078{\mu}g/L$) compared to a Belgian reference value (<$0.061{\mu}g/L$). Mean values for blood lead were markedly higher in the Special Forces ($3.9{\mu}g/dL$), maintenance staff ($5.7{\mu}g/dL$), and instructors ($11.7{\mu}g/dL$) compared to police officers ($1.4{\mu}g/dL$). One instructor exceeded the biological exposure index for blood Pb ($38.8{\mu}g/dL$). Conclusion: Since both Pb and Sb were found to be higher in shooting range employees, especially among frequent shooters, it is advisable to provide appropriate protective equipment, education, and medical follow-up for shooting range personnel in addition to careful choice of ammunition.

• 한국노년학
• /
• v.28 no.4
• /
• pp.773-784
• /
• 2008

This paper is to suggest policy issues to be done in the future health policy for the elderly, analyzing contents of results suggested in academic papers published in Journal of the Korean Gerontological Society. Number of Papers published in the Journal is 61, occupying most of papers related with chronic disease, medical expenditures and health delivery system except dental and psychiatric health. Method used to be analyzed is mostly random sampling among community inhabitants or hospital patients. Policy issues are as follows in case of being based in the above analysis results. Firstly, it is necessary that the development of health promotion specialized for the elderly be developed and activated. Secondly, it is necessary that the primary health care system specialized for the elderly be constructed. Thirdly, it is necessary that the subacute care system specialized for the elderly be constructed after acute care services. Finally, it is necessary that the health care system specialized for the elderly in need of long-term care be constructed also.

• Clinics in Shoulder and Elbow
• /
• v.24 no.2
• /
• pp.72-79
• /
• 2021

Background: A midshaft clavicle fracture is a common fracture that typically responds well to open reduction and internal fixation (ORIF). However, refracture can occur after implant removal (IR). This study aimed to analyze the rate of refracture and related factors after removal of the locking compression plate (LCP) for displaced midshaft clavicle fractures. Methods: We retrospectively reviewed the medical records of 201 patients who had undergone ORIF with LCP for midshaft clavicle fractures after IR after bony union from January 2011 to May 2018 at our institute. We evaluated basic demographic characteristics and radiographic parameters. All patients were treated with an LCP for primary fracture. The patients were divided into two groups: a refracture group that experienced a second fracture within 1 year after IR and a no-fracture group. Results: There were four cases (1.99%) of refracture; three were treated conservatively, while one was treated surgically. All patients achieved bony union. The average interval between refracture and IR was 64 days (range, 6-210 days). There was a significant difference in classification of fractures (AO Foundation/Orthopaedic Trauma Association [AO/OTA] classification) between the two groups. However, other patient demographics and radiographic measurements between refracture and IR, such as bone diameter, showed no significant difference between the two groups. Conclusions: This study showed that one in 50 patients suffered from refracture after removal of the LCP. Thus, if patients desire IR, the surgeon should explain that there is a relatively higher possibility of refracture for cases with simple or segmental fractures than for other types of fracture.

• The Journal of Internal Korean Medicine
• /
• v.43 no.2
• /
• pp.229-236
• /
• 2022

Objective: Jowiseunggi-tang (JWSGT) is a traditional herbal medicine commonly used for purgative activity in constipation. This study evaluates JWSGT for the treatment of opioid-induced constipation (OIC), the most common and debilitating gastrointestinal effect of opioid use. Methods: A 64-year-old man with floor of mouth cancer was hospitalized for OIC, and JWSGT was administered orally twice a day for 10 days, along with acupuncture, moxibustion, and cupping. The primary outcome measures were defecation type according to the Bristol Stool Form Scale (BSFS) and the frequency of bowel movements. The Brief Fatigue Inventory (BFI) and the Functional Assessment of Cancer Therapy-General (FACT-G) were used as secondary measures. Results: After three days of JWSGT administration, spontaneous bowel movements were observed two to three times per week with improved BSFS from type 2 to 4. A reduction in BFI score (8.7 to 2.0) and an increase in FACT-G score (44.3 to 59.0) suggested an improvement in fatigue level and quality of life. Conclusion: This is the first report to assess the efficacy of JWSGT for the management of OIC in patients with cancer, and JWSGT may be an effective option to improve symptoms and quality of life in this group.

• Journal of Society of Preventive Korean Medicine
• /
• v.26 no.2
• /
• pp.1-9
• /
• 2022

Objectives : The purpose of this study is to identify priorities for the 4th Comprehensive Plan for Korean Medicine Development using Delphi and AHP techniques. Methods : This study uses Delphi-AHP method to first, select the target priority policy based on the policy content of the 4th Comprehensive Plan. In addition, two surveys on the priorities were conducted to reach consensus between experts. The main results of the first survey were also provided to experts participating in the second survey to help form expert consensus. Finally, the final policy priority was chosen based on the second survey result. Results : Survey results showed that of the 39 policies in the 4th Comprehensive Plan, "improve the accessibility of Korean medicines," was the most important goal. This was followed by "support for Korean medicine R&D from clinical research to industrialization," "provide foundation for a pilot project that provides customized medical services" and "strengthen the public medicine function of Korean medicine by expanding the its infrastructure in national and public hospitals." Conclusion : The results showed that capacity building of Korean medicine in primary care, improvement of the health insurance system, and research centered on industrialization are relatively more important goals, while the need to enhance global competitiveness was much less important. These key points can serve as a reference when formulating the 5th Comprehensive Plan for Korean Medicine Development in the future.

• Journal of Trauma and Injury
• /
• v.35 no.1
• /
• pp.25-33
• /
• 2022

Purpose: The scoring system for traumatic liver injury (SSTLI) was developed in 2015 to predict mortality in patients with polytraumatic liver injury. This study aimed to validate the SSTLI as a prognostic factor in patients with polytrauma and liver injury through a generalized estimating equation analysis. Methods: The medical records of 521 patients with traumatic liver injury from January 2015 to December 2019 were reviewed. The primary outcome variable was in-hospital mortality. All the risk factors were analyzed using multivariate logistic regression analysis. The SSTLI has five clinical measures (age, Injury Severity Score, serum total bilirubin level, prothrombin time, and creatinine level) chosen based on their predictive power. Each measure is scored as 0-1 (age and Injury Severity Score) or 0-3 (serum total bilirubin level, prothrombin time, and creatinine level). The SSTLI score corresponds to the total points for each item (0-11 points). Results: The areas under the curve of the SSTLI to predict mortality on post-traumatic days 0, 1, 3, and 5 were 0.736, 0.783, 0.830, and 0.824, respectively. A very good to excellent positive correlation was observed between the probability of mortality and the SSTLI score (γ=0.997, P<0.001). A value of 5 points was used as the threshold to distinguish low-risk (<5) from high-risk (≥5) patients. Multivariate analysis using the generalized estimating equation in the logistic regression model indicated that the SSTLI score was an independent predictor of mortality (odds ratio, 1.027; 95% confidence interval, 1.018-1.036; P<0.001). Conclusions: The SSTLI was verified to predict mortality in patients with polytrauma and liver injury. A score of ≥5 on the SSTLI indicated a high-risk of post-traumatic mortality.

• International Journal of Computer Science & Network Security
• /
• v.22 no.11
• /
• pp.43-50
• /
• 2022

A comparative analysis of the state and results of the functioning of the education system of Ukraine with the national educational systems of the USA and Great Britain was carried out. Based on which we found out similar and different in the process of developing the system of training specialists in higher education institutions of the USA, Great Britain, and Ukraine. Describing the main quantitative indicators of education in the UK, USA and Ukraine, we found common features and distinctive features. Consideration in the comparative aspect of trends in the development of higher teacher education in the United States, Great Britain and in Ukraine gives grounds for conclusion. For these countries, such groups of norms as types of educational institutions, forms of Education; introduction of a unified system of credit units in order to create conditions for broad mobility of students; availability of different levels of training; study of the best experience of educational activities of other states and its introduction into the educational process in combination with the cultural traditions of Ukraine coincide. Describing the main quantitative indicators of education in the analyzed countries, we found distinctive features.Teacher development systems in the UK, USA and Ukraine are compared. It was found out that the use of methods of Great Britain and the United States on the organization of independent work in the process of professional development of teachers will have a positive impact on training in the system of advanced training of teachers in Ukraine. The article examines the information culture of future specialists, which is based on knowledge about the information environment, the laws of its functioning and development, and the perfect ability to navigate the limitless modern world of information.

• Journal of Ginseng Research
• /
• v.47 no.3
• /
• pp.429-439
• /
• 2023

Background: The incidence and clinical importance of nonalcoholic fatty liver disease (NAFLD) has emerged. However, effective therapeutic strategies for NAFLD have yet to be found. Panax ginseng (P. ginseng) is a traditional herb in Eastern Asia with therapeutic effects in many chronic disorders. However, the precise effects of ginseng extract on NAFLD are currently unknown. In present study, the therapeutic effects of Rg3-enriched red ginseng extract (Rg3-RGE) on the progression of NAFLD were explored. Methods: Twelve-week-old C57BL/6 male mice were fed a chow or western diet supplemented with high sugar water solution with or without Rg3-RGE. Histopathology, immunohistochemistry, immunofluorescence, serum biochemistry, western blot analysis, and quantitative RT-PCR were used for in vivo experiment. Conditionally immortalized human glomerular endothelial cell (CiGEnC) and primary liver sinusoidal endothelial cells (LSECs) were used for in vitro experiments. Results: Eight weeks of Rg3-RGE treatment significantly attenuated the inflammatory lesions of NAFLD. Furthermore, Rg3-RGE inhibited the inflammatory infiltrate in liver parenchyma and the expression of adhesive molecules to LSECs. Moreover, the Rg3-RGE exhibited similar patterns on the in vitro assays. Conclusion: The results demonstrate that Rg3-RGE treatment ameliorates NAFLD progression by inhibiting chemotaxis activities in LSECs.

• Journal of Medicine and Life Science
• /
• v.20 no.3
• /
• pp.115-125
• /
• 2023

Arteriovenous fistula flow dysfunction is the leading cause of vascular access thrombosis and loss in patients undergoing hemodialysis. However, data regarding the influence of access flow rate measurements on the long-term outcomes of access are limited. This study aims to identify accesses at a high risk of thrombosis and loss among patients undergoing hemodialysis by measuring the access flow rate and exploring an optimal threshold value for predicting future access thrombosis. We enrolled 220 patients with arteriovenous fistula undergoing hemodialysis. The primary outcome was the occurrence of access thrombosis. Access flow rates were measured monthly using the ultrasound dilution method and were averaged using all measurements from patients with patent access. In patients experienced access thrombosis, those immediately before the thrombosis were selected. Using these data, we calculated the access flow rate threshold for thrombosis occurrence by analyzing the receiver operating characteristic curve, and the patients were divided into two groups according to whether access flow rates were higher or lower than 400 mL/min. During a median follow-up period of 3.1 years, 4,510 access flows were measured (median measurements per patient, 33 times; interquartile range, 11-54). A total of 65 access thromboses and 19 abandonments were observed. Access thrombosis and loss were higher in the lowflow group than in the high-flow group. This study revealed that low access flow rates are strongly associated with access thrombosis occurrence and subsequent loss of arteriovenous fistulas in patients undergoing hemodialysis.