• Journal of Trauma and Injury
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• 제34권1호
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• pp.39-43
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• 2021

Purpose: Determining appropriate ways to assess health care quality within the National Health Insurance System is of interest to both the Korean government and the medical community. However, in the trauma field, the number of indicators used to evaluate surgical quality is limited. Using data collected over 5 years at Wonju Severance Christian Hospital Trauma Center in Korea, this study aimed to determine whether the unplanned reoperation rate in the field of trauma surgery could be used to assess the quality of an institution's surgical care. Methods: In total, 665 general surgical procedures were performed at the Trauma Center in 453 patients with abdominopelvic injuries from January 2015 to December 2019. Data were collected from the Trauma Center's data registry and medical records, and included information regarding patients' demographic characteristics, the type of index operation, and the reason for unplanned reoperations. Results: A total of 453 index operations were evaluated. The proportion of patients with an Injury Severity Score (ISS) >15 was 48-70% over the 5-year period, with an unplanned reoperation rate of 2.1-9.3%. Patients had an average ISS score of 17.5, while the average Abbreviated Injury Scale Score was 2.87. Unplanned reoperations were required in about 7% of patients. The most common complications requiring reoperation were recurrent bleeding (26.9%), wound problems (26.9%), intestinal infarction (15.4%), and anastomosis site leakage (7.7%). The procedures most frequently requiring unplanned reoperations were bowel surgery (segmental resection, primary repair, enterostomy, etc.) (24.5%) and preperitoneal pelvic packing (10.6%). Conclusions: The proportion of reoperations was confirmed to be affected by injury severity.

• Journal of Trauma and Injury
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• 제34권1호
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• pp.50-56
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• 2021

Purpose: Fractures are common in the military population, but limited studies have investigated the incidence of fractures among Korean military personnel. Hence, this study aimed to clarify this issue. Methods: Eligible subjects were patients who had sustained a fracture and were registered in the N-DEMIS (the medical records system of participating hospitals) from June 2017 to May 2019. Fractures were categorized according to the fracture site, patients' age, sex, and type of duty. Results: In total, 23,687 patients with 23,981 fractures were included. There were 216 patients with multiple fractures, of whom 156 had fractures at two sites, 42 had fractures at three sites, and 18 had fractures at four sites. Of the 23,687 patients, 23,340 were men and 347 were women. The incidence of fractures in men and women was 12.96 per 1,000 person-years and 0.19 per 1,000 person-years, respectively. In terms of the broad location of fractures, the percentage of fractures was the highest in the hand, followed by the foot and lower leg. When the location of fractures was analyzed more specifically, the percentage of fractures was the highest in the phalanx (thumb and fingers), followed by the ankle and metacarpal bones. Conclusions: Hand, foot, ankle, and wrist fractures were the most commonly encountered fractures in the Korean military population. To prevent the loss of combat power due to non-battle-related injuries, thorough preparation is necessary, including protective equipment and preliminary training for areas with a high frequency of fracture occurrence.

• 건축역사연구
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• 제29권6호
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• pp.101-112
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• 2020

This study focuses on the construction of Gyeongbokgung Palace in the second year of King Gojong's reign, which has been spotlighted for political and economic history. The author analyzed the contents of wood procurement with the Yeonggeon Diary, which records each day of construction site. The results are as follows: First, the 2nd year of King Gojong's reign, Yeonggeon of Gyeongbokgung Palace, was a new building that reflected the old system and 270 years of changed environment on the existing site. Despite the poor economic conditions, it began with years of effort and voluntary volunteer work and dedication. Second, the priority of timber transport was recruiting people in the whole process and the supply and demand of transportation tools. Carrying lumber from the mountains to the riverside and floating it at the right time were all a matter of manpower. Soldiers and carts were used to carry timber that arrived in Hangang River to the construction site. The cart was a consumable product, so it was necessary to continuously use the wood to make cart at the site. Third, fire and flood were the biggest obstacles to the Yeonggeon schedule of Gyeongbokgung Palace. Especially the fire was fatal. It was difficult to extinguish the fire in temporary structure, where was the storage for wood to construct. These disasters greatly affected the construction cost and construction period. Wood procurements of Gyeongbokgung Palace were based on public offerings. At the same time, recycled materials from other palace wood and nearby houses, nationwide buying of private mountain wood, the logging of royal tombs and some of the buildings of Gyeonghui Palace and Changgyeong Palace were relocated.

• Journal of Forest and Environmental Science
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• 제37권2호
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• pp.91-103
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• 2021

We conducted an analysis of agroforestry system efficiency to conserve biodiversity in the Mbalmayo Forest Reserve (MFR) between March 2018 and June 2018. A synthesis of forest fragmentation data observed on multiple strata and scale satellite imageries over 31 years, between 1987 and 2018 as well as, the use of both a floristic and a faunal surveys, revealed that although 29.28% of natural forests was fragmented and converted to agroforests landscapes, banana and cocoa based agroforest appeared to perform the most relevant records in carbon storage and to attract wild terrestrial and avifauna. Analysis of NDVI, NDWI and Iron Oxyde helped monitor the vegetation cover of the reserve, and differentiate natural and fragmented classes, majority of conserved forest wetlands and agroforestry systems, and a minority of natural dryland forest. Further analysis also revealed significant correlations between NDVI and Shannon Index, and between NDVI and carbon stock. Based on the NDVI value and the equation Y=3.827×X-1.587 (where Y for the carbon stocks and X for NDVI value), we estimated the total carbon stock of the forest reserve at about 99557.6 tonnes, and its mean value at about 8.491 tons/ha. Nevertheless, environmental efforts to sustainably manage agroforestry landscape appear to be a relevant key to conserve wild biodiversity and mitigate climate change at the level of the Mbalmayo Forest Reserve. If anthropogenic activities have deeply changed the reserve's natural landscape, reduced its carbon sequestration performance, and wildlife conservation status, forest wetlands appear to remain its most conserved places and the best refuge for wild fauna still occurring in diverse strata of the MFR.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제47권6호
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• pp.432-437
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• 2021

Objectives: The mandible and other parts of the maxillofacial region suffer significant morbid injuries following road traffic accidents. Our study gives epidemiological description of mandibular fractures in Ghana and also evaluates the relevance of closed reduction and indirect fixation for managing mandibular fractures in low-resource health facilities in low-income countries like Ghana. Patients and Methods: This is a retrospective study involving 268 patients who reported to the Department of Oral and Maxillofacial Surgery of the Sunyani Regional Hospital with mandibular fractures from January 2010 to December 2019. Patient medical records were assessed for information on age, sex, fracture etiology, anatomic location of fracture, time of day of road traffic accident, and other associated injuries. Results: A total of 268 patients were included in this study (males, 216 [80.6%]; females, 52 [19.4%]). Motor vehicular accident (MVA) was the leading cause of mandibular fractures (202 injuries, 75.4%). Other etiologies included assault (39, 14.6%), gunshot (13, 4.9%), falls (12, 4.5%), and industrial accidents (2, 0.7%). Of the 161 male cases caused by MVA, 121 (75.2%) occurred at night and in the evening while the remaining 40 (24.8%) occurred in the morning and afternoon. Among all managed 222 patients, 212 (79.1%) were treated with closed reduction and indirect fixation technique while 10 (3.7%) were treated with open reduction and direct fixation. Conclusion: Closed reduction with indirect fixation could successfully be used to manage mandibular fractures in low resourced health facilities, especially in low-income countries. The poor lightening system on roads in Ghana is a major contributory factor to motor vehicular accidents.

• Animal Bioscience
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• 제35권11호
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• pp.1649-1655
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• 2022

Objective: The primary objective of this study was to determine the genetic parameters for reproductive traits among Large White pigs, including the following traits: total number born (TNB), number born alive (NBA), litter birth weight (LBW), average birth weight (ABW), gestation length (GL), age at first service (AFS) and age at first farrowing (AFF). Methods: The dataset consisted of 19,036 reproductive records from 4,986 sows, and a multi-trait animal model was used to estimate genetic variance components of seven reproductive traits. Results: The heritability estimates for these reproductive traits ranged from 0.09 to 0.26, with the highest heritability for GL and AFF, and the lowest heritability for NBA. The repeatabilities for TNB, NBA, LWB, ABW, and GL were ranged from 0.16 to 0.34. Genetic and phenotypic correlations ranged from -0.41 to 0.99, and -0.34 to 0.98, respectively. In particular, the correlations between TNB, NBA and LBW, between AFS and AFF, exhibited a strong positive correlation. Furthermore, for TNB, NBA, LBW, ABW, and GL, genetic correlations of the same trait between different parities were moderately to strongly correlated (0.32 to 0.97), and the correlations of adjacent parities were higher than those of nonadjacent parities. Conclusion: All the results in the present study can be used as a basis for the genetic assessment of the target population. In the formulation of dam line selection index, AFS or AFF can be considered to combine with TNB in a multiple trait swine breeding value estimation system. Moreover, breeders are encouraged to increase the proportion of sows at parity 3-5 and reinforce the management of sows at parity 1 and parity ≥8.

• Earthquakes and Structures
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• 제22권6호
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• pp.561-570
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• 2022

It is of great importance to be able to evaluate different structural systems not only based on their seismic performance but also considering their lifetime service costs. Many structural systems exist that can meet the engineering requirements for different performance levels; therefore, these systems shall be selected based on their economic costs over time. In this paper, two structural systems, including special steel moment-resisting and the ordinary concentric braced frames, are considered, which are designed to meet the three performance levels: Immediate Occupancy (IO), Life Safety (LS), Collapse Prevention (CP). The seismic behavior of these two systems is studied under three strong ground motions (i.e., Tabas, Bam, Kajour earthquake records) using the Perform3D package, and the incurred damages to the studied systems are examined at two hazard levels. Economic analyses were performed to determine the most economical structural system to meet the specified performance level requirements, considering the initial cost and costs associated with damages of an earthquake that occurred during their lifetime. In essence, the economic lifetime study results show that the special moment-resisting frames at IO and LS performance levels are at least 20% more economical than braced frames. The result of the study for these building systems with different heights designed for different performance levels also shows it is more economical from the perspective of long-term ownership of the property to design for higher performance levels even though the initial construction cost is higher.

• Archives of Plastic Surgery
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• 제49권1호
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• pp.43-49
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• 2022

Background Cleft lip and cleft palate are the most frequent congenital craniofacial deformities, with an incidence of approximately 1 per 700 people. Postoperative palatal fistula is one of the most significant long-term complications. This study investigated the incidence of postoperative palatal fistula and its predictive factors based on 25 years of experience at our hospital. Methods We retrospectively reviewed 636 consecutive palatal repairs performed between January 1996 and October 2020 by a single surgeon. Data from patients' medical records regarding cleft palate repair were analyzed. The preoperative extent of the cleft was evaluated using the Veau classification system, and the cleft palate repair technique was chosen according to the extent of the cleft. SPSS version 25.0 was used for all statistical analyses, and exploratory univariate associations were investigated using the t-test. Results Fistulas occurred in 20 of the 636 patients; thus, the incidence of palatal fistula was 3.1%. The most common fistula location was the hard palate (9/20, 45%), followed by the junction of the hard and soft palate (6/20, 30%) and the soft palate (5/20, 25%). The cleft palate repair technique significantly predicted the incidence of palatal fistula following cleft palate repair (P=0.042). Fistula incidence was significantly higher in patients who underwent surgery using the Furlow double-opposing Z-plasty technique (12.1%) than in cases where the Busan modification (3.0%) or two-flap technique (2.0%) was used. Conclusions The overall incidence of palatal fistulas was 3.1% in this study. Moreover, the technique of cleft palate repair predicted fistula incidence.

• Journal of Dental Anesthesia and Pain Medicine
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• 제22권3호
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• pp.187-195
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• 2022

Background: This retrospective study investigated the incidence rate of accidental foreign body aspiration and ingestion according to patient sex, age, and dental department. This study aimed to verify whether the incidence rate is higher in geriatric than in younger patients and whether it is different among dental departments. Methods: Accidental foreign body aspiration and ingestion cases were collected from electronic health records and the safety report system of Yonsei University Dental Hospital from January 2011 to December 2017. The collected data included patients' age, sex, medical conditions, treatment procedures, and foreign objects that were accidentally aspirated or ingested. The incidence rate was calculated as the number of accidental foreign body aspirations and ingestions relative to the total number of patient visits. Differences depending on the patients' sex, age, and dental department were statistically identified. Results: There were 2 aspiration and 37 ingestion cases during the 7-year analysis period. The male to female incidence ratio was 2.8:1. The incidence rate increased with age and increased rapidly among those aged 80 years or older. Seven of the 37 patients with accidental foreign body ingestion had intellectual disability, Lou Gehrig's disease, dystonia, or oral and maxillofacial cancer. The incidence rate was highest in the Predoctoral Student Clinic and the Department of Prosthodontics. The most frequently swallowed objects were fixed dental prostheses and dental implant components. Conclusion: The incidence rate of accidental foreign body aspiration and ingestion differed according to patient sex, age, and dental department. Dental practitioners must identify high-risk patients and apply various methods to prevent accidental foreign body aspiration and ingestion in dental clinics. Inexperienced practitioners should be particularly careful.

• 치위생과학회지
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• 제22권4호
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• pp.206-214
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• 2022

Background: This study analyzed the practice of dental medical dispute prevention rules of dental hygienists to present an improvement plan for improving perceived importance and practice and provide data for the development of effective medical dispute prevention programs. Methods: A self-administered questionnaire survey was conducted targeting dental hygienists who were providing assistance at dental hospitals and dental clinics in Seoul and Gyeonggi-do regions from March 22 to April 28, 2022. The questionnaire collected from 273 dental hygienists consisted of eight questions on general characteristics, 30 questions on medical dispute experience, and 14 questions on medical dispute prevention. Results: Complaints showed a high experience rate in 'Consultation & reservation', medical disputes in 'Patient handling (unkind) related', and 'Prosthesis installation and cement removal'. In both the importance and practice of medical dispute prevention rules, 'Preservation of medical records and other medical-related data' was high, and 'Management of patients on standby for a long time' was low in terms of practice. 'Lack of time' and 'Lack of manpower' were cited as reasons for not resolving dental treatment disputes. The importance of dental dispute prevention rules was found to be significant according to age and position, and it was also found to affect the level of practice. Conclusion: Seventy-six-point six percent of the respondents said that education on the prevention of medical disputes was necessary, although they lacked recognition of prevention rules compared to their perceptions and experiences. This study suggested specifying prevention rules in dental hygiene subjects and expanding education, improvement of dental treatment system, revise the law on the range of work to improve the recognition and practice of prevention rules.