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Clinical Study of Childhood Accidents from a Hospital Over Ten Years with Regard to Foreign Body Aspiration (단일병원에서 관찰한 최근 10년간의 소아 우발사고에 관한 연구 : 이물흡인을 중심으로)

  • Kim, Cheol-Min;Song, Jun-Young;Kim, Ja Hyung;Kim, Ki Soo;Hong, Soo-Jong
    • Clinical and Experimental Pediatrics
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    • v.45 no.9
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    • pp.1134-1140
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    • 2002
  • Purpose : Childhood accidents have been increasing recently. Accidents rank as the leading cause of childhood mortality and morbidity. We performed this study to evaluate the causes of childhood accidents. Methods : The authors analysed retrospectively the medical records of 6,410 cases of childhood accidental injuries who visited the emergency room of Asan Medical Center from January 1990 to December 1999. Results : The most common type of accidents was trauma which accounted for 5,038 cases of the total accidents, followed by falls, burns, foreign body aspiration, and poisoning. The most common age of foreign body aspiration was under two years old and the male to female ratio was 2 to 1. The most common site of foreign body aspiration was the esophagus and the stomach, followed by the respiratory tract. In airways, the right and left main bronchus were the most common site for foreign body aspiration and were accompanied by the highest mortality. The most common foreign body in the gastrointestinal tract and respiratory tract were coins and peanuts, respectively. Conclusion : The most common cause of accidents was trauma, followed by falls, burns, foreign body aspiration, and poisoning. The incidence of foreign body aspiration and poisoning is increasing in infants. In cases of foreign bodies in airways, proper management is needed because of the high mortality rate.

Correlation of SUV According to the Body Weight and Body Surface Area in PET/CT Imaging (PET/CT 검사 시 체중과 체표면적에 따른 SUV의 상관관계)

  • Park, Ju-Seon;Do, Yong-Ho;Kim, Jung-Soo;Lee, Hong-Jae;Kim, Jin-Eui
    • The Korean Journal of Nuclear Medicine Technology
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    • v.17 no.2
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    • pp.44-47
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    • 2013
  • Purpose: There are several methods of measuring SUV in PET/CT imaging including $SUV_{bw}$ which uses the body weight, $SUV_{bsa}$ which that uses body surface area and $SUV_{lbm}$ which uses lean body mass. Currently, Seoul National University Hospital uses $SUV_{bw}$ method which minimizes the variability. In this study, we compared and analyzed the correlation between $SUV_{bw}$ and $SUV_{bsa}$ according to patients' body mass index. Materials and Methods: Using Biograph mCT40 (Siemens, Germany), we conducted $^{18}F-FDG$ PET/CT imaging on 70 patients (41 males, 29 females; ages $58.04{\pm}12.44$). We classified the patients as underweight (BMI<20), normal weight (20$${\leq_-}$$BMI<25), overweight (25$${\leq_-}$$BMI<30), obese (30$${\leq_-}$$BMI<35) and severely obese (35$${\leq_-}$$BMI) according to the patient's sex, age and BIM. Then, bone, liver and lungs were set as ROI for calculation of maximum values of $SUV_{bw}$ and $SUV_{bsa}$, through Syngo.via VA11A analysis program. Results: Comparing the five groups divided according to the BMI by the standard differences between $SUV_{bw}$ to $SUV_{bsa}$, $SUV_{max}$ was measured to be $0.66{\pm}0.15$, $0.78{\pm}0.35$, $0.77{\pm}0.21$, $1.00{\pm}0.44$, $1.53{\pm}0.38$ for bones in underweight, normal weight, overweight, obese and severely obese groups, respectively. For liver, values of $SUV_{max}$ were $1.64{\pm}0.16$, $2.06{\pm}0.34$, $2.19{\pm}0.21$, $2.52{\pm}0.21$ and $2.74{\pm}0.40$ in the same order. And for lung, values of $SUV_{max}$ were $0.69{\pm}0.33$, $0.54{\pm}0.17$, $0.62{\pm}0.23$, $0.83{\pm0.29}$, $1.03{\pm}0.30$. Conclusion: By comparing and analyzing the differences between $SUV_{bw}$ and $SUV_{bsa}$ in this study, it was found that the differences between $SUV_{bw}$ and $SUV_{bsa}$ increased as patient's BMI increased. Thus, there is room for error in the values of SUV depending on the methods of calculations, and appropriate methods must be applied according to the circumstances in clinical settings.

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Study on the Patterns of Helicopter Emergency Medical Services in Ullung Island (울릉도 지역의 헬리콥터를 이용한 응급환자 후송 실태)

  • Kim, Tae-Hun;Lim, Hyun-Sul;Lee, Kwan
    • Journal of agricultural medicine and community health
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    • v.27 no.1
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    • pp.115-123
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    • 2002
  • Objective: The aim of this study was to evaluate the patterns of helicopter emergency medical services (HEMS) in Ullung Island. Methods : The authors reviewed the records from emergency room diaries and the lists of helicopter transfers in the Ullung Public Health Medical Center over the 5-year period from Jan 1, 1997 to Dec 31, 2001. Results : One hundred thirteen cases were transferred by helicopters in 88 flights. According to year, the number of flights was 13(14.8%) and the number of cases was 15(13.3%) in 1997; 17(19.3%) and 21(18.6%) in 1998; 18(20.5%) and 20(17.7%) in 1999; 17(19.3%) and 20(17.7%) in 2000; and 23(26.1%) and 37(32.7%) in 2001. According to the kind of helicopter, the number of flights was 46(52.3%) and the number of cases was 60(53.1%) by Maritime police; and 19(21.6%) and 28(25.1%) by 119 rescue. According to time zone, there were no night flights. According to sex and age, there were 75 male cases(66.4%) and 28 cases(28.3%) of patients aged sixty years and over. The number of flights was 11(12.5%) and the number of cases was 15(13.3%) in November; 10 flights(11.4%) and 14 cases(12.4%) in March; and 7 cases(8.0%) in each of September, October and April. The most common season of helicopter transfer cases was autumn. According to transfer area, there were 48 cases (42.5%) in Pohang city, Gyeonsangbukdo; 35(31.0%) in Gangnung city, Gangwondo; and 17(15.0%) in Daegu metropolitan city. According to condition, there were 27 cases(23.9%) of cerebro-vascular accident, 13(11.5%) of fracture and 11(9.7%) of head injury. According to admission department, there were 42 cases(37.2%) in Neurosurgery, 21(18.6%) in Internal Medicine and 13(11.5%) in Orthopedic Surgery. According tothe Korea Standard Classification of Disease(3-KSCD), circulatory systemic disease(IX) and injury, intoxication and others (XIX) were the two most frequent categories with 34 cases(30.1%) each, followed by digestive system disease (XI) with 23 cases(20.4%). Conclusions : HEMS in Ullung Island leave much to be desired. Helicopters cannot make a night flight and are not equipped with medical facilities. HEMS in islands such as Ullung Island are essential. We hope that night flights, equipment-monitoring systems for emergency patients in the helicopters, and a law related to HEMS in the island will all be established.

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암환자 인식에 관한 연구 - 간호사ㆍ의사를 중심으로

  • Jo, In-Hyang
    • Korean Journal of Hospice Care
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    • v.2 no.1
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    • pp.58-74
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    • 2002
  • This paper constitutes a descriptive investigation and used a structured questionnaire to investigate nurses' and doctors' recognition of cancer patients. The subjects were extracted from the medical personnel working at the internal medicine, the surgery ward, the obstetrics and gynecology department, the pediatrics department, the cancer ward, and the emergency room of five general hospitals located in Seoul and Gyeonggi Province. The research lasted from August, 2001 to September 2001. Total 137 nurses and 65 doctors were included and made out the questionnaires directly distributed by the investigator. The study tool was also developed by the investigator and consisted of such items as the demographic and social characteristics, the medical personnel's recognition degree of cancer and cancer patients, their recognition of the management of cancer patients, and their participation in a hospice. The results were analyzed using the SPSS Window program in terms of technological statistics, ranks, t-test, and ANOVA. The reliability was represented in Cronbach' α=.75. The nurses' and doctors' recognition degree of cancer and cancer patients had an overall average of 3.86 at the 5 point-scale. The items that received an average of 4.0 or more included 'Medical personnel should explain about the cancer cure plans to the cancer patient and his or her family', 'A patient whose case has been diagnosed as a terminal cancer should be notified of it, 'If I were a cancer patient, I would want to get informed of it,' and 'Cancer shall be conquered whenever it is'. In the meantime, the items that received an average of 3.0 or less was 'My relationship with the cancer patient's family has gotten worse since I announced his or her impending death.' And according to the general characteristics and the difference test, the recognition degree of cancer and cancer patient was high among the subgroups of nurses, females, married persons, who were in their 30s, who had a family member that was a cancer patient, and who received a hospice education. The biggest number of the nurses and doctors saw 'a gradual approach over several days'(68.8%) as a method to tell a cancer patient about his or her cancer diagnosis or impending death. Those who usually tell tragic news were the physician in charge(62.8%), the family members or relatives(32.1%) and the clergymen(3.8%) in the order. The greatest number of them recommended a cancer patient's home as the place where he or she should face death because they thought 'it would stabilize his or her mentality'(91.9%) while a number of them recommended the hospital because they 'should give the psychological satisfaction to the patient'(40%) or 'should try their best until the last moment of the patient's death'(30%). A majority of the medical personnel regarded 'smoking or drinking' and 'diet' as the causes of cancer. The biggest symptom of a cancer patient was 'pain' and the pain management of a cancer patient was mostly impeded by the 'excessive fear of drug addiction, tolerance to drugs and side effects of drugs' by medical personnel, the patient, and his or her family. The most frequently adopted treatment plan of a terminal cancer patient was 'to do whatever the patient or his or her family wants' to resort to a hospice' and 'to continue active treatment efforts' in the order. The biggest reasons why a terminal cancer patient went to see a doctor were 'pain alleviation' 'control of symptoms other than pain(intravenous supply)' and 'incapability of the patient's family' in the order. Terminal cancer patients placed their major concern in 'spiritual(religious) matter' 'emotional matters' their family' 'existence' and 'physical matters' in the order. 113(58.5%) of the whole medical personnel answered they 'would recommend' an alternative treatment to a terminal cancer patient mostly because they assumed it would 'stabilize the patient's mentality.' Meanwhile, 80(41.5%) of them chose 'not to recommend it mostly due to the unverified effects and high cost of it(78.7%). A majority of them, I. e. 190(94.1%) subjects said they 'would recommend' a hospice to a terminal cancer patient mostly because they thought it would help the patient to 'mentally prepare'(66.6%) Only 17.3% of them, however, had received a hospice education, most of which was done through the hospital duty education(41.4%) and volunteer training(34.5%). The follows are results of this study: 1. The nurses and the doctors turned out to be still passive and experience confusion in dealing with a cancer patient despite their great sense of responsibility for him or her. 2.Nurses and Doctors realize the need of a hospice, but an extremely small number of them participate in a hospice education or performance. Thus, a whole recognition of a hospice should be changed, for which purpose a hospice education for nurses and doctors should be provided. 3.Terminal cancer patients preferred their home to a hospital as the place to face their impending death because they felt it would bring 'mental stability.' And most of nurses and doctors think it would be unnecessary for them to be hospitalized just for control of their symptoms. Accordingly a terminal cancer patient can be cared at home, and a home hospice care needs to be activated.

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Variation of Seed Germination Among Cultivated and Weedy Types of Perilla Crop in Korea and Japan (한국, 일본에서 수집한 들깨와 차조기의 재배형 및 잡초형들의 종자발아 변이)

  • Jung, Ji-Na;Yu, Chang-Yeon;Kim, Jong-Hwa;Lee, Ju-Kyong
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.54 no.3
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    • pp.270-278
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    • 2009
  • To understand the seed characteristics among cultivated types of Perilla crop and their weedy types in Korea and Japan, we studied the variation of 69 accessions by examining weight of 100 seeds, hardness of seed, germination percent and germination energy. The survey of the weight of 100 seeds and hardness of seed, clarified as follows; cultivated type of var. frutescens showed a range of 0.177 to 0.402 g with weight of 100 seeds, and most accessions of cultivated type of var. frutescens have soft seeds, except for several accessions, which have hard seeds, whereas weedy type of var. frutescens showed a range of 0.045 to 0.172 g with weight of 100 seeds, and has only hard seeds. While cultivated type of var. crispa showed a range of 0.054 to 0.101 g with weight of 100 seeds, and has only hard seeds. The weedy type of var. crispa showed a range of 0.059 to 0.135 g with weight of 100 seeds, and has only hard seeds. According to the result of germination tests, although the most accessions of cultivated and weedy types of var. frutescens and cultivated and weedy types of var. crispa showed below 50% germination rate at the first germination test, but some accessions of cultivated type of var. frutescens showed above 50% germination. While, in the second or third germination tests, most accessions of cultivated types of Perilla crop and their weedy types showed above 50% germination rates, except for several accessions. As a result, in this study, the average of germination percent and germination energy among accessions of cultivated types of Perilla crop and their weedy types showed respectively the highest value at the third germination test, but showed the lowest value at the first germination test. In addition, the germination percent and germination energy showed much higher in the room temperature condition than in $28^{\circ}C$ constant-temperature condition. Although our results may be required much clearly survey in the further study, this current results will be help for our understanding the variation of seed characteristics among cultivated types of Perilla crop and their weedy types in Korea and Japan.

Causes of Unresectability in Non-Small Cell Lung Cancer Patients Thought to Be Resectable Preoperatively (수술시 절제가 불가능하였던 비소세포폐암 환자에 대한 분석)

  • Oh, Yeon-Mok;Mo, Eun-Kyung;Jung, Man-Pyo;Yoo, Chul-Gyu;Kim, Young-Whan;Han, Sung-Koo;Sim, Young-Soo;Kim, Keun-Youl;Han, Yong-Chol
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.2
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    • pp.97-102
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    • 1994
  • Objectives : Since Mountain proposed the new staging system of non-small cell lung cancer in 1986, the indications for operation of NSCLC have been extended. However, operative mortality is from 3 to 6%. Therefore it is important to reduce unnecessary operation and to evaluate unresectability of tumor correctly, preoperatively. The purpose of this study is to find out the causes of unresectability in patients who were initially thought to be resectable preoperatively. Methods : By retrospective analysis, 64 patients out of 291 NSCLC patients who were undergone operation for curative resection in Seoul National University Hospital from Jan. of 1987 to Dec. of 1991, were found to be unresectable at operating room, were selected for this study. Out of 64 patients, 42 were evaluable. The analysis was focused on the change of pre- & post-operative staging and the causes of unresectability of tumors. Results : Among 42 patients with unresectable tumor who could be evaluated, preoperative CT finding showed resectable tumors in 55%(23 patients) and suspicious for unresectable tumors in 45%(19 patients). The causes of unresectability were technically unresectable T3 lesions in 7%(3 patients), T4 lesions in 62%(26 patients), N2 lesions in 17%(7 patients) and N3 lesions in 14%(6 patients). Conclusion : The major causes of unresectability of NSCLC were pulmonary artery invasions. It is suggested that careful evaluation of mediastinal structure, especially great vessels by additional imaging technique other than CT(like MRI) is indicated in selected NSCLC cases.

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Clinical Validation of Nebulized Budesonide and Effect of Nebulized Budesonide on the Hypothalamic-Pituitary-Adrenal Axis in Adult Patients Admitted with Acute Asthmatic Attack (급성 발작으로 내원한 성인 천식 환자에서 Nebulized Budesonide의 임상적인 효과와 시상하부-뇌하수체-부신 축에 대한 작용)

  • Seo, Ki-Hyun;Moon, Seung-Hyug;Kim, Yong-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.5
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    • pp.529-538
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    • 2002
  • Background : Many clinicians are reluctant to prescribe systemic corticosteroids to manage an asthmatic attack because of many complications such as osteoporosis, cushing's syndrome, diabetes, hypertension and bleeding tendency. The use of nebulized budesonide may be of value in some infants, old men, and in particular adult asthmatic patients who complain of severe dyspnea. A clinical validation and steroid-sparing effect of nebulized budesonide in asthmatic adults and COPD were evaluated, and the short-term effects of budesonide use on the HPA axis were assessed. Materials and Methods : Study A was prospectively done with 41 patients diagnosed with pure asthma and 30 patients diagnosed with COPD (including asthmatic component) in Soonchunhyang Hospital, Chunan from June. 2000 to Sep. 2001. They were treated with nebulized budesonide including systemic steroids (Group 1), a budesonide tubuhaler including a systemic steroid (Group 2), or only the systemic steroid(Group 3). The peak flow rate, arterial blood gas in room air, pulmonary function test, symptom scoring, steroid amount and hospital stay were analyzed. Study B was conducted with 19 patients to evaluate the short-term effects on the HPA axis of treatment with nebulized budesonide 1mg twice daily and a budesonide turbuhaler 5 puffs twice daily. The adrenal function was assessed prior to budesonide inhalation and after 7 days of budesonide inhalation. Results : In the pure asthmatic patients, the mean value of the symptoms (dyspnea, wheezing, cough, night asthma) or the arterial BGAs, total amounts of steroid or hospital stay and the difference in the results of the pulmonary function tests or peak expiratory flow rate were similar in the three groups. In COPD with an asthmatic component, there were no significant differences among the three groups. Although nebulized budesonide suppressed HPA function,(p=0.006) the HPA responses from the nebulized budesonide and turbuhaler budesonide were similar (p=0.288) Conclusion : This result suggests that systemic steroid should only be made available for acute asthmatic patients irrespective of the inhaled budesonides. Nebulized budesonide at the therapeutic dose has similar effects on the HPA axis compared to that of turbuhaler budesonide.

A STUDY OF ADDITIONAL VIBRATION EFFECT ON DENTIN BOND STRENGTH (진동이 상아질 결합력에 미치는 영향에 관한 연구)

  • Lee, Jin;Kim, Jung-Wook;Lee, Sang-Hoon;Kim, Chong-Chul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.29 no.4
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    • pp.632-640
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    • 2002
  • The objective of the study was to apply the vibration technique to reduce the viscosity of bonding adhesives and thereby compare the bond strength and resin penetration into dentinal tubules achieved with those gained using the conventional technique. Eighty-eight noncarious extracted human permanent molar teeth were sectioned to remove the coronal enamel and were embedded in 1-inch PVC pipe with acrylic resin. The occlusal surfaces were placed so that the tooth and the embedding medium were at the same level to form one flat surface, and the samples were subsequently polished with silicon carbide abrasive papers. The samples were randomly assigned to 4 groups(n=22). On Group 1 and 2, Single Bond(3M-ESPE, St. Paul, USA) was used, and on Group 3 and 4, One-Step(Bisco Inc., Schaumburg, USA) was used, and each was applied according to its manufacturer's instructions. For Group 2 and Group 4, vibration was applied with ultrasonic scaler for 10 seconds, and the adhesive was light-cured for 10 seconds. Resin composite was condensed on to the prepared surface in two increments using a mold kit(Ultradent Products Inc., USA) and each was light-cured for 40 seconds. After 24 hours in tap water at room temperature the specimens were thermocycled, and shear bond strengths were measured with a universal testing machine(Instron 4465, Canton, USA). To investigate infiltration patterns of the adhesive materials, the surface of specimen was examined with scanning electron microscope. The results were as follows. 1. The shear bond strengths of vibration groups(Group 2, Group 4) were significantly greater than those of the non-vibration groups(Group 1, Group 3)(p<0.05). 2. The shear bond strengths of Single Bond and One-Step were not significantly different (p>0.05). 3. The vibration groups showed greater number of resin tags in tubules and lateral branches under SEM.

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A Study of the Accidents of the Residents in a Rural Area (일개 보건진료소 사업 지역의 사고조사)

  • Kang, Pock-Soo;Lee, Kyeong-Soo;Kim, Seok-Beom;Kim, Chang-Yoon;Lee, Ok-Keum
    • Journal of Yeungnam Medical Science
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    • v.8 no.2
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    • pp.174-184
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    • 1991
  • To determine the incidence rate of accidents and its associated factors, a prospective survey was carried out in a rural area of a total of 1,360 residents for 1 year from January 1 to December 31, 1988 in Shin-am Ri, Jungdong Myun, Sangju Kun, Kyungpook Province. Data for accidents were collected by the community health practitioner who is working at Primary Health Post in Shin-am Ri. A total number of accident cases was 85 among 1,360 persons during one year study period, and annual incidence rate was 62.5 per 1,000 persons. The highest incidence rate of accident was observed in the age group of 30-39 was 179.8. The incidence rate of accident in male was 86.5 which was about 2 times that in female. In male, the highest incidence rate was seen in 30-39 age group and in female, 60-69 age group. The highest incidence rate of accident was observed in spring(29.4%) and summer(29.4%), and the lowest in fall(17.7%). The highest incidence rate of accident was observed in Friday(24.5%) by day of week, and between 9 a.m. to 12 a.m. by time zone. The most frequent use of medical facilities was Primary Health Post(51.8%) and the next was clinic(38.8%). Mean duration of treatment was 9.8 days. The accident occured in the room and kitchen(23.5%), in the yard and barn(23.5%), on the road(22.4%). and in the rice field and dry field(20.0%). The causes of accident were motor vehicle accident(20.0%), piercing or cutting(20.0%), collision or fighting(12.9%), and poisoning(11.8%) in order of frequency. The most common type of injury was open wound which was 43.5%. The most common tool of accident was farm machine which was 23.5%. The most common injuried part of body was extremity(55.3%).

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The Case Study of the Entrepreneurship Intensive Programs and the Successful Diffusing Strategies of the Entrepreneurship Education. (벤처창업전문과정(EIP) 사업추진 성공사례와 확산전략)

  • Ha, Kyu-Soo;Rhee, Taik-Ho;Lee, Seung-Weon;Kim, Ki-Hak
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.1 no.1
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    • pp.127-156
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    • 2006
  • This paper introduced successful case studies of the EIP (Entrepreneurship Intensive Programs) programs that are planed by 5MBA (Small and Medium Business Administration) and executed by Hoseo University and Jinju National University in 2004. Therefore, the illustrations and examples used in this paper are based on the EIP programs of those schools. Currently there are five graduate schools for Entrepreneurship educations that are originated from the EIP program models and those graduateschools are actively and successfully working. The purpose of this paper is to find out the diffusing strategies of the Entrepreneurship spirits and Entrepreneurship Education programs after careful analysis and review of the EIP programs. The main factors of the Success of the EIP are as follows. First, there were excellent modules of the education process. Second, there were firm and clear goals of the education. Three, there were differentiated contents of the entrepreneurship education programs. Four. each and every education performance was monitored. Five, during the programs, real start-up cases were actually handled and students had many opportunities to present their cases. However, there were some shortcomings to improve and change of the entrepreneurship education. First of all, it was very difficult to make proper education formation that is fit in the purpose of the program. Second, motivating students to find out their own business opportunities so as to turn them into real business was not satisfactory or easy. Third, there were some limitations in distributing and executing the EIP budgets. Therefore, to improve the efficiency of the Entrepreneurship education, following expanding strategies should be complemented. First, continuous redesigning of the entrepreneurship education programs is very important. Second, the specialization of the contents of the entrepreneurship education programs is essential. Third, there should be some discretionary room for the management of the entrepreneurship programs. Fourth, it is also important activating the entrepreneurship networks among schools of the entrepreneurship education. Finally, it is necessary to give some incentives and motivations based on the proper performance evaluation system.

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