• Korean Journal of Environmental Biology
• /
• v.35 no.4
• /
• pp.662-669
• /
• 2017

This study evaluated the ecotoxicological properties of livestock waste water treated by a LID (Low Impact Development) system, using a mixture of bio-reeds and bio-ceramics as suitable bed media for a subsequent treatment process of a livestock wastewater treatment plant. The relationship between the pollutant reduction rate and the ecotoxicity was analyzed with the effluents from the inlet pilot plant, with vegetated swale and wetlands and the batch type of an infiltration trench. Each pilot plant consisted of a bio process using bio-reeds and bio-ceramics as bed media, as well as a general process using general reeds and a bed as a control group. The results indicated that, after applying the HRT 24 hour LID method, the ecotoxicity was considerably lowered and the batch type pilot plant was shown to be effective for toxicity reduction. The LID method is expected to be effective for water quality management, considering ecotoxicity by not only as a nonpoint source pollution abatement facility but also, as a subsequent treatment process linked with a livestock manure purification facility. It is necessary to take the LID technic optimization study further to apply it as a subsequent process for livestock wastewater treatment.

• Tuberculosis and Respiratory Diseases
• /
• v.49 no.5
• /
• pp.594-600
• /
• 2000

Background : Positive end expiratory pressure (PEEP) ventilation is well established as an integral part of the management of patients with the acute lung injury. PEEP is a key element in the treatment of hypoxemia resulting from pulmonary edema. Pulmonary capillary pressure (Pcap) is the most important factor influencing lung edema formation, and an understanding of how Pcap is altered by variations of PEEP or pulmonary arterial occlusion pressure (PAOP) is important to improve the treatment of acute lung injury patients. This study was performed to evaluate the effects of PEEP on the pulmonary capillary pressure in acute lung injury patients. Methods : This was a prospective study of 11 acute lung injury patients. The effect of PEEP on pulmonary circulation at four different levels (0,4,8, and 12cm$H_2O$) was analyzed. Pcap was estimated visually at bed side with Swan Ganz catheters. The pulmonary vasculature was analyzed by calculating the pressure difference at the arterial and venous parts of the circulation. Results: As PEEP increased from 0 to 12 cm$H_2O$, the mean pulmonary arterial pressure (PAP) and Pcap increased respectively from $22.7{\pm}7.4$ to $25.3{\pm}7.3$ mmHg and $15.3{\pm}3.3$ to $17.8{\pm}3.2$ mmHg (p<0.05). Similarly, PAOP increased from $9.8{\pm}2.1$ to $12.8{\pm}2.1$ mmHg and the central venous pressure increased from $6.1{\pm}1.6$ to $9.3{\pm}2.3$ mmHg(p<0.05). However, the pressure gradient at the arterial (PAP-Pcap) and venous (Pcap-Pcwp) parts of pulmonary circulation remained unchanged at all evaluated PEEP levels. Conclusion : Although Pcap increased gradually with increased the pressure gradient at the arterial and venous part of the pulmonary vasculature remained unchanged at all evaluated PEEP levels in acute lung injury patients.

• CELLMED
• /
• v.2 no.3
• /
• pp.23.1-23.7
• /
• 2012

The healing properties of medicinal maggots (larval stage of Lucilia sericata) are widely used in the chirurgical debridement of non-healing wounds including diabetic foot ulcers, venous and pressure ulcers, where classical approaches have failed. Several kinds of wounds are prone to complications coming out of a specific wound bed environment. There are multi-resistant bacterial species present, their pathogenic impact is multiplied by their ability to form a biofilm. Moreover, immunological events in chronic wounds differ from those in acute wounds. Non-healing wounds are cycled in the early inflammation phase with increased levels of inflammation attributes like inflammation cytokines and matrix metalloproteinases produced by inflammation phase cells. Application of larval therapy promotes progress in the healing process to the next stages involving tissue granulation and re-epithelisation. Larval debridement is an effective method of cleaning the wound of cell debris, necrotic tissue and bacterial load. This happens in a mechanical and biological manner, but the whole complex mechanism of the maggot healing activity is still not fully elucidated. Centuries of clinical practice brings noticeable proof of the maggots' beneficial effect in wound healing management. This long history led to the investigation of the bioactive components of the larval body and its extracts in vitro. We introduce a review which describes the immunomodulation impact of maggot body components on the cellular and molecular levels of the wound healing process.

• Journal of Chest Surgery
• /
• v.24 no.2
• /
• pp.143-152
• /
• 1991

From 1983, until June, 1990, 10 patients with various type of truncus arteriosus underwent total surgical correction including Rastelli procedure at Seoul National University Hospital. The age at operation ranged from 1 month to 9 years [mean 2.1 years]. Six patients had truncus type I, 3 patients had truncus type II, and one patients had truncus type IIIc. Right ventricular pulmonary artery continuity was established with a porcine valved conduit in 6 patients, mechanical valved conduit in 1 patient, and bovine pericardial conduit in 3 patients. The postoperative right ventricular /left ventricular pressure ratio ranged from 0.4 to 0.71 [mean 0.51${\pm}$0.14]. The lung histology revealed grade II pulmonary obstructive disease even at 4 month of age. Five patients were dead in hospital [50%], and they were less than 2 year of age. One patient, who had severs congestive heart failure preoperatively, died of low output syndrome and the other died of low output syndrome with postoperative bleeding. There were three death, because of a pulmonary hypertensive crisis that might have been prevented. Two of the five survivors had conduit failure over a mean follow up of 42 months [range 1 to 78 months]. Obstructed conduit was removed and a new conduit constructed using the conduit bed as the posterior wall and the patch of bovine pericardium and Dacron as patch the roof of the conduit. One patient died of acute cardiac failure during the operation. Although results in infants less than 2 years old have not been good, current improvement of intra-and postoperative care suggested that prompt repair is indicated for infants with truncus arteriosus.

• Clinical and Experimental Pediatrics
• /
• v.49 no.5
• /
• pp.570-573
• /
• 2006

A healthy, 14-year-old boy presented with right hip pain and consequent fever after falling out of bed while sleeping. The patient could not walk and complained of severe pain with active and passive motion, which consisted mainly in extension and internal rotation of the right hip. Laboratory analysis of the peripheral blood identified leukocytosis and increased levels of acute phase reactants. Magnetic resonance imaging of the hip, which was performed with the expectation of right hip pathology, revealed cellulitis and abscess in the right psoas muscle and associated inflammatory changes in the adjacent presacral fat plane but showed no abnormal lesions in the adjacent pelvic bone and spine. Staphylococcus hominis was cultured from the blood. With empirical antibiotic therapy, the patient recovered fully. We report a case of primary psoas abscess confused with hip pathology in an immunocompetent child without underlying disease.

• The Korean Journal of Pain
• /
• v.18 no.2
• /
• pp.210-213
• /
• 2005

Acute viral meningitis and myositis are rare complications of varicella-zoster virus (VZV) reactivation. A 71-years-old immunocompetent man, who presented with lower back pain radiating to the left lower extremities, developed vesicles on the L5 dermatomal area. The next day, he had complained of aberrant vesicles on the trunk, face and scalp, with generalized myalgia, headache and dizziness. He was confirmed with VZV meningitis and myositis, as demonstrated by the presence of VZV DNA in the blood and cerebral spinal fluid using a polymerase chain reaction (PCR) amplification. PCR has been used in patients with a VZV infection associated neurological symptoms, and provides a useful tool for the early diagnosis of VZV-associated neurological disease. The patient was treated with bed rest, with intravenous acyclovir for the VZV infection, and intravenous Patient-controlled Analgesia for pain management and the prevention of postherpetic neuralgia. When he visited the outpatient department 3 months later, the skin lesion, leg pain, headache and myalgia had all improved, without sequelae. Here, this case is reported, with a discussion of the relevant literature on its diagnosis and management.

• The Journal of Korean Academic Society of Nursing Education
• /
• v.5 no.1
• /
• pp.133-141
• /
• 1999

Recently there are increasing concerns on quality improvement activities related to difficult economic situations, more competitive environment, health professional's emphasis on quality, and customer's needs in health care. The purpose of this study was to identify educational needs in the quality improvement for staff nurses. Study setting was an acute care hospital having more than 1000 bed in Seoul, Korea. The subjects were 40 staff nurses who participated in the first Quality Assurance(QA) inservice education. Data were collected by self-administered questionnaire which consisted of four parts : QA knowledge and attitude(ten items, by five Likert scale), contents of QA education(ten items, by setting the priority), evaluation of the program(structure, time allocation, place, educational method), and general characteristics of respondents (age, duration to work for hospitals etc.) The response rate was 85%(34/40), Most had positive perspective and attitude about QI/QA activities, but 9% had negative impression and knowledge about this activities. Also they'd like to know the plan of hospital-level QI/QA activities, QI/QA current practice, general hospital system, the role of QA specialist and so on. Consequently, for building the quality improvement activities that is customer-focused, coordinated, outcome-oriented, resource-efficient, collaborative in Korea, at first the education about philosophy, theory, and implementation process of QI/QA should be conducted, and then that on QI/QA terminology, quality indicators development, the analysis and presentation of quality-related data and so forth be followed.

• Korea Journal of Hospital Management
• /
• v.12 no.4
• /
• pp.1-21
• /
• 2007

The relaxation of the regulation in selection of medical institution allows patients to use their own judgement in choosing proper institution for their diseases. Since the change of the regulation, there should have been many changes in medical institution selection behavior. The analysis of the change in disease specific selection pattern is critical because there be an optimal selection criteria that ensure the efficient and effective utilization of medical resources. This study analysis the institution selection factors by comparing the choice among the cases of acute diseases, the cases of chronic diseases, inpatient services, outpatient services, and emergency medical service. The comparisons performed in terms of size, class and other characteristics of medical institutions. For the study the nationally surveyed database was used and the data were analyzed using logistic regression procedure. The results indicates that the primary care facilities were not properly utilized. This study speculates that the reason for the undesirable pattern of utilization is that the roles of primary care facilities in the healthcare delivery system was not clearly defined. Based on the results, the medical policy implications are discussed.

• The Journal of Korean Medicine
• /
• v.41 no.4
• /
• pp.106-111
• /
• 2020

Objectives: Hepatitis A is a typical acute hepatitis caused by hepatovirus, and then most patients recover easily without progression to chronic condition. However, certain cases have the risk of severe symptoms or even death. This case report presented a hepatitis A accompanied with pancreatitis, which had been completely recovered in a Korean medicine hospital. Case presentation: A 38-year woman had felt the malaise, mild chilling, muscle pain and abdominal discomfort for 10 days, which led her visit doctors and took anti-pyretic analgesics and digestants. The symptoms, especially epigastric pain and fatigue, became worse, and then she hospitalized in a Korean medicine hospital. Based on the drastic elevations of hepatic enzymes (aspartate transaminase 1,604 IU/L and alanine transaminase 2,825IU/L) with an anti-HAV IgM positive, she was diagnosed with hepatitis A. After bed rest and herbal drug treatment (CGX and Innae-Tang) for 5 days, the laboratory abnormalities and subjective symptoms had been improved gradually, except the upper gastric discomfort and pain. Those symptoms had anticipated the comorbidity with HAV-induced pancreatitis, supported by the high level of serum lipase release. Another 5-day hospitalized treatment improved all subjective symptoms and then the laboratory results were completely normalized including detection of anti-HAV IgG within 15 days after discharge. Conclusion: This study presented a typical hepatitis A accompanied with pancreatitis, which should be considered in diagnosis and management of hepatitis A.

• Archives of Plastic Surgery
• /
• v.37 no.4
• /
• pp.469-472
• /
• 2010

Purpose: Aplasia Cutis Congenita (ACC) is a rare disease characterized by the focal defect of the skin at birth, frequently involving scalp, but it may affect any region of the body. There are no etiology known but some conditions such as intrauterine vascular ischemia, amniotic adherences and viral infections are associated. The ideal treatment for the ACC is not known. Superficial and relatively small sized defects (< $3{\times}5\;cm$) may heal spontaneously and large defects related with risks of infection and bleeding may require aggressive surgical treatment. Hyalomatrix$^{(R)}$ is a bilayer of an esterified hyaluronan scaffold beneath a silicone membrane. It has been used as a temporary dermal substitute to cover deep thickness skin defect and has physiological functions derive from the structural role in extracellular matrix and interaction with cell surface receptor. This material has been used for the wound bed pre-treatment for skin graft to follow and especially in uncooperative patient, like a newborn, this could be a efficient and aseptic way of promoting granulation without daily irritative wound care. For this reason, using Hyalomatrix$^{(R)}$ for the treatment of ACC was preferred in this paper. Methods: We report a case of a newborn with ACC of the vertex scalp and non-ossified partial skull defect. The large sized skin and skull defect ($6{\times}6\;cm$) was found with intact dura mater. No other complications such as bleeding or abnormal neurologic sign were accompanied. Escharectomy was performed and Hyalomatrix$^{(R)}$ was applied for the protection and the induction of acute wound healing for 3 months before the split-thickness skin graft. During the 3 months period, the dressing was renewed in aseptic technique for every 3 weeks. The skin graft was achieved on the healthy granulation bed. Results: The operative procedure was uneventful without necessity of blood transfusion. Postoperative physical examination revealed no additional abnormalities. Regular wound management was performed in out-patient clinic and the grafted skin was taken completely. No other problems developed during follow-up. Conclusion: Hyalomatrix$^{(R)}$ provides protective and favorable environment for wound healing. The combination of the use of Hyalomatrix$^{(R)}$ and the skin graft will be a good alternative for the ACC patients with relatively large defect on vertex.