• Journal of Korean Neurosurgical Society
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• 제45권2호
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• pp.90-95
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• 2009

Objective : We aimed to identify clinico-radiological risk factors that may predict unfavorable neurological outcomes in traumatic brain injury (TBI), and to establish a guideline for patient selection in clinical trials that would improve neurological outcome during the early post TBI period. Methods : Initial clinico-radiological data of 115 TBI patients were collected prospectively. Regular neurological assessment after standard treatment divided the above patients into 2 groups after 6 months : the Favorable neurological outcome group (GOS : good & moderate disability, DRS : 0-6, LCFS : 8-10) and the Unfavorable group (GOS : severe disability-death, DRS : 7-29 and death, LCFS : 1-7 and death). Results : There was a higher incidence of age $\geq$35 years, low initial GCS score, at least unilateral pupil dilatation, and neurological deficit in the Unfavorable group. The presence of bilateral parenchymal lesions or lesions involving the midline structures in the initial brain CT was observed to be a radiological risk factor for unfavorable outcome. Multivariate analysis demonstrated that age and initial GCS score were independent risk factors. The majority of the Favorable group patients with at least one or more risk factors showed improvement of GCS scores within 2 months after TBI. Conclusion : Patients with the above mentioned clinico-radiological risk factors who received standard treatment, but did not demonstrate neurological improvement within 2 months after TBI were deemed at risk for unfavorable outcome. These patients may be eligible candidates for clinical trials that would improve functional outcome after TBI.

• Journal of Trauma and Injury
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• 제36권1호
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• pp.39-48
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• 2023

Purpose: Sports offer several health benefits but are not free of injury risk. Activity dynamics vary across sports, impacting the injury profile and thereby influencing healthcare resource utilization and health outcomes. The purpose of this study was to investigate sports-related major trauma cases and compare differences across sports and activity groups. Methods: A retrospective case notes review of sports-related major traumas over a 5-year period was conducted. Demographic, hospital episode-related, and health outcome-related data were analyzed, and differences were compared across sports and activity groups. The Glasgow Outcome Scale (GOS) at discharge was used as the primary outcome measure and the length of hospital stay as the secondary outcome measure. Results: In total, 76% of cases had good recovery at discharge (GOS, 5), 19% had moderate disability (GOS, 4), and 5% had severe disability (GOS, 3). The mean length of hospital stay was 11.2 days (range, 1-121 days). The most severely injured body region was the limbs (29.1%) and vertebral/spinal injuries were most common (33%) in terms of location. A significant difference (P<0.05) existed in GOS across sports groups, with motor sports having the lowest GOS. However, no significant differences (P>0.05) were found in other health-outcome variables or injury patterns across sports or activity groups, although more competitive sports cases (67%) required admission than recreational sports cases (33%). Conclusions: Spinal injuries are the most frequent sports injuries, bear the worst health outcomes, and warrant better preventive measures. Head injuries previously dominated the worst outcomes; this change is likely due to better preventive and management modalities. Competitive sports had a higher injury frequency than recreational sports, but no difference in health outcomes or injury patterns.

• 대한장애인치과학회지
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• 제5권2호
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• pp.100-103
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• 2009

Dental treatment of mentally challenged patients under general anesthesia is a series of challenging procedures not only for dental operators but also for dental anesthesiologists. Patients presenting with uncooperative behavior often resist the perioperative management for adesthestic administration. This case report suggests oral premedication as a conjuctive method for anestheitic induction. A 26-year-old male dental patient with autism was referred to dental treatment under general anesthesia. The patient refused to enter dental clinic office and was not able to receive preoperative assessment. In the day of operation, 15 mg of midazolam was given to the patient for oral premedication prior to anesthetic induction. Ater 20 minutes, the patient presented with drowziness and was transferred to the office. Anesthestic staff were able to achieve appropriate intravenous access and mask inhalation. The patient recieved 8 hrs long dental treatment and recovered in a noncomplicated way. Oral midazolam is commonly used to reduce anxiety for combative and irritated pateints. In this case, oral midazolam sedation was used as a preanesthetic management of a highly uncoopearive patient.

• Journal of Korean Neurosurgical Society
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• 제51권6호
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• pp.343-349
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• 2012

Objective : Pedicle-based dynamic stabilization systems, in which semi-rigid rods or cords are used to restrict or control spinal segmental motion, aim to reduce or eliminate the drawbacks associated with rigid fusion. In this study, we analyzed the two-year clinical outcomes of patients treated with the NFlex (Synthes Spine, Inc.), a pedicle-based dynamic stabilization system. Methods : Five sites participated in a retrospective study of 72 consecutive patients who underwent NFlex stabilization. Of these 72 patients, 65 were available for 2-year follow-up. Patients were included based on the presence of degenerative disc disease (29 patients), degenerative spondylolisthesis (16 patients), lumbar stenosis (9 patients), adjacent segment degeneration (6 patients), and degenerative lumbar scoliosis (5 patients). The clinical outcome measures at each assessment were Visual Analogue Scale (VAS) to measure back pain, and Oswestry Disability Index (ODI) to measure functional status. Radiographic assessments included evidence of instrumentation failure or screw loosening. Results : Sixty-five patients (26 men and 39 women) with a mean age of 54.5 years were included. Mean follow-up was 25.6 months. The mean VAS score improved from 8.1 preoperatively to 3.8 postoperatively, representing a 53% improvement, and the ODI score from 44.5 to 21.8, representing a 51% improvement. Improvements in pain and disability scores were statistically significant. Three implant-related complications were observed. Conclusion : Posterior pedicle-based dynamic stabilization using the NFlex system seems effective in improving pain and functional scores, with sustained clinical improvement after two years. With appropriate patient selection, it may be considered an effective alternative to rigid fusion.

• Safety and Health at Work
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• 제11권4호
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• pp.543-549
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• 2020

Background: The working conditions of bus drivers are difficult; they lead to occupational diseases and require careful study, particularly in Ukraine. The objective of the article is the description of occupational health risks of passenger bus drivers that lead to deteriorating health. Methods: The risk assessment was performed using a modified Risk Score method, which allowed determining the generalized level of danger to the driver's health. The hygienic hazards level was assessed as based on Stevenson's law, which was generalized later. Results: Based on the modification of the Risk Score method, it was possible to depart from expert assessments method of the risk level and calculate the general indicator based on the degree of dependence of the impact on the human body on its intensity, proposed by V. Minko. This allows objective determining of the impact of hygiene hazards on the health of the driver and to predict the occurrence of occupational diseases associated with the cardiovascular system, musculoskeletal system, and partial or complete disability due to the accumulation of emotional fatigue. The hazard assessment was carried out for three brands of passenger buses common in Ukraine, in which the driver is exposed to the dangers of fever, vibration, noise, harmful impurities in the bus cabin, and emotional load. Conclusion: The health of drivers in the cabins of passenger buses is most affected by hygiene hazards: fever, vibration, and emotional stress. The generalized level of risk is calculated by the modified method of Risk Score is 0.83; -0.99, -0.92 respectively.

• The Journal of Korean Physical Therapy
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• 제32권4호
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• pp.250-257
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• 2020

Purpose: This study examined the effects of training using the slime on the hand function and problem behavior in adults with intellectual disabilities. Methods: Five adults with intellectual disabilities who were judged as Level 1 or Level 2 were selected. The training consisted of one session (50 min)/day, one day/week for 10 weeks (preparatory activities: 5 min, slime activities: 40 min, finishing activities: 5 min) The functions of the hand (Purdue Pegboard Test [PPT], grip strength test [GST]) and problem behavior (Korean Behavior Problems Inventory [KBPI]) were assessed three times (first assessment; pre, second assessment; post-5 weeks, third assessment; post-10 weeks). Wilcoxon signed-rank tests were used to analyze changes in the subjects' performance before and after the intervention. Results: In the PPT, the use of the non-dominant hand was increased significantly (p<0.05). No significant differences were observed in the remaining results, but the mean value increased. In addition, although the problem behavior was not statistically significant, an increase in the problem behavior score was noted. Conclusion: The training using the slime for adults with intellectual disabilities is effective in hand function improvement and reducing problem behavior.

• 치위생과학회지
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• 제23권1호
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• pp.1-12
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• 2023

Background: This study aimed to identify the present level and needs of clinical dental hygienists and to present the Borich needs assessment and the locus for focus model as integrated priorities. Methods: The participants of this study were dental hygienists working in dental clinics (hospitals). The final data of the 194 participants were analyzed using frequency analysis and a paired sample t-test. To analyze the need for clinical dental hygienists to perform work, the Borich priority determination formula was used. The x-y plane consisting of four quadrants was used to analyze the need using the locus for focus model, which helps to determine the priority while showing visual effects. Results: "Scaling" was the highest required level for clinical dental hygienists, and "panorama taking" was the highest present level. The priorities of educational needs were systematically and visually derived from dental hygienists who were currently working through the Borich needs assessment and the locus for focus model for each task performed in the clinical field. Through the priorities of these two models, a total of 13 items appeared in the common high-level area; "oral health care (disability)," "oral health care (systemic disease)," "applying a rubber dam," "professional mechanical tooth cleaning," "root planing," "taking vital signs," "medication counseling," "wire cutting," "removing cement after removing band/bracket," "delivering bracket," "preparing mini-screw implantation," "dental insurance claim," and "patient reception." Conclusion: Based on the results, the department of dental hygiene should maintain and improve the standardized clinical practice curriculum and clinical dental hygienists' practical skills and contribute to the realization of the legal scope of dental hygienists, reflecting the requirements of clinical fields.

• 산업경영시스템학회지
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• 제24권68호
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• pp.51-65
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• 2001

This study is to make LCIA(Life Cycle Impact Assessment) easier as a methodology of environmental scores(called E-score) that integrated environmental load of each emission substance based on environmental damage such as in human health, ecosystem and resources category. The concept is to analyzes the LCI(Life Cycle Inventory) and defines the level of environment damages for human health, ecosystem and resources to objective impact assessment standard, and makes the base of marginal damage to calculate the damage factor, which can present the indication that can establish the standard value of environmental impact. First, damages to human health are calculated by fate analysis, effect analysis and damage analysis to get the damage factor of health effect as a DALY(Disability Adjusted Life Years) unit. Second, damages to ecosystem are calculated by fate analysis, effect analysis and damage analysis to get the damage factor of the effect as a PDF(Potentially Disappeared Fraction) unit through linking potentially increased disappeared fraction. Third, damages to resources are carried out by resource analysis and damage analysis for linking the lower fate to surplus energy conception to get damage factor as a MJ(Mega Joule) unit. For the ranking of relative environment load level each other, LCIA can be carried out effectively by applying this E-score methodology to the particular emission substances. A case study has been introduced for the emission substances coming out of a tire manufacturer in Korea. It is to show how to work the methodology. Based on such study result, product-designers or producers now can apply the E-scores presented in this study to the substances of emission list, and then calculate the environment load of the product or process in advance at any time and can see the environment performance comparatively and expected to contribute to the environmental improvement in view of environmental pollution prevention.

• 동의신경정신과학회지
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• 제8권1호
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• pp.151-165
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• 1997

The primary purpose of this study was to assess the relation of stress perception and poststroke. This study was done on 50 stroke patients in hospital. According to activities of functional impairment, they were classified into walking disturbance, motor weakness, dysphagia, or reattack etc. The stress perception test(GARS Scles) and stress response assessment shows the follwing results. 1. On the distribution in the stroke 50 patients, For the majority group were male in sex, sixty inage, middle towns people in residence. 2. On the comprehensive GARS scale scores, It marked the higest scores thirty at age, merchandise or salesman on jobs, a city in residence. There was no signigicant difference in mean GARS Scales scores between males and females group, the left hemiplegia and the Rt hemiplegia. 3. On the comprehensive GARS Scale tests, Overall glogal stressor(G8) and sickness stresor(G4) marked the highest scores of all GARS Scales. 4. On the comparative assessment of each group's stress reponse test scores, zung-bu(中腑) was showed higher scores than the other group in oriental diagnosis and hemorrage was showed higher scores than the other group in western medical diagnosis. 5. On the comprehensive assessment of each group's stress reponse test scores, aphsia(不語) marked the highest scores in another disphagia group's. It marked the highest scores in another group's that banshinbulsoo(半身不遂) as regards as hemiplegia generally. Standing disability is the higher scores than another group's walking alone or assist, and standing alone. 6. Secondary attack is the highest scores of all reattack stroke on the stress repones test. 7. Comparing and analyzing the GARS Scale total scores and GARS Scale subject fator at stroke, we found that sickness stressor and fininial stressor is showed the highest correlated to stress response fowlloing stroke. With those results, we can see that functional impairment following stroke is correlated to stress perception and reponse. In the furture studies using, we hope that the findings the study would have clinical relevance to the psychosocial adjustment and total rehabilation of stroke patients.

• 대한영양사협회학술지
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• 제25권1호
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• pp.30-43
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• 2019

This study compared the predictive models for the growth kinetics of Staphylococcus aureus in ham rice balls. In addition, a semi-quantitative risk assessment of S. aureus on ham rice balls was conducted using FDA-iRISK 4.0. The rice was rounded with chopped ham, which was mixed with mayonnaise (SHM), soy sauce (SHS), or gochujang (SHG), and was contaminated artificially with approximately $2.5{\log}\;CFU{\cdot}g^{-1}$ of S. aureus. The inoculated rice balls were then stored at $7^{\circ}C$, $15^{\circ}C$, and $25^{\circ}C$, and the number of viable S. aureus was counted. The lag phases duration (LPD) and maximum specific growth rate (SGR) were calculated using a Baranyi model as a primary model. The growth parameters were analyzed using the polynomial equation as a function of temperature. The LPD values of S. aureus decreased with increasing temperature in SHS and SHG. On the other hand, those in SHM did not show any trend with increasing temperature. The SGR positively correlated with temperature. Equations for LPD and SGR were developed and validated using $R^2$ values, which ranged from 0.9929 to 0.9999. In addition, the total DALYs (disability adjusted life years) per year in the ham rice balls with soy sauce and gochujang was greater than mayonnaise. These results could be used to calculate the expected number of illnesses, and set the hazard management method taking the DALY value for public health into account.