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.
Nam, Gi-Sung;Moon, In Seok;Kim, Ji Hyung;Kim, Sung Huhn;Choi, Jae Young;Son, Eun Jin
Clinical and Experimental Otorhinolaryngology
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v.11
no.4
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pp.259-266
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2018
Objectives. Carcinomas of the external auditory canal (EAC) are rare, and management remains challenging. Previous studies seeking prognostic factors for EAC cancers included cancers other than carcinomas. In this study, we analyzed the treatment outcomes of, prognostic factors for, and survival rates associated with specifically squamous cell carcinoma (SCC) of the EAC. Methods. A retrospective review of 26 consecutive patients diagnosed with SCCs of the EAC in a 10-year period was performed in terms of clinical presentation, stage, choice of surgical procedure, and adjunct therapy. Overall survival (OS) and recurrence-free survival (RFS) were calculated and univariate analysis of prognostic factors was performed. Results. The median age of the 26 patients with SCCs of the EAC was 63 years (range, 40 to 72 years), and 16 males and 10 females were included. According to the modified University of Pittsburgh staging system, the T stages were T1 in 11, T2 in six, T3 in four, and T4 in five cases. The surgical procedures employed were wide excision in three cases, lateral temporal bone resection (LTBR) in 17, and extended LTBR in four, and subtotal temporal bone resection in two. Two patients underwent neoadjuvant chemotherapy, and two underwent adjuvant chemotherapy. One patient received preoperative radiation therapy, and eleven received postoperative radiation therapy. Of the possibly prognostic factors examined, advanced preoperative T stage and advanced overall stage were significant predictors of RFS, but not of OS. Conclusion. The advanced T stage and overall stage were associated with decreased survival after surgical treatment in patients with SCC of the EAC, highlighting the importance of clinical vigilance and early detection.
Purpose. This study aimed to assess the influence of various micromechanical surface conditioning (MSC) strategies with or without coupling agent (silane) application on the micro-shear bond strength (µSBS) of resin- matrix ceramics (RMCs). Materials and Methods. GC Cerasmart (GC), Lava Ultimate (LU), Vita Enamic (VE), Voco Grandio (VG), and Brilliant Crios (BC) were cut into 1.0-mm-thick slices (n = 32 per RMC) and separated into four groups according to the MSC strategy applied: control-no conditioning (C), air-borne particle abrasion with aluminum oxide particles (APA), 2W- and 3W-Er,Cr:YSGG group coding is missing. The specimens in each group were further separated into silane-applied and silane-free subgroups. Each specimen received two resin cement microtubules (n = 8 per subgroup). A shear force was applied to the adhesive interface through a universal test machine and µSBS values were measured. Data were statistically analyzed by using 3-way ANOVA and Tukey HSD test. Failure patterns were scrutinized under stereomicroscope. Results. RMC material type, MSC strategy, and silanization influenced the µSBS values (P<.05). In comparison to the control group, µSBS values increased after all other MSC strategies (P<.05) while the differences among these strategies were insignificant (P>.05). For control and APA, there were insignificant differences between RMCs (P>.05). The silanization decreased µSBS values of RMCs except for VE. Considerable declines were observed in GC and BC (P<.05). Conclusion. MSC strategies can enhance bond strength values at the RMC - cement interface. However, the choice of MSC strategy is dependent on RMC material type and each RMC can require a dedicated way of conditioning.
Journal of the Korea Academia-Industrial cooperation Society
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v.22
no.1
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pp.439-444
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2021
There are many reasons why myths are used in the cultural context. However, the primary reason is that myths tend to be a safe choice as they are guaranteed to be entertaining and connect people over the past thousands of years, and are also free from issues related to plagiarism. In particular, myths from Northern Europe are used in many parts of modern cultural content as they have a clear conflict between good and evil and present a universe with various tribes and worlds. This study analyzed the movie series of Thor and the game Ragnarok to investigate how myths are used in the modern cultural context. In the movie series of Thor and the game Ragnarok, it is possible to identify how myths are modified while keeping their basic storyline. The findings from the analysis can be summarized as follows.
Objectives : Computer-based test (CBT) will be introduced in the national examination of Korean medicine doctors from 2023. This study was aimed to provide some information, including prior considerations, to those preparing for CBT, by presenting a summary of the survey results from participants in a CBT simulation test. Methods : In December 2020, applicants from the graduating class of the college of Korean medicine from four universities participated in the simulation test for CBT. An online anonymous survey on the applicants' preference for CBT versus paper-based tests (PBT) was conducted. The questionnaire consisted of multiple-choice questions on a 5-point Likert scale and free-form questions. Results : A total of 176 students responded to the survey. Their response to CBT was generally positive. The item with the highest agreement was that it should provide a sufficient opportunity to experience CBT in the undergraduate exam (4.38±0.839). Concerns about the possibility of cheating or poor concentration were also detected. In addition to guaranteeing the stability of the CBT system, there were many comments expressing the need to supplement functions within the CBT system, including the memo or highlighter function. Conclusions : This study confirmed the feasibility of CBT including multimedia questions in the field of Korean medicine education and identified overall positive responses from those who experienced the CBT simulation test. Although time is short and there is so much to prepare, we hope this will be a leap forward for effective educational innovation in line with the changing environment of the health care education field.
The Journal of the Convergence on Culture Technology
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v.8
no.3
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pp.183-189
/
2022
COVID-19 is also influencing the coffee industry. This will increase untact consumption, a new consumption trend. Consumption utilizing online channels and delivery service applications that represent untact consumption is becoming commonplace. The coffee industry is also increasingly using coffee shops with drive-through and smart ordering systems that can be ordered with minimal contact. While most of the untact services are preempted at franchise stores, many independent coffee shops still offer differentiated services by communicating directly with customers. However, along with the prolonged COVID-19 infection, coffee shops in the present era, which cannot be free from infectious diseases, have no choice but to worry about delivery services. Therefore, this study analyzed the factors that influence coffee delivery services. Research results due to the influence of COVID-19, regular delivery services have increased along with coffee delivery services. Regular delivery services will play a central role in coffee delivery services due to increased use of home cafes by consumers who want to enjoy coffee in various ways.
Background and objective: This study conducted a conjoint analysis on early childhood teachers to find out their preferences in horticultural activities that are used as a means of education in early childhood education. Methods: For the conjoint analysis, five attributes of horticultural activities were selected. Attribute 1 was method of horticultural activities, divided into two levels: exclusive and integrated horticultural activities. Attribute 2 was object of horticultural activities, divided into three levels: fruit crops, vegetable crops, and floricultural crops. Attribute 3 was activity type, divided into three levels: big and small group, free choice, and outdoor play. Attribute 4 was place for horticultural activities, and divided into two levels: indoors and outdoors. Attribute 5 was time for horticultural activities, divided into two levels: 30 minutes and 30-60 minutes. The orthogonal design was used to extract 20 profiles, after which we conducted a survey on 320 early childhood teachers and analyzed the valid responses from 257 teachers. Results: The preference of early childhood teachers showed highest importance in object (29.1%), followed by activity type (23.2%), activity method (17.4%), time (16.1%), and place (14.2%) (Pearson's R = .591, p = .008). By level of each attribute, the importance was high in exclusive horticultural activities for activity method, big and small group for activity type, vegetable and floricultural crops for object, indoors for place, and 30 minutes for time. Conclusion: The horticultural program preferred by early childhood teachers is comprised of big and small group activities using vegetable and floricultural crops, carried out indoors for 30 minutes as an exclusive class.
Purpose: Treatment options are limited after the failure of first-and second-line treatments in patients with HER2+ metastatic gastric cancer (mGC). The present study aimed to explore the efficacy, safety, and prognostic factors of apatinib efficacy as a third-line therapy for patients with human epithelial growth factor receptor 2-positive (HER2+) mGC. Materials and Methods: A total of 59 HER2+ mGC patients who received apatinib as third-line therapy were retrospectively enrolled in this two-center, single-arm, cohort study; the clinical response, survival data, and adverse events were retrieved. Results: The median progression-free survival (PFS) was 5.2 months (95% confidence interval [CI], 3.9-6.5), and the median overall survival (OS) was 8.2 months (95% CI, 6.6-9.8) Furthermore, forward stepwise multivariate Cox regression analysis showed that a higher Eastern Cooperative Oncology Group performance status score and multiple metastases were independently correlated with decreased PFS and OS (both P<0.05). The main adverse events were leukopenia (45.8%), hypertension (44.1%), thrombocytopenia (39.0%), hand-foot syndrome (37.3%), and elevated transaminase (33.9%). Grade 3 adverse events mainly included hypertension (5.1%) and neutropenia (5.1%); grade 4 adverse events did not occur. Conclusions: Apatinib is efficient and well tolerated in patients with HER2+ mGC as a third-line treatment, suggesting that it may be a candidate of choice for these patients.
Joon Young Kim;Won Chul Cho;Dong-Hee Kim;Eun Seok Choi;Bo Sang Kwon;Tae-Jin Yun;Chun Soo Park
Journal of Chest Surgery
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v.56
no.6
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pp.394-402
/
2023
Background: The optimal choice of valve substitute for aortic valve replacement (AVR) in pediatric patients remains a matter of debate. This study investigated the outcomes following AVR using mechanical prostheses in children. Methods: Forty-four patients younger than 15 years who underwent mechanical AVR from March 1990 through March 2023 were included. The outcomes of interest were death or transplantation, hemorrhagic or thromboembolic events, and reoperation after mechanical AVR. Adverse events included any death, transplant, aortic valve reoperation, and major thromboembolic or hemorrhagic event. Results: The median age and weight at AVR were 139 months and 32 kg, respectively. The median follow-up duration was 56 months. The most commonly used valve size was 21 mm (14 [31.8%]). There were 2 in-hospital deaths, 1 in-hospital transplant, and 1 late death. The overall survival rates at 1 and 10 years post-AVR were 92.9% and 90.0%, respectively. Aortic valve reoperation was required in 4 patients at a median of 70 months post-AVR. No major hemorrhagic or thromboembolic events occurred. The 5- and 10-year adverse event-free survival rates were 81.8% and 72.2%, respectively. In univariable analysis, younger age, longer cardiopulmonary bypass time, and smaller valve size were associated with adverse events. The cut-off values for age and prosthetic valve size to minimize the risk of adverse events were 71 months and 20 mm, respectively. Conclusion: Mechanical AVR could be performed safely in children. Younger age, longer cardiopulmonary bypass time and smaller valve size were associated with adverse events. Thromboembolic or hemorrhagic complications might rarely occur.
Jae Hoon Lim;Hyun-Jung Jang;Eung Yeop Kim;Cheol Keun Park;Jae-Won Joh;Yong Il Kim
Korean Journal of Radiology
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v.1
no.1
/
pp.38-42
/
2000
Objective: The purpose of this study was to determine the utility of preoperative CT in predicting early recurrence of hepatocellular carcinoma after partial hepatic resection. Materials and Methods: Preoperative three-phase helical CT scans in 53 patients with hepatocellular carcinoma were retrospectively reviewed by two radiologists. In 27 patients (group I), HCC had recurred within six months, while 26 (group II) had remained disease free for at least two years. In each group, preoperative CT findings were evaluated in each group for the tumor size and number, the presence or absence of capsule, distinctness of tumor margin, perinodular extension, and the presence or absence of portal vein thrombosis. Results: In group I, a tumor capsule of tumor was seen in five of 27 patients (19%), and in group II, in 16 of 26 (62%) (p = .001). The tumor margin was distinct in eight patients (30%) in group I and in 20 (77%) in group II (p = .001). Multiple tumors, perinodular extension, and portal vein thrombosis were more frequently seen in group I but the differences were not statistically significant (p > .05). Tumor size was similar in each group (p > .05). Conclusion: Preoperative CT findings that may help predict the early recurrence of hepatocellular carcinoma after surgical resection are an absence of capsule of tumors and an indistinct margin. Reference to these findings during preoperative CT can guide clinicians in their choice of treatment.
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