• Archives of Plastic Surgery
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• 제49권2호
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• pp.253-257
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• 2022

The free fibula flap (FFF) is based on the peroneal artery (PA) system, and it is well known that several anatomical variations of the lower limb vascular system exist, including peronea arteria magna (PAM). PAM is a rare congenital variation in which both anterior tibial artery and posterior tibial artery are either aplastic or hypoplastic, and as a result, PA will be the dominant blood supply to the foot. This variation was described as type III-C in Kim-Lippert's Classification of the Infra-Popliteal Arterial Branching Variations. The awareness of its existence is crucial as it often precludes FFF from being harvested due to the risk of significant limb ischemia and limb loss. Despite some literature reporting donor site complications and impending limb loss following FFF harvest in PAM, preoperative vascular mapping before FFF transfer remains controversial among the microsurgeons. We present a case with an incidental intraoperative finding of PAM that had a successful FFF harvest by luck, without preoperative vascular mapping.

• Journal of Digestive Cancer Research
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• 제11권2호
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• pp.108-113
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• 2023

Dyspnea is a common symptom among patients with gastrointestinal cancer, and a comprehensive evaluation of their respiratory function is essential. Self-reporting aids in the assessment of the degree of dyspnea, while objective examination methods are performed to identify the potential underlying causes when subjective symptoms are present. Standard treatment protocols should be followed for potentially reversible and common causes of dyspnea, such as pleural effusion, pneumonia, airway obstruction, anemia, asthma, exacerbation of chronic obstructive pulmonary disease, pulmonary thromboembolism, or drug-induced interstitial lung disease. Careful and close monitoring is required due to the high frequency of pulmonary thromboembolism and the risk of cardiovascular accidents, drug-induced interstitial lung disease, or other complications from some anticancer drugs. In case of hypoxemia with an oxygen saturation of 90% or less, palliative treatment should comprise standard oxygen therapy such as nasal cannula, mask, or high-flow nasal cannula. If non-pharmacological oxygen therapy is not effective, pain control through systemic narcotic analgesics and anti-anxiety therapy with benzodiazepines may be helpful.

• Clinical Endoscopy
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• 제55권4호
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• pp.480-488
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• 2022

Endoscopy is vital for diagnosis, assessing treatment response, monitoring and surveillance in patients with inflammatory bowel disease (IBD). With the growing importance of mucosal healing as a treatment target, the assessment of disease activity by endoscopy has been accepted as the standard of care for IBD. There are many endoscopic activity indices for facilitating standardized reporting of the gastrointestinal mucosal appearance in IBD, and each index has its strengths and weaknesses. Although most endoscopic indices do not have a clear-cut validated definition, endoscopic remission or mucosal healing is associated with favorable outcomes, such as a decreased risk of relapse. Therefore, experts suggest utilizing endoscopic indices for monitoring disease activity and optimizing treatment to achieve remission. However, the regular monitoring of endoscopic activity is limited in practice owing to several factors, such as the complexity of the procedure, time consumption, inter-observer variability, and lack of a clear-cut, validated definition of endoscopic response or remission. Although experts have recently suggested consensus-based definitions, further studies are needed to define the values that can predict long-term outcomes.

• 한국임상약학회지
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• 제27권4호
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• pp.221-227
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• 2017

Background: As personalized healthcare industry has attracted much attention, big data analysis of healthcare data is essential. Lots of healthcare data such as product labeling, biomedical literature and social media data are unstructured, extracting meaningful information from the unstructured text data are becoming important. In particular, text mining for adverse drug reactions (ADRs) reports is able to provide signal information to predict and detect adverse drug reactions. There has been no study on text analysis of expert opinion on Korea Adverse Event Reporting System (KAERS) databases in Korea. Methods: Expert opinion text of KAERS database provided by Korea Institute of Drug Safety & Risk Management (KIDS-KD) are analyzed. To understand the whole text, word frequency analysis are performed, and to look for important keywords from the text TF-IDF weight analysis are performed. Also, related keywords with the important keywords are presented by calculating correlation coefficient. Results: Among total 90,522 reports, 120 insulin ADR report and 858 tramadol ADR report were analyzed. The ADRs such as dizziness, headache, vomiting, dyspepsia, and shock were ranked in order in the insulin data, while the ADR symptoms such as vomiting, 어지러움, dizziness, dyspepsia and constipation were ranked in order in the tramadol data as the most frequently used keywords. Conclusion: Using text mining of the expert opinion in KIDS-KD, frequently mentioned ADRs and medications are easily recovered. Text mining in ADRs research is able to play an important role in detecting signal information and prediction of ADRs.

• Journal of Information Technology Applications and Management
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• 제15권3호
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• pp.195-208
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• 2008

In an emergency management case, evaluating the economic value of information technology investments is a challenging problem due to the effects of decision making, uncertainty of disasters, and difficulty of measurements. Risk assessment and recovery process, one of the major functions in emergency management, consists of (1) measurement of damages or losses, (2) recovery planning, (3) reporting and approving budgets, (4) auctioning off recovery projects to constructors, and (5) construction for the recovery. Specifically and of our interest, measurement of damages or losses is often a costly and time-consuming process because the wide range of field surveys should be performed by a limited pool of trained agents. Managers, therefore, have to balance accuracy of the field survey against the total time to complete the survey. Using information technologies to support field survey and reporting has great potential to reduce errors and lowers the cost of the process. However, existing cost benefit analysis framework may be problematic to evaluate and justify the IT investment because the cost benefit analysis often include the long-run benefit of IT that is difficult to quantify and overlook the impact of managerial control upon the investment outcomes. Therefore, we present an alternative cost-centric control model that conservatively quantifies all cost savings to replace benefits in cost benefit analysis and incorporate the managerial control. The model provides a framework to examine how managerial decision making and uncertainty of disaster affect the economic value of IT investments. The current project in Emergency Agency in South Korea is introduced as a case to apply the cost-centric control model. Our work helps managers to better evaluate and justify IT-related investment alternatives in emergency management.

• Safety and Health at Work
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• 제3권3호
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• pp.209-215
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• 2012

Objectives: Knowledge, attitudes, and practices of healthcare providers related to occupational exposure to bloodborne pathogens were assessed in a tertiary-care hospital in Middle East. Methods: A cross-sectional study was undertaken using a self-administered questionnaire based on 3 paired (infectivity known vs. not known-suspected) case studies. Only 17 out of 230 respondents had an exposure in the 12 months prior to the survey and of these, only 2 had complied fully with the hospital's exposure reporting policy. Results: In the paired case studies, the theoretical responses of participating health professionals showed a greater preference for initiating self-directed treatment with antivirals or immunisation rather than complying with the hospital protocol, when the patient was known to be infected. The differences in practice when exposed to a patient with suspected blood pathogens compared to patient known to be infected was statistically significant (p < 0.001) in all 3 paired cases. Failure to test an infected patient's blood meant that an adequate risk assessment and appropriate secondary prevention could not be performed, and reflected the unwillingness to report the occupational exposure. Conclusion: Therefore, the study demonstrated that healthcare providers opted to treat themselves when exposed to patient with infectious disease, rather than comply with the hospital reporting and assessment protocol.

• 대한후두음성언어의학회지
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• 제15권1호
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• pp.10-15
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• 2004

Background and Objective : Voice disorders are one of the major occupational hazards of school teaching. Prolonged voice use through verbal instruction has been implicated as a cause of vocal impairment among members of this profession. They all depend on their voice for their livelihood and are greatly alarmed by slightest alteration in voice quality. Despite considerable research in the area of voice problems in teachers, the prevalence of voice disorders in this group is unknown. Severe voice problems can affect teacher's ability to teach in the classroom. Materials and Method : This study investigated the prevalence of self-reported voice problems in teachers using a survey of a simple random sample of middle school teachers (n=1000). As part of the survey, teachers were asked to report voice problems for the day of the survey, duration, main symptom, smoking, caffeine, alcohol history etc. Results : The reponse rate was 91%(n=94) with 89.7%(n=812) teachers reporting voice problems on the day of the survey, and 40%(n=330) of these group reporting the history of medical consult. Conclusion : These finding indicate a need for vocal hygiene education in teachers and for the development of educational programs aimed at preventing voice problems in this group of professional voice users.

• 한국항행학회논문지
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• 제18권4호
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• pp.334-340
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• 2014

최근 항공 안전의 발전에도 불구하고, 항공기 사고의 뚜렷한 감소 추세 없이 유지되고 있다. 따라서 국제적인 항공안전관리의 방향은 기존의 항공안전 방식을 탈피하여 자료에 근거하여 분석된 요소들을 통하여 사고예방을 위한 위험요소를 제거하는 것에 관심을 가지고 있다. 본 논문은 전 세계적으로 항공안전 데이터의 보고와 교환을 위한 표준이 되고 있는 ECCAIRS를 소개한다. 또한 최근 10년간의 국내 항공사고 데이터를 활용하여 항공기 분류별(고정익과 회전익)로 항공기 사고와 준사고의 분포, 연도별 및 월별 사고 분포, 비행 단계 분포, 그리고 분류체계 분포 등에 대한 경향을 분석한다. 본 논문의 항공기 사고와 준사고의 추세 분석은 향후 추구해야 할 정량적인 안전관리의 유용한 방향이 될 것이다.

• 한방재활의학과학회지
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• 제28권2호
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• pp.73-82
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• 2018

Objectives The purpose of this study is to systematically explore the effects and safety of acupuncture treatment for upper extremity peripheral nerve injury and to review the methodology of clinical trials. Methods We searched 9 electronic databases(3 international, 1 Chinese, 5 Korean) including English, Korean and Chinese, up to December 2017 for randomized controlled trials which evaluated the effects of the acupuncture in patients with upper extremity peripheral nerve injury. We abstracted the designs of the randomized clinical trials and the method of acupuncture treatment according to the Standards for Reporting Interventions in Clinical Trials of Acupuncture(STRICTA). Results A total of 8 papers were reviewed. All randomized clinical trials were conducted in China. Of them, five studies(62.5%) were electro-acupuncture as intervention. All randomized clinical trials reported favorable effects of acupuncture treatments compared to baseline or control group with outcomes of efficacy rate. However risk of bias seemed high. LI4, LI11, SI3, PC3, PC6 were most frequently used for acupoints to treat upper extremity peripheral nerve injury. Conclusions These results suggest that it is recommended to develop more detailed reporting standards for acupuncture treatment method. In the future, well designed randomized clinical trials which evaluate the effects and safety of acupuncture treatment for upper extremity peripheral nerve injury is highly needed.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제25권5호
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• pp.376-386
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• 2022

Functional gastrointestinal disorders (FGIDs) are classified as a combination of persistent gastrointestinal symptoms. The Rome IV criteria can elucidate several factors in the pathogenesis of FGIDs. The frequency of FGIDs can differ between clinical and nonclinical settings and between geographic regions. To determine the global prevalence of FGIDs in neonates and toddlers according to the Rome IV criteria. We included cohort and descriptive observational studies reporting the prevalence of FGIDs according to the Rome IV criteria in children aged 0-48 months. We searched the Medline, Embase, Lilacs, and CENTRAL databases from May 2016 to the present day. Furthermore, unpublished literature was searched to supplement this information. The Strengthening the Reporting of Observational Studies in Epidemiology statement was used to evaluate the risk of bias. A meta-analysis of the proportions was performed using MetaProp in R. The results are reported in forest plots. We identified and analyzed 15 studies comprising 48,325 participants. Six studies were conducted in Europe, three in Latin America, two in North America, and four in Asia. Most participants were 12-48 months old (61.0%) and were recruited from the community. The global prevalence of FGIDs was 22.0% (95% confidence interval, 15-31%). The most common disorder was functional constipation (9.0%), followed by infant regurgitation syndrome (8.0%). Its prevalence was higher in the Americas (28.0%). FGIDs, as defined by the Rome IV criteria, are present in 22% of children, and the most common primary disorder is functional constipation. A higher prevalence of FGIDs has been reported in America.