• Journal of Trauma and Injury
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• v.37 no.2
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• pp.97-105
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• 2024

Purpose: Massive transfusion protocols (MTPs) implementation improves clinical outcomes of the patient's resuscitation with hemorrhagic trauma. Various predictive scoring system have been used and studied worldwide to improve clinical decision. However, such research has not yet been studied in Korea. This systematic review aimed to assess the predictors of MTPs activation in patients with trauma in Korea. Methods: The PubMed, Embase, Cochrane Library, Research Information Sharing Service databases, KoreaMed, and KMbase were searched from November 2022. All studies conducted in Korea that utilized predictors of MTPs activation in adult patients with trauma were included. Results: Ten articles were eligible for analysis, and the predictors were assessed. Clinical assessments such as systolic and diastolic blood pressure, shock index (SI), prehospital modified SI, modified early warning system (MEWS) and reverse SI multiplied by the Glasgow Coma Scale (rSIG) were used. Laboratory values such as lactate level, fibrinogen degradation product/fibrinogen ratio, and rotational thromboelastometry (ROTEM) were used. Imaging examinations such as pelvic bleeding score were used as predictors of MTPs activation. Conclusions: Our systematic review identified predictors of MTPs activation in patients with trauma in Korea; predictions were performed using tools that requires clinical assessments, laboratory values or imaging examinations only. Among them, ROTEM, rSIG, MEWS, SI, and lactate level showed good effects for predictions of MTPs activation. The application of predictors for MTP's activation should be individualized based on hospital resource and skill set, also should be performed as a clinical decision supporting tools.

• Journal of Chest Surgery
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• v.57 no.5
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• pp.430-439
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• 2024

Background: This study investigated the incidence and clinical consequences of abnormal radiological and clinical findings during routinely performed 6-week outpatient visits in patients treated conservatively for multiple (3 or more) rib fractures. Methods: A retrospective analysis was conducted among patients with multiple rib fractures treated conservatively between 2018 and 2021 (Opvent database). The primary outcome was the incidence of abnormalities on chest X-ray (CXR) and their clinical consequences, which were categorized as requiring intervention or additional clinical/radiological examination. The secondary focus was the incidence of deviation from standard treatment in response to the findings (clinical or radiological) at the routine 6-week outpatient visit. Results: In total, 364 patients were included, of whom 246 had a 6-week visit with CXR. The median age was 57 years (interquartile range, 46-70 years) and the median Injury Severity Score was 17 (interquartile range, 13-22). Forty-six abnormalities (18.7%) were found on CXR. These abnormalities resulted in additional outpatient visits in 4 patients (1.5%) and in chest drain insertion in 2 (0.8%). Only 2 patients (0.8%) with an abnormality on CXR presented without symptoms. None of the 118 patients who had visits without CXR experienced problems. Conclusion: Routine 6-week outpatient visits for patients with conservatively treated multiple rib fractures infrequently revealed abnormalities requiring treatment modifications. It may be questioned whether the 6-week outpatient visit is even necessary. Instead, a more targeted approach could be adopted, providing follow-up to high-risk or high-demand patients only, or offering guidance on recognizing warning signs and providing aftercare through a smartphone application.

• Journal of Ginseng Research
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• v.36 no.4
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• pp.461-468
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• 2012

In this study, photosynthetic parameters such as the net photosynthesis rate, stomatal conductance, intercellular $CO_2$ concentration, and transpiration rate were examined in selected ginseng varieties and/or lines that are resistant (Yunpoong, HTIR 1, HTIR 2, and HTIR 3) and susceptible (Chunpoong) to high temperature injury (HTI). The net photosynthesis rate increased with the increase in the light intensity in all the HTI-resistant and -susceptible ginseng lines with a light saturation point of $200\;{\mu}mol\;m^{-2}s^{-1}$, except for Yunpoong that had a light saturation point of $400\;{\mu}mol\;m^{-2}s^{-1}$. At the light saturation point, the net photosynthesis rate in July was highest in HTIR 3, at $4.2\;{\mu}mol\;CO_2\;m^{-2}s^{-1}$, and was lowest in Yunpoong, HTIR 1, Chunpoong, and HTIR 2, in that order, at 1.9 to $3.7\;{\mu}mol\;CO_2\;m^{-2}s^{-1}$. The net photosynthesis rate in August was highest in Yunpoong at $5.9\;{\mu}mol\;CO_2\;m^{-2}s^{-1}$, and lowest in HTIR 1 and HTIR 3 ($4.5\;{\mu}mol\;CO_2\;m^{-2}s^{-1}$) and in other lines, in that order, at 2.8 to $2.9\;{\mu}mol\;CO_2\;m^{-2}s^{-1}$. The stomatal conductance in July was highest in HTIR 3 (0.055 mol $H_2O\;m^{-2}s^{-1}$) and Yunpoong, Chunpoong, HTIR 1, and HTIR 2 were 0.038, 0.037, 0.031, and 0.017 in that orders. In August, meanwhile, HTIR 1 showed the highest as 0.075, and followed by HTIR 3, Chungpoong, and HTIR 2 with 0.070, 0.047, and 0.023, respectively. The intercellular $CO_2$ concentration at the light saturation point in July and August was much lower in HTIR 2 at 139 and $185\;{\mu}mol\;mol^{-1}$ than in the other ginseng lines at 217 to 257 and 274 to $287\;{\mu}mol\;mol^{-1}$, respectively. The transpiration rate in July and August was higher in the HTI-resistant lines of Yunpoong, HTIR 1, and/or HTIR 3 at 0.83 to 1.03 and 1.67 to 2.10 mol $H_2O\;m^{-2}s^{-1}$ than in the other ginseng lines at 0.27 to 0.79 mol $H_2O\;m^{-2}s^{-1}$ and 0.51-1.65 mol $H_2O\;m^{-2}s^{-1}$, respectively. Conclusively, all the photosynthetic parameters that were examined in this study were generally higher in the HTI-resistant ginseng lines than in the HTI-susceptible lines, except for HTIR 2, and were much higher in August than in July, especially in the resistant ginseng lines. All these results can be used to provide basic information for the selection of HTI-resistant ginseng lines and the application of cultural practices that are efficient for ginseng growth, based on the photosynthetic characteristics of the lines.

• Journal of Trauma and Injury
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• v.30 no.4
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• pp.113-119
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• 2017

Purpose: Despite the numerous protocols and evidence-based guidelines that have been published, application of the therapeutics to eligible patients is limited in clinical settings. Therefore, a rounding checklist was developed to reduce errors of omission and the implementation results were evaluated. Methods: A checklist consisting of 12 components (feeding, analgesia, sedation, thromboembolic prophylaxis, head elevation, stress ulcer prevention, glucose control, pressure sore prevention, removal of catheter, endotracheal tube and respiration, delirium monitoring, and infection control) was recorded by assigned nurses and then scored by the staff for traumatized, critically ill patients who were admitted in the trauma intensive care unit (ICU) of Dankook University Hospital for more than 2 days. A total of 170 patients (950 sheets) between April and October 2016 were divided into 3 periods (period 1, April to June; period 2, July to August; and period 3, September to October) for the analysis. Questionnaires regarding the satisfaction of the nurses were conducted twice during this implementation period. Results: Record omission rates decreased across periods 1, 2, and 3 (19.9%, 12.7%, and 4.2%, respectively). The overall clinical application rate of the checklist increased from 90.1% in period 1 to 93.8% in period 3. Among 776 (81.7%) scored sheets, the rates of full compliance were 30.2%, 46.2%, and 45.1% for periods 1, 2, and 3, respectively. The overall mean score of the questionnaire regarding satisfaction also increased from 61.7 to 67.6 points out of 100 points from period 1 to 3. Conclusions: An ICU rounding checklist could be an effective tool for minimizing the omission of preventative measures and evidence-based therapy for traumatized, critically-ill patients without overburdening nurses. The clinical outcomes of the ICU checklist will be evaluated and reported at an early date.

• The Korean Journal of Health Service Management
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• v.3 no.1
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• pp.14-24
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• 2009

This study aims at deriving any useful information necessary to strengthen the competitiveness for growth through empirical analyses on general hospital located in a province in order to countermeasure the opening and competition of medical markets. The characteristics of user were identified on the basis of disease groups under KCD in the research method. In addition, the analysis on the expenses of diagnosis and treatment was divided into the treatment progress and degree of hospital resource utilization And the regression was carried out to identify the impacts of characteristics of inpatient users on the degree of hospital resource utilization. As a result of major research, the inpatient users of the general hospital located in the provincial area in consideration of inpatient users were formed around the inpatient disease groups representative for Korea(diseases of the respiratory system, injury and poisoning & certain other consequences of external causes). And it was understood that most of residents within a distance of 40 minute by the public transportation were using. And mostly were under the age of 9 or over 60, and the provision of medical features such as the degree of consultation and operational functions were inadequate. When we classify inpatient treatment cost for each resource application as the medical cost being the center of patient care function, the equipment and human resource application sector are constituted over half. Accordingly, the following suggestions are made as plans to strengthen the competitiveness for the growth of general hospitals located in the provincial areas on the basis of analytical results. First, it is necessary to have the characterization matching to the age and disease groups with a high frequency. Second, it is necessary to increase the degree of hospital resource utilization according to the characterization. Third, it is necessary to concentrate on public relations. The above suggestion, as a method for securing image improvement and competitive power as a general hospital, and through expansion of social function that a regional general hospital needs to secure not only as an individual institution but also as a general hospital, it can be seen that a general improvement of image as a regional general hospital is possible.

• Horticultural Science & Technology
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• v.29 no.4
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• pp.298-305
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• 2011

This study was conducted to enhance the stem firmness of standard chrysanthemum 'Baekma' bred in Korea for commercial quality improvement and inhibition of stem breaking during transportation through foliar spray with calcium agents. Calcium agent screening 'Baekma' was examined using $CaCl_2{\cdot}2H_2O$, $Ca(NO_3)_2{\cdot}4H_2O$, and OS-Ca (natural liquid calcium compounds extracted from oyster shell) depending on each concentration (0, 0.001, 0.01, 0.1, and 1.0%, respectively). All calcium agents sprayed with 1.0% caused chemical injury such as stem bending or leaf burn. OS-Ca also showed more sensitive response to chemical injury than the other calcium agents because OS-Ca was absorbed very well by 'Baekma' leaves. Maximum stem firmness measured during the final harvest was greater in OS-Ca than in the other calcium agents. Especially, maximum stem firmness was greatest in 0.01% OS-Ca. However, elastic strength and maximum bending stress were greater in 0.001% OS-Ca than in the others. Thus, OS-Ca ranged from 0.005 to 0.05%, which did not show any chemical injury, was finally selected as the first candidate for hardening the stem of 'Baekma'. The next experiment using OS-Ca was conducted with the concentrations of 0, 0.005, 0.01, and 0.05%, respectively. From the results, 0.05% OS-Ca showed better plant growth and parameters such as plant height, stem diameter (upper and middle part), the number of leaves, and dry weights of each part than the other concentrations of OS-Ca and control. As for stem firmness depending on OS-Ca concentration, the Ca content within stem, maximum firmness, elastic strength, and maximum bending stress of stem in 'Baekma' sprayed with 0.05% OS-Ca showed the highest values among all the treatments and it turned out to be very high level of significance between control and OS-Ca treatments. However, the area and percentage of the inside cavity within horizontal stem section in 'Baekma' did not show any significance between any treatments including control. Thus, stem firmness of 'Baekma' did not show any correlation with the inside cavity area of stem. In conclusion, we recommend foliar sprays with 0.05% OS-Ca at vegetative growth stage to enhance stem firmness of 'Baekma' during transportation.

• Physical Therapy Korea
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• v.12 no.3
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• pp.22-30
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• 2005

This study was designed to identify the effect of various decline boards and postures of lower extremities on surface electromyographic (EMG) activity of knee muscles during isometric single-leg decline squat exercises. The subjects were twenty young male adults who had not experienced any knee injury and their Q-angles were within a normal range. They were asked to perform single-leg decline squat exercises in five various conditions. The EMG activities of the gluteus maximus (GM), vastus lateralis (VL), vastus medialis (VMO), tibialis anterior (TA), and gastrocnemius (GCM) muscles were recorded in five various single-leg decline squat exercises by surface electrodes and normalized by maximal voluntary isometric contraction (MVIC) values. The normalized EMG activity levels were compared using one-way ANOVA with repeated measures. The results of this study were as follows: 1) Exercises 2 and 4 produced significantly greater EMG activity of VMO than did exercise 1 ($p_{adj}$<.05/10), 2) The VMO/VL ratio of EMG activity of exercise 4 was the highest, producing a significantly greater ratio than exercise 1 ($p_{adj}$<.05/10). These results show that single-leg lateral oblique decline squat exercise is the best exercise for selective strengthening of VMO, and the posture of the contralateral leg does also affect strengthening of VMO, but we'll need to research patellofemoral joint compression for clinical application of single-leg lateral oblique decline squat exercises.

• Journal of the Korean Society of School Health
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• v.2 no.1
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• pp.131-146
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• 1989

This study was conducted for the development of recording system of students' health problems, and for the application of International Classification of Health Problem in Primary Care(ICHPPC) as a tool of morbidity classification in school health care. The data were collected from 12th of September to 24th of September in 1988. The objects were composed of health problems written by 10 school nurses who take service in the elementary school. The results were as follows: 1. The features of students' health problmes. The health problems of students were 68 problems from the total numbers of 361 codes of ICHPPC. The 93.4% of health problems was contained in 20 descriptive diagnoses and 97.0% was contained in 30 descriptive diagnoses. According to frequency of main health problems, There were abrasion, scratch and blister(26.7%); disorder of stomach function, other disease of stomach and duodenum (20.4%); headache(10.6%); bruise and contusion (5.3%); acute URI (5.0%); laceration and open wound(4.6%); Insect bite and sting(4.0%); epistaxis(3.4%): abdominal pain(2.6%): superficial tissue(1.7%). Out of all health problems, Category 17(accident, injury and poisoning was 44.7%. and Category 9(digestive system Disease) was 22.2%. 2. Applicability of ICHPPC by the school nurses. School nurses used 68 codes, among the total number of 361 codes from ICHPPC. According to ICHPPC method, school nurses can classified more diverse health problems systematically and objectively than that in other studies on school nurses activities. ICHPPC was found as a useful and applicable tool of morbidity classification in the practice of school nurses.

• Herbal Formula Science
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• v.28 no.4
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• pp.365-384
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• 2020

Objectives : This report describes 241 prescriptions related to the use of Gardenia Fructus blended prescriptions from Dongeuibogam. Methods : The following conclusions were reached through investigations on the prescriptions that use Gardeniae Fructus. Results : The Gardeniae Fructus is used in 49 fields of treatment such as urinary diseases, jaundice and furuncle, etc. Prescriptions that utilize Gardeniae Fructus are used in the treatment of fever, eye disease, hemorrhage, skin disease, ear disease, internal disease and so on. In the view of the causative agent of a disease, the prescriptions which are compounded with Gardeniae Fructus are related to endogenous agents such as jaundice, seven emotion, alcohol, exogenous agents such as cold, wind, heat and non-endo-exopathogenic factors like disease due to external factor, injury. The dosage of Gardeniae Fructus is 1pun(about 0.375) to 5don 5pun(about 21g), however 5pun(about 1.87g)~1don(about 3.75g) has been taken the most for clinical application. Conclusions : Hwangryunhaedok-tang is the most base prescriptions which use the Gardenia Fructus. Gardeniae Fructus is mainly used as a raw material.

• Journal of Korean Medical classics
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• v.30 no.3
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• pp.77-93
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• 2017

Objectives : Clear and detailed analysis on Pulse-taking on both Carotid and Wrist Pulses is an absolute prerequisite if it is to be applied in real practice or its practical value proven. Methods : The original notes found in Suwen and Lingshu, their translations, and conventional studies regarding Suwen LiuJieCangXiangLun's Pulse-taking are compared and analyzed to find cases within medical texts where this method was used and to get an idea of the direction taken by the conventional study. Results : The ilsung, esung, samsung, and sasung of Carotid (or wrist pulses) refers that the pulse is one-, two-, three-, four-fold in differences. Refrainment should be practiced while comparing carotid and wrist pulses. Rather, they need to be compared with their normal states. Used by Luo Tianyi in Ming Dunasty, this method of pulse-taking was used for (radial artery) when diagnosing and treating the degree of seriousness of food injury. The measurement of maximum blood flow velocity using TCD done recently proved the validity of this pulse-taking, and it's been used for alleviating hypertension or tinnitus through acupuncture, or abating intractable diseases (around carotid). Conclusions : The obscurity of the measuring method of this pulse-taking can be resolved, and the problem which occurs while comparing carotid and wrist pulses can be solved. Even though there are differences in opinion regarding the positions when comparing the two pulses, their practical values are acknowledged since their usages in diagnosis, treatments, experiments, and researches have yielded positive results to a degree. They may not be used that often, but they are nonetheless under utilization.