• The Journal of Korean Medicine
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• v.30 no.1
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• pp.40-50
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• 2009

Objectives: The clinical document forms, a format for collecting clinical data, is the most fundamental object of standardization. Doctors must have a mutual understanding of the clinical chart. Methods: Clinical document forms were developed by investigating existing conditions in hospitals and conducting demand surveys, doing literature research, and seeking expert advice for the improvement of version 1.0. In addition, an organization of a network of 19 Oriental medical doctors and nurses, 190 patients, and users of collected and assessed data was formed to come up with version 2.0. Results: The overall format was divided into different portions that the patient, nurse, and doctor must fill out, respectively. The patient's section consists of demographic data, lifestyle details, history, and symptoms. The data to be supplied by the nurse include the patient's vital signs and anthropometric parameters. As for the doctors, they are to supply data regarding the patient's palpitation, the detailed symptoms of the patient's head, ophthalmological and otorhinolaryngological symptoms (mouth), respiration, circulatory organ and chest conditions, digestive-organ conditions (thirst), neuropsychiatric conditions, reproductive system, musculoskeletal system, skin (depilation), etc. Conclusions: Common clinical chart development is the prior question to Traditional Korean Medicine standardization. A web-based clinical document format should be developed to support diagnosis and treatment, and furthermore EMR (electronic medical record system) and EHR (electronic health record) developed. Clinical information could be shared through a network of medical institutions and be useful Traditional Korean Medicine for evidence-based medicine.

• Journal of Biomedical Engineering Research
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• v.41 no.1
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• pp.42-47
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• 2020

A personal authentication system based on biosignals has received increasing attention due to its relatively high security as compared to traditional authentication systems based on a key and password. Electrocardiography (ECG) measured from the chest or wrist is one of the widely used biosignals to develop a personal authentication system. In this study, we investigated the feasibility of using similar ECG measured behind the ears to develop a personal authentication system. To this end, similar ECGs were measured from thirty subjects using a pair of three electrodes attached behind each of the ears during resting state during which the standard Lead-I ECG was also simultaneously measured from both wrists as baseline ECG. The three ECG components, Q, R, and S, were extracted for each subject as classification features, and authentication accuracy was estimated using support vector machine (SVM) based on a 5×5-fold cross-validation. The mean authentication accuracies of Lead I-ECG and similar ECG were 90.41 ± 8.26% and 81.15 ± 7.54%, respectively. Considering a chance level of 3.33% (=1/30), the mean authentication performance of similar ECG could demonstrate the feasibility of using similar ECG measured behind the ears on the development of a personal authentication system.

• Korean Journal of Community Nutrition
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• v.3 no.3
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• pp.358-367
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• 1998

The study purpose was to investigate psychosocial factors related to smoking among adolescent boys. The Theory of Planned Behavior provide the basis for the study. Twenty-five attitudinal beliefs, 9 normative beliefs and 20control beliefs were identified through questionnaire development. The data were analyzed using t-test and χ2-test. Thirty-three percent of 300 students were smokers. Most of the beliefs examined were significantly different between smokers(n=92) and nonsmokers(n=92). With respect to attitudinal beliefs, smokers responded less negatively on the items of bad health effects of smoking such as sore throat, headache, chest pain, risk of cancer and bad blood circulation(p<0.001), and decreased physical strength(p<0.05). Smokers believed less negatively on the items that smoking leads to bothering others, bad breath, yellow teeth and making them spend money(p<0.001). In contrast, smokers felt more positively on smoking as a means of stress management, relaxing, helping digestion(P<0.001). Smokers felt less pressure for not smoking from significant others. Especially mother, siblings, friends, girl friends, seniors of school were important sources of influence regarding subject's smoking. Smokers felt less confident in controlling the urge to smoke in several situations including; when they were with friends or asked to smoke by friends; after the meal, or drinking; when they were bored or stressed, upset, and when they felt unstable(p<0.001). Smokers also scored lower on specific skills to quit or control the urge to smoke as well as overall perceived control, compared to nonsmokers(p<0.001). These results suggest that interventions for adolescents incorporate diverse strategies to increase the perceived control over smoking in specific situations as well as overall perceived control, to help them realize and modify attitudinal beliefs, and to elicit support from significant others for not smoking. (Korean J Community Nutrition 3(3) : 358∼367,1998)

• Journal of Chest Surgery
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• v.38 no.2 s.247
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• pp.168-171
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• 2005

Solitary fibrous tumor is an uncommon sybnesitgekuak mesenchymal neoplasm that arises primarily from the pleura. Extrapleural solitary fibrous tumors are rare. Solitary Fibrous tumors are often asymptomatic and discovered incidentally but may become symptomatic when vital structures are involved or they grow large. In general, solitary fibrous tumor is diagnosed on the basis of radiologic findings and its histologic features, with immunohistochemistry serving to support the diagnosis. Most solitary fibrous tumors pursue a benign course, and the single most important predictor of clinical outcome is the ability to excise the entire lesion. We experienced a case of intrapulmonary solitary tumor arising from the right lower lobe which was treated with wedge resection. We report this case of the patient.

• Journal of Chest Surgery
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• v.39 no.4 s.261
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• pp.317-319
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• 2006

Under median sternotomy and left thoracotomy, extra-anatomic aorta bypass between ascending aorta and descending thoracic aorta without cardiopulmonary bypass support has been done effectively and easily without complications for a selected case of atypical coarctation associated with hypoplasia of aortic arch. It should be considered as an alternative operative technique for complex aortic arch reconstruction.

• Journal of Chest Surgery
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• v.45 no.5
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• pp.301-307
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• 2012

Background: Perioperative transfusion of red blood cell (RBC) may cause adverse effects. Bloodless-cardiac surgery has been spotlighted to avoid those problems. Off pump coronary artery bypass (OPCAB) surgery can decrease the transfusion. However, the risk factors of transfusions in OPCAB have not been investigated properly. Materials and Methods: One hundred and thirteen patients (male:female=35:78, mean age=$66.7{\pm}9.9$ years) who received isolated OPCAB were retrospectively analyzed from March 2006 to September 2007. The threshold of RBC transfusion was 28.0% of hematocrit. Bilateral internal thoracic arteries graft were used for 99 patients (87.6%). One hundred and three (91.1%) and 35 patients (31.5%) took aspirin and clopidogrel just before surgery. Results: Sixty-five patients (47.5%) received the RBC transfusion (mean $2.2{\pm}3.2$ units). Mortality and major complications were not different between transfusion and no-transfusion group. But, ventilator support time, intensive care unit stay and hospitalization period had been reduced in no-transfusion group (p<0.05). In multivariate analysis, patients risk factors for RBC transfusion were preoperative low hematocrit (<37.5%) and clopidogrel medication. Surgical risk factors were longer graft harvesting time (<75 minutes) and total operation time (<5.5 hours, p <0.05). Conclusion: We performed the transfusion according to transfusion guideline; over 40% cases could conduct the OPCAB without transfusion. There were no differences in major clinical results between transfusion and non-transfusion group. In addition, when used together with accurate understanding of transfusion risk factors, it is expected to increase the proportion of patients that do not undergo transfusions.

• Journal of Chest Surgery
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• v.54 no.5
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• pp.348-355
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• 2021

Background: Congenital diaphragmatic hernia (CDH) is a rare disease often requiring mechanical ventilation after birth. In severe cases, extracorporeal membrane oxygenation (ECMO) may be needed. This study analyzed the outcomes of patients with CDH treated with ECMO and investigated factors related to in-hospital mortality. Methods: Among 254 newborns diagnosed with CDH between 2008 and 2020, 51 patients needed ECMO support. At Asan Medical Center, a multidisciplinary team approach has been applied for managing newborns with CDH since 2018. Outcomes were compared between hospital survivors and nonsurvivors. Results: ECMO was established at a median of 17 hours after birth. The mean birth weight was 3.1±0.5 kg. Twenty-three patients (23/51, 45.1%) were weaned from ECMO, and 16 patients (16/51, 31.4%) survived to discharge. The ECMO mode was veno-venous in 24 patients (47.1%) and veno-arterial in 27 patients (52.9%). Most cannulations (50/51, 98%) were accomplished through a transverse cervical incision. No significant between-group differences in baseline characteristics and prenatal indices were observed. The oxygenation index (1 hour before: 90.0 vs. 51.0, p=0.005) and blood lactate level (peak: 7.9 vs. 5.2 mmol/L, p=0.023) before ECMO were higher in nonsurvivors. Major bleeding during ECMO more frequently occurred in nonsurvivors (57.1% vs. 12.5%, p=0.007). In the multivariate analysis, the oxygenation index measured at 1 hour before ECMO initiation was identified as a significant risk factor for in-hospital mortality (odds ratio, 1.02; 95% confidence interval, 1.01-1.04; p=0.05). Conclusion: The survival of neonates after ECMO for CDH is suboptimal. Timely application of ECMO is crucial for better survival outcomes.

• Korean Journal of Applied Biomechanics
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• v.29 no.3
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• pp.129-135
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• 2019

Objective: The purpose of this study is to present the scientific and quantitative data by finding the common points and differences of the side-kick according to the height change through the difference of the side kick motion performance according to the three target height changes and the function of the lower limbs muscle in side kick motion of Taekwondo Poomsae. Method: For this, total 14 players were selected who were registered in Korea Taekwondo Association and skilled group 7 players who had a medal from national competition and 7 players who did not have Taekwondo experience from department of physics. 4 video cameras to the feature on side kick per target height, and the subjects' support foot was located on the ground reactor and the practice was conducted 3 times: waist, chest, and head as the target height. the basic materials were collected by using Kwon 3D XP program and the T-test was conducted to verify the statistic difference between groups (SPSS 24.0). At this time, the statistics significance level was set as .05 and the following conclusion was obtained. Results: The lower the proficiency and the higher the height, the more the joint coordination between the hip and the knee. Conclusion: Summary of the result shows a common point that the change of target's height makes the lower the proficiency and the higher the height, the more the joint coordination between the hip and the knee. Also, the higher the target's height became, the greater angular momentum of thighs, shanks, foot became in common.

• Journal of Chest Surgery
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• v.52 no.5
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• pp.335-341
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• 2019

Background: The endovascular approach to aortic disease treatment has been increasingly utilized in the past 2 decades. This study aimed to determine the long-term results of using the Seal thoracic stent graft. Methods: We retrospectively reviewed the outcomes of patients who underwent thoracic endovascular aortic repair or a hybrid procedure using the Seal thoracic stent graft (S&G Biotech, Seongnam, Korea) from January 2008 to July 2018 at a single institution. We investigated in-hospital mortality and the incidence of postoperative complications. We also investigated the mid-term survival rate and incidence of aorta-related complications. Results: Among 72 patients with stent grafts, 15 patients underwent the hybrid procedure and 21 underwent emergency surgery. The mean follow-up period was $37.86{\pm}30.73$ months (range, 0-124 months). Five patients (6.9%) died within 30 days. Two patients developed cerebrovascular accidents. Spinal cord injury occurred in 2 patients. Postoperative renal failure, postoperative extracorporeal membrane oxygenation support, and pneumonia were reported in 3, 1, and 6 patients, respectively. Stent-related aortic complications were observed in 5 patients (6.8%). The 1- and 5-year survival and freedom from stent-induced aortic event rates were 81.5% and 58.7%, and 97.0% and 89.1%, respectively. Conclusion: The use of the Seal thoracic stent graft yielded good mid-term results. Further studies are needed to examine the long-term outcomes of this device.

• Journal of The Korean Society of Emergency Medicine
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• v.29 no.6
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• pp.616-623
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• 2018

Objective: The shock index (SI), as a trauma triage tool, is a capable clinical indicator of hemodynamic instability and hypovolemic shock, but the conception of SI is contradictory to shock. The reverse shock index (RSI) was introduced recently, but its utility has not been sufficiently proven. Methods: This study examined the RSI utility by evaluating the procedures performed at an emergency department (ED) and the associated outcomes when the RSI is used alone or in combination with the Korean Triage and Acuity Scale (KTAS). This was a retrospective study conducted by including data of 4,789 adult trauma patients for a year. The clinical variables, procedures performed on patients, and outcomes were investigated. The median RSI was 0.9 in the RSI<1 group. Results: Patients in the RSI<1 group had a higher odds of requiring procedures at the ED and for experiencing worse outcomes: intubation (odds ratio [OR], 5.4; 95% confidence interval [CI], 2.3-13.1; P<0.001), chest tube insertion (OR, 6.5; 95% CI, 0.4-111.84; P<0.001), use of emergency drugs (OR, 3.6; 95% CI, 1.5-8.5; P<0.001), circulatory support (OR, 5.4; 95% CI, 2.3-12.9; P<0.001), intensive care unit admission (OR, 3.5; 95% CI, 1.8-6.8; P<0.001), and mortality during the ED stay (OR, 20.4; 95% CI, 5.5-75.7; P<0.001). In the group with KTAS 1-3, trends similar to those in the RSI<1 group were observed. Patients with RSI<1 had more severe injuries and poorer outcomes than those with $RSI{\geq}1$, regardless of whether the RSI was used alone or in combination with KTAS. Conclusion: RSI can provide an appropriate triage with concurrent KTAS use.