• Tuberculosis and Respiratory Diseases
• /
• 제84권3호
• /
• pp.217-225
• /
• 2021

Background: Despite the proven benefits of dexamethasone in hospitalized coronavirus disease 2019 (COVID-19) patients, the optimum time for the administration of dexamethasone is unknown. We investigated the progression of COVID-19 pneumonia based on the timing of dexamethasone administration. Methods: A single-center, retrospective cohort study based on medical record reviews was conducted between June 10 and September 21, 2020. We compared the risk of severe COVID-19, defined as the use of a high-flow nasal cannula or a mechanical ventilator, between groups that received dexamethasone either within 24 hours of hypoxemia (early dexamethasone group) or 24 hours after hypoxemia (late dexamethasone group). Hypoxemia was defined as room-air SpO₂ <90%. Results: Among 59 patients treated with dexamethasone for COVID-19 pneumonia, 30 were in the early dexamethasone group and 29 were in the late dexamethasone group. There was no significant difference in baseline characteristics, the time interval from symptom onset to diagnosis or hospitalization, or the use of antiviral or antibacterial agents between the two groups. The early dexamethasone group showed a significantly lower rate of severe COVID-19 compared to the control group (75.9% vs. 40.0%, p=0.012). Further, the early dexamethasone group showed a significantly shorter total duration of oxygen supplementation (10.45 days vs. 21.61 days, p=0.003) and length of stay in the hospital (19.76 days vs. 27.21 days, p=0.013). However, extracorporeal membrane oxygenation and in-hospital mortality rates were not significantly different between the two groups. Conclusion: Early administration of dexamethasone may prevent the progression of COVID-19 to a severe disease, without increased mortality.

• 중환자간호학회지
• /
• 제10권3호
• /
• pp.9-18
• /
• 2017

Purpose : This study aimed to identify nurses' job satisfaction, patients' satisfaction, and direct nursing time according to the change in grade of nursing management fee. Methods : Descriptive design was used in this study. Nurses (n = 200) and patients (n = 200) were recruited from one university hospital in Busan. Four aspects were measured: direct nursing time, overtime, nurses' job satisfaction, and patients' satisfaction. Data were analyzed using descriptive statistics, ${\chi}^2-tests$, and t-tests. Results : There was a significant difference in patient satisfaction (t = -2.09, p = .038) and direct nursing time (t = -4.77, p < .001) when the nurse staffing grade was changed from the level two to the level one. Conclusion : The findings from this study showed that a higher nurse-to-patient ratio can provide a greater amount of direct nursing time for individual patients and increase patient satisfaction.

• 한국국방경영분석학회지
• /
• 제24권1호
• /
• pp.41-57
• /
• 1998

Since the aircraft has a property of moving in the three-dimensional space, it may cause personally and financially critical damage in the case of an accident. Among the causes of aircraft accident, human factor has occupied about 70% of all accidents. Specially, fatigue among human's problems has been studied earlier than any other factor. Fatigue has been the cause of 75% of accidents that are related to human factor. So many studies have been conducted. But the direction of these studies mainly attach importance to the sleep loss and circadian rhythm. Limitation for flight time of ICAO is 8 hours per day, civil airlines in domestic line also adopt the limitation. But this rule is not based on human's performance but compromise between labor and management. The long-haul flight brings about a mental block to pilot. This mental block decreases performance of pilot and loses a lot of important information. So this may cause many accidents. This paper is to offer optimal flight time according to the amount of fatigue due to increasing flight time. The optimal flight time is searched through the field experiment. The experiment has adopted two methods. One is to examine pilot's objective fatigue accumulation rate through the critical fusion frequency, and another is to investigate pilot's subjective fatigue feeling through the fatigue subjective symptoms investigation table.

• 한국산학기술학회논문지
• /
• 제13권11호
• /
• pp.5247-5253
• /
• 2012

본 연구는 식혜와 액상 커피의 제조 공정중 HACCP system을 이용하여 한계 기준 설정을 위한 목적으로 실시하였다. 살균공정의 한계 기준 설정은 충북 진천시 소재의 P사에서 약 30일 (2012년 4월 1~30일) 동안 살균온도와 시간을 측정하였다. 그 결과, 멸균전에는 식혜와 액상 커피에서 미생물이 검출되었다. 반면에 식혜(238mL Can, 500mL and 300mL PP, 1.8L PP)에서 모든 미생물은 살균($121{\pm}1^{\circ}C$에서 $15{\pm}1$, $35{\pm}1$ and $45{\pm}1$분) 후에는 검출되지 않았고, 액상 커피도 살균($121{\pm}1^{\circ}C$, $20{\pm}1$분)후 검출되지 않았다. 가장 적당한 온도와 시간을 결정하기 위한 살균기 조건은 $121{\pm}1^{\circ}C$, $20{\pm}1$분이었다. 결론적으로, 살균공정은 유해미생물(일반세균, 대장균군, 병원성 미생물)를 예방, 감소 또는 제거할 수 있는 좋은 대안이 될 것이다. 따라서 품질 유지와 생물학적 안전성을 위한 살균 온도와 시간의 한계기준은$121{\pm}1^{\circ}C$에서 $20{\pm}1$분으로 설정하였다. 그리고 HACCP 계획은 살균 공정중 모니터링 방법과 모니터링 주기, 문제 해결 방법, 교육, 훈련, 기록 관리 등을 위하여 필요하여 이를 제안하고자 한다.

• 대한간호학회지
• /
• 제31권1호
• /
• pp.68-80
• /
• 2001

The purpose of this study is to analyze ER patient's Triage and other statistical data. The subjects were 12,618 patients who visited the ER during the year 1998. The study showed the following results; 1. The male vs female ratio was 1.3 : 1.0, the male were in the majority (56.6%), and the age range of 20-29 old was the majority (15.3). The patients who visited ER at 8-10 pm were the majority (11.5%). On Sunday the number of patients who visited the ER were 2,189, and the majority were 17.4%. On Saturday the number of patients was visited the ER were 1,944 patients the second majority (15.4%). Their traffic means : the general passenger cars (75.5%), 119 or hospital ambulance (11.3%). 2.The reasons of visiting ER were : diseases (59.2%), injuries (23.7%). The disease vs injury ratio was 100 : 69. 3. Triage : urgent 40.7%, non-urgent 38.2%, acute 17.8%, and critical 3.2%. 4. The time of waiting and staying in the ER by the Triaget: the average time was 572 minutes (9.53 hrs.). The majority of critical patients (20.5%), acute patients (24.7%) and urgent patients (21.2%) stayed 12-24 hrs., but the majority of non-emergent (27.8%) stayed not longer than one hour. 5. Treatments by the Triage : the 42.9% of critical patients, and 61.3% of acute patients, 57.5% of urgent patients were admitted. But 91.8% of the non-emergents were discharged and 4.7% was admitted. Mortality of total ER visiter were 1.7%. DAA portion was 0.86%. 26.6% of the critical patients were DAA. DAA vs DOA ratio was 1.3 : 1.0. 6. Visiting time, monthly and seasonal distribution by the Triage : the majority of critical patients (12.2%), visited 10-12 am. The majority of acute (12.9%) and urgent (11.7%) visited 4-6 pm, but the majority of non-emergents (15.1%) visited during 8-10 pm. Autumn visiter were the majority (27.6%). The percentage of non-emergent visited in Spring was 41.4% and Autumn was 41.3%. The percentage of urgents who visited in the Summer was 45.3% and the Winter was 40.4%. By clinical departments: the 48.0% of critical patients was NS. The 45.5% of acute and the 33.6% of urgent patients were IM. But the majority of non-emergent patients was PS (21.2%), and the second majority of non-emergent patients was oral Surgery (12.8%).

• Tuberculosis and Respiratory Diseases
• /
• 제68권3호
• /
• pp.180-184
• /
• 2010

Slowly growing lung cancers are quite rare and the leading cause of length time bias and over-diagnosis bias in lung cancer screening. We report 6 cases of slowly growing lung cancer in a tertiary hospital between January 1999 and December 2008. The clinical characteristics of these 6 cases with slowly growing lung cancer were examined. The median age at diagnosis was 68 years (range, 49~72), and 5 patients (83%) were female. The most common histology type was adenocarcinoma (83%). After excluding two patients who showed no change in the tumor size, the median tumor doubling time was 189 months (range, 86~387). The proportion of patients with slowly growing lung cancer appears to be particularly large in women, especially among patients with adenocarcinoma. Our experience shows that slowly growly lung cancers are more heterogeneous and diverse.

• Tuberculosis and Respiratory Diseases
• /
• 제70권1호
• /
• pp.28-35
• /
• 2011

Background: The aim of the study was to describe the characteristics, treatments, and outcomes of critically ill patients with pandemic Influenza A/H1N1 2009 at a major medical center in Korea. Methods: This retrospective observational study examined critically ill adult patients with pandemic Influenza A/H1N1 2009, who were admitted to the AMC between August and December 2009. Results: 27 patients with confirmed pandemic Influenza A/H1N1 2009 were admitted to the intensive care unit (ICU) at the Asan Medical Center (AMC). The median age (IQR) was 59 years (41~67), and 66.7% of the patients were older than 51 years. A total of 81.5% of the patients had 2 or more co-morbidities. The median time (IQR) from symptom onset to presentation was 2 days (1~4), and the median time from presentation to ICU admission was 0 days (0~1.5). All patients received oseltamivir (300 mg/day) and 13 patients received triple combination therapy (oseltamivir, amantadine, ribavirin). Twelve patients required mechanical ventilation on the first day of ICU admission. A total of 6 patients (22.2%) died within 28 days of admission. The patients who died had significantly higher acute physiology and chronic health evaluation (APACHE) II and sequential organ failure assessment (SOFA) scores at presentation. There were no significant differences in age, co-morbidities, or antiviral regimens between survivors and non-survivors. Conclusion: Critical illness related to pandemic Influenza A/H1N1 2009 was common in elderly patients with chronic co-morbidities. All patients were given high-dose oseltamivir or triple combination antiviral therapy. Nonetheless, patients with critical illnesses associated with pandemic Influenza A/H1N1 2009 had a death rate of 22.2%.

• 한국산학기술학회논문지
• /
• 제13권8호
• /
• pp.3578-3585
• /
• 2012

유탕면류의 HACCP(Hazard Analysis Critical Control Point) 시스템 구축을 위하여 유탕 공정-CCP(Critical Control Point)에 대한 미생물학적(Biological hazards)과 화학적(Chemical hazards) 한계 기준 설정을 위한 목적으로 수행하였으며, 경기도 이천 소재의 P사에서 실행하였다. 유탕공정은 각각의 시간과 온도 측정에 따라 미생물학적, 화학적 위해요소를 제거하거나 감소에 대해 실험하였다. 실험결과 Standard plate count와 식중독균은 유탕공정(Temperature : $145{\pm}10^{\circ}C$, Time : $75{\pm}30$ sec)에 의해 검출되지 않았다. 유탕공정에 의해 생성되는 화학적 위해 기준의 산가는 법적 기준치인 0.6보다 낮은 0.2 이하였다. 증숙실과 유탕실의 공중낙하균을 측정한 결과 3 CFU/mL, 3 CFU/mL 검출되었다. 따라서 유탕공정의 CCP-BC는 일반세균과 식중독균, 산화생성물 생성을 예방, 제거하는데 좋은 대안책이 될 것이다. 결론적으로 HACCP을 위해 유탕공정에 대한 한계기준설정, 모니터링방법, 개선조치, 검증방법, 교육, 기록관리가 필요하다고 생각된다.

• The Korean journal of internal medicine
• /
• 제39권2호
• /
• pp.295-305
• /
• 2024

Background/Aims: The prognosis of patients with idiopathic pulmonary fibrosis (IPF) and respiratory failure requiring mechanical ventilation is poor. Therefore, mechanical ventilation is not recommended. Recently, outcomes of mechanical ventilation, including those for patients with IPF, have improved. The aim of this study was to investigate changes in the use of mechanical ventilation in patients with IPF and their outcomes over time. Methods: This retrospective, observational cohort study used data from the National Health Insurance Service database. Patients diagnosed with IPF between January 2011 and December 2019 who were placed on mechanical ventilation were included. We analyzed changes in the use of mechanical ventilation in patients with IPF and their mortality using the Cochran-Armitage trend test. Results: Between 2011 and 2019, 1,227 patients with IPF were placed on mechanical ventilation. The annual number of patients with IPF with and without mechanical ventilation increased over time. However, the ratio was relatively stable at approximately 3.5%. The overall hospital mortality rate was 69.4%. There was no improvement in annual hospital mortality rate. The overall 30-day mortality rate was 68.7%, which did not change significantly. The overall 90-day mortality rate was 85.3%. The annual 90-day mortality rate was decreased from 90.9% in 2011 to 83.1% in 2019 (p = 0.028). Conclusions: Despite improvements in intensive care and ventilator management, the prognosis of patients with IPF receiving mechanical ventilation has not improved significantly.

• Journal of Pharmaceutical Investigation
• /
• 제29권4호
• /
• pp.295-307
• /
• 1999

Using a Rheometries Fluids Spectrometer (RFS II), the dynamic viscoelastic properties of aqueous poly(ethylene oxide) (PEO) solutions in small amplitude oscillatory shear flow fields have been measured over a wide range of angular frequencies. The angular frequency dependence of the storage and loss moduli at various molecular weights and concentrations was reported in detail, and the result was interpreted using the concept of a Deborah number De. In addition, the experimentally determined critical angular frequency at which the storage and loss moduli become equivalent was compared with the calculated characteristic time (or its inverse value), and their physical significance in analyzing the dynamic viscoelastic behavior was discussed. Finally, the relationship between steady shear flow and dynamic viscoelstic properties was examined by evaluating the applicability of some proposed models that describe the correlations between steady flow viscosity and dynamic viscosity, dynamic fluidity, and complex viscosity. Main results obtained from this study can be summarized as follows: (1) At lower angular frequencies where De<1, the loss modulus is larger than the storage modulus. However, such a relation between the two moduli is reversed at higher angular frequencies where De>l, indicating that the elastic behavior becomes dominant to the viscous behavior at frequency range higher than a critical angular frequency. (2) A critical angular frequency is decreased as an increase in concentration and/or molecular weight. Both the viscous and elastic properties show a stronger dependence on the molecular weight than on the concentration. (3) A characteristic time is increased with increasing concentration and/or molecular weight. The power-law relationship holds between the inverse value of a characteristic time and a critical angular frequency. (4) Among the previously proposed models, the Cox-Merz rule implying the equivalence between the steady flow viscosity and the magnitude of the complex viscosity has the best validity. The Osaki relation can be regarded to some extent as a suitable model. However, the DeWitt, Pao and HusebyBlyler models are not applicable to describe the correlations between steady shear flow and dynamic viscoelastic properties.