• Clinical and Experimental Emergency Medicine
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• 제3권3호
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• pp.175-180
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• 2016

Objective Combination of ${\beta}_1-adrenergic$ receptor (AR) blockade and ${\beta}_2-AR$ activation might be a potential novel therapy for treating heart failure. However, use of ${\beta}-AR$ agonists and/or antagonists in the clinical setting is controversial because of the lack of information on cardiac inotropic or chronotropic regulation by AR signaling. Methods In this study, we performed hemodynamic evaluation by examining force frequency response (FFR), Frank-Starling relationship, and response to a non-selective ${\beta}-AR$ agonist (isoproterenol) in hearts isolated from 6-month-old transgenic (TG) mice overexpressing ${\beta}_1-$ and ${\beta}_2-ARs$ (${\beta}_1-$ and ${\beta}_2-AR$ TG mice, respectively). Results Cardiac physiologic consequences of ${\beta}_1-$ and ${\beta}_2-AR$ overexpression resulted in similar maximal response to isoproterenol and faster temporary decline of positive inotropic response in ${\beta}_2-AR$ TG mice. ${\beta}_1-AR$ TG mice showed a pronounced negative limb of FFR, whereas ${\beta}_2-AR$ TG mice showed high stimulation frequencies with low contractile depression during FFR. In contrast, Frank-Starling relationship was equally enhanced in both ${\beta}_1-$ and ${\beta}_2-AR$ TG mice. Conclusion Hemodynamic evaluation performed in the present showed a difference in ${\beta}_1-$ and ${\beta}_2-AR$ signaling, which may be due to the difference in the desensitization of ${\beta}_1-$ and ${\beta}_2-ARs$.

• 한국응급구조학회지
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• 제22권3호
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• pp.7-34
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• 2018

Purpose: The purposes of this research were to study the validity of the National Examination based on smart based test(SBT) by 7 types of healthcare occupation. Methods: We conducted a questionnaires survey among 1,219 people including 210 professors for all 7 types of healthcare occupation and 573 clinical specialists ; 436 students from random sampling participated and the reliability of the questionnaire was tested using Cronbach's alpha. Results: Professors from 7 types of healthcare occupation were investigated for their opinions on the introduction of the SBT system ; 65.9% of the professors answered positively on the introduction of the SBT National Examination System, while 40.1% of the clinical experts answered likewise. In particular, professors and the clinical experts recognized altogether that the multimedia questionnaire, being effective for the evaluation of clinical and practical competence of the subjects, enabling the evaluation of various areas and strengthening the school education in clinical practices, the 42.0% of the students from 7 departments answered that the future direction of the national test is in the SBT test system with significant difference (p=.000) found in students majoring in order of Emergency Medical Services, Radiology and Physical therapy, compared to students from other majors, showing the positive response to the SBT system. Conclusion: The results of this study comprehensively evaluated the positive recognition of development of multimedia items and SBT system in national examination of 7 types of healthcare occupation in professors, field specialists and students.

• 정신신체의학
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• 제27권2호
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• pp.130-137
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• 2019

연구목적 자살시도로 음독을 시도한 환자가 응급실에 내원했을 때, 응급의학과, 내과, 정신건강의학과가 서로 의사소통을 하고 우선순위에 따른 처치를 하는 것은 중요하다. 본 연구는 약물중독 환자에 대한 다학제 응급협진체계(이하 약물중독 응급협진체계)의 효용성을 검증하고자 시행되었다. 방 법 약물중독 응급협진체계 구축을 위해 정신건강의학과, 응급의학과, 내과의 전문의가 협의체를 구성하여, 응급실 내원 당시 복용 약물의 종류와 의식 수준에 따른 담당 진료과 및 협진의뢰과 배정, 각 과별 약물중독 환자 전담 교수 배정, 정기회의, 협진 응답 소요시간 제한, 원내 생명사랑위기대응센터 및 지역사회 자원 연계 등을 모두 프로토콜화하였다. 본 연구에서는 약물중독 응급협진체계가 시행되기 전인 2017년 7월부터 2018년 5월까지의 기간과, 시행 이후인 2018년 7월부터 2019년 5월까지의 의무기록 데이터를 후향적으로 통계분석하여, 약물 중독 응급협진체계의 효과를 검증하고자 하였다. 결 과 약물중독 응급협진체계 시행 후, 시행 전에 비해 중환자실보다 개방병동으로의 입원이 유의하게 증가하였다(χ²=8.567, p=0.014). 또한 타과로 입원한 환자 중 정신건강의학과로의 협진 비율이 증가하는 경향을 보였고χ²=4.202, p=0.053), 협진 응답 소요시간은 감소하였다(Z=-2.031, p=0.042). 한편, 협진 결과 전과된 환자의 비율이 증가였하고(χ²=4.692, p=0.043), 전과까지 소요된 시간은 감소하는 경향을 보였다(Z=-1.941, p=0.052). 결 론 약물중독 응급협진체계 시행 후 불필요한 중환자실 입원, 협진 응답 소요시간, 전과 소요시간이 감소하였으며, 협진 의뢰 비율 및 전과 비율은 증가하였다. 이는 다학제 협진체계가 환자에게 필수적인 의료서비스를 보다 적은 의료비용으로 신속하게 제공하였음을 의미한다. 향후 약물중독 이외의 자살시도에 대해서도 응급협진체계를 구축하여, 각 과 간 명확하고 책임있는 의학적 권고를 신속하게 공유한다면, 환자의 치료 및 의료비용 측면에서 긍정적인 효과를 보일 수 있을 것으로 기대된다.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제19권2호
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• pp.31-40
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• 2013

Purpose: It seems obvious that the hospital structures become more large-sized and tall-risen in Korea today. Nothing is more influential than the vertical core plan on the movements of various people in such large-tall hospitals. The present paper, therefore, aims to study on the efficient hospital core space paying first attention to patients by analysing the data on relations between/among department layouts of vertical and horizontal movements. Methods: This study sampled representative 14 hospitals and drew their degrees of data importance on the basis of precedented relative studies. This study also analysed their placements on the blueprint and made confirmations of their arrangements through their homepage on line. Actual visits were made to make sure of the spacial connections between/among departments in the hospitals as well. Results: Even in emergency case in need for vertical movements, the central main core spaces are usually used, which is because special vertical transportation systems are not provided. In these cases, the main core spaces are very important for those who have to move vertically and/or horizontally according to the locations and types of main cores. While special lifts or dumbwaiters are prepared to install for the important articles, such as samples of pathology department, most patients should share with regular visitors the elevators not separated visually and spatially from them. Implications: Vertical core plans are greatly dependent on the ward types and hospital styles. This study is hopefully expected to contribute itself to the standard setting-up of comfortable and quick vertical core system operations for patients.

• Parasites, Hosts and Diseases
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• 제55권4호
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• pp.425-428
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• 2017

Human diphyllobothriasis is a parasitic disease caused by ingestion of larvae (plerocercoids) in raw or undercooked fish and commonly found in temperate areas. Rare cases were reported in tropical or subtropical areas especially in children. The first documented case of pediatric diphyllobothriasis in Taiwan had been reported 11 years ago. Here, we report another 8-year-old girl case who presented with a live noodle-like worm hanging down from her anus, with no other detectable symptoms. We pulled the worm out and found the strobila being 260 cm in length. Examination of gravid proglottids showed that they were wider than their lengths, containing an ovoid cirrus sac in the anterior side and the rosette-shaped uterus. Eggs extracted from the uterus were ovoid and operculated. Diphyllobothrium latum was confirmed by molecular analysis of the mitochondrial DNA cytochrome c oxidase subunit 1 (cox1) gene. The girl was treated with a single oral dose of praziquantel, and no eggs or proglottids were observed from her stool in the subsequent 3 months. The reemergence of human diphyllobothriasis in non-endemic countries is probably due to prevalent habit of eating imported raw fish from endemic areas. This pediatric case raised our concern that human diphyllobothriasis is likely underestimated because of unremarkable symptoms.

• 대한공간정보학회지
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• 제23권3호
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• pp.11-21
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• 2015

최근 각종 재난재해로 인해 인명피해가 증가함에 따라 응급의료서비스의 중요성이 더욱 부각되고 있다. 이러한 응급의료서비스의 기본이 되는 119구급대의 이동 시간은 인명 구출의 핵심 요소라고 할 수 있으며, 이로 인해 119구급대의 효율적인 출동 방안에 대한 관심 또한 높아지고 있다. 따라서 본 연구에서는 GIS 네트워크 분석을 활용하여 119구급대의 출동 권역을 효율적으로 재조정하고자 하였다. 새로운 권역을 형성하기 위해 대전지역 경계 내에서 무작위로 생성한 약 80만 개의 가상 신고 위치와 26135개의 소방관서 위치를 기점으로 기종점 OD 행렬 분석을 실시하였으며, 이를 바탕으로 Thiessen Polygon을 생성함으로써 새로운 권역을 도출하였다. 그 결과, 각 소방관서로부터 신고 위치까지의 평균 이동 시간이 9.93분에서 5.53분으로, 4.4분이 단축되었으며, 면적의 경우 평균 $32.07km^2$에서 $20.72km^2$로, $11.35km^2$가 감소된 것을 확인할 수 있었다. 따라서 유관 기관에서 소방관서의 관할권역을 재조정하고자 하는 경우 본 연구가 유용하게 사용될 수 있을 것으로 보인다.

• 한국산학기술학회논문지
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• 제14권2호
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• pp.728-736
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• 2013

본 연구의 대상자는 G광역시에 소재한 G대학교 보건계열 3년제 학과 중에서 응급구조과, 물리치료과, 보건행정과를 임의선정하고 편의표집 한 390명으로 하였다. 조사기간은 2012년 6월 4일부터 6일까지의 기간 동안 구조화된 무기명 자기기입식의 설문조사에 의하였다. 최종 분석은 366부를 사용하였다. 수집된 자료는 SPSS WIN(Statistical Package for Social Science Windows) 12.0 프로그램을 사용하였으며, 모든 검정의 유의수준은 p<0.05이었다. 연구 결과 자살생각에 대한 우울과 사회적 지지의 상호작용 효과가 부적(-) 관계로 통계적으로 유의미하게 나타났다. 결과적으로 우울과 자살생각과의 관계에서 사회적 지지가 조절 효과를 나타내는 것으로 검증 되었다. 따라서 자살을 예방하고 자아존중감을 증진하기 위한 개별 및 집단 상담, 정규 교육 프로그램의 개발과 적용이 요구되며, 실천적 교육 프로그램을 실시하여 결과 및 효과성을 제시하는 연구가 필요하다.

• Archives of Plastic Surgery
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• 제47권5호
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• pp.444-450
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• 2020

Background Fingertip injuries are the most common type of traumatic injury treated at emergency departments and require prompt and adequate interventions for favorable wound survival outcomes. Hyperbaric oxygen (HBO₂) therapy is well known for its many positive effects on wound healing. We hypothesized that treatment with HBO₂ would improve the graft survival outcomes of amputated fingertip injuries treated with composite grafts. Methods This retrospective observational study included fingertip amputations that were treated between January 2013 and December 2017. A conventional group and an HBO₂ therapy group were statistically compared to evaluate the effect of HBO₂ treatment. Graft survival was categorized as either success or failure. Results Among 55 cases (digits), 34 digits were conventionally treated, while 21 digits were treated with HBO₂. No statistically significant differences were observed between the groups with regard to general characteristics. Among patients with guillotine-type injuries, the composite graft success rate was statistically significantly higher in the group that received HBO₂ therapy than in the conventional group (P=0.0337). Overall, the HBO₂ group also demonstrated a statistically significantly shorter healing time than the conventional group (P=0.0075). As such, HBO₂ treatment facilitates composite graft survival in cases of fingertip injury. Conclusions HBO₂ treatment was associated with an increased composite graft survival rate in guillotine-type fingertip injuries and reduced the time required for grafts to heal.

• Journal of Chest Surgery
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• 제23권5호
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• pp.905-915
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• 1990

A clinical evaluation was performed on 545 cases of the chest trauma those had been admitted and treated at the department of thoracic and cardiovascular surgery in Chosun University Hospital during the past 11 years 5 months period from January 1978 to may 1989. Obtained results were as follows: 1. The ratio of male to female was 3.9: 1 in male predominance, and the majority[66.6%] was distributed from 3rd to 5th decade. 2. Nonpenetrating chest trauma was more common than penetrating about 4.6 times, and the most common cause of the nonpenetrating injuries was traffic accident[241/448, 53.8%] and of the penetrating injuries was stab wound[88/97, 90.7%]. 3. Only 79 cases[14.5%] were arrived to our emergency room within one hour after trauma. 4. The most common lesion due to trauma among these admitted patients was rib fracture[390/545, 71.6%], and the others were lung contusion[217/545, 39.8%], hemothorax[35%], hemopneumothorax[19.6%], and pneumothorax[11.8%] et al in decreasing order. 5. The associated injuries those required special treatment of other departments were 223 cases and its distributions were bone fractures[178/545, 32.7%], head injury[5.3%], and abdominal injury[6.6%]. 6. The others, but interesting chest injuries were follows: sternum fracture[3.1%], diaphragm rupture[2.6%], myocardial laceration and rupture[2 cases], bronchial rupture and laceration[2 cases], and traumatic thymoma rupture[1 case]. 7. The incidence of flail chest was 5.8%a[26/448] in the nonpenetrating injury, and the causes were multiple rib fracture which was in rows more than 4 rib fracture[20 cases], and sternum fracture[6 cases]. 8. We could managed the most of the patient with conservative treatment[43.1%] or closed tube thoracostomy[52.7%], but required emergency open thoracotomy in 64 cases

• 임상간호연구
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• 제18권1호
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• pp.63-73
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• 2012

Purpose: The purpose of this study was to compare job satisfaction and nursing performance of nurses on fixed night shifts (FNS) and nurses working three shifts (W3S), to identify the environment of night work and recognition of the viability of the FNS system. Methods: The research was conducted with 106 nurses on FNS and 257 on W3S. The nurses had worked for 1 to 11 years at A hospital, Seoul. Results: Job satisfaction was significantly higher (t=-3.51, p< .001) for nurses on FNS. However, no significant difference was found for nursing performance (t=-1.019, p=.309) between the two groups. Both groups of nurses were mostly satisfied. Subjective fatigue scores (0 to 10 points) during the night for nurses on FNS (6.02) were lower than for W3S nurses (7.28) A high percentage (88.7%) of nurses on FNS indicated a willingness to further participate in FNS. Conclusion: Results indicate that the demonstration FNS system showed its effectiveness. Therefore, efforts are needed to enhance and revitalize FNS and to upgrade the system to control patient transfer time from emergency departments to wards, and to provide nurses needed resources for emergency or intensive care.