• 제목/요약/키워드: Emergency medical

검색결과 3,230건 처리시간 0.028초

관통성 경부 손상에 관한 임상적 고찰 (Clinical Analysis of Penetrating Neck Injury: Review of 42 Operated Cases)

  • 최환;홍석진;김연수;조재구;백승국;우정수;정광윤;권순영
    • 대한기관식도과학회지
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    • 제16권2호
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    • pp.121-125
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    • 2010
  • Background: Penetrating neck injuries are potentially dangerous and require emergency management because of the presence of vital structures in the neck. The risk of airway, vascular, neurological, and pharyngoesophageal injuries leads to many difficult diagnostic decisions. The purpose of this retrospective study is to evaluate our experience with management of penetrating neck injuries, and to assess treatment outcome. Material and Method: Forty-two consecutive patients were identified (26 patients from Korea university Ansan hospital, 16 patients from Guro hospital) as having penetrating neck injuries from 2003 to 2009. With review of medical records, variables were collected and evaluated including the location of injury, mechanism of injury, number of significant injuries, diagnostic modalities, duration of hospital stay and outcome. Results: The location of injury was zone I (lower neck) in 13 cases (31%), zone II (midportion of the neck) in 22 (52%), and zone III (upper neck) in 7 (17%). Injuries were caused by stab wounds in 23 patients, penetrating foreign bodies in 12. Among 35 patients who had deep injuries that violated the platysma, significant injuries, including major vascular (20), trachea (5) Pharyngoesophageal injuries (5) were identified in 24 patients. The mean hospital stay was 9.5 days. Conclusion: The penetrating trauma in the neck may show various degrees of severity. However, Cervical penetrating injury should not be underestimated in spite of the minimal width of the lesion.

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경피적 관동맥 확장술의 시술량과 조기 시술결과의 관련성 (Relationship between Percutaneous Transluminal Coronary Anigioplasty Volume and Associated Immediate Outcome)

  • 김용익;김창엽;이영성;김선민;이진석;오병희;강영호
    • Journal of Preventive Medicine and Public Health
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    • 제34권1호
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    • pp.9-20
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    • 2001
  • Objectives : To explore the relationship between Percutaneous Transluminal Coronary Angioplasty(PTCA) volume and the associated immediate outcome. Methods : A total of 1,379 PTCAs were peformed in 25 hospitals in Korea between October 8 and December 31 in 1997. Data from 1,317 PTCAs (95.5%) were collected through medical record abstraction. Inter-observer reliability of the data was examined using the Kappa statistic on a subsample of 110 PTCA procedures from five hospitals. Intra-observer reliability of the data was also examined. PTCA success and immediate adverse outcomes were selected as the outcome variables. A successful PTCA was defined as a case that shows less than 50% diameter stenosis and more than 20% reduction of diameter stenosis. Immediate adverse outcomes included deaths during the same hospitalization, emergency coronary artery bypass graft (CABG) within 24 hours after PTCA, and acute myocardial infarction within 24 hours after PTCA. The numbers of PTCAs performed in 1997 per hospital were used as the volume variables. Results : Without adjusting for patient risk factors that may affect outcomes, procedures at high volume hospitals ($\geq200$ cases per year) had a greater success rate (P=0.001) than low volume hospitals. There was a marginally significant difference (P=0.070) in major adverse outcome rates between high and low volume hospitals. After adjusting for risk factors, there were significant differences in procedural failure and major adverse outcome rates between high and low volume hospitals. Conclusions : After adjusting for patient clinical risk factors, the hospital volume of PTCA was associated with immediate outcomes. It is recommended that a PTCA volume per year be established in order to improve the immediate outcome of this procedure in Korea.

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Risk Factors Related with Mortality in Patient with Pulmonary Tuberculosis

  • Kim, Chong Whan;Kim, Sang-Ha;Lee, Shun Nyung;Lee, Seok Jeong;Lee, Myoung Kyu;Lee, Ji-Ho;Shin, Kye Chul;Yong, Suk Joong;Lee, Won Yeon
    • Tuberculosis and Respiratory Diseases
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    • 제73권1호
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    • pp.38-47
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    • 2012
  • Background: The prevalence rate of pulmonary tuberculosis (PTB) is steadily decreasing in South Korea. However, PTB is a disease with relatively high mortality and morbidity rates throughout Korea. Although there are many studies and statistics about the risk factors of PTB mortality in many countries, there are only a limited number of domestic papers on this topic. The aim of this study is to determine predictive factors for mortality among in-hospital patients associated with PTB. Methods: From December 2006 to January 2011, we reviewed medical records of 2,122 adult patients diagnosed with tuberculosis at a single tertiary hospital in a suburban area. In this study period, 960 patients were diagnosed with PTB by positive Acid fast bacilli smear and/or mycobacterial culture of the respiratory specimen. We compared the groups of patients deceased and patients discharged alive with PTB. The number of dead patients was 82 (47 males, 35 females). Results: Mortality was significantly associated with increased values of white blood cells (WBC), blood urine nitrogen (BUN), creatinine, C-reactive protein (CRP), numbers of involved lung field, and length of hospitalization. Also, it was associated with the decreased values of hemoglobin, lymphocyte, sodium, albumin, and cholesterol. Furthermore, admission through the emergency department, initial intensive care unit admission, and drug resistant PTB affected mortality in PTB patients. Independent predictors associated with PTB mortality are BUN, initial intensive care unit care, and admission during treatment of tuberculosis. Conclusion: In our study, mortality of pulmonary tuberculosis was related with parameters associated with nutritional status, disease severity at the time of admission, and drug resistance.

경기지역 일 산업장 근로자의 건강관리에 대한 지식 및 실태에 관한 연구 (A Study on the Knowledge and Attitude about Emplyee's Health Management in the Provinces)

  • 김은희
    • 지역사회간호학회지
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    • 제6권2호
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    • pp.299-318
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    • 1995
  • This study was conducted in order to grasp the condition of the Worker's knowledge and attitude about health management. And to offer the basic materials for the health promotion in industrial field. The objects were comprised 336 of volunteered who work in E.shoemaking factory. The material of this study was the questionair (chronbach a=.8871) suited to the purposed of this research which has been made through studying references. All the guestionaire were collected inmediately without explanation. The data collected from 18th September to 1st Octover. Analysis of the data was done utilizing SAS program for percentage, mean, ANDVA. The result are as follows: 1. General features of the objects of study. Male was highest (58.6%), mean age was 30.07 years, graduated high school was highest(59.2%), producer in present place of employment was highest (76.2%), mean career was 7.45 years. 2. The conditions of attitude about health man agement. Correct answer of health examination was 77.8%. Having experience of health examination was 69.5%, among them have regularity was 70.9%. Think it too much trouble to do not health examination was 69.7%. Have got to do health examination was 95.6%. The reason of set up health clinic was emergency care 58.9%, health education 22.1%. Using health clinic was 70.4%, by monthly was 53.0%. The reason of think it too much trouble to use not health clinic was 65.2% The need of health clinic was 96.4% 3. The conditions of knowledge about health management. When 5 points was given to 'very affirming' and 1 point was given to 'very deny', the total average was 3.67, the range was 2.96-4.54. Exactly, company must given to employee put in operative health examination was highest, worked 34 hours per week on harmful worked place was lowest. And knowing about kind of harmful work was 2.86, dangerous work was 2.90. 4. Correlation between the general features and attitude variables. Female group may have more knowledge on reason of health examination. Over 50 years aged group, middle school graduated group, white colored group, less then 1 year career group may have more knowledge on health examination. White colored group may have more attitude on health examination$(\chi^2=5.210,\;P<.07)$. High careered group may have more using on health clinic $(\chi^2=12.08,\;P<.007)$. 5. Difference between the general features and knowledge of health management. High educated group were highest score in knowledge (F=5.214, P<.002). White colored group were highest score in knowledge (F=23.019, P<.000). 6. Difference between the attitude and knowledge of health management. Needing of health examination group were highest score in knowledge. (t=2.54, P<.011). Using of health clinic group were highest score in knowledge(t=190, P<.048). Needing of health clinic group were highest score in knowledge(t=5.13, P<.000).

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대학생의 식사규칙성과 구강건강지식 및 구강건강 간의 관계 (Correlation between Regular mealtime, Oral health knowledge and Oral health of college students)

  • 남미정;엄동춘
    • 한국산학기술학회논문지
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    • 제12권2호
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    • pp.788-794
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    • 2011
  • 대학생들의 식사규칙성과 구강건강지식 및 구강건강의 수준과 그들의 관련성을 확인하는 것을 목적으로 본 연구를 시도하였다. 본 연구는 상관성 조사연구로 D시와 C도에 위치한 3개 대학(교)에 재학 중인 대학생을 대상으로 2010년 6월 1일부터 6월 30일까지 1000부의 설문지 배포 후 최종 903부를 수거하였다. 수집된 자료는 SPSS PASW Statistics 18.0 Program으로 분석하였다. 조사결과 대상자의 50%이상이 식사습관이 규칙적이지 않은 것으로 나타났다. 구강건강지식에서는 치주병 예방방법(82.6%)에 대한 지식 정답률이 가장 높았다. 대학생들의 일반적인 특성에 따른 식사규칙성과 구강건강지식, 구강건강을 분석한 결과 식사규칙성은 학년(p<.001), 전공(p<.01), 흡연(p<.05) 및 음주 (p<.001), 희망치과치료(p<.01)에서, 구강건강지식은 성별(p<.001), 연령(p<.05), 학년(p<.05), 흡연(p<.01) 및 치아검진(p<.05) 등에서 통계적으로 유의한 차이가 나타났다. 한편 구강건강은 희망치과치료(p<.001)에서만 통계적 유의성이 나타났다. 또한 본 연구 대상자들의 식사규칙성, 구강건강지식 및 구강건강 간의 상관관계에서는 식사규칙성이 구강건강과 유의한 음의 상관관계(p<.01)를 보여 식사습관이 규칙적일수록 구강건강이 양호한 경향성을 보이는 것으로 볼수 있다. 구강건강을 유지하기 위한 교육은 어렸을 때부터 규칙적인 식습관을 갖도록 하며, 음주와 흡연이 구강건강에 미치는 영향과 올바른 잇솔질부터 교육하는 것이 중요하다고 할 수 있다.

윈드서핑 참여자들의 참가동기가 몰입경험, 자아성취감 및 생활만족도에 관한 구조적 관계 모형 검증 (Test of a Model for the Structural Relationship of Participation Motivation to Flow Experience, Self-Achievement and Life Satisfaction in Windsurfers)

  • 문태영
    • 한국산학기술학회논문지
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    • 제18권8호
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    • pp.152-161
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    • 2017
  • 본 연구는 윈드서핑 참가자의 참가동기가 몰입경험, 자아성취감 및 생활만족도에 관한 구조적 관계 모형 검증을 규명하는데 그 목적이 있다. 이를 위해 2016년 7월 5일부터 8월 20일까지 강원도 양양군 해수욕장에서 이루어지고 있는 윈드서핑에 참여하고 있는 성인 남녀 206명을 대상으로 조사하였다. 수집된 자료는 SPSS/PC+ 20.0 Version과 AMOS 16.0을 사용하여 통계분석을 하였다. 첫째, 윈드서핑 참가자의 참가동기가 몰입경험에 유의한 영향을 미치는 것으로 나타났다(t=18.156, p<.001). 둘째, 윈드서핑 참가자의 참가동기가 자아성취감에 유의한 영향을 미치는 것으로 나타났다((t=19.848, p<.001). 셋째, 윈드서핑 참가자의 참가동기가 생활만족도에 유의한 영향을 미치는 것으로 나타났다((t=8.219, p<.001). 넷 번째, 윈드서핑 참가자의 몰입경험이 자아성취감에 유의한 영향을 미치는 것으로 나타났다((t=9.769, p<.001). 다섯 번째, 윈드서핑 참가자의 몰입경험이 생활만족도에 유의한 영향을 미치지 않는 것으로 나타났다((t=16.033, p<.001). 여섯 번째, 윈드서핑 참가자의 자아성취감이 생활만족에 유의한 영향을 미치지 않는 것으로 나타났다((t=17.438, p<.001). 이러한 결과들 기초로 윈드서핑 동호인들의 삶의 질을 높일 수 있는 방향을 제시하는 것이 필요할 것이다.

외상 후 스트레스 위기 소방관에 대한 단기간 음악치료의 효과 (Effects of Short-Term Music Therapy in Fire Fighters with Post-Traumatic Stress Risk)

  • 심규식;김남송;방성환
    • 한국산학기술학회논문지
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    • 제16권6호
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    • pp.4040-4047
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    • 2015
  • 본 연구는 외상 후 스트레스 장애(Post-traumatic Stress Disorder; PTSD) 발생 가능성이 높은 소방관에게 단기간 음악치료 프로그램을 적용해 외상 후 스트레스(post-traumatic stress; PTS) 수준의 변화와 음악치료 효과의 지속성을 분석하고자 하였다. 연구방법은 3개 지역의 소방관 42명을 실험군(21명)과 대조군(21명)으로 임의배정 하고 5일간 1일 2회기(120분)씩 총 10회기의 음악치료를 적용하였다. PTS 수준은 음악치료 종료 직후, 4주 후, 12주 후에 변화를 측정 하였다. 연구결과 음악치료 전 PTS 수준은 $26.52{\pm}2.32$점 이었으나 음악치료 직후 $8.90{\pm}4.55$점으로 유의하게 감소하였다(p<0.05). 사후 PTS 수준은 4주 후 $11.95{\pm}4.57$점, 12주 후 $13.76{\pm}5.62$점으로 4주 및 12주 후까지 효과가 유의하게 지속되었다(p<0.05). 이상의 결과를 통해 음악치료는 PTSD 고위험군인 소방관에게 PTS 수준을 낮추는데 효과적인 접근 방법으로 판단된다. 따라서 소방관의 정신건강 관리를 위해 음악치료가 정규적인 프로그램으로 적용된다면 현장 업무능력을 향상시키는데 기여할 수 있을 것이다.

여고생의 자동제세동기에 대한 강사중심학습과 영상자가학습과의 교육효과 비교 (Comparison of Educational Effectiveness Between Instructor-Centered Learning and Video Self-Instruction about Automatic External Defibrillator for High School Girls)

  • 박상섭
    • 한국산학기술학회논문지
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    • 제12권4호
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    • pp.1732-1739
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    • 2011
  • 본 연구는 여고생의 자동제세동기(AED)에 대한 강사중심 학습과 영상자가 학습(VSI)간의 교육효과 비교를 통하여 자동제세동기 교육에 효과적인 교육방법의 선택에 도움을 주는데 목적이 있다. 본 연구는 2010년 7월 7일부터 7월 14일까지 J도 소재 고등학교 여학생 총 59명으로 하였다(실험군 29명, 대조군 30명). 분석방법은 SPSS WIN 12.0 Version 프로그램을 사용하여 분석하였다. 자동제세동기(AED) 교육 전 후 지식 차이는 실험군(1.72)이 대조군(1.60)에 비해 높게 증가하였고, 자동제세동기(AED) 교육 전 후 자신감 차이는 실험군(1.58)이 대조군(1.46)에 비해 높게 증가하였고, 자동제세동기(AED) 교육 전 후 술기수행 정확도 차이는 대조군(5.46)이 실험군(4.20)에 비해 높게 증가하였다. 자동제세동기 학습만족도는 실험군(5.68)이 대조군(4.95)보다 높게 나타났다. 연구결과 대부분 영역에서 영상자가학습이 강사중심학습보다 교육효과가 높게 증명되었기에 향후 자동제세동기 교육에 있어서 영상자가학습방법을 적용해 볼 필요가 있다. 그러나 영상자가학습방법이 효과적인가에 대해서는 지속적 연구가 이루어져야 할 것이다.

배드민턴 참여자들의 라이프스타일이 스포츠웨어 추구혜택에 미치는 영향 (Impact of Lifestyle on Sportswear Benefit Pursuit among Participants in Badminton)

  • 문태영
    • 한국산학기술학회논문지
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    • 제11권7호
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    • pp.2483-2490
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    • 2010
  • 본 연구는 배드민턴 참여자들의 라이프스타일이 스포츠웨어 추구혜택에 미치는 영향을 규명함으로써 배드민턴에 참여하고 있는 동호인들에게 보다 효과적인 스포츠웨어에 대한 정보를 제공하는 연구의 목적이 있다. 본 연구의 대상으로는 현재 강원도에서 배드민턴 클럽에 가입하여 참여하고 있는 성인 남녀를 모집단으로 선정하여 편의추출법에 의하여 총 206명을 표집하여 SPSS/PC+ 11.0 Version을 사용하여 빈도분석, 신뢰도 및 요인분석, 다중회귀분석을 실시하였다. 이 연구의 결론은 다음과 같다. 첫째, 배드민턴 참여자들의 라이프스타일과 스포츠웨어 추구혜택 간의 상관관계가 있는 것으로 나타났다. 둘째, 라이프스타일의 하위요인 패션 유행추구, 사회지향성의 순으로 스포츠웨어 추구혜택인 이상적 추구혜택에 영향을 미치는 것으로 나타났다. 셋째, 라이프스타일의 하위요인 물질추구, 패션 유행추구, 현실만족 순으로 스포츠웨어 추구혜택인 유행과 브랜드 추구혜택에 영향을 미치는 것으로 나타났다. 넷째, 라이프 스타일의 하위요인 자기충실, 사회지향성, 건강추구, 현실만족의 순으로 스포츠웨어 추구혜택인 편안함 추구혜택에 영향을 미치는 것으로 나타났다. 다섯째, 라이프스타일이 패션 유행추구, 물질추구, 사회지향성의 순으로 젊음과 개성 추구혜택에 영향을 미치는 것으로 나타났다. 이러한 결과들을 바탕으로 스포츠활동에 참여하는 대상자들이 스포츠웨어 추구혜택을 정확히 파악함으로써 스포츠활동에 보다 더 질 좋은 스포츠웨어 제품을 기대할 수 있을 것이다.

요로결석 위치 진단에 대한 복부자세 변화에 따른 연구 (A Study on the Diagnosis of Urinary Stone Location by Abdominal Positioning Variations)

  • 김동진;채종상;유채민;이배원
    • 대한방사선기술학회지:방사선기술과학
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    • 제41권1호
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    • pp.7-12
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    • 2018
  • Patients who visit the emergency room with urinary stones have difficulty lying down in a supine position due to severe pain when performing the KUB test. The purpose of this study was to find methods to reduce the patients' pain and image distortion, and obtain medical images with high diagnostic values. After checking the standard classification of disease and cause of death, the target group consisted of 121 patients who had clearly distinguished stones from computed tomography. Patients with stones in the ureteralvesical junction were excluded. Qualitative image evaluation was performed by confirming the location of the stone in the computed tomography images. and evaluated the rate of visual discrimination of stones possible through KUB and abdominal plain X-ray. Quantitative image evaluation was performed on the KUB, abdominal plain X-ray images. The transverse process of the first lumbar vertebrae served as the standard point, and the length from this point to the lower part of the stone was measured. Results from looking at the rate of visual discrimination of stones possible through KUB and abdominal plain X-ray showed: 94 patients (77.6%) for KUB images and 91 patients (75.2%) for computed tomography images. The standard deviation for KUB and abdominal X-ray was 3 (2.4%). Comparing and analyzing the location from KUB images and abdominal plain X-ray images, the stone position was 10.1 mm in the kidney, 10.5 mm in the ureteropelvic junction, and 9.7 mm in the ureters. It was shown that the stone moved 10 mm on average with significant statistical difference (P<0.05). In cases where the pain is so severe that it is impossible to perform the test in the supine position, an alternative may be to check the stone position by performing a modified KUB test by having the patient stand in a vertical position. In the future, this will provide convenience to both the examiner and the patient when performing the examination, and it will contribute with its reproducibility.