• 대한임상독성학회지
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• 제6권2호
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• pp.110-116
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• 2008

Purpose: Acute toxic hepatitis is a common cause of acute liver failure (ALF). We investigated the causes, clinical manifestation, and outcomes of ALF patients who underwent liver transplantation due to acute toxic hepatitis caused by herbal medicines and preparations. Methods: Between January 1992 and May 2008, we retrospectively reviewed the medical records of 24 patients who were transplanted due to acute toxic hepatitis caused by herbal medicines and preparations. We applied the RUCAM score to patients with acute toxic hepatitis and assessed the relationship between herbal preparations and liver injury. We studied the patients' medication history, liver function tests, and clinical outcomes. Results: The type of liver injury was divided into three groups: hepatocellular type, 14 patients (58.3%); cholestatic type, 4 patients (16.7%); and mixed type, 6 patients (25%). Polygonum multiflorum Thunberg (3 cases) was the most common cause of acute toxic hepatitis, followed by Acanthopanax senticosus (2 cases), pumpkin juice (2 cases), Dictamnus dasycarpus Turcz (2 cases), Hovenia dulcis (1 case), Phellinus linteus (1 case), and Artemisia capillaries (1 case). One year survival after liver transplantation was 76%. Conclusion: We identified the herbal preparations leading to acute liver failure. Many patients consider herbal remedies to be completely free of unwanted side effects. However, we found that many herbal products have biological activities that can lead to severe hepatotoxicity.

• 한국응급구조학회지
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• 제14권3호
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• pp.29-40
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• 2010

Purpose: We investigated the motivation of selecting major, the satisfaction of major and the view on occupation of emergency medical technology (EMT) students. The results of study will be used to increase the satisfaction of major of university students. Also, it can be used to support decision of major for high school students. Method: We conducted 1,586 surveys from 665 students at six four-year colleges and 921 students at seven three-year colleges. Our research period was from Aug. 27th to Oct. 31st in 2010. The surveys were analyzed by SPSS 18.0 using description statistics, t-test, ANOVA, Scheffe and Pearson correlation coefficient. Result: In our study, the motivation of selecting major is 35.8% of students selected 'good employment prospects', satisfaction of major's $M{\pm}SD$ is $3.15{\pm}.486$, adaptation of major's $M{\pm}SD$ is $3.11{\pm}.472$. The satisfaction of major show difference (t = 4.548 p = .000) by sex, also the adaptation of major show difference (t = 2.279, p = .023) by sex. The satisfaction of major show first grade students higher (F = 3.605, p = .013) than fourth grade students at four-year colleges. If satisfaction of major is high, accumulation evaluation score is high (F = 3.276, p = .011), too. Clinical practice experienced students was higher (t = -2.878, p = .004) than non experienced it satisfaction. In view of occupation, ideal job's factors and actual job's factors a lot of students selected 'aptitude'. Also, there is a statistically significant correlation (r = .618, p = .000) between the satisfaction of major and the adaptation of major. High satisfaction indicates high adaptation of major. Conclusion: In our study satisfaction of major and adaptation of major was very high score. EMT students concern about employment prospects at most. It is inferred that they select job which match with one's aptitude. We can suppose that students select major as a tool for employment by seeing result that a lot of students consider employment prospects at most when they select major. A method to improve the satisfaction and adaptation of major should be developed by realizing problems which occur the dissatisfaction of major. Also, there as on why students conflict between ideal and actual job should be revealed. There as on seems students want stable occupation in unstable job market situation. Therefore, the expansion of job matching aptitude and being stable should be processed. Finally, university should actively support the method that help to finding jobs for student by identifying job preparation of students.

• 한국산학기술학회논문지
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• 제19권9호
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• pp.215-224
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• 2018

본 연구에서는 119구급대원의 행위태도, 주관적 규범 및 지각된 행위 통제가 안전의도와 안전행동에 관한 구조적 관계 모형 검증을 규명하기 위하여 서울, 인천, 강원, 대구, 충남, 경북, 부산에 거주하고 있는 소방공무원 중 119구급대원으로 활동하는 남녀 373명 대상으로 조사하였다. 수집된 자료처리는 Windows용 SPSS 2.1과 Amos 16.0을 사용하여 빈도분석, 신뢰도 분석, 상관관계를 실시하였고, 가설 검정을 위해 구조방정식 모형분석을 실시하였다. 모든 통계분석은 유의수준 p<.05로 설정하였다. 결과는 다음과 같다. 첫째, '구급대원의 행위 태도가 안전 의도와 안전 행동에 미치는 영향을 검증한 결과 행위 태도가 안전 의도와 안전 행동에 영향을 미치는 것으로 나타났다(t=.32, p<.001). 둘째, '구급대원의 주관적 규범이 안전 의도와 안전 행동에 미치는 영향을 검증한 결과 주관적 규범이 안전 의도와 안전 행동에 영향을 미치는 것으로 나타났다(t=.27, p<.001). 셋째, '구급대원의 지각된 행위 통제는 안전 의도와 안전 행동에 미치는 영향을 검증한 결과 지각된 행위 통제가 안전 의도와 안전 행동에 영향을 미치는 것으로 나타났다(t=.28, p<.001). 넷째, '구급대원의 안전 의도는 안전 행동에 미치는 영향을 검증한 결과 안전 의도가 안전 행동에 영향을 미치는 것으로 나타났다.(t=.39, p<.001).

• Tuberculosis and Respiratory Diseases
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• 제69권2호
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• pp.103-107
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• 2010

Background: The aim of the present study was to evaluate whether findings on initial chest computed tomography (CT) of influenza pneumonia can help predict clinical outcome. Methods: We reviewed all adult patients admitted to the Emergency Department (ED) with a confirmed diagnosis of novel influenza A H1N1 virus (2009 H1N1) pneumonia, who underwent chest CT upon admission between Aug 26, 2009 and Jan 31, 2010. Radiologic findings were characterized by type and pattern of opacities and zonal distribution. Clinical outcome measures were intensive care unit (ICU) admission, mechanical ventilation, and inhospital death. Results: Of 59 patients diagnosed with 2009 H1N1 pneumonia, 41 (69.5%) underwent chest CT on admission into ED. Nine (22%) of these patients developed adverse clinical outcomes requiring the following treatments: 9 (22.0%) ICU admissions, 5 (12.2%) mechanical ventilation, and 3 (7.3%) inhospital deaths. Counting the number of patients with more than 4 involved lobes, the sensitivity, specificity, positive predictive value, and negative predictive value for detection of adverse clinical outcome were 67%, 84%, 55% and 80%, respectively. Conclusion: Extensive involvement of both lungs (over 4 lobes) is related to ICU admission, mechanical ventilation, and inhospital death. Initial chest CT may help predict an adverse clinical outcome of patients with 2009 H1N1 influenza pneumonia.

• 대한임상독성학회지
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• 제19권1호
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• pp.1-7
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• 2021

Purpose: The purpose of this study was to conduct a systematic review to investigate the socio-economic benefits of the poison control center (PCC) and to assess whether telephone counseling at the poison control center affects the frequency of emergency room visits, hospitalization, and length of stay of patients with acute poisoning. Methods: The authors conducted a medical literature search of the PubMed, EMBASE, and Cochrane Library databases. Two reviewers evaluated the abstracts for eligibility, extracted the data, and assessed the study quality using a standardized tool. Key results such as the cost-benefit ratio, hospital stay days, unnecessary emergency room visits or hospitalizations, and reduced hospital charges were extracted from the studies. When meta-analysis was possible, it was performed using RevMan software (RevMan version 5.4). Results: Among 299 non-duplicated studies, 19 were relevant to the study questions. The cost-benefit ratios of PCC showed a wide range from 0.76 to 36 (average 6.8) according to the level of the medical expense of each country and whether the study included intentional poisoning. PCC reduced unnecessary visits to healthcare facilities. PCC consultation shortened the length of hospital stay by 1.82 (95% CI, 1.07-2.57) days. Conclusion: The systematic review and meta-analysis support the hypothesis that the PCC operation is cost-beneficial. However, when implementing the PCC concept in Korea in the future, it is necessary to prepare an institutional framework to ensure a costeffective model.

• Tuberculosis and Respiratory Diseases
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• 제69권3호
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• pp.184-190
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• 2010

Background: The purpose of this study was to determine the prognostic significance of chest computed tomographic (CT) parameters in acute submassive pulmonary embolism (PE). Methods: Between January 2006 and December 2009, 268 consecutive patients with acute submassive PE that was confirmed by chest CT with pulmonary angiography in emergency room were studied. One experienced radiologist measured CT parameters and judged the presence of right ventricular dysfunction. CT parameters were analyzed to determine their ability to predict a major adverse event (MAE). Results: There were 220 patients included and 61 (27.7%) had MAE. Left ventricular and right ventricular maximum minor axis ($36.4{\pm}8.0$ vs. $41.7{\pm}7.4$, p<0.01; $45.7{\pm}9.4$ vs. $41.5{\pm}7.6$, p<0.01), superior vena cava diameter ($19.2{\pm}3.4$ vs. $18.0{\pm}3.4$, p=0.02), azygos vein diameter ($10.0{\pm}2.2$ vs. $9.2{\pm}2.3$, p=0.02), septal displacement (19 vs. 18, p<0.01) were significantly higher in MAE group than in no MAE group. Patients with MAE had high right ventricular/left ventricular dimension ratio (RV/LV ratio) compared to patients without MAE ($1.34{\pm}0.48$ vs. $1.03{\pm}0.28$, p<0.01). The most useful cut-off value of RV/LV ratio for MAE was 1.3 and the area under the curve was 0.71 (0.62~0.79). Conclusion: RV/LV ratio on chest CT was a significant predictor of submassive PE related shock, intubation, in-hospital mortality, thrombolysis, thrombectomy within 30 days.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제5권8호
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• pp.63-70
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• 1999

The patient characters in medical emergency facilities is in emergent situation and very wide medical area. So, the spatial composition of this facilities should be more efficient than general medical ones. For this reason, patient who visit medical emergency center should be triaged by each property of patient. And then the clinical space is to be composed in response to flow of each patient group that triaged. Therefore this study aims to find method of the spatial composition and architectural details of medical emergency center.

• 한국응급구조학회지
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• 제10권2호
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• pp.15-23
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• 2006

Simulators were introduced in education as a tool to make advanced training standardized, less expensive, and without danger to those involved. In 1922 in the Unites States, Edward Link presented his homemade flight simulator, which became common place in both military and civilian aviation, known as the "Link Trainer". The development of mannequin simulators used for education, training, and research is reviewed, tracing the motivations, evolution to commercial availability, and efforts toward assessment of efficacy of those for teaching cardiopulmonary resuscitation, cardiology skills, anaesthesia clinical skills, and crisis management. This will provide a brief overview of simulators and trainers in several domains.

• 간호행정학회지
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• 제17권4호
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• pp.432-442
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• 2011

Purpose: The purpose of this study was to identify the factors influencing the intention of the reuse in patients admitted in university hospital emergency medical center. Method: The participants were 253 patients admitted to a niversity hospital emergency medical center. Data were collected with self-administrated questionnaires and analyzed by hierarchical multiple regression. Results: Patient satisfaction with nursing care service and switching cost were positively correlated with reuse by patients while the perceived risk was negatively correlated. As levels of satisfaction with nursing care services and switching cost increase, intention of reuse increases. Satisfaction with nursing care service, switching cost and perceived risk in emergency medical center influence intention to reuse and explain 68.8% of total variation of intention to reuse. Conclusion: Findings provide strong empirical evidence for importance of atient satisfaction with nursing care service, the switching costs and the perceived risk in explaining the intention of reuse an emergency medical center.

• 성인간호학회지
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• 제18권4호
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• pp.533-542
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• 2006

Purpose: The purposes of this study were to investigate medical records and to develop care records for management of patients with chest pain in the emergency department. Method: Retrospective review of the 42 medical chart of patients presented to the emergency department with chest pain were used. The collected data were analyzed with a frequency of items in the medical records. Results: In a frequency analysis of recorded items for doctors' chest pain assessment during history taking, the history/risk factors was the highest rank. The following ranks were 'commenced with when/timing, extra symptoms, place, nature, stay/radiate, alleviate/aggravate, intensity' in sequence. In a frequency of recorded items in nurse's progress notes according to nursing actions, the 'checking/monitoring' was the highest rank. The following ranks were 'performing, administering/injecting, referring/arranging, testing, preparing/catheterizing, teaching/informing' in sequence. Chest pain care records for the emergency department was designed, based upon data analysis and literature review. Conclusion: The designed records can be a rapid and effective approach tool for assessment and recording of patients with chest pain. Further research is necessary for evaluating the designed chest pain care records.