• Journal of Industrial Convergence
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• v.21 no.2
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• pp.25-32
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• 2023

Constipation is the most common digestive disorder, and it occurs frequently in the early stages and affects the prognosis on rehabilitation stage in the patients with brain injury. The purpose of this study is to evaluate the bowel habits of brain-injured patients undergoing enteral nutrition immediately after admission to rehabilitation and transmission, and to investigate the effects of abdominal massage and lower extremity exercise. The study design is a quasi-experimental study to investigate the effect of a bowel care intervention (abdominal massage and lower extremity exercise) applicable to patients with brain lesions. As a result of the study, the number of bowel movements was significantly higher in the intervention group (p=.030), and the use of suppositories in the control group was statistically significantly higher than that in the intervention group (p=.004). The time of constipation relief was 1.73 days for the experimental group and 4.61 days for the control group, indicating that there was a difference in the time of constipation relief between the two groups (p<.001). Abdominal massage and lower extremity exercise were effective as nursing interventions to relieve constipation and prevent constipation in patients with brain injury from the early stage of rehabilitation.

• Journal of Chest Surgery
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• v.43 no.3
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• pp.285-291
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• 2010

Background: Thoracic trauma is one of the leading causes of morbidity and mortality in developing countries. A rib fracture that is secondary to blunt thoracic trauma is an important indicator of the severity of the trauma. The purpose of study was to determine the morbidity and mortality rates and the management of rib fractures. Material and Method: We performed a retrospective study that involved all the blunt trauma patients with rib fractures, excluding those that were transferred to other hospital within 3 days, that were seen at our hospital between May 2002 and December 2008. Of the 474 admitted patients, 454 met the inclusion criteria. There were 356 male and 98 females, and their overall mean age was 53 years (range: 5~90 years). The outcome parameters included the mechanism of injury, the number of fractured ribs, the length of stay in the ICU, the Injury Severity Score (ISS), the length of the hospital stay, the pulmonary complications and the mortality. Result: The mechanism of trauma included traffic accidents in 189 (41.7%) cases, slipping down in 103 (22.7%) cases, falls in 85 (18.7%) cases, cultivator accidents in 30 (6.6%) cases, industrial accidents in 32 (7.0%) cases and assault in 15 (3.3%) cases. Intrathoracic injury was noted such as hemothorax in 269 (59.3%) cases, pneumothorax in 144 (31.7%) cases, pulmonary contusion in 95 (20.9%) cases, subcutaneous emphysema in 29 (6.4%) cases and great vessel injury in 5 (0.1%) cases. Conservative treatment was administered to most of the patients. Tube thoracostomy was administered in 234 (51.5%) cases, whereas thoracotomy was performed in 18 (4.0%) cases. The mean duration of thoracostomy was $5.2{\pm}6.2$ days. Most of the cases with rib fracture were treated in wards and their mean duration of hospital stay was $22.5{\pm}20$ days. The mean Injury Severity Score (ISS) was $14.8{\pm}10.9$ (range: 3~75). The mortality rate was calculated to be 4.8% (n=22). The main factors correlated with an adverse outcome were the number of ribs fractured, the duration of thoracostomy and pulmonary disease. Industrial insurance affected the length of hospitalization. Pulmonary contusion and the Injury Severity Score (ISS) affected the mortality. Conclusion: Rib fractures are a indicator of severe injury. Because of the complication and associated injuries, we believe these patients should be admitted for evaluation and treatment. Recent studies on the impact of rib fractures after blunt trauma have shown that patients as young as 40 years of age demonstrate increased morbidity and mortality with similar injuries as compared to that of older patients. The ISS and pulmonary contusion influenced the mortality rate. Patients with isolated rib fractures should be hospitalized if the number of fractured ribs is one or more.

• Journal of Trauma and Injury
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• v.30 no.4
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• pp.186-191
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• 2017

Purpose: Recently, as the number of people who enjoy water sports life in river or lake easy to accessible are increasing, that of the patients who are injured in water sports also does gradually. We intend to investigate the type of the injured patients of water sports and the riskiness of the sports in this study. Methods: We retrospectively looked into the medical records of the patients who were injured in water sports and visited a general hospital in Gangwondo-province from 2010 to 2015. Results: Total 146 patients came to the hospital during six years. Patients mostly occurred at younger ages, in summer, and on holidays, rather than weekdays. The most common lesions of injuries were faces (53 patients). The most common types of injuries were contusions (62 patients), followed by fractures (32 patients) and lacerations (26 patients). The most frequent fracture sites were the upper extremities (11 patients). Most of the trauma patients were mild, but a small number of patients with aspiration pneumonia occurred and their severity was higher than trauma patients. Conclusions: In this study, facial injuries were most frequent in water sports injuries. In the fractures, upper extremities were the most common fractured lesions. In addition, even if there is no direct trauma, aspiration pneumonia is serious, so caution should be taken with protective equipment suitable for water sports.

• Journal of Chest Surgery
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• v.46 no.2
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• pp.130-134
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• 2013

Background: Rib fractures are the most common type of thoracic trauma and cause other complications. We explored the risk factors for pneumonia in patients with multiple rib fractures. Materials and Methods: Four hundred and eighteen patients who visited our hospital with multiple rib fractures between January 2002 and December 2008 were retrospectively reviewed. Chest X-rays and chest computed tomography were used to identify injury severity. Patients with only a single rib fracture or who were transferred to another hospital within 2 days were excluded. Results: There were 327 male patients (78%), and the median age was 53 years. The etiologies of the patients' trauma included traffic accidents in 164 cases (39%), falls in 78 cases (19%), slipping and falling in 90 (22%), pedestrian accidents in 30 (7%), industrial accidents in 41 (10%), and assault in 15 (4%). The median number of rib fractures was 4.8. Pulmonary complications including flail chest (2.3%), lung contusion (22%), hemothorax (62%), pneumothorax (31%), and hemopneumothorax (20%) occurred. Chest tubes were inserted into the thoracic cavity in 216 cases (52%), and the median duration of chest tube insertion was 10.26 days. The Injury Severity Score (ISS) and rib score had a median of 15.27 and 6.9, respectively. Pneumonia occurred in 18 cases (4.3%). Of the total cases, 33% of the cases were managed in the intensive care unit (ICU), and the median duration of stay in the ICU was 7.74 days. Antibiotics were administered in 399 patients (95%) for a median of 10.53 days. Antibiotics were used for more than 6 days in 284 patients (68%). The factors affecting pneumonia in patients with multiple rib fractures in multivariate analysis included age (p=0.004), ISS (p<0.001), and rib score (p=0.038). The use of antibiotics was not associated with the occurrence of pneumonia (p=0.28). In-hospital mortality was 5.3% (n=22). Conclusion: The factors affecting risk of pneumonia in patients with multiple rib fractures included age (p=0.004), ISS (p<0.001), and rib score (p=0.038). Elderly patients with multiple traumas have a high risk of pneumonia and should be treated accordingly.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.5
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• pp.3344-3352
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• 2015

The purpose of this study is to investigate the effects of Korean computer-based cognitive rehabilitation program (CoTras) on frontal-executive functions in patients with traumatic brain injury (TBI). This study was performed at C hospital in Changwon, Gyeongsangnam-do, Korea from August 2013 to March 2014. Ten patients with TBI were randomly divided into two groups. The experimental group had been given CoTras once a day, five times a week for four weeks, whereas the control group had performed self-cognitive training under the same conditions. To verify the effect of intervention, the following executive function measures were used: Korean Montreal Cognitive Assessment (K-MoCA), Executive Clock Drawing Test (ECDT), Trail Making Test (TMT), Rey-Complex Figure Test (RCFT). Intervention group showed significant increase in K-MoCA, TMT, RCFT-delayed recall (p<.05). However, control group showed no significant change in any test. There was significant difference of changed scores (post test-pre test) between two groups in K-MoCA, TMT and RCFT-delayed recall (p<.05). This study showed that CoTras is effective to improve frontal-executive functions in patients with traumatic brain injury.

• Journal of Chest Surgery
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• v.24 no.11
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• pp.1115-1124
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• 1991

Recently the thoracic injuries have been markedly increasing due to the vast increase of traffic accident, industrial disaster, and incidental accident as well as the frequent use of the murderous weapons including gun or rifle. Because the thoracic injuries could involve the heart, lung, and great vessels, and would influence the lives, prompt diagnosis and adequate treatment are essential. Most of thoracic injuries can be managed with the conservative treatment and simple surgical procedure such as closed thoracostomy, but certain cases require open thoracotomy to preserve lives and to return to their normal environment. The authors have analysed the result of 53 cases of open thoracotomy after thoracic injuries mainly according to the patient`s chart review. The mean age was 33.4 years old and male to female ratio was about 5: l. Injury mechanisms that elicited thoracic trauma indicated for open thoracotomy were penetrating[47%] and non-penetrating[53%] injuries. The Most common type of the thoracic lesion was hemothorax with or without pneumothorax and diaphragm rupture was the second. 58\ulcornero of thoracic injuries were accompanied by abdominal injuries and 47% by bone fractures. 34 patients were operated within 24 hours after injury and their average elapsed time was 13.6 hour. The remained patients were operated after 24 hours and their average elapsed time was 7.8 days. 71 cases of operative procedures containing some overlappings were performed: diaphragm repair[28], bleeding control[12], pulmonary and cardiac repair[4 cases] Postoperative complication rate was 32.1% and operative mortality rate was 9.4%[5/53].

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.2
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• pp.747-754
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• 2012

The purpose of this study was to compare inter-regional accident modes using the National Hospital Discharge Patient Injury Survey. In order to determine economic status of each region, 234 cities and counties were categorized as 5 groups according to their financial self-reliance ratio. The main results are as follows. First, transport accidents had increased by the age group of 25 to 44 but decreased thereafter. Second, the frequency of car accidents was the highest among several types of transport accidents. Most common site of transport accidents was roads and highways. Third, there was significant difference in the modes of transport accident among regions. Fourth, emergency admission rate was quite different according to regional groups but it was no significant difference by economic status. Lastly, there was significant difference in injury patterns by region groups. In regions which were high economic status, there were relatively less serious injury patterns such as sprain, strain, dislocation while regions which were in low economic status had experienced serious injury including fracture, stab wound, and open fracture. We could find the difference in accident modes by regional economic status. Therefore, health authority should consider different accident prevention strategies by regional groups.

• Journal of Korean Physical Therapy Science
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• v.6 no.1
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• pp.905-913
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• 1999

The hand is a part of the body which has various functions and a sophisticated structures bone, Joint, tendon, ligament and logical nerve organ are aggregated densely in the hand of anatomy its functions are delicate. The hand's functions are very important for doing ADL and a worker's As the hand is structure which is used often and commonly it is a site that can be easily damaged by a accident on work. This study was investigated and analyzed by the results from 238 workers who had hand injury and physical therapy from January, 1997 to June, 1998 at Shin-Pung, Jang-Lim industrial complex which is located in Pusan. 1. A hand injury most frequertly happened in worker in their 30's and 20's(66 case, 28%), second was 57 case(24%) their 40's. 2. Among workers suffering from injury, who had one or less than 2 years on the job, a injury most frequently occurred. 3. Scale of workers, A injury most frequently happend in a place where had workers from 10 to 50. 99 workers from that place were 42% of total. 4. Month of occurrence rate in March were the highest compared to other months 40 injury workers in march were 17% of the total. Second was July, and the least was April that injury appeared with 10 workers. (4.2% of the total) 1. Frocture was the most common lesion 82 workers had that lesion(34%) soft tissue rupture was 71 workers who were 30% of total in type of lesion. 2. Of the site of lesion multiple case was the most common in which 57 workers had that lesion it were 24% of the total. The next was the index finger site in which 44 workers were 19% of the total. The index finger was the most common mono-site that can be lesion 36 workers were the middle finger lesion workers who were 15% of the total. Of the joint lesion, PIP was the most in which 76 workers were 44% and in MC 27 workers were 15% of the total. 3. Interval of physical therapy 79 workers from one month to 2 months, was 33% of the total and 174 workers who had therapy below 3 months were 71% 4. Post injury of disablity of the site, phalangeous disability was the most in which 148 workers had that injury and they were 62% of the total of the grade of disability 110 workers who were 46% of the total state from less than 25% disability in hand-function and 59 patients who were 25% had no disability. There were 6 workers (3% of the total) who had over -75%-dibability in the hand-function.

• Industrial Engineering and Management Systems
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• v.7 no.2
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• pp.133-142
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• 2008

The Emergency Department (ED) is an integral part of hospitals. Admissions from the ED account for a significant proportion for a hospital's activity. Ensuring a timely and efficient flow of patients through the ED is crucial for optimising patient care. In recent years, ED overcrowding and its impact on patient flow has become a major issue facing the health sector. Simulation is rapidly becoming a tool of choice when examining hospital systems due to its capacity to involve numerous factors and interactions that impact the system. An analytical simulation model is used to investigate potential impacts by changing the following aspects of ED (physical layouts; number of beds; number and rate of patient arrivals; acuity of illness or injury of patients; access to radiology and pathology services; hospital staffing arrangements; and access to inpatient beds). Results of a significant numerical investigation at a hospital are also presented.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.10
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• pp.4910-4918
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• 2013

This study aims to design a Severity-Adjusted LOS(Length of Stay) Model in order to efficiently manage LOS of AMI(Acute Myocardial Infarction) patients. We designed a Severity-Adjusted LOS Model with using data-mining methods(multiple regression analysis, decision trees, and neural network) which covered 6,074 AMI patients who showed the diagnosis of I21 from 2004-2009 Korean National Hospital Discharge in-depth Injury Survey. A decision tree model was chosen for the final model that produced superior results. This study discovered that the execution of CABG, status at discharge(alive or dead), comorbidity index, etc. were major factors affecting a Sevirity-Adjustment of LOS of AMI patients. The difference between real LOS and adjusted LOS resulted from hospital location and bed size. The efficient management of LOS of AMI patients requires that we need to perform various activities after identifying differentiating factors. These factors can be specified by applying each hospital's data into this newly designed Severity-Adjusted LOS Model.