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Optimization Method for Patient Placement by Floor in Elderly Care Hospital for Evacuation Safety (피난안전성을 위한 요양병원의 층별 환자배치에 대한 최적화방안)

  • Lee, Hong-Sang;Kong, Ha-Sung
    • Journal of the Korea Safety Management & Science
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    • v.22 no.3
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    • pp.43-51
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    • 2020
  • This study analyzed the appropriate placement method by floor for evacuating all occupants during the nighttime through evacuation simulation. The analysis results are as follows. First, when non-self evacuating patients were placed on the first floor, 266 patients and 6 workers were found to be evacuated after 460 seconds. This result shows that it is meaningful to place non-self evacuating patients on the lower floor with a time that is faster than 540 seconds, which is an evaluation criterion set using life Safety standards for human. This result is a time faster than the evaluation criteria of 540 seconds, which is set using the life safety standards, and it can be confirmed that it is meaningful to place non-self evacuating patients on the lower floor. Next, as a result of placing non-self evacuating patients from the first floor to the fourth floor, it was found that evacuation of all occupants required 460 seconds for the first floor, 834 seconds for the second floor, 1,508 seconds for the third floor, and 1,915 seconds for the fourth floor. These results indicate that the placement of non-self evacuating patients on the rest of the floors, except for the first floor, can lead to dangerous results in excess of 540 seconds, which is a flashover time. As a result, it is necessary to place non-self evacuating patients on a lower floor for safe evacuation. The study has limitations except for comparative analysis of changes in evacuation time due to changes in the number of workers at eldery care hospitals and situations in which fire-fighting facilities such as sprinkler facilities operated. It is necessary to study the evacuation time linked to the operation of the fire-fighting facilities and the evacuation time according to the change in the number of workers in the future.

Level of Nutrition Knowledge, Diet Practice and Education Demands in Dialysis Patients with Chronic Renal Failure (투석치료 중인 만성신부전 환자의 영양지식 수준과 식사요법 실천 정도 및 교육요구도)

  • Kim, Soomin;Lim, Hyunsook
    • Journal of the Korean Dietetic Association
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    • v.24 no.2
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    • pp.117-140
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    • 2018
  • The number of patients is increasing and their mean age is also increasing. Proper dietary adjustments are necessary to prevent protein-calorie malnutrition or complications but it is difficult for dialysis patients to adapt to diet therapy due to stress or anorexia. Education does not consider the individual characteristics, knowledge, dietary inhabit education demands, and initial education. The purpose of this study was to identify dialysis patient's nutrition knowledge and, dietary practice and compare those with nutrition education or counseling demands for providing basic data of desirable nutrition management. The data were collected by a survey consisting of the general characteristics, disease related characteristics, nutrition education and counsel characteristics, level of nutrition knowledge, diet therapy, and nutrition education and counsel demands from the 28th March to 22th July 2017. The total number of subjects were 33 patients among dialysis patients at two tertiary medical institutions and an artificial kidney room at a private hospital in Incheon Gyeonggi. The data collected were analyzed statistically using the SPSS program 23.0, followed by further analyses using frequency analysis, one-way ANOVA, cross analysis, and correlation analysis. The results of the dialysis patients showed that younger (P<0.05), female (P<0.05), abnormal high school diploma (P<0.001) groups had high nutrition scores. In addition, dietary practice and nutrition education and counsel demands showed a positive correlation (P<0.05, P<0.01). In particular, females were higher than males in nutrition knowledge, dietary practice, nutrition education, and counseling demand scores.

A Clinical study of Atopic Dermatitis treated by external application with Gynostemma Pentaphyllum MAKINO in cosmetics (아토피 피부염 환자에서 칠엽담(七葉膽)을 함유한 화장품의 임상적 연구)

  • Hwang, Sun-Yi;Hwang, Bo-Min;Jee, Seon-Young;Kim, So-Youn;Kwon, Young-Gyu;Seo, Jung-chul
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.20 no.3
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    • pp.212-221
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    • 2007
  • Objectives : This study was conducted to test patients with Atopic Dermatitis by external application with Gynostemma Pentaphyllum MAKINO in cosmetics. Methods : We gave scores to 59 patients who visited the Dept. of Oriental Medical Opthalmology & Otolaryngology & Dermatology of Daegu Hanny Oriental Medical Center from July 1st, 2005 to December 31th. We checked the clinic index score(extent. intensity : the degree of erythema, induration or papulation, puritus, excorination, lichenification, scaling or dryness, erosion or oozing or weeping. the degree of itching), Eosinophil count and IgE. Results : There are 46 patients we could check by clinic index score, and 44 patients by laboratory. 1. In the 46 cases clinic index score was significantly decreased between the before- and afterexternal application treatment periods(P<0.01). 2. The 46 cases was devided into two types (moist heat type and blood dryness type) by intensity. External application of Gynostemma Pentaphyllum MAKINO in cosmetics did not significant change by two types. 3. In the 44 laboratory cases, the number of eosinophil counts was decreased but the number of IgE was significantly increased. Conclusions : Considering the above results, we have concluded that cosmetics with Gynostemma Pentaphyllum MAKINO have the remedical effect for Atopic Dermatitis.

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A Study of Family Adaptation with Chronically III Patients (I) - Stroke Patients at an Oriental Medical Hospital - (만성질환자 가족의 질병 적응과정 연구(I) - 한방병원에 입원한 뇌졸중 환자를 중심으로 -)

  • Lee, Young-Ae
    • Journal of East-West Nursing Research
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    • v.3 no.1
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    • pp.96-103
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    • 1998
  • This study was conducted to identify the adaptation process of the families with chronically ill patients. A descriptive comparative research design was used to the subjects of forty families that have stroke patients at an oriental medical hospital. Research tools were Demands of Illness Inventory(Woods, Haberman & Packard, 1987), Relative and Friend Support Index(McCubbin, Patterson & Glynn, 1982), Family Coping-Coherence Index (McCubbin, Larsen & Olson, 1982), Family Hardiness Index(McCubbin, McCubbin & Thompson, 1986), and Family Member Wellbeing Scale(McCubbin, McCubbin & Thompson, 1986). Data were collected from October 7, 1998 to November 7, 1998 at an oriental medical hospital located in IkSan city. The number of cases was forty and the data were analyzed by SPSS $PC^+$. Descriptive statistics of frequency, number, mean and standard deviation were used to report the results. The results were as follows ; 1. There was no significant differences between the two groups on the family stress. 2. There was significant differences between the two groups on the family strength (t value = - 3.09, p value=$.004^{**}$). 3. There was significant differences between the two groups on the family adaptation(t value= -2.08, pvalue=$.05^*$).

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The Study on the Elderly Homodialysis Patients' Transition of Health Condition and Health-related Quality of Life (혈액투석노인의 건강상태 변화인식과 건강관련 삶의 질에 관한 연구)

  • Shim, Ok Su
    • 한국노년학
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    • v.30 no.1
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    • pp.179-194
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    • 2010
  • The purpose of this study examines the elderly hemodialysis patients' Health-related quality in life(HRQL) and investigates the relationship between HRQL and transition of health condition. The subject were 443 elderly hemodialysis patients(over 65 years old) in Seoul and Gyeonggi province. The Health-related quality of life scale was used in this research, in which were analysed a wide range of statistical descriptive analysis, Pearson's correlation, reliability analysis, multiple regression and the Scheffe test. The results were as follows. The HRQL were statiscally significant difference by Gender, Educational level, Live with spouse, Best supporter, and Number of Disease. Also the factor related to transition of health condition was Number of Disease. The transition of health condition accounted for 13.9% of variance in HRQL and Number of Disease accounted for an additional 7.4% of HRQL. The factors, which influenced finally on the HRQL in the elderly hemodialysis patients, were transition of health condition and number of disease. In conclusion adequate hemodialysis treatment and social services should be provided in accordance with the factors affecting HRQL in order to improve the HRQL for elderly hemodialysis patients.

Valve Replacement in a Patient with Chronic Renal Failure -a Case Report- (만성 신부전 환자에서의 판막치환술 1례 보고)

  • 구본일
    • Journal of Chest Surgery
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    • v.21 no.2
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    • pp.347-350
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    • 1988
  • Recent advances in the managements of chronic renal failure have increased the number of the candidates for cardiac operation in patients with chronic renal disease. There have been reports that the operative mortality of the open cardiac surgery in patients with end stage renal diseases was equal to that of the patients with normal renal function. Aortic valve replacement and mitral annuloplasty was successfully performed in a patient with chronic renal failure, and the pre-and postoperative managements are presented.

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A study on the incremental oral health care of C pediatric clinic using a Dentocult-SM test (C소아치과의원의 개량형 Dentocult-SM검사를 이용한 계속관리에 관한 조사 연구)

  • Woo, Hee-Sun
    • Journal of Korean society of Dental Hygiene
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    • v.8 no.2
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    • pp.39-51
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    • 2008
  • The research was conducted to 100 child patients selected by random sampling, which got a Dentocult-SM test in the first visit and then was being continuously managed, out of child patients of a pediatric clinic located in Gyeonggi-do. The period of there search is one year from June 2007 to May 2008, Using Dentocult-SM test, we analyzed the correlation between the distribution of dental plaque, a streptococcus mutans in saliva and condition of dental caries cavity in the teeth of child patients, then we measured the distribution of a streptococcusmutans. According to SM score, we applied incremental oral heath care for child patients to clinical and obtained the following results, 1. In terms of the age of child patients in research, the number of 3 years old patients was 29(lst ranked), the number of 2 years old patients was 28(2nd ranked). 2. The result of SM score showed that female child patients(52.0%) was higher than male ones in negative, male child patients(52.0%) was higher than female ones in mild, female child patients(68.2%) was higher than male ones in moderate, male child patients(57.1%) was higher than female ones in severe. 3. At the first visit, the SM score showed statistically remarkable difference between dt and dmft. We can also confirm the average of severe is the highest. 4. At the second visit, the SM score showed statistically remarkable difference among dt, ft, and dmft index We can also confirm the average of severe is the highest. 5. At the third visit, The SM score showed statistically remarkable difference among dt, ft, and dmft index We can also confirm the average of severe is the highest. 6. The comparison of dmft index differences to SM score showed statistically no remarkable difference in incremental oral heath care for negative and mild, In addition to that, we can confirm that the incremental oral heath care makes statistically remarkable differences in moderate and severe. 7. The comparison of dt index differences to SM score showed statistically no remarkable difference in incremental oral heath care for negative, mild, and moderate, In addition to that, we can con firm that the incremental oral heath care makes statistically remarkable differences in severe. 8. The comparison of mt index differences to SM score showed statistically no remarkable difference in incremental oral heath care for mild and moderate, In addition to that, we can confirm that the incremental oral heath care makes statistically remarkable differences m severe. 9. The comparison of ft index differences to SM score showed statistically no remarkable difference in incremental oral heath care for mild, In addition to that, we can confirm that the incremental oral heath care makes statistically remarkable differences in negative, moderate, and severe. 10. According to the comparison of dmft index to the age, the 4 years old patients showed the highest number(5.50 in the first visit and 6,08 in the second one). In the third visit, the 6 years old patients showed the highest number(7.00). By the above results, we can find that the incremental oral heath care by SM score makes the results of oral care better. Therefore, the improvement or maintenance in oral health of child patients needs continuing personal oral health management and regular systematic management focused on prevention by the specialist.

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Programmed Follow-up and Quality Control of Treatment Techniques Enhance Chronic Thromboembolic Pulmonary Hypertension Management: Lessons From a Multidisciplinary Team

  • Taek Kyu Park;Sung-A Chang;Jeong Hoon Yang;Woochan Kwon;Min Yeong Kim;Young Seok Cho;Hye Yun Park;Dong Seop Jeong;Hojoong Kim;Duk kyung Kim
    • Korean Circulation Journal
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    • v.54 no.7
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    • pp.409-421
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    • 2024
  • Background and Objectives: The recent developments in chronic thromboembolic pulmonary hypertension (CTEPH) are emphasizing the multidisciplinary team. We report on the changes in clinical practice following the development of a multidisciplinary team, based on our 7 years of experience. Methods: Multidisciplinary team was established in 2015 offering both balloon pulmonary angioplasty (BPA) and pulmonary endarterectomy (PEA) with technical upgrades by internal and external expertise. For operable cases, PEA was recommended as the primary treatment modality, followed by pulmonary angiography and right heart catheterization after 6 months to evaluate treatment effect and identify patients requiring further BPA. For patients with inoperable anatomy or high surgical risk, BPA was recommended as the initial treatment modality. Patient data and clinical outcomes were closely monitored. Results: The number of CTEPH treatments rapidly increased and postoperative survival improved after team development. Before the team, 38 patients were treated by PEA for 18 years; however, 125 patients were treated by PEA or BPA after the team for 7 years. The number of PEA performed was 64 and that of BPA 342 sessions. World Health Organization functional class I or II was achieved in 93% of patients. The patients treated with PEA was younger, male dominant, higher pulmonary artery pressure, and smaller cardiac index, than BPA-only patients. In-hospital death after PEA was only 1 case and none after BPA. Conclusions: The balanced development of BPA and PEA through a multidisciplinary team approach proved synergistic in increasing the number of actively treated CTEPH patients and improving clinical outcomes.

The Correlation between Caudal Epidurogram and Low Back Pain

  • Jo, Dae-Hyun;Jang, Sul
    • The Korean Journal of Pain
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    • v.25 no.1
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    • pp.22-27
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    • 2012
  • Background: The common causes of lower back pain with or without leg pain includes disk disease and spinal stenosis. A definitive diagnosis is usually made by means of magnetic resonance imaging (MRI), but treatment is often difficult because the MRI findings are not consistent with the symptoms of the patient in many cases. The objective of this study was to observe the correlation between the patterns of epidurography performed in patients having lower back pain with or without leg pain and the position or severity of the pain as subjectively described by the patients. Methods: The subjects of this study were 69 outpatients with lower back pain with or without leg pain who visited our clinic and complained of predominant pain on one side. We performed caudal epidural block using an image intensifier. A mixture of the therapeutic drug and the contrast agent (10 ml) was injected to observe the contrast flow pattern. The patients who complained of predominant pain on one side were divided into the left side group and the right side group. A judgment of inconsistency was made if the contrast agent flowed to the side of the pain, while a judgment of consistency was made if the contrast agent flowed to the opposite side of the pain. The degree of the drug distribution was evaluated by counting the number of cells to which the contrast agent's flowed for evaluating the correlation between the contrasted cell and the severity of pain (one group ${\leq}$ VAS 7, the other group ${\geq}$ VAS 8) the degree of the contrast agent's contrast was evaluated by dividing and counting an image into 15 cells (the left, right, and middle sections at each level of L4, L5, S1, S2, and S3). Results: Thirty out of the 69 patients who had laterality in pain, that is, those who complained of predominant pain on one side, showed that the laterality of the pain and the contrast agent flow was consistent, while 39 patients showed that the laterality was inconsistent (P: 0.137). The evaluation of the correlation between the pain and the contrast agent flow showed that the mean number of contrasted cells was $9.0{\pm}2.2$ for the 46 patients in the group with a VAS of 7 or lower and $6.5{\pm}2.0$ for the 23 patients in the group with a VAS of 8 or higher, indicating that the former group showed a significantly greater number of contrasted cells (P < 0.001). Conclusions: This study, conducted with patients having lower back pain with or without leg pain, showed that the contrast flow pattern of caudal epidurography had a significant correlation with the severity of the pain but not with the laterality of the pain.

The Relationship Between Esophageal Manometry and 24 Hour Double Prove pH-metry with Gastroesophageal Reflax in Pharyrngeal Neurosis Patients. (인두신경증 환자에서 Esophageal manometry와 24hour double prove pH metry 검사 및 위식도 역류와의 관계)

  • 김선태
    • Korean Journal of Bronchoesophagology
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    • v.2 no.1
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    • pp.88-96
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    • 1996
  • In recently the gastroesophageal reflux disease(GERD) has been known to induce the otolaryngologic manifestations. Pharyngeal neurosis is a disease which we could have not found the cause frequently. So we have studied the relation between the pharyngeal neurosis and the GERD among 50 patients who were diagnosed as pharyngeal neurosis after esophagogram and laryngoscopic examination. We performed esophageal manometry and 24hour double-probe pH-metry and then compared with normal control group(n=30). The results are as follows 1 Among 50 patients, 12(24%) patients were diagnosed as GERD by DeMeester scoring. 2. In esophageal manometry, the upper and lower esophageal sphincter between the patients and the control group have no significant difference(p>0.05) and 9 among 50 pateints showed abnormal peristaltic movement in esophageal body contraction. 3. In 24hour double-probe pH-metry, the esophageal probe showed that in GERD group(n= 12) the number of reflux episode, episodes greater than 5 minutes and the percentage of time

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