• Journal of Trauma and Injury
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• 제34권1호
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• pp.3-12
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• 2021

Purpose: To evaluate the severity of trauma, many scoring systems and predictive models have been presented. The quick Sequential Organ Failure Assessment (qSOFA) is a simple scoring system based on vital signs, and we expect it to be easier to apply to trauma patients than other trauma assessment tools. Methods: This study was a cross-sectional study of trauma patients who visited the emergency department of Jeju National University Hospital. We excluded patients under the age of 18 years and unknown outcomes. We calculated the qSOFA, the Modified Early Warning Score (mEWS), Revised Trauma Score (RTS), and Injury Severity Score (ISS) based on patients' initial vital signs and assessments performed in the emergency department (ED). The primary outcome was mortality within 14 days of trauma. We analyzed qSOFA scores using multivariate logistic regression analysis and compared the predictive accuracy of these scoring systems using the area under the receiver operating characteristic curve (AUROC). Results: In total, 27,764 patients were analyzed. In the multivariate logistic regression analysis of the qSOFA, the adjusted odds ratios with 95% confidence interval (CI) for mortality relative to a qSOFA score of 0 were 27.82 (13.63-56.79) for a qSOFA score of 1, 373.31 (183.47-759.57) for a qSOFA score of 2, and 494.07 (143.75-1698.15) for a qSOFA score of 3. In the receiver operating characteristic (ROC) curve analysis for the qSOFA, mEWS, ISS, and RTS in predicting the outcomes, for mortality, the AUROC for the qSOFA (AUROC [95% CI]; 0.912 [0.871-0.952]) was significantly greater than those for the ISS (0.700 [0.608-0.793]) and RTS (0.160 [0.108-0.211]). Conclusions: The qSOFA was useful for predicting the prognosis of trauma patients evaluated in the ED.

• Asian Pacific Journal of Cancer Prevention
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• 제16권17호
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• pp.8009-8013
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• 2015

Background: Orthotopic organ transplantation, a treatment option for irreversible organ dysfunction according to organ failure, severe damaged organ or malignancy in situ, was usually accompanied with massive blood loss thus transfusion was required. We aimed to evaluate the adverse impact of blood transfusion on solid organ transplantation. Materials and Methods: From January, 2009 to December, 2014, patients who received orthotopic organ transplantation at Far Eastern Memorial Hospital medical center were enrolled. Clinical data regarding anemia status and red blood cell (RBC) transfusion before, during and after operation, as well as patient outcomes were collected for further univariate analysis. Results: A total of 105 patients who underwent orthotopic transplantation, including liver, kidney and small intestine were registered. The mean hemoglobin (Hb) level upon admission and before operation were $11.6{\pm}1.8g/dL$ and $11.7{\pm}1.7g/dL$, respectively; and the nadir Hb level post operation and the final Hb level before discharge were $8.3{\pm}1.6g/dL$ and $10.2{\pm}1.6g/dL$, respectively. The median units (interquartile range) of RBC transfusion in pre-operative, peri-operative and post-operative periods were 0 (0-0), 2 (0-12), and 2 (0-6) units, respectively. Furthermore, the median (interquartile range) length of hospital stay (LHS) from admission to discharge and from operation to discharge were 28 (17-44) and 24 (16-37) days, respectively. Both peri-operative and post-operative RBC transfusion were associated with longer LHS from admission to discharge and from operation to discharge. Furthermore, it increased the risk of post-operative septicemia. While peri-operative RBC transfusion elevated the risk of acute graft rejection in patients who received orthotopic transplantation. Conclusions: Worse outcome could be anticipated in those who had received massive RBC transfusion in transplantation operation. Hence, peri-operative RBC transfusion should be avoided as much as possible.

• 대한불안의학회지
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• 제19권2호
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• pp.37-47
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• 2023

This review article explores the psychological characteristics, comorbid mental disorders, and psychosocial assessments throughout the solid organ transplant journey, spanning the pre-transplant, peri-transplant, and post-transplant phases for transplant recipients. The psychological burden and anxiety in the pre-transplant phase are high for organ failure patients with complex physical difficulties who are deciding to undergo transplantation and are on the waiting list. The pre-transplant psychosocial evaluation covers various aspects, including the patient's readiness, awareness of, and commitment to transplant treatment, medical compliance, psychopathological conditions such as cognitive function and personality disorders, lifestyle factors, including substance abuse, as well as various psychosocial factors like social support. During the peri-transplant phase, mental health problems such as postoperative delirium should be carefully recognized and addressed. After transplantation, it is essential to assist patients in coping with the various stressful experiences they encounter, manage psychiatric symptoms such as depression, anxiety, and insomnia, and improve treatment adherence and quality of life during long-term care for the transplanted organ. Managing psychiatric problems in post-transplant patients requires a deep understanding of immunosuppressant medications and a keen awareness of associated risks, including adverse effects and potential drug interactions. This comprehensive review emphasizes the significance of proactive mental health care and psychosocial evaluation, highlighting the necessity of a multidisciplinary approach to enhance the quality of life and overall success of transplant patients throughout all phases of transplantation.

• Journal of Chest Surgery
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• 제40권7호
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• pp.512-516
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• 2007

기계적인 순환보조장치는 급성호흡부전이나 심부전에서 생명을 구할 수 있는 방편의 하나이다. 현재 여러 가지 형태의 순환 보조장치가 있으며 Twin-Pulse Life Support (T-PLS) system은 박동형 펌퍼의 한 종류다. 3예의 심한 심폐기능부전 상태 환자에게 순환보조장치로 T-PLS system을 사용하였다. 적응증은 인공호흡기와 강심제를 최대한 사용함에도 불구하고 지속되는 호흡부전이나 심부전이었다. 감염에 의한 호흡부전환자가 2예, 심근염에 의한 심부전 환자가 1예였다. 각각 한 명의 호흡부전환자와 신부전 환자가 생존하였는데 보조장치의 사용시간은 각각 3일과 5일이었다. T-PLS system은 순환보조장치로 유용하게 사용할 수 있으며 다발성 장기부전이 오기 전에 적용하여야 할 것으로 생각된다.

• Journal of Chest Surgery
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• 제24권9호
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• pp.913-917
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• 1991

Ventricular septal defect complicating myocardial infarction is rare but fatal condition which requires early surgical intervention before end-organ failure ensues from cardiogenic shock. Since the first successful repair by Cooley et al in 1956, surgical skills and strategies were developed and modified to a great extent, and we adopted the new repair technique in our case which stresses that minimal or no part of the infarcted septum and left ventricular wall be resected. This technique obviates the need to resect the infarcted part of the septum and prevents recurrence of an even larger VSD, and provides adequate size and shape of the left ventricle after of transinfarction left ventriculotomy.

• Journal of Korean Neurosurgical Society
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• 제56권6호
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• pp.534-536
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• 2014

Due to improvements in emergency resuscitation provided by rescue teams, more trauma victims who could have died due to sudden heart failure at the scene are brought to the hospital following resuscitation. Most of these patients present with major organ injuries and hypovolemic shock at the time of trauma. However, head trauma associated with sudden heart arrest is rare. Here, we report a case of ring fracture with pontomedullary laceration that led to sudden heart arrest.

• 대한약학회:학술대회논문집
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• 대한약학회 2002년도 Proceedings of the Convention of the Pharmaceutical Society of Korea Vol.2
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• pp.431.2-432
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• 2002

Mucopolysaccharidosis (MPS) is a genetic disorder with deficiency of Iysomal enzymes needed for the degradation of glycosaminoglycans(GAGs). This storage disease is characterized by intra-lysosomal accumulation of GAGs. progressive mental and physical deterioration. multi-organ failure and premature death. Quality of life (QOL) is very low in MPS patients. The MOS 36-ltem Short Form Health Survey (SF-36) was designed to measure the eight (8) dimensions of health in clinical and general population settings. (omitted)

• Journal of Yeungnam Medical Science
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• 제36권3호
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• pp.254-259
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• 2019

Pheochromocytoma (PCC) is a rare catecholamine-producing tumor with the incidence in hypertension of 0.1-0.6%. PCC crisis is an endocrine emergency that can lead to hemodynamic disturbance and organ failure such as catecholamine-induced cardiomyopathy. The circulatory collapse caused by it often requires mechanical support. The author reports an unusual case in which a patient who previously underwent surgery for malignant PCC developed catecholamine-induced cardiomyopathy, and successfully recovered using extracorporeal membrane oxygenation.

• Journal of Trauma and Injury
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• 제24권2호
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• pp.155-158
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• 2011

Mechanical ventilation is usually the treatment of choice for severe respiratory failure associated with trauma. However, in case of severe hypoxia, mechanical ventilation may not be sufficient for gas exchange in lungs. Patients with Acute Respiratory Distress Syndrome (ARDS) undergo difficulties in oxygen and carbon dioxide exchange. Extracorporeal Membrane Oxygenation (ECMO) is the ideal therapeutic option for those patients with severe traumatic injuries. ECMO allows lungs to reserve their functions and decreases further lung injuries while increasing survival rate at the same time. We report two cases of patients with traumatic ARDS and Multiple Organ Failure including compromised heart function. The preservation of lung function was successful using ECMO therapy.

• Journal of Chest Surgery
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• 제18권2호
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• pp.193-204
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• 1985

During the period from February to March, 1984, we employed a partial left heart bypass [left atrium to ascending aorta] in 2 patients who could not weaned from cardiopulmonary bypass with inotropic agents and cardiac pacing after coronary bypass surgery. These two patients showed significant improvement in ventricular function 18 to 47 hours after inserting the left heart bypass and were able to wean from the left heart bypass under using inotropic agents. Two patients died of multiple organ failures 11 days and 15 days postoperatively. These results indicate that early institution of left heart bypass in ventricular failure patients after open heart surgery can provide satisfactory long-term result.