• Journal of the Korea Convergence Society
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• v.10 no.1
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• pp.371-380
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• 2019

Electromygram was measured in three different cases; not wearing of a helmet, wearing of a 920g helmet, and wearing of a 1310g helmet, and it was revealed that there was a high level of muscle activities on the opposite side (sternocleidomastoid muscle) while the head and the neck were moving right and left and muscle activities of the curve and of the hyperextension were found to be not significant. Especially, the presence of a helmet seemed to cause a difference in a level of muscle activities on the deltoid and erector spine muscles while lifting or lowering with a weight placed on the deniz backboard. Therefore, it would be possible to assume that this newly developed smart helmet would not affect muscles around the necks of paramedics if they do not move their necks and heads right and left while lowering or lifting a patient using the deniz backboard. In addition, in case of the deltoid and erector spine muscles, it is shown that an increase in the degree of movement could lead to an increase in the level of muscle activities on the muscles controlling of the corresponding action, which are waist and back muscles. Despite it, it would be possible to prevent possible injuries and/or muscular and skeletal diseases around the lumbar by fully complying with a basic rule of straightening of the waist while making a power-lifting motion.

• Journal of Trauma and Injury
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• v.36 no.4
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• pp.441-446
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• 2023

Inferior vena cava (IVC) injuries, while accounting for fewer than 0.5% of blunt abdominal trauma cases, are among the most difficult to manage. Despite advancements in prehospital care, transportation, operative techniques, and perioperative management, the mortality rate for IVC injuries has remained at 20% to 66% for several decades. Furthermore, 30% to 50% of patients with IVC injuries succumb during the prehospital phase. A 65-year-old male patient, who had been struck in the back by a 500-kg excavator shovel at a construction site, was transported to a regional trauma center. Injuries to the right side of the infrarenal IVC and the right external iliac vein (EIV) were suspected, along with fractures to the right iliac bone and sacrum. The injury to the right side of the infrarenal IVC wall was repaired, and the right internal iliac artery was ligated. However, persistent bleeding around the right EIV was observed, and we were unable to achieve proximal and distal control of the right EIV. Attempts at prolonged manual compression were unsuccessful. To decrease venous return, we ligated the right superficial femoral vein. This reduced the amount of bleeding, enabling us to secure the surgical field. We ultimately controlled the bleeding, and approximately 5 L of blood products were infused intraoperatively. A second-look operation was performed 2 days later, by which time most of the bleeding sites had ceased. Orthopedic surgeons then took over the operation, performing closed reduction and external fixation. Five days later, the patient underwent definitive fixation and was transferred for rehabilitation on postoperative day 22.

• Journal of Korean Public Health Nursing
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• v.15 no.2
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• pp.314-323
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• 2001

The purpose of this study was to investigate the levels of hope and the influencing factors on the hope in the hemodialysis patients. The subjects of this study consisted 101 patients who had received hemodialysis In two hospitals affiliated with Catholic University from June to August, 2000. The instruments used for the study were the Hope scale by Miller(1998) and Quality of life scale, Self esteem scale and Social support scale. Cronbach's $\alpha$ of measurement tools used in the study were 0.93 for the hope, 0.96 for quality of life, 0.78 for self-esteem and 0.92 for the social support. The data were analyzed by mean, t-test, ANOVA. Scheffe test, Pearson correlation coefficients and Stepwise multiple regression using the SAS program. The results were as follows; 1. Out of a score of 164 the mean score of the hope was $107.3\pm16.7$. The mean quality of life score was 102.5 out of 160. The scores concerning social support turned out to have a mean of 67.8 out of 100. The levels concerning self-esteem and self respect had a mean of 25.1 out of 40. 2. There was a positive relation between the quality of life and social support. Furthermore, the hope level was proportional to factors such as quality of life and social support. 3. Social support accounted for $32\%$ of influential variable on the hope. If transportation way to the hospital and quality of life were added. the total predictors explained $45\%$. The results suggested that the hope levels of hemodialysis patients were influenced by their social support and quality of life. Therefore nurses are encouraged to elevate the levels of patients' hope by using the social support and quality of life in caring the patients receiving hemodyalysis.

• Journal of Trauma and Injury
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• v.28 no.3
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• pp.108-114
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• 2015

Purpose: To improve outcome of severe trauma patient, the shortening of transport time is needed. Although helicopter emergency medical services (HEMS) is still a subject of debate, it must also be considered for trauma system. The aim of this study is to assess whether transport method (HEMS versus ground EMS) is associated with outcome among inter-hospital transport. Methods: All trauma patients transported to regional emergency center by either HEMS or ground EMS from September 2011 to September 2014. We have classified patients according to two groups by transport method. Age younger than 15 years and self-discharged patients were excluded. Results: A total of 427 patients were available for analysis during this period. 60 patients were transported by HEMS and 367 patients were transported by ground EMS. HEMS group had higher mortality than ground EMS group (23.3% vs 3.5%; p<0.001), and included more patients with excess mortality ratio adjusted injury severity score (EMR-ISS) above 25 (91.7% vs 48.8%; p<0.001). In the multivariable regression analysis, HEMS was not associated with improved outcome compared with ground EMS, but only EMR-ISS was associated with a mortality of patients (odds ratio, 1.06; 95% confidence interval, 1.04-1.09). Conclusion: In this study, helicopter emergency medical services transport was not associated with a decreased of mortality among the trauma patients who inter-hospital transported to the regional emergency center.

• Journal of Trauma and Injury
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• v.29 no.3
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• pp.68-75
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• 2016

Purpose: The purpose of this study was to analyze the effectiveness of regional trauma center's management. Methods: Data collected between January 2013 and December 2015 from a regional trauma center registry was retrospectively reviewed. The patients who had injury severity score (ISS) greater than 15 and over the age of 18 were included. We compared annual general characteristics, the injury mechanism, the pathway of transportation, the injury severity score, the length of stay in emergency department (ED) and hospital, the in-hospital mortality. Results: The annual numbers of enrolled patients were 337, 334 and 278, respectively. No significant differences were found in the annual patient's median ages, injury mechanism, ISS and in-hospital mortality. The annual proportions of coming from other hospital and the median length of stay in hospital were increased after establishment of regional trauma center. The annual median lengths of stay in ED were decreased remarkably. Conclusion: Through the establishment of regional trauma center, the length of stay in ED can be reduced but not in-hospital mortality. More multidisciplinary cooperation and well-organized study is needed to reduce mortality of major trauma patients and maximize effect of regional trauma center.

• Korea Journal of Hospital Management
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• v.18 no.1
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• pp.59-69
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• 2013

Purpose Patients should have a regular medical check-up, the cost direct and indirect medical expenses to check the results, and revisit the hospital. Some of patients often want to use the telephone for a medical consultation, Method The subjects participating in this study were a selection 485 patients who received outpatient service in Asan Medical Center and Gangbuk Samsung Hospital. The patients's favorite method for medical check-up, time, cost, fatigue, and inconvenience, in regard with the revisit to check the examination results, were researched and analyzed on identical questionnaires about them. Results The average transportation, food expenses and opportunity costs the subjects spent was 90,400 for those from the Seoul and Gyunggi area, and 269,800 from other area. And the average required time per visit was 4.13 hours for those from the Seoul and Gyunggi area, 11.84 hours from other areas, and averagely 7.72 hours for all the subjects. More than 75% of the subjects answered that they felt tired and their work was interrupted. The subjects from both areas preferred the check by phone. Conclusion If the scope of telephone medical consultation is defined and the doctor-patient certification is possible, it can be thought as an efficient alternative of the medical check-up by revisit. It is necessary to discuss an appropriate amount of the medical check-up by phone which the same cost and effort can be allocated in.

• Journal of the Korea Society of Computer and Information
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• v.19 no.12
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• pp.101-109
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• 2014

Medical technology development and increase the income level of a "Long and healthy Life=Wellness," with the growing interest in actively promoting and maintaining health and wellness has become enlarged. In addition, the demand for personalized health care services is growing and extensive medical moves of big data, disease prevention, too. In this paper, the main interest in the market, highlighting wellness in order to support big data-driven healthcare quality through patient-centered medical services purposes. Patients with drug dependence treatment is not to diet but to improve disease prevention and treatment based on analysis of big data. Analysing your Tweets-daily information and wellness disease prevention and treatment, based on the purpose of the dictionary. Efficient big data analysis for node while increasing processing time experiment. Test result case of total access time efficient 26% of one node to three nodes and case of data storage is 63%, case of data aggregate is 18% efficient of one node to three nodes.

• Journal of the Korea Institute of Information and Communication Engineering
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• v.19 no.10
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• pp.2481-2490
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• 2015

The issue of PHR is maintained on the server will be in the hospital. PHR information stored on the server, such as a patient's illness and treatment is very sensitive information. Therefore, patients should be guaranteed the protection of privacy. In addition, the PHR should be allowed to group access of it's approach. Therefore, in this paper the proposed group signature using hierarchical identity-based encryption schemes into can guarantee the PHR data privacy. The session key generated by group signature, it is use a tiered approach. The generated session keys safe PHR data transmission is possible. The proposed method is average 80% than the PKI encryption and ID-based encryption rather than average 50% the algorithm processing is more efficient

• Clinical and Experimental Pediatrics
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• v.63 no.5
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• pp.184-188
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• 2020

Background: Many critically ill patients require transfer to a higher-level hospital for complex medical care. Despite the publication of the American Academy of Pediatrics guidelines for pediatric interhospital transportation services and the establishment of many pediatric transport programs, adverse events during pediatric transport still occur. Purpose: To determine the incidence of adverse events occurring during pediatric transport and explore their complications and risk factors. Methods: This prospective observational study explored the adverse events that occurred during the interhospital transport of all pediatric patients referred to the pediatric intensive care unit of Ramathibodi Hospital between March 2016 and June 2017. Results: There were 122 pediatric transports to the unit. Adverse events occurred in 25 cases (22%). Physiologic deterioration occurred in 15 patients (60%). Most issues (11 events) involved circulatory problems causing patient hypotension and poor tissue perfusion requiring fluid resuscitation or inotropic administration on arrival at the unit. Respiratory complications were the second most common cause (4 events). Equipment-related adverse events occurred in 5 patients (20%). The common causes were accidental extubation and endotracheal tube displacement. Five patients had both physiologic deterioration and equipment-related adverse events. Regarding transport personnel, the group without complications more often had a physician escort than the group with complications (92% vs. 76%; relative risk, 2.4; P=0.028). Conclusion: The incidence of adverse events occurring during the transport of critically ill pediatric patients was 22%. Most events involved physiological deterioration. Escort personnel maybe the key to preventing and appropriately monitoring complications occurring during transport.

• Journal of Trauma and Injury
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• v.23 no.2
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• pp.180-187
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• 2010

Purpose: The "golden hour" concept in trauma is pervasive despite little evidence to support it. This study addressed the association between prehospital time and in-hospital mortality in seriously injured abdominal trauma victims. Methods: A retrospective study was conducted over a three-year period from 2006 to 2008. We analyzed trauma victims with abdominal injuries who underwent an emergency laparotomy in a local emergency center located in a city with a population of 2,500,000. According to the 'golden hour' oncept, we separated the trauma victims into two groups (Gourp 1: prehospital time ${\leq}$ 1 hour, Group 2: prehospital time > 1hour) and investigated several factors, such as time, process, and outcome. Results: During the period from January 2006 to December 2008 139 trauma victims underwent an emergency laparotomy, and 89 of them were enrolled in this study. Between the two groups, emergency department (ED) access, transportation, and injury mechanism showed statistically meaningful differences, but no statistically meaningful differences were observed in various measures of the outcome, such as length of hospital stay, length of Intensive Care Unit stay, and mortality. In a univariate logistic regression study, age (odds ratio [OR]: 1.101; 95% confidence interval [CI]: 1.026 to 1.182), Revised Trauma Score (RTS) (OR: 0.444; 95% CI 0.278 to 0.710), hemoglobin (OR: 0.749; 95% CI: 0.585 to 0.960), and creatinine (OR: 24.584; 95% CI: 2.019 to 299.364) were significant prognostic factors, but prehospital time was not. In a multivariate logistic regression study, age and RTS were significant associated with mortality. Conclusion: In this study, we found no association between prehospital time and mortality among abdominal trauma patient who underwent an emergency laparotomy. We suggest that in our current out-of-hospital and emergency care system, until arrival at the hospital time may be less crucial for trauma victims than once thought.