• 한국실내디자인학회논문집
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• 제23권6호
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• pp.195-203
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• 2014

This study selects factors affecting form type of hospital architecture by considering studies and references on hospital architecture type in korea and other countries in general. Also this study classifies general hospitals chronologically and analyzes type change of general hospitals in relation with periodic change of healthcare environment. Through this, this study aims to analyze chronological change of general hospitals' form type and provide the current of hospital architecture's general type. The form type classification of this study is classification according to the form of ward, classification according to the relationship between ward and D.T.D(Diagnostic and Treatment department), classification according to the relationship between O.P.D(Out Patient department) and D.T.D, classification according to the rate of centralization, classification according to the circulation system. The form type of ward changed from plate type to tower type, and the circulation system of ward changed from middle corridor to double corridor, the number of Team Nursing chaged from 1 to 2 in 1990. On the other hand the chage of others classifications took place from 1990' to 2010'. It is judged that this overall change is appeared by a change from an inpatien-oriented system to an outpatient-oriented system followed by an increase in number of outpatients, an increase in amenities in ground floor and adoption of healing environment for patients and visitors.

• Korea-Australia Rheology Journal
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• 제16권3호
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• pp.141-146
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• 2004

Shear-induced damage of Red Blood Cell (RBC) is an imminent problem to be solved for the practical application of artificial organs in extra corporeal circulation, as it often happens and affects physiological homeostasis of a patient. To design and operate artificial organs in a safe mode, many investigations have been set up to correlate shear and shear-induced cell damage. Most studies were focused on hemolysis i.e. the extreme case, however, it is important as well to obtain a clear understanding of pre-hemolytic mechanical damage. In this study, the change in deformability of RBC was measured by ektacytometry to investigate the damage of RBC caused by shear. To a small magnitude of pre-shear, there is little difference, but to a large magnitude of pre-shear, cell damage occurs and the effect of shear becomes significant depending on both the magnitude and imposed time of shearing. The threshold stress for cell damage was found to be approximately 30 Pa, which is much less than the threshold of mechanical hemolysis but is large enough to occur in vitro as in the extra corporeal circulation during open-heart surgery or artificial heart. In conclusion, it was found and suggested that the decrease of deformability can be used as an early indication of cell damage, in contrast to measuring plasma hemoglobin. As cell damage always occurs during flow in artificial organs, the results as well as the approach adopted here will be helpful in the design and operation of artificial organs.

• Archives of Plastic Surgery
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• 제32권4호
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• pp.479-484
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• 2005

Raynaud's syndrome causes discolorization, ischemic claudication(pain) and necrosis of the digits through insufficiency in the circulation which is induced by intermittent spasms of the digital arteries. From January, 2002 to December, 2004, 10 patients were surgically treated for Raynaud's syndrome. 9 patients were female and 1 patient was male. 2 patients showed unilateral involvement, 8 patients were operated on both hands. 6 patients had necrotic changes on the finger tips due to the disease. Ages ranged from 21 to 60 with an average of 39.1. Ischemic pain, discolorization, and cold intolerance of the digits were the common symptoms. All patients were evaluated with color doppler before the surgery. Two different procedures were applied according to the severity of the disease: Patients with decreased circulation received, what we call a limited digital sympathectomy, i.e. stripping of the adventitia of the ulnar, radial and common digital arteries. An extended procedure, radical digital sympathectomy, was performed on patients with a complete block of circulation. Stripping of the adventitia in these patients also involved the proper digital arteries. Symptoms like discolorization, ischemic pain, and cold intolerance improved immediately after the surgery. The patients did not suffer from pain even with exposure to cold weather. We conclude that digital sympathectomy could improve the symptoms in Raynaud's patients who do not respond to conservative treatment such as calcium channel blocker and other vasodilators.

• 한국응급구조학회지
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• 제9권1호
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• pp.79-87
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• 2005

Purpose: Investigates the results of CPR operation in visited patients with arrest state, and element to affect the results, and it is checks a problem, and it is made to promote. Methods: As for this study, analysis studied the results that operation CPR with the object arrest patients of 69 visited Jecheon Seoul hospital emergency center for during the period from January 2002 to February 2005. It was played writing partly changed In-hospital Utstein Style, and to stick a record in it. Paramedic which participated in CPR directly did the record of a variable, As for the data processing, use SPSS Version 12.0 for Windows. Results: It was male 68.1% female 31.9% for 69 people, and the sex ratio didn't affect return of spontaneous circulation, with female 8 people to male 16 people for ROSC(Return of spontaneous circulation) 24 people. with female 14 people to male 31 people for NROSC(Non-return of spontaneous circulation) 45 people(p>0.05). The initial EKG rhythm was asystole 34.8%, VF 31.9%, The case that initial EKG was VF compared it to a patient of asystole, and a survivor had a lot of VF and there were a lot of survivors(p<0.05). The wasn't relativity between VF and PEA(p>0.05), The CPR lead time was short in ROSC with NROSC $25.0{\pm}15.0$ minutes, ROSC $11.9{\pm}10.7$ minutes(p<0.01). Epinephrine administer time was NROSC $3.0{\pm}4.1$ minutes, ROSC $2.1{\pm}1.9$ minutes(p>0.05). It was survivor 18 people(21.1%) than 24 hours and the PAM Index affected in ROSC. with $9.0{\pm}1.2$ points NROSC, with $1.6{\pm}1.7$ points ROSC(p<0.01). A correlation was high between a CPR lead time and PAM Index(p<0.02), a correlation was examined by being high between ROSC and a CPR lead time, PAM Index(p<0.01).

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제22권4호
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• pp.37-45
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• 2016

Purpose: The purpose of this paper is to analyze a sample of single corridor, pod type and composite type of ICUs in terms of patient visibility, spatial configurations and nurse walking distance focused on Korean cases. Methods: The measures of static visibility were used to quantify the patient visibility (upper third part of the patient bed) from the nurse station. The measure of space programme and area distribution (patient zone percentage, staff zone percentage, circulation zone percentage, corridor length per bed, distance from nurse station (NS) to patient bed and departmental gross square meter (DGSM) per patient bed) were calculated by using AutoCAD and MS Excel programs. In the second step of analysis the values of space distribution were compared among the three type of ICUs as well as the nurse walking distance, DGSM per bed and gross factor. in the third step of analysis regression analysis was conducted for the possible correlation between visibility and space programme and area distribution factors as well as nurse walking distance factors. Results: (1) It was found that on average composite type unit offer highest value of patient visibility followed by pod type, while single corridor type unit offers the minimum value of patient visibility among the three plan typologies. (2) Average patient visibility and DGSM per bed shows a strong positive correlation ($r^2=0.75$) and p=0.026. (3) Average patient visibility and average distance from NS has a strong negative correlation ($r^2=0.78$), and P=0.02. (4) On average composite type unit offer the minimum walking distance from NS (7.22 meter) followed by pod type unit (8.35 meter) and single corridor (9.76 meter). (5) Maximum distance from NS was noted in single corridor (18.19 meter) followed by pod type unit (15.14 meter) and Composite type unit (11.1 meter). Implications: This study may contribute to the visibility analysis of existing and future ICU design in Korea to achieve maximum patient visibility and reduced nurse walking distance.

• 한국화재소방학회논문지
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• 제34권1호
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• pp.127-134
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• 2020

임신부에서 심정지가 발생하였을 때, 가장 중요한 것은 임신부를 소생시키는 것이다. 임신부에서의 심정지는 산모와 태아를 동시에 고려해야 한다는 점 때문에 일반적인 심정지와 다른 부분이 있다. 임신부 심정지 환자에서는 태아를 분만해야 하는지를 결정하는 것은 산모와 태아 모두를 위하여 매우 중요하다. 심폐소생술이 수행되더라도 임신부 심정지 환자가 모두 소생되는 것은 아니며, 얼마나 신속하고 정확하게 심폐소생술이 시행되었느냐에 따라 환자의 생존율이 결정된다. 임신부 심정지 환자는 30세 목격당시 보호자에 의한 빠른 인지와 신속한 신고 및 목격자 심폐소생술이 이루어져 졌으며 119구급대에 의한 전문소생술이 적용되었고, 환자와 태아 모두 적절한 치료 후 6일 만에 건강하게 퇴원한 사례이다. 병원 전 단계에서 임신부 환자가 자발순환회복(Return of spontaneous circulation, ROSC)되어 이송하는 경우와 전문심장구조술을 시행 하는 경우는 매우 드물다. 임신부 심정지가 발생하여 목격자에 의한 심폐소생술과 119구급대원에 의한 전문심장소생술로 현장에서 자발순환회복되어 생존퇴원한 1례를 경험하여 문헌고찰과 함께 보고하는 바이다.

• 대한한의진단학회지
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• 제14권1호
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• pp.79-95
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• 2010

Background and Purpose : By preventing diseases caused by exogenous evil, disorder of internal organs, and seven modes of emotions and adapting to mother nature when the mind is unsettled, and keeping the body and mind relaxed diseases can be avoided, but there can be unpredicted situations caused accidentally by stroke. Currently the general prescription is regulating the flow of vital energy including drugs eliminating blood stasis. Even though the stroke is resulted from diseases caused by exogenous evil, by observing the patient's physical appearance, essence of life, vital energy, and mental faculties which are believed to be the functions of the heart to clear the upper body and invigorate the functions of the spleen and stomach and purge with drugs of warm nature is a closer approach than simply prescribing vital energy regulating drugs with eliminating blood stasis to the main purpose of treatment. Methods : 1) The subject of the study are 2 cases of patients who have visited the private hospital of the person who is announcing the results of the study. These patients have been given a diagnosis of edema or cystoma caused by bursitis in the knee joint through perception or medical examination and were waiting for operational application. 2) Sources related to stroke from Dong Eui Bo Gwam(東醫寶鑑) were used as the general standard of Korean Traditional Medicine, and to promote the understanding the original text and the translation has been given. 3) By observing the whole body such as the patient's usual physical appearance, essence of life, vital energy, and mental faculties which are believed to be the functions of the heart, or partly using the "Yin is even and well while Yang is firm" theory of "Plain Questions" as the background to present the results of the clinical study. Results and Conclusion : Generally the prescriptions from the first volume of Dong Eui Bo Gwam(東醫寶鑑) are mostly drugs eliminating stagnated blood including extravasated blood and the blood moving sluggishly in circulation or congested in a viscus, alleviating pain, invigorating blood circulation. Also prescriptions for bone fracture or fracture of bones and sinews are mostly to eradicate blood stasis with drastic drugs or coaptation drugs added to drugs eliminating stagnated blood including extravasated blood and the blood moving sluggishly in circulation or congested in a viscus, alleviating pain, invigorating vital energy, possessing warm properties for the Xue system.

• Journal of Chest Surgery
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• 제16권3호
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• pp.281-288
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• 1983

Heparinization is an essential step in extracorporeal circulation for open heart surgery. But wide individual variation to heparin effect sometimes makes it difficult to anticoagulate safely or neutralize appropriately. Because the conventional set protocol of heparinization did not consider this individual variation, a new method of control of heparinization was proposed by Dr. Brian Bull in 1974. We compared the group in which a conventional set protocol was used [Control group] with the other in which a new protocol modified from that of Bull was used [ACT group], on the aspects of the dosages of heparin and protamine administered and postoperative bleeding. Our conventional protocol [Control group] consisted of: 1. Initial heparin was given at dose of 350U/Kg into the right atrium prior to bypass. 2. Additional heparin was given every hour during E.C.C., as much as a half of the Initial dose. 3. 600U of heparin was mixed into every 100ml. of priming solution. 4. The protamine dose was calculated by totalling the units of heparin given to the patient and giving 1 .8mg. of protamine per 100 units of heparin. ACT protocol [ACT group] consisted of: 1. Initial heparinization was same as that of conventional protocol. 2. ACT`s were checked before [A point] and 10 minutes after initial heparinization [B point]. With these 2 points, a dose response curve was drawn. 3. Heparin for the priming solution was same as in control group. 4. Every 30 minutes during E.C.C., ACT`s were checked with Hemochron [International Technidyne Corp.]. ACT between 450 and 600 seconds was regarded as safety zone. If ACT checked at a time was below 450 seconds, heparin dose was calculated on the dose-response curve to lengthen ACT to 480 seconds and was given into the oxygenator. 5. About 10 minutes before the term of E.C.C., ACT was checked to estimate the blood heparin level at the time. Then, protamine dose was calculated at dose of 1.Stag per 100 units of heparin. The calculated dose of protamine was mixed into 50 to lO0ml of 5% Dextrose Water and dripped intravenously during the period of 15 minutes. Compared these two groups mentioned above, results were obtained as follows: 1. Mean value of normal ACT checked with Hemochron on 30 preoperative patients was 124 seconds [range 95-145 sec.]. 2. Doses of heparin and protamine given to the patient were decreased in ACT group as much as 32.2% and 62.2% respectively. 3. Postoperative bleeding and transfusion were also decreased in ACT group in 60.5% and 67.1% respectively. 4. Our modified dose-response curve did not cause any problems in the control of heparinization. 5. Initial heparinization [Heparin 350U/Kg] was sufficient for the most patients until 60 minutes under extracorporeal circulation. 6. We used 1.5mg of protamine to neutralize 100 units of heparin. But smaller dose of protamine may be sufficient for appropriate neutralization.

• Korean Circulation Journal
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• 제52권1호
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• pp.1-33
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• 2022

In primary prevention for cardiovascular diseases, there are significant barriers to adherence including freedom from symptoms, long latency for therapeutic benefits, life-long duration of treatment, and need for combined lifestyle changes. However, to implement more systematic approaches, the focus on adherence improvement needs to be shifted away from patient factors to the effects of the treatment team and healthcare system. In addition to conventional educational approaches, more patient-oriented approaches such as patient-centered clinical communication skills, counseling using motivational strategies, decision-making by patient empowerment, and a multi-disciplinary team approach should be developed and implemented. Patients should be involved in a program of self-monitoring, self-management, and active counseling. Because most effective interventions on adherence improvement demand greater resources, the health care system and educational or training system of physicians and healthcare staff need to be supported for systematic improvement.

• Journal of Chest Surgery
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• 제43권6호
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• pp.804-807
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• 2010

둔상에 의한 기관지 손상은 소아에서 드물게 발생하나 치명적일 수 있으며 성공적인 치료를 위해서는 호흡 유지가 중요하다. 외상에 의해 기관지가 절단된 소아 환자에게 기도 유지에 어려움이 었었으나 응급실에서 체외막형 산화기를 이용한 환기 보조 하에 성공적으로 수술적 치료를 시행하였기에 이를 보고하고자 한다. 체외막형 산화기 보조 기간 동안 전신적 헤파린 투여는 필요하지 않았으며, 혈전성 합병증도 발생하지 않았다. 결론적으로 헤파린 사용 여부와 상관없이 선택적인 둔상 환자에게서 환기 보조를 위한 체외막형 산화기는 유용하다 할 수 있겠다.