• Journal of rehabilitation welfare engineering & assistive technology
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• v.7 no.2
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• pp.55-62
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• 2013

The exoskeleton robot to assist walking of hemiplegia patients or disabled persons has been studied in this paper. The exoskeleton robot with degrees of freedom of 2 axis has been developed and tested for joint motion. The obtained EMG signal from normal person was analyzed and the control signal was extracted from it for convenient and automotive performance of assistance robot to help hemiplegia patient walks as normal person does. the purpose of using FES(Functional Electrical Stimulation) for hemiplegia patient's walk is to restore damaged body function by this, but this could give fatal electrical shock to patients by wrong use or cause quick fatigue in muscle by continuous stimulation. The convenient movement of hemiplegia patients with minimum muscle fatigue was looked possibly by operation of assistance robot exoskeleton using control signal. and the walking assistance exoskeleton robot seemed works more efficiently than using FES stimulator. The experiment in this study was performed based on usual motion in our life like walking, standing-up, sitting-down, and particularly feedback control system using Piezo sensor along with button switch was applied for smooth swing motion in walking. The experiment also shows that hemiplegia patients can move conveniently by using electromyogram signal of healthy leg for the operation signal of assistance robot system attached at damaged symmetrical leg.

• Journal of Chest Surgery
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• v.31 no.11
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• pp.1076-1080
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• 1998

Background: Spontaneous hemopneumothorax, occurring in 1% to 12% of patients with spontaneous pneumothorax, is a rare disorder that can potentially lead to life-threatening complications. Materials and methods: We have experienced 15 cases (2.28%) with spontaneous hemopneumothorax among 659 episodes of spontaneous pneumothorax for eight years, from 1990 to 1997, at our hospital. We studied our previously treated patients by retrospective case studies to determine the nature of optimal management. Results: There were 14 male and 1 female patients whose mean age was 27.5 years, ranging from 19 to 58. The sides with disorder were as following: right in 10 cases and left in 5, unilaterally. The amount of initial bleeding ranged from 400 to 1,500 mL and 8 patients received a homologous blood transfusion. Patients exhibited symptoms of chest pain, dyspnea, chest discomfort, and hypovolemic shock. We concluded that causes of this disease in our patients were a torn pleural adhesion (14 cases) and a rupture of vascularized bullae (1 case with an underlying intrinsic lung disease, tuberculosis). All patients underwent closed thoracostomy and had good results except for 3. One patient underwent thoracotomy within 3 days from the onset because of continuous active hemorrhage. Decortication was required in one case because of a reactive fluid collection in the pleural space, which led to impaired lung expansion. Another patient underwent thoracotomy due to a ipsilateral recurrent pneumothorax without blood collection. Conclusions: The goals of treatment include hemostasis and reexpansion of the collapsed lung. Thus, if patients arrive early at hospital, closed thoracostomy and transfusion are thought to be sufficient treatments, although early surgical repair has been considered recently.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.6
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• pp.119-128
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• 2017

This study estimated the optimal nursing workforce and financial costs of providing comprehensive nursing services at hospitals under the national health insurance system. Data on registered nurses, nursing aids, medical institutions, and number of patients were obtained from the Health Insurance Review and Assessment Service. The optimal size of the nursing workforce was calculated using the workload model. A bottom-up approach was used to estimate the annual total financial cost of comprehensive nursing services. The number of registered nurses and nursing aids would need to be increased by 81.75% and 83.23%, respectively, in order to fully apply comprehensive nursing care on a national scale. The additional financial costs for comprehensive nursing services at all hospitals was estimated to be as much as 110.39% of the current cost. For the comprehensive nursing service, nurses with a career and newcomers need to be retained at their hospitals, and the validity of the nurse-patient ratio should be continuously checked. The financial shock to the national health insurance system could be minimized by gradually extending the system to all hospitals.

• Tuberculosis and Respiratory Diseases
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• v.54 no.2
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• pp.230-235
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• 2003

A primary pulmonary artery sarcoma is a rare malignant tumor derived from the intimal layer of the pulmonary artery. Its clinical presentation can lead to a misdiagnosis of more common diseases such as thromboembolic disease. It is known to have a very poor prognosis. Therefore, the correct diagnosis of a primary pulmonary artery sarcoma is difficult and often delayed. We experienced a case of primary pulmonary artery sarcoma mimicking a pulmonary thromboembolism. The patient was admitted as a result of progressive dyspnea and coughing. The lung perfusion scan showed a large perfusion defect involving almost the entire right lung and suspicious small perfusion defects in the left upper lobe. Magnetic resonance imaging of the chest showed an enhancing nodule within the thrombus in the right pulmonary artery. The mass was removed completely by surgery, but the patient died as a result of shock.

• Pediatric Infection and Vaccine
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• v.11 no.1
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• pp.126-130
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• 2004

Neisseria meningitidis is a leading cause of meningitis and septicemia in children and young adults. Meningococcemia, the most severe form of infection, represents a part of the various spectrum of the illness, and its clinical manifestations varied from mild fever and occult bacteriemia to fulminant catastrophic events(e.g., sepsis, shock, and death) within a few hours after onset of symptoms. Complement deficiencies, either congenital or acqired, increase the risk for invasive meningococcal disease. Since C3 plays a critical role in the complement cascade, congenital C3 deficiency or conditions that decrease C3(e.g., systemic lupus erythematosus, cirrhosis, nephritis, C3 nephritic factor) increase the risk for invasive disease due to pyogenic bacteria including N. meningitidis. We had experienced a case of meningococcemia and meningococcal meningitis presenting with mild fever, petechiae, and purpura. The patient was a 7-year old male. He had mild fever, vomiting, headache, nuchal rigidity, petechiae and purpura on both lower extremities, which spreaded to the whole body. His blood culture grew Neisseria meningitidis. The diagnosis of meningococcal meningitis was confirmed by examination of cerebrospinal fluid. The clinical symptoms of the illness were improved after treatment of antibiotics(cefotaxime) for 12 days. However the patient had developed generalized edema, microscopic hematuria & proteinuria on the third day after admission. High ASO titer and low serum C3 level were also noted. The microscopic hematuria returned to normal about 2 months after discharge. The C3 level returned to normal range about 3~4 months after discharge. we report a case of combined acute poststreptococcal glomerulonephritis and acute invasive meningococcal disease with reference review.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.32 no.2
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• pp.142-150
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• 2006

PURPOSE : The 3rd molar extraction of mandible is common in out-patient office of oral and maxillofacial surgery. And it is dynamic minor operation with changes of vital signs. most of patients are already sensitive about their dental treatment. The changes of emotion are reached to the highest level when patients is laid down to be treated on unit chair. It can be induced to undesirable accidents as to this fear. The undesirable complications are nausea, vomiting, hyperventilation, dyspnea, syncope, shock and so on. The severe changes of vital signs may influence their behavior and make serious medical malpractice or suit such as fracture of dental instruments and injury of proximal area. METHOD AND PATIENTS : A total of 99 selected normal patients were reviewed. Among this, 70 patients(43 men, 27 women with statistical significance) were included in this study. Each steps(pre-anesthesis, 5 minutes after anesthesis, just after mucogingival incision, just after tooth section, just after suture and gauze biting) were investigated for a change of a vital signs. It is analyzed to 2 categories,"Means" and "Tendency". The "Means" is the amount of vital signs changed in comparison with pre-step during operation. That means is the amount of vital changes by each step operation. Next, " Tendency" is changes of vital signs in comparison with step1 during operation. RESULT : This is the changing tendency of vital signs with time. That is active effect of fear and pain. Thus this "Means" and "Tendency" will present a sudden changes of vital signs and it can lead to more safe treatment. CONCLUSION : Thus, the purpose of this study is, through careful operation in each step, to less on patients' complication and increase trust between patient and OMFS. This study is a first article shown with the amount of "Means" and "Tendency" in vital signs, when a third molar of mandible is extracted. This study will be base study of patients with general diseases, because it selected only patients without general diseases.

• The Korean Journal of Emergency Medical Services
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• v.1 no.1
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• pp.28-41
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• 1997

The purpose of this study was to identify the change of perceptions related to E.M.T. profession of E.M.T. student and to provide the basic data for development of curriculum. The subjects of the survey were 216 students from 3 junior college by questionaire from November 25 to November 29, 1996 in Kwang-Ju, Cheong-Ju, and Kong-Ju. The results were analyzed using the SAS and can be summerized as follows : 1. The view on profession was a statistically significant difference inspecial knowledge & skill training (t=-1.686, P<.001), high income (t=-0.753, P<.05) 2. The view on competence as a E.M.T. was a statistically significant differncein sufficient professional knowledge on the E.M.T. (t=-1.144, P<.001), own's health (t=-0.808, P<.001), sincerity and responsibility (t=-1.429, P<.01), satisfaction and effort (t=-1.335, P<.01), boundary of affairs (t=-1.356, P<.01) 3. The view on E.M.T. profession was a statistically significant difference inprotect of pt. life & to relieve the pain (t=-2.388, P<.001) 4. The view on necessary knowledge of E.M.T. was a statistically significant difference in patient assessment (t=-2.168, P<.001), ACLS (t=1.678, P<.001), hemorrhage & shock (t=-3.252, P<.001), trauma (t=-4.284, P<.001), cardiopulmonary disturbance (t=-2.897, P<.001), acute abdomen (t=-4.284, P<.001), neonatal disease (t=-4.032, P<.001), OBGY disease(t=-4.151, P<.001), emergency delivery (t=-2.825, P<.001), infectious disease (t=-2.930, P<.001), environmental emergency (t=-3.123, P<.05), recording(t=2.22, P<.05) 5. The view on ideology of E.M.T. was a statistically significant difference in belief & faith (t=-2.344, P<.001), knowing of own (t=-2.142, P<.01), humanity (t=-2.581, P<.05), knowing of patient (t=-2.079, P<.05).

• Journal of Chest Surgery
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• v.36 no.10
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• pp.741-747
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• 2003

Background: Coronary artery bypass graf t (CABG) has been settled as most safe surgery among the open heart surgeries. However, in patients with cardiogenic shock, the emergency CABG has higher mortality than elective CABG. We analyzed thirty four patients who underwent emergency CABG and report the middle and long-term results. Material and Method: From June 1994 to December 2001, 34 patients who underwent emergency CABG at Kang-dong Sacred Heart Hospital were include in this study. On the basis of hospital databases and Out Patient Department (OPD) follow up data, preoperative diagnosis, risk factor, coronary artery anatomy, operation technique, postoperative mortality, complication, recurrence of symptom, and mid and long term mortality were analyzed retrospectively. Result: Indications for emergency CABG were 29 cardiogenic shocks (85.3%), 4 intractable chest pains (11.8%), and 1 polymorphic ventricular tachycardia (2.9%). Preoperative angiographic diagnoses were triple vessel disease in 16 (47.1%) and left main disease in 8 (23.5%) patients. We used saphenous vein grafts in 81 and left internal thoracic artery grafts in 14 anastomosis. The mean number of grafts per patients was 2.8$\pm$0.8. The mean aortic cross clamp time was 91.9$\pm$34.6 minutes and the mean cardiopulmonary bypass time was 262.7$\pm$198.3 minutes. Early mortality was 50% and the most common cause of early mortality was low cardiac output in 7 (20.6%) patients. The mean follow-up period was 30.9$\pm$35.7 months. There were no recurrences of symptom and late mortality. Conclusion: In the case of emergency operation, aggressive and proper management with drugs and IABP should be done for preoperative hemodynamic stability and early surgical intervention is the most important factor for patient salvage.

• Journal of radiological science and technology
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• v.28 no.2
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• pp.105-110
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• 2005

Background/Aim : Common bile duct (CBD) stones may cause jaundice, cholangitis, or pancreatitis. Extracorporeal shock wave lithotripsy (ESWL) may be needed whenever endoscopic procedure are failed to extract common bile duct stones. The aim of this study is to provide the standard for patient's best choice on ESWL for treatment of CBD stones resistant to endoscopic extraction. Materials and Methods : Fourty-six patients failed in endoscopic stone extraction including mechanical lithotripsy were treated by ESWL. In all patients, endoscopic sphincterotomy and nasobiliary drainage tube was done before ESWL using the ultrasonography for stone localization with a spark-gap type lithotriptor. Patients were sedated with an intravenous injection of 50 mg of Demerol. None were treated under general anesthesia. Results : Overall complete clearance rate of CBD stone was 89.1% (41/46). In 82.6% of the patients, the stones were extracted endoscopically after ESWL, and spontaneous passage was observed in 6.5%. In the clearance rate after ESWL, there were no noticeable differences with regard to number (single: 82.8%, two or three: 100%, more than three: 100%) and size of the stone (less than 33mm: 92.9%, 33 mm or larger: 83.3%), whereas there were significant differences with regard to the ratio of sum of long-axis length of the all stones to sum of long-axis length of the CBD excluding stone (1:2.4, 1:2.1) and diameter of the largest stone to diameter of CBD excluding stone (1:0.9, 1:0.4) for patients with complete clearance compared with those without. Conclusion : We propose that stones without the fragments are travelable sufficient space in CBD or extractable sufficient diameter of CBD regardless of stone size and number should be treated by other technique to prevent time and cost consuming, such as percutaneous transhepatic cholangioscopylithotomy.

• Journal of Chest Surgery
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• v.40 no.11
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• pp.765-769
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• 2007

Background: The curative treatment of choice for empyema is decortication of the pleura. The risks of this treatment however are increased for the patient with reduced pulmonary function, complicated calcification or septic shock. In the past, open window thoracostomy was a final stage treatment for chronic empyema. Relatively safe treatment of empyema could be achieved in difficult cases with a closure of the open window after open drainage and use of a myocutaneous flap (one stage or staged). Material and Method: A retrospective study of the cause, progression and final outcome of empyema patients who received open window thoracostomy was performed. 21 patients were followed from 1995 to 2004 in the department of Thoracic and Cardiovascular Surgery in the College of Medicine, Pusan National University. Result: The average age of the patients was $57.5{\pm}15.5$ years (range $25{\sim}78$ years), of whom 16 (76.2%) were men and five (23.8%) were women. Pulmonary function test results showed an average FEV1 of $1.58{\pm}0.49 L$. The type of empyema was tuberculous empyema in 13 cases (61.9%), aspergillosis in three cases (14.3%), parapneumonic empyema in three cases (14.3%) and post-resectional empyema in two cases (10%). Bronchopulmonary fistula was seen in 14 cases. Eight cases were complicated by severe calcification of the pleura. For the four cases of bronchopulmonary fistula, the patients' serratus anterior muscle was covered in their first operation. The average number of ribs resected was $4{\pm}1$. Closure of the open window thoracostomy was performed in 12 cases. The average time to closure after open drainage was $10.22{\pm}3.11$ months and the average defect of the empyemal cavity before the final operation was $330{\pm}110 cc$. Among the 12 cases, there were two cases of spontaneous closure. In two cases closure was only achieved by using the reserved skin fold during the first surgery. Of the remaining eight cases, in seven we used the myocutaneous flap (four cases of lattisimus dorsi muscle and three cases of pectoralis major muscle), and in one case we used soft tissue. As regards complications of the closure, tissue necrosis occurred in one case, which led to failed closure, and there was one case of abdominal hernia in the rectus abdominis muscle flap. One patient died within 30 days of the surgery and one patient died of metastatic cancer. Conclusion: A staged operation with a final closure using open window thoracostomy, which consists of open drainage, transposition of the muscle and a myocutaneous flap, can be a safe and effective option for the chronic empyema patient who is difficult to cure with traditional surgical methods.