• 성인간호학회지
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• 제25권3호
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• pp.312-321
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• 2013

Purpose: The purpose of this study was to compare health promotion behavior, post-traumatic growth and quality of life according to the stages of survivorship in patients with female genital neoplasm. Methods: Data were collected from August 1st, 2011 to September 31st 2011 from 142 gynecologic cancer patients who completed treatment or were treated at an out-patient clinic. The instrument were HPLP developed by Walker, Sechrist & Pender, PTGI developed by Tedeschi & Calhoun, and Korean C-QOL. Results: Health promotion behavior scores were significantly higher in the acute survival stage than the extended survival stage. Post-traumatic growth score was higher in the acute survival stage than the extended survival stage. The quality of life scores were higher in the lasting survival stage than the extended survival stage. Conclusion: Gynecological cancer patients in the extended survival stage reported low scores of health promotion behavior, post-traumatic growth and quality of life. Intervention needed to be developed to improve health promotion behavior, post-traumatic growth and quality of life for patients with female genital neoplasm in the extended survival stage.

• 영어영문학
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• 제57권3호
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• pp.495-513
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• 2011

Murdoch's novel, The Black Prince, is not, as most critics have suggested, an autobiographical novel. It is about the inner life or rather trauma of Bradley Pearson, an artist who repeatedly dreams about a shabby paper shop which used to be run by his "unsuccessful" parents. In this respect, Freudian concept of trauma is helpful since it can explain Bradley's present repetition of his past traumatic experience, while allowing us to understand the nature of his trauma which reveals itself not only through his repeated nightmares but also through the women who are represented as diverse versions of his mother, the origin of Bradley's trauma. Caruth's concept of traumatic awakening and traumatic survival is also instrumental in understanding the nature of the traumatic experience which Bradley undergoes in this novel. Induced by Loxias's address, Bradley makes a confession of "the sins," which makes possible his traumatic survival as well as traumatic awakening, which is transmitted not only to Loxias but also to us the readers. In this sense, the significance of Bradley's awakening is not confined to his past only, but becomes a matter of a social dimension. The meaning of Bradley's writing lies in this fact.

• Journal of Trauma and Injury
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• 제26권3호
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• pp.190-197
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• 2013

Purpose: Trauma is one of the major cause of death in Korea. This study focused on the survival rate and the neurologic outcome for patients with traumatic cardiac arrest (CA) at one emergency center. Methods: We retrospectively reviewed the medical records of patients with traumatic CA who were seen at a regional emergency medical center from January 2010 to December 2011. From among major trauma patients at that medical center, adults older than 18 years of age who had CA were included in this study. CA included out-of-hospital CA with arrival at the Emergency Department (ED) within three hours and in-hospital CA. We checked the survival rate and the neurologic outcome. Results: A total of 61 patients were analyzed: 32 patients had return of spontaneous circulation (ROSC), 6 patients survived to discharge (survival rate: 9.84%), and 4 were still alive 90 days after discharge. The Cerebral performance category (CPC) scores at 6 months after discharge showed 1 good and 5 poor in neurologic outcomes. Factors such as initial rhythm of CA, part with major injury, Revised Trauma Score (RTS) and pH, were significant for ROSC, survival, and neurologic outcome in patients with traumatic CA. Conclusion: In this study, patients who had traumatic CA showed a 9.84% survival rate and a 1.64% good neurologic outcome. The results are poorer than those for CA caused by disease. Multi-center, prospective studies are needed.

• 한국융합학회논문지
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• 제12권4호
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• pp.285-291
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• 2021

본 연구는 외상성 경막하 혈종 환자의 생존 여부에 영향을 미치는 요인을 규명하기 위해 시도된 후향적 조사연구이다. 연구대상자는 G광역시에 소재한 C대학교 병원에 2017년 1월부터 2019년 2월까지 응급실로 내원한 외상성 경막하 혈종 환자 207명이다. 자료분석은 SPSS 23.0 프로그램을 이용하였으며, χ2-test, t-test, 로지스틱 회귀분석을 시행하였다. 연구결과 대상자의 생존 여부에 영향을 미치는 요인은 기저질환, 입원 시 합병증, 내원 시 GCS로 나타났다. 따라서 대상자의 과거력을 확인할 수 있는 의료시스템 구축과 합병증 예방을 위한 의료진의 교육이 이루어져야 할 것이다. 이와 함께 의료기관 이송 전 단계부터 대상자의 GCS를 측정하여 신속히 치료 가능한 병원으로 이송될 수 있도록 이송체계의 개선이 필요하다.

• Journal of Chest Surgery
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• 제56권2호
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• pp.108-116
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• 2023

Background: Resuscitative endovascular balloon occlusion of the aorta (REBOA) has recently gained popularity as an adjunct to resuscitation of patients with traumatic shock. However, the effectiveness of REBOA is still debated because of inconsistent indications across centers and the lack of medical records. The purpose of this study was to investigate the effectiveness and feasibility of REBOA by analyzing clinical results from a single center. Methods: This study included 96 patients who underwent REBOA between August 2016 and September 2021 at a regional trauma center according to the center's treatment algorithm for traumatic shock. Medical records, including the time of the decision to conduct the REBOA procedure, time of operation, type of aortic occlusion, and clinical outcomes, were collected prospectively and analyzed retrospectively. Patients were classified by REBOA protocol (group 1, 2, or 3) and survival status (survivor or non-survivor) for analysis. Results: The overall success rate of the procedure was 97.9%, and the survival rate was 32.6%. In survivors, blood pressure was higher than in non-survivors both before the REBOA procedure (p=0.002) and after aortic occlusion (p=0.03). The total aortic occlusion time was significantly shorter (p=0.001) and the proportion of partial aortic occlusion was significantly higher (p=0.014) among the survivors. The non-survivors had more acidosis (p<0.001) and higher lactate concentrations (p<0.001) than the survivors. Conclusion: REBOA may be a feasible bridge therapy for resuscitation of patients with traumatic shock. Prompt and accurate decision-making to perform REBOA followed by damage control surgery could improve survival rates and clinical outcomes.

• Journal of Korean Neurosurgical Society
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• 제54권1호
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• pp.42-46
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• 2013

Objective : Despite several limitations, the Trauma Injury Severity Score (TRISS) is normally used to evaluate trauma systems. The aim of this study was to evaluate the preventable trauma death rate using the TRISS method in severe trauma patients with traumatic brain injury using our emergency department data. Methods : The use of the TRISS formula has been suggested to consider definitively preventable death (DP); the deaths occurred with a probability of survival (Ps) higher than 0.50 and possible preventable death (PP); the deaths occurred with a Ps between 0.50 and 0.25. Deaths in patients with a calculated Ps of less than 0.25 is considered as non-preventable death (NP). A retrospective case review of deaths attributed to mechanical trauma occurring between January 1, 2011 and December 31, 2011 was conducted. Results : A total of 565 consecutive severe trauma patients with ISS>15 or Revised Trauma Score<7 were admitted in our institute. We excluded a total of 24 patients from our analysis : 22 patients younger than 15 years, and 2 patients with burned injury. Of these, 221 patients with head injury were analyzed in the final study. One hundred eighty-two patients were in DP, 13 in PP and 24 in NP. The calculated predicted mortality rates were 11.13%, 59.04%, and 90.09%. The actual mortality rates were 12.64%, 61.547%, and 91.67%, respectively. Conclusion : Although it needs to make some improvements, the present study showed that TRISS performed well in predicting survival of traumatic brain injured patients. Also, TRISS is relatively exact and acceptable compared with actual data, as a simple and time-saving method.

• Journal of Chest Surgery
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• 제18권3호
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• pp.461-465
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• 1985

Rupture of the aorta following blunt trauma of the thorax may occur more frequently than has generally been recognized. Actual complete transection of the aorta usually results in immediate death but varying degrees of lesser disruption permit increased chance of survival. Chronic traumatic aneurysms are so designated following a period of 3 months from the traumatic incident. The exact time required for the acute process and hematoma to convert into an aneurysm is unknown. Because a thoracic surgeon encounters so few of these aneurysms, it is difficult for him to arrive at sound dicta of management from his personal experience. It is not surprising that controversy exists concerning the therapeutic approach to the aneurysm which is asymptomatic and is discovered months or years after the causative injury. In the hope of improving the surgical treatment of patients with this condition, we reported one case with chronic traumatic aneurysm of the descending thoracic aorta.

• Tuberculosis and Respiratory Diseases
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• 제57권2호
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• pp.148-159
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• 2004

연구 배경 : 본 연구는 비외상성 객혈을 주소로 내원한 환자에서 기관지 동맥 색전술의 생존 효과를 파악하고자 시행하였다. 방 법 : 환자에 대한 임상적인 정보는 의무기록, 전자처방기록(Order Communication System), 방사선 기록 등을 통하여 수집하였으며, 사망 관련 정보는 통계청 사망 자료를 통하여 획득하였다. 전체 환자를 최대 2년 동안 관찰하였으며, 기관지 동맥 시행 여부에 따라 시행군과 비시행군 등 두 군으로 나누어 관련 요인별로 생존과 사망에 대한 단변량 분석을 시행하였다. 기관지 동맥 색전술 시행 여부로 층화하여 Kaplan-Meier 생존곡선을 구한 후, 관련 요인을 보정하여 Cox-proportio-nal hazard regression analysis를 시행하여 기관지 동맥 색전술에 따른 생존 효과를 평가하였다. 결 과 : 대상 환자는 총 272명으로 이 중 기관지 동맥 색전술을 시행 받은 환자는 63명, 시행 받지 않은 환자는 209명이었으며, 원인 질환별로 악성 폐종양군은 69명, 양성 만성 폐질환군은 149명, 기타 질환군은 54명이었고 이 중 2년 이내에 사망한 경우는 69명이었다. 전체 환자를 대상으로, 그리고 악성 폐종양군, 양성 만성 질환군 등 세부 군을 대상으로 기관지 동맥 색전술의 생존효과를 평가하였을 때, 유의한 결과를 보여주지 않았다. 결 론 : 2년 동안의 관찰 기간 동안, 비외상성 객혈환자에서 기관지 동맥 색전술은 유의한 생존 효과를 보여주지 못하였다.

• 한국화재소방학회논문지
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• 제25권5호
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• pp.21-31
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• 2011

병원 밖에서 발생한 비외상성 심정지 환자에 대한 119 구급대원의 처치 현황과 개선방안을 연구하기 위해 대전충남에 근무하는 119 구급대원 322명에게 설문을 실시하였다. 119 구급대원들은 병원전 비외상성 심정지 환자에 대해 CPR은 96.9%(309명), AED는 53%(169명)에서 거의 매번 또는 매번 실시한다고 하였다. 1급 응급구조사와 간호사의 경우 IV는 94.7%(143명)에서 가끔 실시하거나 실시한 적이 없다고 하였고 약물처치의 경우도 90.7%(136명)에서 실시한 적이 없다고 응답하였다. AED, 기도확보 및 IV 를 실시하지 못했던 이유에 대해서는 구급인원이 부족하고, 시간이 부족하며, 흔들리는 구급차 때문이라는 의견이 많았다. 임상실습이나 병원실습의 경험이 있는 119 구급대원이 IV나 약물처치를 더 자주 실시하는 것으로 나타났다. 결론적으로, 심정지 환자의 소생률을 향상시키기 위해서는 구급차에 탑승하는 구급인원을 보강하고, 일반인들도 할 수 있는 기본심폐소생술 처치에서 더 나아가 전문심장소생술을 실시할 수 있도록 1급 응급구조사에게 에피네프린의 사용을 허가하며, 임상실기 교육을 강화하고 구급대원을 법적으로 보호할 수 있는 방안이 마련되어야 할 것이다.

• Journal of Trauma and Injury
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• 제20권2호
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• pp.125-129
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• 2007

Purpose: The liver is one of the most commonly injured organs in abdominal trauma. Surgery has played a major role in treating traumatic liver injury. Recently, it was reported that conservative treatment could be the first-line management for hemodynamically stable patients without combined intraabdominal surgical problems. The aim of this study was to examine the prognostic factors in traumatic liver injury. Methods: The medical records of 41 patients who were treated for traumatic liver injury at Seoul National University Bundang Hospital from March 2003 to October 2007 were retrospectively reviewed. Results: Among the 41 patients, 34 cases (82.9%) were managed nonsurgically, and 7 cases (17.1%) were managed surgically. Out of the 5 (12.2%) mortalities, 2 were encountered in those who underwent surgery, and 3 were encountered in those who were treated nonsurgically. Univariate analysis showed that the initial systolic blood pressure, the initial hemoglobin level, and the grade of liver injury were significant prognostic factors for survival. Multivariate analysis indicated that initial low systolic blood pressure was the only independent risk factor. Conclusion: Patients with unstable vital signs initially have a poor prognosis. Aggressive management might be helpful for improving the survival rate in these patients.