• Journal of Trauma and Injury
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• v.37 no.1
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• pp.37-47
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• 2024

Purpose: This study aimed at developing a novel tube thoracostomy technique using the sternum, a fixed anatomical structure, as an indicator to reduce the possibility of incorrect chest tube positioning and complications in patients with chest trauma. Methods: This retrospective study analyzed the data of 184 patients with chest trauma who were aged ≥18 years, visited a single regional trauma center in Korea between April and June 2022, and underwent chest computed tomography (CT) with their arms down. The conventional gold standard, 5th intercostal space (ICS) method, was compared to the lower 1/2, 1/3, and 1/4 of the sternum method by analyzing CT images. Results: When virtual tube thoracostomy routes were drawn at the mid-axillary line at the 5th ICS level, 150 patients (81.5%) on the right side and 179 patients (97.3%) on the left did not pass the diaphragm. However, at the lower 1/2 of the sternum level, 171 patients (92.9%, P<0.001) on the right and 182 patients (98.9%, P= 0.250) on the left did not pass the diaphragm. At the 5th ICS level, 129 patients (70.1%) on the right and 156 patients (84.8%) on the left were located in the safety zone and did not pass the diaphragm. Alternatively, at the lower 1/2, 1/3, and 1/4 of the sternum level, 139 (75.5%, P=0.185), 49 (26.6%, P<0.001), and 10 (5.4%, P<0.001), respectively, on the right, and 146 (79.3%, P=0.041), 69 (37.5%, P<0.001), and 16 (8.7%, P<0.001) on the left were located in the safety zone and did not pass the diaphragm. Compared to the conventional 5th ICS method, the sternum 1/2 method had a safety zone prediction sensitivity of 90.0% to 90.7%, and 97.3% to 100% sensitivity for not passing the diaphragm. Conclusions: Using the sternum length as a tube thoracostomy indicator might be feasible.

• Journal of Radiation Protection and Research
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• v.42 no.2
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• pp.83-90
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• 2017

Background: Different cases exist in the measurement of thyroid radiobioassays owing to the individual characteristics of the subjects, especially the potential variation in the counting efficiency. An In situ Object Counting System (ISOCS) was developed to perform an efficiency calibration based on the Monte Carlo calculation, as an alternative to conventional calibration methods. The purpose of this study is to evaluate the applicability of ISOCS to thyroid radiobioassays by comparison with a conventional thyroid monitoring system. Materials and Methods: The efficiency calibration of a portable high-purity germanium (HPGe) detector was performed using ISOCS software. In contrast, the conventional efficiency calibration, which needed a radioactive material, was applied to a scintillator-based thyroid monitor. Four radioiodine samples that contained $^{125}I$ and $^{131}I$ in both aqueous solution and gel forms were measured to evaluate radioactivity in the thyroid. ANSI/HPS N13.30 performance criteria, which included the relative bias, relative precision, and root-mean-squared error, were applied to evaluate the performance of the measurement system. Results and Discussion: The portable HPGe detector could measure both radioiodines with ISOCS but the thyroid monitor could not measure $^{125}I$ because of the limited energy resolution of the NaI(Tl) scintillator. The $^{131}I$ results from both detectors agreed to within 5% with the certified results. Moreover, the $^{125}I$ results from the portable HPGe detector agreed to within 10% with the certified results. All measurement results complied with the ANSI/HPS N13.30 performance criteria. Conclusion: The results of the intercomparison program indicated the feasibility of applying ISOCS software to direct thyroid radiobioassays. The portable HPGe detector with ISOCS software can provide the convenience of efficiency calibration and higher energy resolution for identifying photopeaks, compared with a conventional thyroid monitor with a NaI(Tl) scintillator. The application of ISOCS software in a radiation emergency can improve the response in terms of internal contamination monitoring.

• Journal of The Korea Institute of Healthcare Architecture
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• v.18 no.2
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• pp.55-64
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• 2012

Recently, our country is caused with economic growth and development and city intensive brazier being caused by industrial accident, crime accident and suicide of traffic facility, it is caused by with Western dietary life and the emergency patient is to an increase tendency. And the life increases with medical development and the medical emergency demand of the old people are increasing. Approximately 80% of the patients are non-emergent patients who receive ambulatory care and the rest 20% of the patients are serio us- emergent patients Emergency patients because non-strategy it is doing with function as imported medical treatment and provides, equipment, the operation is being impossible with manpower tribal etc.

• Journal of Trauma and Injury
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• v.18 no.1
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• pp.17-25
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• 2005

Background: Traumatic rupture of the aorta is a life-threatening injury that must be diagnosed as rapidly as possible and treated immediately. The chest X-ray is a valuable tool for screening traumatic rupture of the aorta in blunt chest trauma. And various chest radiologic parameters are being used as diagnostic tools for aortic injury. The purpose of this study is to identify chest radiographic parameters that may assist in the detection of traumatic rupture of the aorta and to compare these findings with those of other reports. Methods: This study involved 30 adult patients with traumatic rupture of the aorta seen at the emergency department of the Asan Medical Center from 1997 to 2004. The control subjects were 30 healthy patients with neither lung nor cardiovascular disease. We retrospectively assessed over 14 parameters on chest X-rays. Results: In 11 of the 14 parameters, there were significant differences between the study group and the control group. There was no significant difference in the M/C ratio (mediastinumto-chest width ratio) between the two groups, and neither the left nor the right paraspinal interface was statistically significant (p value>0.05). Our study indicates that new criteria for the MC ratio and for the paraspinal interfaces are needed for screening traumatic aorta injury. The other radiographic parameters for traumatic rupture of the aorta need to be further assessed through a prospective study.

• Proceedings of the Korea Information Processing Society Conference
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• 2004.05a
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• pp.1083-1086
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• 2004

Switched Network는 Shared Network 에 비해서 스니핑에 안전하다. 하지만 비교우위일뿐 절대적으로 스니핑에 안전한 것은 아니다. 이미 Switched Network 상에서 스니핑을 할 수 있는 공격툴들이 많이 소개되어 있다. 본 논문에서는 Switched Network 상에서 ARP(Address Resolution Protocol) 스푸핑을 통한 ARP 캐시 오염을 통하여 스니핑이 가능한 시나리오를 기술한다. 이러한 시나리오를 탐지하기 위한 기존의 방법은 DHCP와 같은 동적인 환경이 포함된 경우 False Positive 를 자주 발생시키기 때문에 문제가 된다. 여기에서는 이러한 False Positive를 줄인 탐지 방법을 제시하고자 한다.

• Journal of Trauma and Injury
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• v.35 no.4
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• pp.240-247
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• 2022

Purpose: Studies on the relationship between obesity and injuries, especially those sustained in pedestrian traffic accidents, are lacking. We aimed to assess the effects of obesity on the severity of injury at the time of admission to the emergency room in patients who experienced pedestrian traffic accidents. Methods: This study included trauma patients registered in the Korean Trauma Database from July 1, 2018 to December 31, 2020, whose mechanism of injury was pedestrian traffic accidents and who were treated at a single institution. Those aged below 15 years were excluded. Patients were assigned to nonobese and obese groups based on a body mass index of 25 kg/m². An Injury Severity Score of 25 or greater was considered to indicate a critical injury. Results: In total, 679 cases of pedestrian traffic accidents were registered during the study period, and 543 patients were included in the final analysis. Of them, 360 patients (66.3%) and 183 patients (33.7%) were categorized as nonobese and obese, respectively. The median age was significantly higher in the nonobese group than in the obese group (60 vs. 58 years). Multivariate analysis demonstrated that the odds ratio for critical injury in obese patients was 1.59 (95% confidence interval, 1.01-2.48) compared with nonobese patients. Conclusions: Obesity affected the likelihood of sustaining severe injuries in pedestrian traffic accidents. Future studies should analyze the effects of body mass index on the pattern and severity of injuries in patients with more diverse injury mechanisms using large-scale data.

• Journal of The Korean Society of Clinical Toxicology
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• v.7 no.2
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• pp.164-171
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• 2009

Purpose: The number of patients who take warfarin is growing and so is the number of complications. Hemorrhage is the major complication, but the clinical characteristics and outcomes have not been determined for Korean patients. Therefore, we tried to evaluate the characteristics of the patients with hemorrhagic complications after taking warfarin as anticoagulation therapy. Methods: We retrospectively reviewed the medical records of the patients who visited the emergency room with bleeding complications after taking warfarin anticoagulation at the out-patient clinic for 1 year from 1 st January 2008. We compared between two groups (the major hemorrhage group vs. the minor hemorrhage group) according to the clinical criteria, the unstable vital signs that required blood transfusion, transfusion more than 2 units of blood, the need for further laboratory follow-up, the need for interventional treatment and the development of critical complications or death due to bleeding. Results: There were 150 patients who met the criteria and had acute hemorrhagic complications (the major group: 90 patients and the minor group: 60 patients). In the major hemorrhage group, the frequent sites of bleeding were the gastro-intestinal system (40 patients), lung (14 patients) and intracranium (7 patients). At the emergency room, the major group showed a higher initial INR of the activated prothrombin time than did the minor group (p=0.02). The bleeding sites of the fatal cases were the gastro-intestinal system (3 patients), lung (3 patients) and intracranium (3 patients), but the percentage of fatality was the highest for intracranium bleeding. Conclusion: In the major hemorrhage group, gastrointestinal bleeding was the most frequent complication and fatality was the highest for intracranium bleeding. An initially higher INR showed a greater risk of major bleeding, but not more fatalities.

• Journal of Trauma and Injury
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• v.36 no.4
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• pp.343-353
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• 2023

Purpose: The COVID-19 pandemic led to significant changes in the lifestyle patterns of children and affected the patterns of pediatric injuries. This study analyzed the changing patterns of pediatric injury overall and by age groups, based on the datasets before and during the COVID-19 pandemic. Methods: This study is based on the data of patients who presented with injuries at 23 hospital emergency departments participating in the Emergency Department-based Injury In-depth Surveillance (EDIIS) conducted by the Korea Disease Control and Prevention Agency. The surveillance data was categorized by injury mechanism, location, activity, and severity. We analyzed the injury patterns of pediatric patients aged 0 to 15 years. Subgroup analysis was conducted by age group in children aged 7 to 15 years, 1 to 6 years, and <1 year. Results: When comparing the COVID-19 pandemic period to the pre-COVID-19 period, the total number of pediatric patients with injuries decreased by 38.7%, while the proportions of in-home injuries (57.9% vs. 67.9%), and minor injuries (38.9% vs. 39.7%) increased. In the 7 to 15 years group, bicycle riding injuries (50.9% vs. 65.6%) and personal mobility device injuries (2.4% vs. 4.6%) increased. The 1 to 6 years group also showed an increase in bicycle accident injuries (15.8% vs. 22.4%). In the <1 year group, injuries from falls increased (44.5% vs. 49.9%). Self-harm injuries in the 7 to 15 years group also increased (1.6% vs. 2.8%). Conclusions: During the COVID-19 pandemic period, the overall number of pediatric injuries decreased, while injuries occurring at home and during indoor activities increased. Traffic accidents involving bicycles and personal mobility devices and self-harm injuries increased in the 7 to 15 years group. In the <1 year group, the incidence of falls increased. Medical and societal preparedness is needed so that we might anticipate these changes in the patterns of pediatric injuries during future infectious disease pandemics.

• The Korean Journal of Emergency Medical Services
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• v.12 no.2
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• pp.59-69
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• 2008

Purpose : This study aims to provide basic data to establish an effective emergency medical service system by analyzing health educator' understanding and use of emergency medical service system at schools. Method : 93 questionnaires from 200 elementary, middle and high school nurses in the city D were collected from May 26 to July 7, 2008 and ${\chi}^2$ analysis and frequency analysis were carried out with SPSS win PC 14.0. Results : 1. As for emergency contact points, 3(3.30%) answers 'they do not have any knowledge', 40(43.96%) said 'they have some idea' and 48(52.75%) said 'they do know about it'. Among 24 respondents who have less than five years of working experience, 2(8.33%), 16(66.67%) and 6(25.00%) answered 'have no knowledge', 'a little knowledge' and 'clear knowledge on it' respectively. As for 9 who have 6-10 years of career, 1(12.50%), 4(50.00%) and 3(37.50%) answered 'have no knowledge', 'a little knowledge' and 'clear knowledge on it' respectively. Among 32 respondents who have 11~20 years, there were no respondents with no knowledge on the given question, and 9(29.03%) said they have some understanding and 22(70.97%) answered they have clear understanding on the topic. From this result, it can be said that there is statistically meaningful differences among different working year groups with ${\chi}^2=16.583$ and p= .010. 2. As for 119 emergency contact in the given district, 24(29.63%), 30(37.04%) and 27 (33.33%) answered 'do not know', 'know' and 'know very well' respectively. As for the question to ask whether they know Emergency Medical Information Center 1339, 66(70.97%) answered 'Yes' and 27(29.03%) answered 'No'. When it comes to emergency contact numbers and list of hospitals, 59(63.44%) said 'they have some list', 20(21.51%) answered 'they have well established contact network' and 14(15.05%) said 'they have none'. 3. As for the use of 119 service at the time of emergency at schools, 59(63.44%), said 'Yes' and 12(12.90%) answered 'No'. Among those who said 'yes', 29(31.18%), 24(25.81%) and 5(5.38%) answered they have used the service 1-2, 3-5 and 6-10 times respectively. Conclusion : In order to ensure health educator to effectively deal with emergency situations at schools, there should be special activities to enhance health educator' understanding on 119 and Emergency Medical Information Center 1339 and at the same time, a system should be established to connect schools, 119 in a given district, hospitals and Emergency Medical Information Center 1339.

• The Korean Journal of Emergency Medical Services
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• v.16 no.2
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• pp.91-102
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• 2012

Purpose : This study was designed to identify factors influencing burnout of nurses in emergency medical center. Methods : Data were collected by questionnaires from 178 emergency room nurses randomly selected from 6 general hospitals in two metropolitan cities. Measures were burnout, QEC, depression, decision latitude and job demand. Data were analysed using frequencies, means, standard deviation, t-test or one way ANOVA, Pearson's correlation coefficients and multiple regression with SPSS/win 18.0 version. Results : The mean score for burnout in emergency room nurses was 2.59 out of possible 4. There were significant differences in burnout according to exercise, leisure, position, job demand and depression. Burnout correlated negatively with exercise and leisure, and positively with job demand and depression. Factors influencing burnout in emergency room nurses were identified as exercise(${\beta}$=-.399, p<.001), leisure(${\beta}$=-.354, p<.001), job demand(${\beta}$=.301, p=.006) and depression(${\beta}$=.189, p=.021). These factors explained 49.8% of burnout reported by emergency room nurses. Conclusion : The result indicate which factors are major factors influencing burnout in emergency room nurses in general hospitals. Therefore, these factors may serve as predictors of burnout in emergency room nurses.