• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.2
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• pp.707-712
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• 2013

In patients with acute myocardial infarction (AMI), the delay from symptom onset to hospital arrival has a critical effect on morbidity and mortality. This study examined to find out the determinants of the prehospital delay in patients with AMI. The study sample consisted of 597 patients hospitalized with AMI between Jan and Dec 2009. Demographic, medical history, and clinical data were abstracted from the hospital medical records of patients with confirmed AMI, the prehospital delay was categorized as less than or greater than 6 hours. Older age, low socioeconomic status(medical aid), and low use of Emergency medical system were associated with delays in seeking emergency care for Acute myocardial infarction. Education programs to improve patient knowledge of acute coronary syndrome symptoms and promote patient responsiveness with regard to seeking medical care should be used to reduce the prehospital delay time, especially in the low socioeconomic group.

• The Journal of the Korea Contents Association
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• v.10 no.11
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• pp.275-284
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• 2010

The purpose of this study is to investigate the relationship between family environment and developmental delay in a sample of normal 3-5 years old children. Developmental evaluation is performed using K-DDST II and K-ASQ. Family environment is researched by survey. The survey questions include children's order, family numbers, religion, patient's age, patient's education history. Subject is selected between the age of 3-5 years old children. The test has been conducted to find an interrelationship between a developmental delayed result and family environment. Study has found that there is a strong relationship between developmental delay and children's family environment. Family environment factor includes children's gender, birth order, parent's age, education history. Therefore, developmental evaluation must have consideration on the element of children's family environment for developmental delay test because of a strong relationship between family environment and developmental delay result.

• Journal of Medicine and Life Science
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• v.16 no.1
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• pp.13-16
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• 2019

In a patient with blunt abdominal trauma with small bowel injury, early diagnosis is clinically challenging due to unclear clinical symptoms and signs in the early stage of an injury. On the other hand, a delay of diagnosis of bowel disruption may lead to increased complication and mortality. The diagnostic laparoscopy is very useful for the evaluation of the small bowel injury. Laparoscopy can reduce unnecessary open surgery in a patient with blunt abdominal trauma with subtle symptoms and imprecise findings on abdominal computed tomography. Also it can prevent delay of treatment and be converted immediately to open surgery as soon as bowel damage is revealed. Furthermore, extracorporeal repair of small bowel via mini-laparotomy after a single incision diagnostic laparoscopy in a patient with traumatic small bowel perforation was a feasible and safe alternative to conventional laparoscopy. We are pleased to introduce successfully treated cases by extracorporeal repair of small bowel via mini-laparotomy after a single incision diagnostic laparoscopy in a patient with small bowel perforation after blunt trauma.

• Korea Journal of Hospital Management
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• v.7 no.3
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• pp.44-62
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• 2002

Advanced surgical technology demands more precise, meticulous, and time-consuming procedures. In addition, the patient's preference of tertiary health providers makes over crowding of the University Hospitals. Therefore, it has been necessary to maximize utilization of the operating room of such hospitals to accommodate these requirements. This study, targeting 1,302 surgical cases performed in 22 operating rooms at a university hospital in Seoul from October 8 to November 1, 2001, analyzed reasons for delay, and factors that caused delayed use of operating rooms. This study also assessed that the rate of operating room use would increase if the sources for possible reform were improved. 1. Among total of 1,302 cases of surgery, the incidence of surgeries in which there were no time delays and no factors for delay were discovered is 71.4% or 930 cases: the incidence in which surgeries were delayed was 28.6% or 372 cases. 2. As results of logistic regression for delay, procedures involving women were delayed 1.4 times more frequently than those of men. Compared to Department A, Department B was 1.8 times more likely to be delayed, and Department H was 0.4 times less likely to be delayed. Regional anesthesia was 2.4 times more likely to be delayed than general anesthesia, and surgeries that PCA was applied were 0.6 times less likely to be delayed than those when it was not. Surgeries performed on the Thursday were 1.7 times more likely to be delayed than those performed on the Monday. Compared to surgeries performed between 07:00-07:59, those performed between 08:00-08:29 were 4.3 times higher. 3. The reasons for delay were related to surgeon, surgical department, patient, anesthesia, administrative system, sick ward, and support services. Among these, 5,755 minutes for 276 delayed cases could be resolved easily, and resolving delays of 3,320 minutes for 131 cases would be more difficult. Among the causes for delay that could be improved, delays due to patient's transfer and surgeon's factor were the most common, 21.6% and 17.4% respectively. 4. If resolvable delays are improved, pre-anesthesia room is administered, and regional anesthesia and PCA are done ahead of time, use of emergency operating rooms will increase, we can increase overall utilization by 4.09%, we will save 744 minutes a day, we can reduce the time the operation room is used after 4 PM by 35%, and we can resolve the operation cancellations due to insufficient operating rooms. For the increase in the use of operating rooms, we need to maximally decrease the delays that could be improved, by allocating block time based on used totals hours of elective cases, giving accurate information on surgery schedule, voluntary cooperation by staff participating in surgeries in reducing delay time, and the hospital management's will to improve delay.

• Journal of Preventive Medicine and Public Health
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• v.26 no.4 s.44
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• pp.650-660
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• 1993

This study aims to describe the causes of medically unnecessary hospital stay at a teaching tertiary hospital, using modified version of Delay Tool in which the causes of delay are divided into slx major categories : delay related to test scheduling, test results, surgery, medical staff, patient/family, and administration. For the analysis of hospital stay, 6,479 inpatient-days were reviewed in two medical and four surgical departments for one month. Initially inappropriate hospital stays were identified using Appropriateness Evaluation Protocol (AEP), and causes of delay listed in Delay Tool were assigned to each of them. In both medical and surgical services, the most important cause of delay was related to medical staffs, ranging from 3.6% to 51.6% of total inpatient days. Next important category was delay related to test scheduling in medical services ($4.7{\sim}9.2%$), and delay related to surgery in surgical services ($7.3{\sim}15.0%$). Among subcategories of delay related to medical staffs, delay due to conservative care was the most important cause of inappropriate hospital stay ($2.9{\sim}6.4%$). Each clinical departments had different distribution among delay categories, which could not be fully justified by their clinical charateristics. The Delay Tool would be helpful in exploring factors related to the inefficient use of hospital beds. As a measurement tool of inappropriate hospital stay, however, the Delay Tool should be refined in the definitions of categories and its contents.

• Journal of Genetic Medicine
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• v.10 no.1
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• pp.52-56
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• 2013

Mosaic trisomy 14 syndrome is a well-known but unusual chromosomal abnormality with a distinct and recognizable phenotype. Array comparative genomic hybridization (CGH) analysis has recently become a widely used method for detecting DNA copy number changes, in place of traditional karyotype analysis. However, the array CGH shows a limitation for detecting the low-level mosaicism. Here, we report the detailed clinical and cytogenetic findings of patient with low-frequency mosaic trisomy 14, initially considered normal based on usual cut-off levels of array CGH, but confirmed by G-banding karyotyping. Our patient had global developmental delay, short stature, congenital heart disease, craniofacial dysmorphic features, and dark skin patches over her whole body. Estimated mosaicism proportion was 23.3% by G-banding karyotyping and 18.0% by array CGH.

• Korean Journal of Adult Nursing
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• v.26 no.5
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• pp.500-511
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• 2014

Purpose: The purpose of this study was to investigate predictors of violent behavior by patient or caregiver of patient in the emergency department. Methods: Subjects of the study were 447 residents who have visited the emergency department in community P Metropolitan City during the past year. The data collecting period was from June 1, 2012 to August 31, 2012. Data was collected using self-reported questionnaires. Results: Predictors of violent behavior in the emergency department were divided into personal and institutional factors. Personal factors included relationship with patients, presence of alcohol, reports of discontent during and past treatment and responses to deterioration in patient's conditions, institution factors included perceived attitudes toward medical workers' explanations and proficiency of medical workers, and delay in medical treatment hours. Conclusion: Knowledge of personal and institutional factors may permit emergency staff to minimize or prevent potential violence in the emergency department.

• KSII Transactions on Internet and Information Systems (TIIS)
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• v.11 no.12
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• pp.5835-5854
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• 2017

The implementation of IEEE 802.15.6 in Wireless Body Area Network (WBAN) is contention based. Meanwhile, IEEE 802.15.4 MAC provides limited 16 channels in the Superframe structure, making it unfit for N heterogeneous nature of patient's data. Also, the Beacon-enabled Carrier-Sense Multiple Access/Collision-Avoidance (CSMA/CA) scheduling access scheme in WBAN, allocates Contention-free Period (CAP) channels to emergency and non-emergency Biomedical Sensors (BMSs) using contention mechanism, increasing repetition in rounds. This reduces performance of the MAC protocol causing higher data collisions and delay, low data reliability, BMSs packet retransmissions and increased energy consumption. Moreover, it has no traffic differentiation method. This paper proposes a Low-delay Traffic-Aware Medium Access Control (LTA-MAC) protocol to provide sufficient channels with a higher bandwidth, and allocates them individually to non-emergency and emergency data. Also, a Contention Differentiated Adaptive Slot Allocation CSMA-CA (CDASA-CSMA/CA) for scheduling access scheme is proposed to reduce repetition in rounds, and assists in channels allocation to BMSs. Furthermore, an On-demand (OD) slot in the LTA-MAC to resolve the patient's data drops in the CSMA/CA scheme due to exceeding of threshold values in contentions is introduced. Simulation results demonstrate advantages of the proposed schemes over the IEEE 802.15.4 MAC and CSMA/CA scheme in terms of success rate, packet delivery delay, and energy consumption.

• Clinical and Experimental Pediatrics
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• v.59 no.sup1
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• pp.25-28
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• 2016

Phelan-McDermid syndrome is a rare genetic disorder caused by the terminal or interstitial deletion of the chromosome 22q13.3. Patients with this syndrome usually have global developmental delay, hypotonia, and speech delays. Several putative genes such as the SHANK3, RAB, RABL2B, and IB2 are responsible for the neurological features. This study describes the clinical features and outcomes of Korean patients with Phelan-McDermid syndrome. Two patients showing global developmental delay, hypotonia, and speech delay were diagnosed with Phelan-McDermid syndrome via chromosome analysis, fluorescent in situ hybridization, and multiplex ligation-dependent probe amplification analysis. Brain magnetic resonance imaging of Patients 1 and 2 showed delayed myelination and severe communicating hydrocephalus, respectively. Electroencephalography in patient 2 showed high amplitude spike discharges from the left frontotemporoparietal area, but neither patient developed seizures. Kidney ultrasonography of both the patients revealed multicystic kidney disease and pelviectasis, respectively. Patient 2 experienced recurrent respiratory infections, and chest computed tomography findings demonstrated laryngotracheomalacia and bronchial narrowing. He subsequently died because of heart failure after a ventriculoperitoneal shunt operation at 5 months of age. Patient 1, who is currently 20 months old, has been undergoing rehabilitation therapy. However, global developmental delay was noted, as determines using the Korean Infant and Child Development test, the Denver developmental test, and the Bayley developmental test. This report describes the clinical features, outcomes, and molecular genetic characteristics of two Korean patients with Phelan-McDermid syndrome.

• Journal of Korean Academy of Nursing Administration
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• v.16 no.3
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• pp.219-228
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• 2010

Purpose: The purpose of this study was to explore the degree of delay in waiting time, and the relationships of waiting time, patient satisfaction, and revisiting intention of outpatient in general hospitals. Methods: The data were collected from June 22 to July 4, 2009. A total of 536 outpatients who visited 21 clinics of a general hospital were subjected to evaluate the waiting time. The survey tools used were the Korea Health Industry Development Institutes (2008) tool for patient satisfaction and Reichheld & Sasser (1990) for revisiting intention. The data were analyzed by SAS version 9.1, descriptive statistics, t-test, ANOVA, and Pearson correlation coefficient. Results: The mean patient's waiting time was $28.3{\pm}30.7\;min$, the revealed mean score of patient's satisfaction was 2.92, and the revisiting intention showed was 4.56. The waiting time was negatively correlated with patient's satisfaction (r=-.10, p<.019). Patient's satisfaction was positively correlated with revisiting intention (r=-.51, p<.001). Conclusion: Waiting time management is an important factor of increasing patient's satisfaction and revisiting intention in general hospitals. It is mandatory that reservation management systems take into account the patient's characteristics of visiting outpatient department in order to shorten the real waiting time.