• Clinics in Shoulder and Elbow
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• v.20 no.3
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• pp.162-166
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• 2017

Traumatic anterior shoulder dislocation combined with scapular fracture in elderly patients is relatively rare. In this case, a patient visited Emergency Room of Dong-A University Hospital for shoulder pain after falling off a ladder. Radiographs demonstrated anterior shoulder dislocation with displaced Ideberg type IIb scapula (glenoid fossa) fracture combined with a large rotator cuff tear on magnetic resonance imaging. We performed arthroscopic rotator cuff repair, but a large fragment in the inferior glenoid was left untreated. At the 1 year follow-up visit, the pain visual analogue scale of the patient was 2, the American Shoulder and Elbow Society score was 88 and the patient had gained nearly full range of motion without any apprehension.

• Journal of Korean Neurosurgical Society
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• v.39 no.3
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• pp.228-230
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• 2006

Hypothermia is relatively a common condition and most cases involve mild hypothermia. But severe hypothermia below $30^{\circ}C$ is medical an emergency condition. We report the case of a 41-year-old man who had been left in a manhole for more than 9 hours on a freezing cold water. He was transported to our emergency room in semicomatose state with a body temperature $26.5^{\circ}C$. The patient was warmed with active rewarming. After initial stabilization, the patient was taken for a brain computed tomography and found to have large fronto-temporo-parietal[FTP] subdural hemorrhage. The patient underwent an emergent decompressive craniectomy and hematoma evacuation. After surgery, he recovered to drowsy mentation and vital signs were stable.

• Korean Institute of Interior Design Journal
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• v.26 no.6
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• pp.71-80
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• 2017

The purpose of this study is identify the status of the ward of public hospital for integrated nursing care service. Integrated nursing care service has been expanding on a national scale from 2016 but most of public hospitals are currently unable to operate due to nursing shortage. In this study 8 wards of public hospital have been chosen and analyzed. The measure of space program and area distribution(patient area percentage, staff area percentage, circulation area percentage), nurses's walking distance(distance from ns to patient room, distance from ns to core) were calculated by depthmapX and autocad programs. The result of this study is as follows. Nurse's walking distance is more than 24m so the efficiency of nurse's patient care is reduced. The percentage of patient area in double-corridor is higher and the patient feels more comfortable but the Nurse's walking distance is longer and the accessibility is lowered. NS should be located in the center of the ward and close to the core but some wards are not composed of proper space-separation and flow of human trrafic is overlapped. This study may serve as basic research for the architectural plan for future integrated nursing care ward.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.8 no.2
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• pp.231-241
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• 1998

To assess biological indoor air quality in hospital, concentrations of viable airborne microbes were determined at intensive care unit(ICU), patient room (PR), outpatient waiting room(OPWR) in hospitals of large(1000 beds), middle(500 beds), small(100 beds) hospitals, respectively. Gram positive bacteria, gram negative bacteria, fungi were sampled using suctional sampling method by RCS sampler (Reuter centrifugal air sampler) and RCS GK-A agar plate. In gram positive bacteria groups, CNS(Coagulase Negative Staphylococcus), Micrococcus, Lactobacillus, S. aureus, Enterococcus, St. viridans identified. In gram negative bacteria groups, A. baumannii, Kl. peumoniae and E. coli were identified, and Penicillium was identified in fugi groups. Results of the study were as follows. 1. The highest concentrations of airborne microbes was $971CFU/m^3$ at 5:00 PM in small hospital patient room, and average concentrations of airborne microbes in large, middle and small hospitals were $282CFU/m^3$, $289CFU/m^3$ and $625CFU/m^3$, respectively. Average concentrations of airborne microbes in office(control) was $90CFU/m^3$. Thus, the small hospital showed the worst condition. 2. Representatives of 8 different genera were identified in 150 samples. The most frequently isolated organisms were Staphylococcus (73.0%), Micrococcus (20.7%) and Lactobacillus (4.7%), respectively. Pathogenic microbes isolated were A. baumannii, E. coli, Enterococcus, Kl. peumoniae, S. aureus, St. viridans and Penicillium as fungi. In office, no pathogenic microbes were identified. Average concentrations of airborne pathogenic microbes in large, middle and small hospital were $5CFU/m^3$ (2%), $11CFU/m^3$ (4%) and $12CFU/m^3$ (2%), respectively. Thus, condition in a large hospital was better than those in a middle and a small hospital.

• Journal of Chest Surgery
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• v.31 no.12
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• pp.1243-1246
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• 1998

Tracheobronchial injuries are uncommon. Except for the cervical region, most tracheobronchial injuries are due to blunt chest trauma in Korea. The depth of the tracheobronchial trees renders these structures relatively safe from stab wound. We experienced a case of left main bronchial laceration with azygos vein tear following stab wound in the back of right chest firstly in Korea. The patient was a 24 years old male. A routine chest radiography showed a knife in chest at emergency room. We didn't remove the knife at emergency room. This patient was carried to operation room in 30 minutes after arrival of our hospital without computed tomography and bronchoscopy. The operation was performed through standard right posterolateral thoracotomy and then the knife was removed. The left main bronchus and azyos vein were lacerated obliquely. The penetrated azygos vein was ligated and the laceration of the left main bronchus was repaired. Postoperative course was uneventful.

• Journal of Korean Physical Therapy Science
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• v.9 no.4
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• pp.119-130
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• 2002

Objective: The purpose of this research was to use data for furnish quality physical therapy service. The research subjects were admitted shoulder pain patients treated with physical therapy that was to grasp physical therapy method as distinguishing application time. Subject: Total number of distributed questionnaire was 563 persons that was to utilized physical therapy room of 56th medical institution and distributed it to each physical therapist in charge. Method: The research used questionnaire in order to research itemized treatment application time that is according to physical therapy method to applicated with shoulder pain patient. The research contents is to received shoulder pain diagnosis period, total duration of utilizing physical therapy room, the number of times per week to used physical therapy room, etc. And we had physical therapist recording the time of application physical therapy method come under the items. Result: The average treatment time was 59.2 minutes at all patients. During this time, 39.7 min was modality treatment. Active movement treatment was only 7.1 min. Total treatment time was longest in general hospital at 64.9 min, it was shortest in clinical hospital at 53.3 min. Treatment time was difference as hospital scale(p<0.001). Active movement treatment time was longest in general hospital at 11.5 min. The average treatment time was 4.5 min in clinical hospital. Therefore, it was related to hospital scale(p<0.05). The average of manual therapy time by physical therapist was 7.5 min. General hospital was linger at 8.6 min than clinical hospital at 6.7 min(p<0.05). Patient of 90.2 % were treated to hot pack, ultra-sound treatment was next as 50.1%. Active strengthening exercise was most carrying out of the active treatment as 25.4 %. Active sensorimotor exercise was practiced only 28 persons of 5.0 %. Most joint mobilization (38.4 %) was used of the passive manual therapy items, next to soft tissue mobilization (33.0 %), and next to manual distraction therapy(14.0 %).

• Journal of Yeungnam Medical Science
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• v.39 no.1
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• pp.77-80
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• 2022

Fistulas between the arteries and the gastrointestinal tract are rare but can be fatal. We present a case of an ilioenteric fistula between the left external iliac artery and sigmoid colon caused by radiotherapy for cervical cancer, which was treated with endovascular management using a stent graft. A 38-year-old woman underwent concurrent chemoradiotherapy for cervical cancer recurrence. Approximately 9 months later, the patient suddenly developed hematochezia. On her first visit to the emergency room of our hospital, computed tomography (CT) images did not reveal extravasation of contrast media. However, 8 hours later, she revisited the emergency room because of massive hematochezia with a blood pressure of 40/20 mmHg and a heart rate of 150 beats per minute. At that time, CT images showed the presence of contrast media in almost the entire colon. The patient was referred to the angiography room at our hospital for emergency angiography. Inferior mesenteric arteriography did not reveal any source of bleeding. Pelvic arteriography showed contrast media extravasation from the left external iliac artery to the sigmoid colon; this was diagnosed as an ilioenteric fistula and treated with a stent graft. When the bleeding focus is not detected on visceral angiography despite massive arterial bleeding, pelvic arteriography is recommended, especially in patients with a history of pelvic surgery or radiotherapy.

• The Korean Journal of Emergency Medical Services
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• v.10 no.1
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• pp.13-21
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• 2006

Purpose: This study aims to examine characteristics and actual conditions of patients using emergency room at farming and fishing villages, solve overcrowding of emergency room at the tertiary hospital and activate local emergency clinics. Methods: It examines department of diagnosis and treatment, vehicles used, sex, age, residential area, visit hour, length of stay, presence or absence of trauma, measures after first aid and degree of severity based on medical records of 6,740 patients using emergency room at farming and fishing villages from Jan. 1 to Dec. 31, 2005. Conclusion : 1. Sex distribution of patients of emergency room was male 54.9% and female 45.1% and age distribution between over 40 and below 50 was most as 15.9%. 2. Transport means to emergency room were 91.4 of private car and others (public transport and going on foot), 7.5 of 119, 129 and police car and 1.0% of ambulance. 3. According to distribution of residential areas of emergency patients, 38.9% were Eup area, 42.1% Myeon area, 11.4% distant area and 7.5% adjacent area. 4. According to distribution of emergency patients by department of diagnosis and treatment, internal medicine was most as 35.8% and 55% of patients visited emergency room from 3:31 p.m. to 11:30 p.m.. 5. According to total hours of diagnosis and treatment of subjects, 51.2% were within 30min. and cases of non-trauma disease were 68.2%. 6. According to degree of emergency of emergency patients, non-emergency cases were 65.3%, urgent cases 27.7% and emergency cases 7.0% and 74.2% of patients returned home after first aid and 20.6% of them hospitalized. In conclusion, characteristics and diversification of patients should be examined and efforts by government and local medical institutions which must organize emergency system and facility and personnel levels suitable to regional conditions are needed in order to prevent overcrowding of emergency center of the tertiary hospital and activate local emergency center.

• The Journal of the Korea Contents Association
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• v.16 no.10
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• pp.522-532
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• 2016

Purpose: This study was conducted to develop case-based self-learning multimedia contents for preventing malpractice that frequently occurred among nurses working in the operating room. Methods: Based on the learning needs of operating room nurses, real case reports, and literature reviews, the case-based multimedia learning contents were developed according to the instructional design procedure. The assessment of learning needs was performed by the combination of surveys using structured questionnaire and of interviews for 40 operating room nurses. Results: The learning contents included four learning modules with real malpractice cases from the areas of operating preparation, nursing skills during operation, environmental management of operating room, and patient safety and observation-related. The 80 minute long case-based multimedia learning contents were finally developed after content validity tests from clinical experts. Each module contained photos, sounds and flash animation with voice recording on the contents of nursing error cases and standardized protocols. Conclusion: The developed multimedia learning contents based on real error cases in this study can be utilized as an educational hands-on training materials for nurses to prevent malpractice in the operating room.

• Journal of The Korea Institute of Healthcare Architecture
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• v.25 no.2
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• pp.51-62
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• 2019

Purpose: This study aims to examine spatial characteristics of ambulatory care department Chronologically through case studies; and to consider the social implication of these spatial changes. Methods: In this study, a total of eight ambulatory care departments, one or two for each period, were selected in order to analyze the spatial characteristics. Results: First, since the 1990s, the outpatient department of the US has been changed into a patient-centered space by providing high quality outpatient medical services through individual exam room planning. Second, the exam room has been changed from open/semi-open/group exam room to individual exam room since 1990, and the trend is shifting from the cluster type to the modular type consisting of universal exam rooms in order to achieve the flexibility of exam room. Third, the diagnostic/testing area has been deployed to the ambulatory clinic to enable 'one-stop shopping' for patients-centered care since 1990s, however, it has been disappearing since 2000 due to Reduce medical expenses. Fourth, the Central Nursing Station type first appeared in the outpatient department In the 2000s, followed by the type of decentralized nursing station type since 2010s. And fifth, the area of medical support has been placing to be concentrated on one place due to the Lean Design strategy since 2010. Implications: In the future, it is expected that Korea will be more focused on efficiency, visual control, and flexibility in the planning of the ambulatory care department as in the case of the United States.