• The Korean Journal of Emergency Medical Services
• /
• v.8 no.1
• /
• pp.149-160
• /
• 2004

Background : To save out-of-hospital cardiac arrest cases is a major concern for Korea. Cardiac arrest is a very common problem, with > 18,000 cases dying each year in Korea. Overall, survival to hospital discharge remains poor. Resuscitation has become an important multidisciplinary branch of medicine, demanding a spectrum of skills and attracting a plethora of specialities and organizations. Since the "Utstein Style" was advocated in 1991, many reports about out-of-hospital cardiac arrest have been published based on this guideline. These differences prevent valid inter-hospital and international comparisons. However, we do not know the true effectiveness of resuscitation. There are no guideline for reviewing, reporting, conducting research on resuscitation in Korea. This study evaluated the out-of-hospital factor associated with survival discharge of out-of-hospital cardiac arrest, was especially to provide basic data for the unified reporting guideline of resuscitation in Korea. Methods : From January 1990 to July 2004, we collected data about out-of-hospital cardiac arrest at Wonju Christian Hospital(WCH-CAD), Ewha Women University Mokdong Hospital(Ewha-CAD), I used same record form based on the "Utstein Style". The "Utstein Style" is internationally recommended guidelines for reporting outcome data from resuscitation events. Results : Resuscitation was performed in 1443 out-of-hospital cardiac arrest patients at 2 hospitals. Five hundred eighty(40.25%) patients recovered the spontaneous circulation at least once and One hundred sixty eight(11.66%) patients discharged alive. Initial EKG showed Ventricular Tachycardia/Ventricular Fibrillation in One hundred thirty five(9.33%) patients, asystole in one thousand nine(69.73%) patients and other rhythms in one hundred thirty nine(20.94%) patients. Among one hundred two cardiogenic cardiac arrest patients, two(2.0%) patients was discharged alive. Conclusion : Overall survival rate of out-of-hospital cardiac arrest patients was 11.66% which was poorer than that of the western country. The proportion of the cardiogenic cause was 33.38% which was only half of the western country. VT/VF is relatively not common ac a initial EKG rhythm. These differences might be to due difference in the prevalence pattern of out-of-hospital cardiac arrest as well as prematurity of the EMSS. It is needed that the best survival can be achieved if all following links have been optimized : rapid access, early CPR, early defibrillation, early ACLS.

• Journal of Korean Neurosurgical Society
• /
• v.56 no.4
• /
• pp.295-302
• /
• 2014

Objective : This study was conducted to clarify the association factors and clinical significance of the CT angiography (CTA) spot sign and hematoma growth in Korean patients with acute intracerebral hemorrhage (ICH). Methods : We retrospectively collected the data of 287 consecutive patients presenting with acute ICH who arrived within 12 hours of ictus. Baseline clinical and radiological characteristics as well as the mortality rate within one month were assessed. A binary logistic regression was conducted to obtain association factors for the CTA spot sign and hematoma growth. Results : We identified a CTA spot sign in 40 patients (13.9%) and hematoma growth in 78 patients (27.2%). An elapsed time to CT scan of less than 3 hours (OR, 5.14; 95% CI, 1.76-15.02; p=0.003) was associated with the spot sign. A CTA spot sign (OR, 5.70; 95% CI, 2.70-12.01; p<0.001), elevated alanine transaminase (GPT) level >40 IU (OR, 2.01; 95% CI, 1.01-4.01; p=0.047), and an international normalized ratio ${\geq}1.8$ or warfarin medication (OR, 5.64; 95% CI, 1.29-24.57; p=0.021) were independent predictors for hematoma growth. Antiplatelet agent medication (OR, 4.92; 95% CI, 1.31-18.50; p= 0.019) was significantly associated with hematoma growth within 6 hours of ictus. Conclusion : As previous other populations, CTA spot sign was a strong predictor for hematoma growth especially in hyper-acute stage of ICH in Korea. Antithrombotics medication might also be associated with hyper-acute hematoma growth. In our population, elevated GPT was newly identified as a predictor for hematoma growth and its effect for hematoma growth is necessary to be confirmed through a further research.

• Journal of Trauma and Injury
• /
• v.26 no.3
• /
• pp.190-197
• /
• 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.

• Journal of Preventive Medicine and Public Health
• /
• v.33 no.1
• /
• pp.17-24
• /
• 2000

Objectives : To propose the referential data to evaluate the health impacts of Vietnam veterans' children whose father were exposed to herbicides in Vietnam War. Methods : Vietnam veterans who visited to Pusan Veteran Hospital for medical care were recruited from April to October, 1998. They were 71 and asked about their own combat history, symptoms and illness, and health status of their 182 children. The informations were collected by direct and phone interview. Exposure estimation was also performed as exposure score depending on year and unit of participation, and personal episodes related to exposure to herbicide in the war. It classified into three groups; lower(<18.0), moderate(18-53), high$(\geq53)$ exposure group. Results : The mean age and the period into the combat of the veterans were 52.8 years and 15.0 months. The mean exposure score was $18.1{\pm}9.9$, and mainly distributed in lower (46.5%) and moderate(52.1%) exposure group. Most(90.1%) of them were diagnosed as sequelae(21 cases) and suspected sequelae(43 cases) of the herbicides by Korean veteran's hospital diagnostic criteria. The major sequelae was peripheral neuropathy 13 cases, chloracne 5 cases, and the major suspected sequelae was hypertension 20 cases, diabetes mellitus 18 cases, liver disease 12 cases, central neuropathy 11 cases, etc. About birth, 42.2% and 16.9% experienced spontaneous abortion and stillbirth, respectively. The mean exposure score was higher in stillbirth experience group(p<0.05). About half of the children(90 cases, 49.5%) hold the abnormal health status: those were skin pigmentation 38 cases, rash 23 cases, congenital anomaly 15 cases, general weakness 12 cases, purpura 8 cases, visual disturbance 8 cases, etc. These health problems had no association with father's exposure level(p>0.05). Conclusions : These results were depend on their own answers, and expectation for compensation did not excluded, therefore, this study may have limitations: inaccuracy of informations due to recall bias and response bias. Nevertheless, through this study, we could image the fundamental aspect for health impacts of Vietnam veterans' children for preparing the national control program and policy. A large scale epidemiologic study with valid exposure assessment on the health impacts of Vietnam veterans' children is recommneded.

• Therapeutic Science for Rehabilitation
• /
• v.9 no.4
• /
• pp.55-67
• /
• 2020

Objective : This study aimed to understand the burnout experience of hospital occupational therapists through phenomenological research. Methods : We conducted in-depth interviews with 6 occupational therapists working at hospital for 8 weeks. The data were analyzed using the Palangsae 2.0 software to derive meaning through the process of transcription and data entry, coding, and topic creation. Results : From the collected data, 14 sub-themes, 9 theme clusters, 3 categories were identified. The cause of burnout was confirmed as being due to therapy-related work and workplace conditions. The impacts of burnout on individual life were psychological in nature and also included being an adverse, influence on others. The coping strategies to deal with burnout were enrichment of personal life, self-awareness and philosophy, conscious approach, social support, and setting new goals for life. Conclusion : We suggest that spontaneous efforts are needed by occupational therapists in order to alleviate the conflicts of job identity. In addition, organizational regulations and programs and the establishment of horizontal organizational cultures are required to overcome and prevent burnout of occupational therapists.

• Journal of Pharmacopuncture
• /
• v.17 no.3
• /
• pp.31-39
• /
• 2014

Objectives: This study was performed to analyze the toxicity and to find the lethal dose of the test substance Water-soluble Carthami-flos pharmacopuncture (WCF) when used as a single intravenous-dose in 6-week-old, male and female Sprague-Dawley rats. Methods: The experiment was conducted at Biotoxtech according to Good Laboratory Practices. 20 female and 20 male Spague-Dawley rats were divided into 4 groups of 5 female and 5 male animals per group. The rats in the three experimental groups received single intravenous injections with 0.125-mL, 0.25-mL and 0.5-mL/animal doses of WCF, Groups 2, 3, and 4, respectively, and the control group, Group 1, received a single intravenous injection with a 0.5-mL dose of normal saline. Clinical signs were observed and body weight measurements were carried out for 14 days following the injections. At the end of the observation period, hematology, clinical chemistry, histopathological tests and necropsy were performed on the injected parts. Results: No deaths occurred in any of the groups. Also, no significant changes in body weight, hematological parameters or clinical chemistry test results between the control group and the experimental groups were observed. Visual inspection after necropsy showed no abnormalities. Histopathological tests on the injected parts showed no significant differences, except for Group 1 females; however, the result was spontaneous generation and had no toxicological meaning because it was not dose-dependent. Therefore, this study showed that WCF had no effect on the injected parts in terms of clinical signs, body weight, hematology, clinical chemistry, and necropsy. Conclusion: As a result of single intravenous-dose tests of the test substance WCF in 4 groups of rats, the lethal dose for both males and females exceeded 0.5 mL/animal. Therefore, WCF is a relatively safe pharmacopuncture that can be used for treatment, but further studies should be performed.

• Tuberculosis and Respiratory Diseases
• /
• v.72 no.5
• /
• pp.441-447
• /
• 2012

Background: Chest tube drainage (CTD) is an indication for the treatment of pneumothorax, hemothroax and is used after a thoracic surgery. But, in the case of incomplete lung expansion, and/or persistent air leak from CTD, medical or surgical thoracoscopy or, if that is unavailable, limited thoracotomy, should be considered. We evaluate the efficacy of bronchoscopic injection of ethanolamine to control the persistent air leak in patients with CTD. Methods: Patients who had persistent or prolonged air leak from CTD were included, consecutively. We directly injected 1.0 mL solution of 5% ethanolamine oleate into a subsegmental or its distal bronchus, where it is a probable air leakage site, 1 to 21 times using an injection needle through a fiberoptic bronchoscope. Results: A total of 15 patients were enrolled; 14 cases of spontaneous pneumothorax [idiopathic 9, chronic obstructive pulmonary disease (COPD) 3, post-tuberculosis 2] and one case of empyema associated with broncho-pleural fistula. Of these, five were patients with persistent air leak from CTD, just after a surgical therapy, wedge resection with plication for blebs or bullae. With an ethanolamine injection therapy, 12 were successful but three (idiopathic, COPD and post-tuberculosis) failed, and were followed by a surgery (2 cases) or pleurodesis (1 case). Some adverse reactions, such as fever, chest pain and increased radiographic opacities occurred transiently, but resolved without any further events. With success, the time from the procedure to discharge was about 3 days (median). Conclusion: Bronchoscopic ethanolamine injection therapy may be partially useful in controlling air leakage, and reducing the hospital stay in patients with persistent air leak from CTD.

• Korean Journal of Psychosomatic Medicine
• /
• v.8 no.1
• /
• pp.58-64
• /
• 2000

Objectives : This study aimed to examine a correlation between the somatic complaints, emotion, vocabulary and alexithymia as a component of personality in normal persons. Methods : 204 subjects were collected by age-based systematic sampling from the 662 persons without confirmed medical illness. We used the Korean version of 20-item Toronto Alexithymia Scale(TAS-20K) to measure alexithymia. The somatic complaints were checked by the list of somatic symptoms on the diagnostic criteria of somatization disorder and major depressive episode in DSM-IV. The vocabulary was evaluated by the total number of associating-words from the spontaneous association of word and the secondary association to given words. The anxiety and depression were evaluated using 5-point self-report scale. Results : 1) The degree of alexithymia was significantly correlated with the somatic complaints, anxiety, depression. 2) The somatic complaints were significantly correlated with the anxiety and depression. 3) The number of associating-words showed negative correlation with the age. 4) The degree of alexithymia was not correlated with the number of associating-words. Conclusion : The more degree of alexithymia increased, the more somatic complaints appeared. There was a significant correlation between the degree of alexithymia, anxiety and depression. But the degree of alexithymia was not correlated with the amount of vocabulary.

• Journal of Korean Ophthalmic Optics Society
• /
• v.13 no.2
• /
• pp.43-50
• /
• 2008

Purpose: The purpose of this study is to evaluate the effect of a VR (Virtual Refractor), which is a simulator for a PR (Practical Refraction), as an educational tool. Methods: Twenty four third year students enrolled in the department of visual optics volunteered for VR education. Each student attended a VR training course and practiced with the VR by themselves. One month later, each student tested three virtual subjects on the VR and one real subject on the PR and were given a performance score for each refraction. And the scores for the virtual and practical refractions were compared. In addition, a self-report questionnaire based on a five point Likert-scale was designed, consisting of domains such as spontaneous participation, contribution for the refraction, confirmity of the VR and PR, and necessity of the VR. Results: The Spearman's correlation coefficient between the testing score of the practical and virtual refractions indicated a significantly correlation (R=0.71, p<0.001). In the questionnaire, the mean score of the domains was 3.67${\pm}$0.96 and it indicated that students expressed that using the VR was beneficial. The correlation value among these domains was a high significant level, 0.91~0.68 (p<0.001). Conclusions: Although the VR required certain improvements in its concentration and systematic approaches for practical situations, it showed a high correlation between the VR and the PR and represented a positive evaluation in the PR.

• Journal of Radiation Protection and Research
• /
• v.41 no.3
• /
• pp.196-205
• /
• 2016

Background: The emergency planning zone (EPZ) of the city of Busan is divided into the precautionary actions zone (PAZ) and the urgent protective action planning zone; which have a 5-km radius and a 20-km to 21-km radius from the nuclear power plant site, respectively. In this study, we assumed that a severe accident occurred at Shin-Kori nuclear unit 3 and evaluated the dispersion speed of radiological material at each distance at various wind speeds, and estimated the effective dose equivalent and the evacuation time of PAZ residents with the goal of supporting off-site emergency action planning for the nuclear site. Materials and Methods: The total effective dose equivalent, which shows the effect of released radioactive materials on the residents, was evaluated using the RASCAL 4.2 program. In addition, a survey of 1,036 residents was performed using a standardized questionnaire, and the resident evacuation time according to road and distance was analyzed using the VISSIM 6.0 program. Results and Discussion: According to the results obtained using the VISSIM and RASCAL programs, it would take approximately 80 to 252.2 minutes for permanent residents to move out of the PAZ boundary, 40 to 197.2 minutes for students, 60 to 232.2 minutes for the infirm, such as elderly people and those in a nursing home or hospital, and 30 to 182.2 minutes for those temporarily within the area. Consequently, in the event of any delay in the evacuation, it is estimated that the residents would be exposed to up to $10mSv{\cdot}h^{-1}$ of radiation at the Exclusion Area Boundaries (EAB) boundary and $4-6mSv{\cdot}h^{-1}$ at the PAZ boundary. Conclusion: It was shown that the evacuation time for the residents is adequate in light of the time lapse from the initial moment of a severe accident to the radiation release. However, in order to minimize the evacuation time, it is necessary to maintain a system of close collaboration to avoid traffic congestion and spontaneous evacuation attempts.