• Journal of Chest Surgery
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• v.56 no.6
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• pp.431-434
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• 2023

Background: The first 3 ribs are anatomically well-protected, shielded by the large thoracic muscles, the shoulder girdle, and the arm. A significant force is required to fracture these ribs; thus, such fractures suggest a high-energy trauma and are associated with injuries to vital organs of the thorax, such as the aorta, the heart, the lungs and the great vessels. Methods: A retrospective analysis was conducted over a 10-year period at a single hospital. The study assessed patients with fractures of the second rib, including their concurrent injuries and the overall severity of their trauma. Results: Among the 76 patients included in the study, the average age was 47.35 years, 81.5% were men, and 19.5% were women. Thirteen patients (17.1%) survived their injuries. The most common causes of injury were road traffic accidents (63%) and pedestrian injuries (22%). The patients who did not survive sustained injuries to an average of 5 additional organs, while survivors had injuries to an average of 2.07 additional organs. Left rib fractures were the most frequently observed (46%). The most serious concurrent injuries reported were to the aorta (5.26%), heart (10.52%), lung (52.36%), head (57.89%), liver (30.2%), spleen (26.31%), and kidney (17.1%). Conclusion: As indicators of serious injury to vital endothoracic organs, isolated fractures of the second rib should be considered equal to first rib fractures in clinical importance.

• The Journal of Internal Korean Medicine
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• v.45 no.2
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• pp.167-175
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• 2024

Hospital-acquired bacterial infections, including vancomycin-resistant enterococci (VRE) infection (MIC: 32 mcg/ml), are common. We describe the case of a 63-year-old female patient with subarachnoid hemorrhage and VRE infection treated with Jashin-bowon-tang and Samhuang-sashim-tang for 57 days and 22 days, respectively. The therapeutic effect was assessed weekly via culture, color and viscosity of pus from a coccyx sore, and C-reactive protein (CRP). Vital signs were checked four times a day. Seventeen days after treatment, VRE was not colonized in patient and color and viscosity of pus, CRP and vital sign were improved. This case report suggests that Jashin-bowon-tang and Samhuang-sashim-tang might be an alternative option for VRE infection patients reducing the need for extended isolation periods and speeding up recovery times.

• Journal of Korea Multimedia Society
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• v.14 no.1
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• pp.121-132
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• 2011

A healthcare system is a type of medical information system that performs early detection and prevention in diseases by checking one's health condition periodically. Such a healthcare system is based on the signal obtained from the body. However, the developed existing system represents certain differences in the storage and description of vital signs according to medicare devices and the evaluation method of the system. It brings some disadvantages, such as lacks in the interoperability between systems, increases in the development cost of systems, and absence of a unified system. Thus, this study develops a healthcare system based on a meta model. For establishing this objective, this study describes and stores vital sign data based on the standard meta model of HL7 and applies OCL, which is a mathematical specification language, for defining wellness indexes and extracting data in order to evaluate health risk appraisals in health. In addition, this study implements components based on OSGi and assemble them in order to easily extend various devices and systems. By describing vital data based on the meta model, it represents some advantages that it makes possible to ensure the interoperability between systems and introduce the standardization of the evaluation method of health conditions through defining the wellness index using OCL. Also, it provides dear specifications.

• Advances in pediatric surgery
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• v.14 no.1
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• pp.37-47
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• 2008

Recently, the survival rates of extremely low-birth-weight (ELBW) infants have improved with the development of neonatal intensive care. However, these infants were susceptible to intestinal perforation due to prematurity, fluid restriction, and injection of indomethacin, etc. Because of the risks of transportation, anesthesia and surgery itself, peritoneal drainage has been compared with laparotomy. Through our experience, we investigate the usefulness of peritoneal drainage retrospectively. From 1997 to 2007, six ELBW (M:F=5:1) underwent primary peritoneal drainage for intestinal perforation. Their median birth weight was 685g (405~870) and gestational age was $25^{+1}$ weeks ($24^{+3}{\sim}27^{+0}$). We noticed the intestinal perforation at median 10.5 days (8~18) after birth, and placed Penrose drain or Jackson-Pratt drain through right lower quadrant incision under local anesthesia. The cause of intestinal perforation was necrotizing enterocolitis in one patient, but that of the others was not clear. Three patients who showed normal platelet count and stable vital signs recovered uneventfully. Two patients (birth weight less than 500g) who showed unstable vital signs and low platelet count (12,000 / $mm^3$ to 30,000 / $mm^3$)expired despite aggressive resuscitation. One patient required laparotomy due to persistent intestinal obstruction after drain removal and survived. Our experience shows that peritoneal drainage was an acceptable treatment for ELBW infants and the prognosis was related to vital sign and platelet count at the time of intestinal perforation, and birth weight.

• The Journal of Dong Guk Oriental Medicine
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• v.3
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• pp.237-267
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• 1994

The purpose of this study is the approach to I.I.C.P. centered on the meaning of consciousness disorder and the pathological aspect of Kwul (Jose consciousness ; faint, fall into a coma). The meaning of consciousness disorder and apoplexy is evidently involved the definition of Kwul. 1. It is found that the etymological interpretation on Kwul which the energy rises back to go through blocked space and the meaning interpretation of regarding Kwul as apoplexy with medical viewpoint, are related with consciousness disorder and motor disturbance in IICP in the aspect of the rise of Kwul and the abnormal rising of vital energy and blood, In addtion, the overall of meaning of Kwul is showed in table <1-1> by reference to doctors of many generations, 2. The pathology of Kwul includes abnormal rising, sthenia-syndrome in the upper part and asthenia in the lower, the origin of Kwul, the lower, looking like Yin by too sthenic Yang and looking like Yang by too sthenic Yin. The headache, vomiting, papilledema, paralysis of nervi craniales, coma, blood pressure rising, tachycardia by I.I.C.P can be regarded as a conception of trouble of vital energy, sthenia-syndrome of Kwul. The pulse pressure, brachycardia, bradypnea can be regarded as the conception of looking like Yin by too sthenic Yang. 3. In the emergency of Kwul, the abnormal ternimal reversion of the Kwulyin channel, Kuyang channel, and three Yins are related with the phenomenon in I.I.C.P. It is considered that the reverse movement of materials, I.I.C.P. can be closely observed by giving meaning on the meridian of Kwul in Somunkwulron. And the content of phrases of Naelyung which includes consciousness disorder refered in the chapter of Kwul, is compared with I.I.C.P. 4. The followings should be considered; examination of optic symptom and abnormal posture in cerebral herniation ; understanding and working out counterplans of factors and symptoms of consciousness disorder by the observation of vital sign, check of general stages, neurologic inverstigation, clinical diagnosis, and subsidiary diagnosis; application of morphological change of opinion; addtion of the conception of demonstration centered on Yunkyung, Samyinkwulruk, asthenia and thenia of healthy energy in oriental medicine. 5. The similarity of Kwul and I.I.C.P. can be found from etiology and pathotenic factor. The similarity is clearly found by investigation of etiology, pathotenic factor, symptoms and thrapy of Kwul, disease symptom ar.d other symptoms.

• Journal of Korean Academy of Nursing Administration
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• v.16 no.2
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• pp.121-142
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• 2010

Purpose: The purpose of this study was to identify NANDA, NIC, and NOC frequently used and their linkages in major nursing departments for development of the nursing process and nursing management system. Methods: This study was a descriptive study. Data were collected from 123 nurses who worked in medical, surgical, pediatric, gynecologic, and psychiatric department. The questionnaire was based on the NANDA, NOC, NIC, and NANDA-NOC-NIC linkage system. This research was analyzed by an EXCEL program and SPSS $Pc^{+}15.0$. Results: Nursing diagnoses frequently used were 'anxiety', 'disturbed sleep pattern', 'activity intolerance', 'social isolation', 'nausea', 'ineffective airway clearance', 'chronic pain', nursing outcomes frequently used were 'thermoregulation', 'bowel elimination', 'pain control', 'vital sign status', 'pain level', and nursing interventions frequently used were 'nausea management', 'airway suctioning', 'bowel elimination management', 'diarrhea management', 'medication management'. NANDA-NOC-NIC linkages in major nursing departments were recognized, and these results were similar to the results of other researches. Conclusion: The results of this study will be provided as a guideline to apply to the nursing process and development of the nursing process system with the NANDA-NOC-NIC linkage in major nursing department.

• The Journal of Korean Academic Society of Nursing Education
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• v.19 no.2
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• pp.273-284
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• 2013

Purpose: The study was done to identify the effects of OSCE program prior to clinical practice for nursing students and to find out the weakest area of fundamental nursing skills. Methods: Study design was methodological triangulation. Qualitative analysis was done to derive nursing students' OSCE experiences using OSCE reflection note. Level of basic nursing skill acquirement was identified by quantitative method. Results: Four themes and 10 sub-categories emerged: (a) confidence and interests in nursing being increased, (b) being encouraged by mentor and evaluator, (c) requiring much effort to learn nursing skill, (d) being aware of themselves and understanding others in their shoes. Results of analysis of OSCE application score record showed as followings ; Intravenous injection(92.6%), Intramuscular injection(89.5%), Foley catheterization(85.2%), Vital sign(81.5%): BP check(63.0%) Respiration check(50.0%), Health assessment: respiration sound auscultation(33.3%) heart sound auscultation(44.4%). Conclusion: OSCE program application before frist clinical nursing practice was effective in terms of fundamental nursing skills learning. It is necessary to reinforce nursing skills based on the study results.

• The Korean Journal of Emergency Medical Services
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• v.17 no.1
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• pp.41-50
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• 2013

Purpose : This study intended to improve the quality of prehospital emergency care for patients with dyspnea by figuring out the current situations and problems based on run-sheets of 119 emergency medical technicians (EMTs). Methods : A total of 336 dyspnea patients were transferred to G university hospital by 119 ambulances from January 1, 2011 to December 31, 2011. Results : The data were analyzed by SPSS 19.0. Patients over 60 years old accounted for 57.2% and 48.4% had the history of heart disease. Among the heart disease patients, 31.7% complained of dyspnea and chest pain. The vital sign measurement performance by 119 EMTs increased compared to previous study. The number of prehospital treatment by 119 EMTs significantly increased depending on the mental state of the patients. Conclusion : 119 EMTs should remind the heart disease and other past history of the patients when they perform the dyspnea patient care.

• The Korean Journal of Emergency Medical Services
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• v.3 no.1
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• pp.102-115
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• 1999

This study was performed to investigate transport activities and strategize improvement of 119 rescue. We reviewed emergency care records of users who were transported by 119 rescue of six agencies in Chungnam from July 13, 1998 to August 8, 1998. The results were as follows ; 1. In sex distribution of users, the male was 65.0%. And the highest age group among users was above sixties(21.6%), then thirties in second order(19.3%). Accident was 50.8% as occupied first cause of transport, and then acute disease 22.8%. The highest requester for 119 rescue call was patient's families(47.1%) and average number of 119 rescue users per day was 20.9. 2. The nonurgent state of users was 58.9%. The frequency of users was 26.0 persons at sunday in most frequently, weekend and holiday was more common than ordinary day, and most frequent weather state was cloudy(23.8 persons). 3. Total running distance of 119 ambulance was 7.0km in average. Call time by users was 20-24 hours most commonly(21.9%). In then running time by each transport stage, 8 minutes were taken from 119 call receipt to scene arrival, 13 minutes from scene arrival to hospital. The kinds of pre-hospital care by 119 rescuer was vital sign check(81.2%), wound dressing or fracture fixation(41.2%), airway maintenance and O2 supply(30.4%).

• Quality Improvement in Health Care
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• v.7 no.1
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• pp.18-31
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• 2000

Background : This study is to identify the inappropriate hospital services for elderly inpatients over 65 years in general hospital with acute care functioning. Consequently elderly inpatient care and the management of long-term care facilities are key issues for current government health policy. Method : The survey was conducted for two months for all inpatients over 65 in 7 general hospitals, 6 work sampling days randomly selected. In each survey day, the subjective judgement by medical staff on the degree of acute care needs and by nursing unit manager on hospital services of each inpatients was also conducted. Result : The total number of cases collected are 2,541 elderly inpatients, according to subjective judgements by medical staff on inpatient condition. However 46.8% of cases are turned out to be non-acute care group. The frequency of medical services provided to non-acute group are 2~3 vital sign checks per day 78.2%, IV injection 40.1%, antibiotics medication 20.2%. Conclusion : Lots of elderly patients' who are staving in acute hospitals, at present need to be transferred to long-term care facilities. However, there was been shortage of long-term care facilities. It is expected to identify the need of elderly inpatients and therefore, to provide cost-effective, appropriate and good quality health services to elderly inpatients depending on their needs.