• Title/Summary/Keyword: 사망환자

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Early Thoracotomy in the Treatment of Chest Trauma (흉부외상 치료에서 조기 개흉술)

  • 김한용;황상원;이연재;유병하
    • Journal of Chest Surgery
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    • v.31 no.6
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    • pp.604-609
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    • 1998
  • Trauma to the thorax represents a significant portion of injuries seen in an inner-city emergency room. Although most of these patients may be sucessfully managed without thoracotomy, a certain percentage requires operative intervention either immediately or within several hours. 126 records of patients who had early thoracotomy for chest trauma from March 1986, to June 1997, in the Department of Thoracic and Cardiovascular Surgery in Masan Samsung General Hospital were reviewed. There were 96 males and 30 females whose ages ranged from 4 to 72 years, with a mean age of 32.8 years. The modes of injury were as follows : stab wounds, 55 cases(44%), blunt trauma, 70 cases(55%), and gunshot wound, 1 case(1%). Immediate operation was performed in 105 cases(84%) and delayed operation in 21 cases(16%). Indications that operation was necessary were hemorraging and shock in 66 cases(52%), cardiac tamponade in 27 cases(21%), and rupture of the diaphragm in 33 cases(27%). Most of these patients were sucessfully treated but 21 cases were resulted in death. The mortality rate was 16.6% and common causes of death were irreversible shock and hypoxia.

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Design and Implementation of Electrocardiogram Data Interpretation system using AdaBoost Algorithm (AdaBoost 알고리즘을 이용한 심전도 정보 판독 시스템의 설계 및 구현)

  • Lim, Myung-Jae;Hong, Jin-Kyoung;Kim, Kyu-Ho;Choi, Mi-Lim
    • The Journal of the Institute of Internet, Broadcasting and Communication
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    • v.10 no.2
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    • pp.129-134
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    • 2010
  • Diseases such as cardiovascular illnesses, according to the National Statistical Office opened reveals that 600-800 people were killed, blood pressure, arteriosclerosis, heart disease, stroke, etc. will be a flow of blood disorders that occur in cardiovascular illnesses today are fulfilling the Master / Slave samangryulin disease appears high. Died of cardiovascular disease also told them the correct first aid survival when patients are accounted for approximately 40% of emergency rapid response is required. Therefore, this paper, the weak classifier in the AdaBoost algorithm to generate a strong classifier by combining effects throughout the analysis to measure the ECG, and cardiovascular disease that occurred to you as soon as the emergency management system that can deliver on the proposed Desk was. The electrocardiogram data measured by the ZigBee-based sensors, communication devices and emergency transport for emergency alarms in the determination and monitoring of the management desk by providing health services to enable the delivery was fast.

Joint model of longitudinal data with informative observation time and competing risk (결시적 자료에서 관측 중단을 모형화하기 위해 사용되는 경쟁 위험의 적용과 결합 모형)

  • Kim, Yang-Jin
    • The Korean Journal of Applied Statistics
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    • v.29 no.1
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    • pp.113-122
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    • 2016
  • Longitudinal data often occur in prospective follow-up studies. Joint model for longitudinal data and failure time has been applied on several works. In this paper, we extend it to the case where longitudinal data involve informative observation time process as well as competing risks survival times. We use a likelihood approach and derive an EM algorithm to obtain maximum likelihood estimate of parameters. A suggested joint model allows us to make inferences for three components: longitudinal outcome, observation time process and competing risk failure time. In addition, we can test the association among these components. In this paper, liver cirrhosis patients' data is analyzed. The relationship between prothrombin times measured at irregular visiting times and drop outs is investigated with a joint model.

Retrohepatic Inferior Vena Cava Injury by Gunshot - A case report - (총상에 의한 간 후부 하대정맥 손상 - 1예 보고 -)

  • Yoo, Dong-Gon;Park, Chong-Bin;Choi, Kun-Moo;Jung, Hwa-Sung;Kim, Chong-Wook
    • Journal of Chest Surgery
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    • v.41 no.1
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    • pp.124-127
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    • 2008
  • Injury to the inferior vena cava (IVC) is associated with a high mortality rate, and little progress has been made for improving the treatment for this since the 1970s. Injury to the retrohepatic IVC, in particular, has been associated with up to a 75% mortality rate due to the difficulty in gaining adequate exposure and controlling the bleeding. Both the severity of injury and anatomic accessibility has been directly correlated with survival in IVC injury. We have experienced a patient with retrohepatic IVC that was ruptured by a penetrating gunshot injury and we managed to save this patient's life.

Differences in Medical Care Utilization by Regional Economic Status (지역 소득수준에 따른 의료이용의 차이)

  • Lim, Nam Gu
    • Journal of Digital Convergence
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    • v.11 no.10
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    • pp.459-467
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    • 2013
  • The purpose of this study was to identify the differences in medical care utilization by regional economic status using the National Hospital Discharge Patients Injury Survey. In order to determine economic status of each region, 234 cities and counties were categorized 5 quintiles according to their financial self-reliance ratio. The main results are as follows. First, low economic region has high age-standardized admission rate and standardized mortality rate. Second, of 16 major diseases, cerebrovascular and heart diseases, lung cancer, and stomach cancer reported greater changes in standardized mortality rate by regional economic status. Third, the rate of admission via emergency room in low economic region is higher than that of high economic region. Lastly, in the major illnesses, lower economic status led to an increase in average length of stay. Therefore, In order to bridge the gap in health inequality across regions, a regional medical policy tailored for each region and characteristics of the economic status should be established.

Study on Weaning Pattern and Nutritional Status of Infants and Toddlers in Korea (한국 영유아기에 있어서의 이유 양상과 영양상태에 관한 연구)

  • Yoon, Jong-June;Kim, In-Dal
    • Journal of Nutrition and Health
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    • v.3 no.2
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    • pp.65-80
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    • 1970
  • 영유아 시기의 영양여하는 그 시기에 있어서 뿐만 아니라 일생을 통한 정신적 육체적 성장발육 및 질병에 대한 저항력, 이환율과 사망율, 그리고 국민 평균여명에 까지도 영향을 미치는 것으로서 그 중요성은 잘 알려져 있는 사실이다. 저자들은 우리나라에 있어서 이유기를 전후한 식품 섭취양상을 엿보기 위하여 전국을 도시, 읍, 평야, 산간 및 섬 지역으로 나누어 만 3세 미만의 어린이 304명을 대상으로 봄과 가을 2회에 걸쳐 조사를 실시하여 다음과 같은 결과를 얻었다. 1. 7개월까지는 모두가 모유를 먹고 있었으며 1예는 우유를 먹고 있었다. 8개월 이후 17개월까지는 약 10%에서, 18개월에서 23개월 사이에는 약 50%가 이유를 끝냈으며 30개월과 35개월 사이에는 84%가 이유를 완료하고 있었다. 2. 모유를 18개월 까지는 하루 4회이상, 그리고 그 후 30개월까지도 2회 이상씩 계속 먹이다가 그 후 갑자기 그치고 있었다. 3. 적절한 유동식이나 보조식등의 이유식이 없이 일반 성인음식을 그대로 먹이고 있었으며 동물성 단백질이나 지방질 섭취는 적었고 식물성 단백질음식도 묽은 국물 형태도 섭취하고 있었다. 4. 채소류와 멸치등은 쉽게 구할 수 있음에도 불구하고 충분히 보급받지 못하고 있었다. 5. 체중 및 신장의 신체계측에 의한 발육상태는 6개월 내지 12개월 경부터 뒤지기 시작하여 그후 계속발육지연을 보여주고 있었다. 6. 심한 단백 ${\ulcorner}$칼로리${\lrcorner}$ 영양실조증 환자가 1예 있었으며 다른 1예는 영양소모증 환자였다. 7. 상완위 측정결과는 3개월 이하의 남아를 제외하고는 모두가 충분한 크기에 달하지는 못했다. 8. 영양결핍양상을 신장에서는 지수 1이 5.9%, 체중에서는 지수 1이 8.9%, 2가 1.3%, 4가 1.0%로서 체중 전체로는 11.2%였고, 상박위에 있어서는 지수 2,3,4 가 도합 8.9%였다. 9. 1-3세의 유아 사망률은 12.3%였고 이유기 설사발병율이 19.7%였다. 이상의 결과로 우리나라 영육아들에 있어서 적절한 시기에 적절한 방법으로 이유를 실시하므로써 이 시기의 질병발생율 및 사망율의 저하를 가져올 수 있고 나아가서는 신체발육양상을 호전시킬 수 있을 것이다.

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Mid-term Results of Mitral Valve Repair in Mitral Regurgitation (승모판 폐쇄부전중에서 승모판막 재건술 및 중기성적)

  • Yun, Yang-Gu;Jang, Byeong-Cheol;Yu, Gyeong-Jong;Kim, Si-Ho
    • Journal of Chest Surgery
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    • v.29 no.1
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    • pp.24-31
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    • 1996
  • Between January 1992 and February 1995, 36 patients with mitral regurgitation were treated by a mitral repair There wert nineteen men and seventeen women whose mean age was 41.8 years, ranged from 10 to 71. Seventeenth patients had dystrophic change of mitral valve, twelve patients had rheumatic change of mitral valve, second patients had infective change of mitral valve and another fifth patients had functional change of mitral valve. Operation proced res were suture annuloplasty (35 cases), resection of leaflet (25 cases), chordal shortening(9 cases) and commisurotomy(1 cases). These procedures were combined in most patients. Two third of the patients were in New York Heart Association class III or IV and four fifth of the patients were in mitral regurgitation grade III or IV by doppler echocardiogram. After mitral valve repair, the patients were improved hemodynamic, echocardiographic data and functional class. Intraoperative TEE had been used in all most patients after weaning of bypass. If there remained MR more than grade 2, the valve was re-repaired or replacement. There were no operative death. The late mortality was 5.5% and cause of death was congestive heart failure. Patients have been followed up from 3 to 40 months, mean 15. Second patients underwant reoperation due to recurred mitral regurgitation, 4 and 19 days after the operation. During reoperation, we found that the repair suture was disrupted in both patients. Th s expierence demonstrated that intraoperative TEE is accurate and predictable and excellent immediate and mid-term results have been achieved by mitral valve repair.

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Clinical Characteristics and Prognosis of Elderly Patients Receiving Prolonged Mechanical Ventilation in the Medical Intensive Care Unit at a University Hospital (한 대학병원 내과계 중환자실에서 장기간 기계환기를 받은 노인 환자들의 특징 및 예후)

  • Han, Min Soo;Moon, Kyoung Min;Lee, Yang Deok;Cho, Yongseon;Na, Dong Jib
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.6
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    • pp.445-450
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    • 2008
  • Background: As the number of older-aged people increases, the number of elderly patients who receive critical care services is expected to increase substantially. The objective of this study was to examine the clinical characteristics and outcomes of elderly patients who receive mechanical ventilation for more than 30 days in the medical intensive care unit (MICU) at a university hospital. Methods: We retrospectively examined forty-one elderly patients (${\geq}65$ years old) who were receiving mechanical ventilation, from April 2004 to March 2007, for periods exceeding 30 days at the MICU at Eulji University Hospital. Results: The MICU and hospitalmortality rate were 60.9% and 65.9%, respectively. The mean length of the ICU stay was 57.5 days and the mean duration of mechanical ventilation was 49.3 days. The most common reason for MICU admission was acute respiratory failure (73.2%), followed by sepsis (12.2%), neurological problems (9.8%), and gastrointestinal bleeding (4.9%). The Acute Physiology and Chronic Health Evaluation (APACHE) II scores were higher for the nonsurvivors than for the survivors (28.0 vs. 25.0, respectively, p=0.03). The nonsurvivors received more red blood cell (RBC) transfusions during their ICU stay than did the survivors (84.0% vs. 43.8%, respectively p=0.007). The factors associated with hospital death were the APACHE II score and if the patient had received a RBC transfusion. Conclusion: The APACHE II score and a RBC transfusion were predictors of increased hospital mortality for the elderly patients who were on prolonged mechanical ventilation. These predictors may assist physicians to make clinical decisions for this patient population.

Development of Convergence Core Technology for Cancer Prognosis from Circulating Tumor Cells (혈중 암세포 기반 암 예후 예측 진단 융합기술 개발)

  • Jung, M.Y.;Lee, D.S.;Park, J.W.;Shin, Y.K.;Kim, Y.D.
    • Electronics and Telecommunications Trends
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    • v.29 no.5
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    • pp.105-113
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    • 2014
  • 주치의에게는 암환자의 암 전이 여부가 초미의 관심사다. 암환자의 10명 중 9명이 전이암으로 사망하기 때문이다. 암의 전이 초기에 그 전이 여부를 방사선 진단법으로 가능하지 않다. 혈액을 채취하여 암의 전이 유무를 진단 하는 기술이 개발되고 있다. 이 혈중 암세포는 혈구세포 10억개당 1~100개 정도의 극히 미량이 존재하여 암세포 분리기술이 특별히 잘 개발되어야 한다. 최근 마이크로바이오칩 형태의 분리기술이 큰 기술적 진화를 보이고 있어 본고에 소개하고자 한다. 이 기술은 한 가지 큰 의미를 갖는다. 그것은 암환자의 암 전이 모니터링에 필요한 도구가 될 수 있기 때문이다. 전이암세포 검출 키트로 전이암세포를 계수 하여 환자에게 투약한 항암제가 적합한지에 대한 답을 의사는 얻을 수 있다. 전이암세포 진단용 마이크로바이오칩 기술이 기존의 영상진단법만큼 중요한 임상 수단이 될 것으로 전망된다.

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A Study on the Fallen Patient Detection Model in Indoor Hospital Using YOLOv5 (YOLOv5를 이용한 병원 내부환경에서의 환자 낙상 탐지모델에 관한 연구)

  • Hong, Sang-Hoon;Bae, Hyun-Jae
    • Proceedings of the Korean Society of Computer Information Conference
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    • 2022.07a
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    • pp.93-94
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    • 2022
  • 최근 고령화 사회가 심각한 사회적 문제로 급부상하고 있으며, 이에 병원을 찾아 입원하는 비중이 이전에 비하여 높아지고 있다. 거동이 불편하거나 근력이 부족한 환자의 경우 스스로 거동할 능력이 다소 떨어지며, 낙상사고가 발생하면 부상 혹은 치명적일 경우 사망으로 이어질 수 있다. 하지만, 이들을 보살피는 간호 인력만으로 병원 내 모든 낙상사고를 파악하기에는 한계가 있다. 또한, 환자들의 낙상 탐지에 관한 연구는 지속해서 수행되어왔지만, 병원 내부환경에서의 낙상 탐지 연구는 부족하다. 이에 본 논문에서는 병원 내부환경에서 낙상을 탐지하기 위해 실제 병실에서 수집한 데이터로 YOLOv5 모델을 학습하여 환자 낙상 탐지모델을 구축 및 평가하였다.

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