• Journal of Biomedical Engineering Research
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• v.21 no.3 s.61
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• pp.255-260
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• 2000

This paper presents a radio-telemetry patient monitor. which is used for intensive cal?e units. emergency and surgical operation rooms to monitor continuously patients' vital signs. The radio-telemetry patient monitor consists of a vital sign acquisition unit. wireless data transmission units and a vital sign-monitoring unit. The vital sign acquisition unit amplifies biological signals, performs analog signal to serial digital data conversion using the one chip micro-controller. The converted digital data is modulated FSK in UHF band using low output power and transmitted to a remote site in door. In comparison with analog modulation. FSK has major advantages to improve performance with respect to noise resistance with fower error and the potential ability to process and Improve quality of the received data. The vital sign-monitoring unit consists of the receiver to demodulate the modulated digital data, the LCD monitor to display vital signs continuously and the thermal head printer to record a signal.

• Tuberculosis and Respiratory Diseases
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• v.65 no.4
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• pp.301-307
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• 2008

Background: The triggering receptor expressed on myeloid cells-1 (TREM-1) is an activating receptor that is expressed on the surface of neutrophils and mature monocytes when stimulated with several microbial components, which can amplify the inflammatory response. This study analyzed the prognostic value of the sTREM-1 levels in patients with acute respiratory distress syndrome (ARDS). Methods: The bronchoalveolar lavage (BAL) fluid and blood was collected prospectively from 32 patients with ARDS, 15 survivors and 17 nonsurvivors. An enzyme-linked immunosorbent assay was performed to measure the sTREM-1. The following data was obtained: APACHE II score, Clinical Pulmonary Infection Score (CPIS), BAL fluid analysis, C-reative protein. Mortality in the ICU was defined as the end point. Results: The serum sTREM-1 level was significantly higher in the nonsurvivors than survivors ($54.3{\pm}10.3pg/ml$ vs. $22.7{\pm}2.3pg/ml$, p<0.05). The sTREM-1 level in the serum, but not in the BAL fluid, was an independent predictor of the ICU mortality (OR: 22.051, 95% CI: 1.780~273.148, p<0.016), and a cut-off value of ${\geq}33pg/ml$ yielded a diagnostic sensitivity of 71% and specificity of 93%. Conclusion: The serum sTREM-1 level may be a useful predictor of the outcome of ARDS patients.

• Journal of Chest Surgery
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• v.37 no.10
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• pp.827-832
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• 2004

Background: The significance of MIDCAB is emerging topics recently as OPCAB is going to be universalized, and long-term outcome of bypass graft surgery was proved to be more excellent than balloon dilation or stent insertion. We report our MIDCAB results in 73 patients in the last three years. Material and Method: Retrospective analysis of medical records was done from November 1, 2000 through November 31, 2003. There were 47 males and 26 females ranging in age from 31 years to 79 years (average $61.3\pm9.8$ years). Observation periods after operative procedures were 10 to 1238 days (average $763\pm319.8$ days). Left longitudinal parasternal incision as a standard procedure was done to approach the heart after dissection of the left internal thoracic artery by partial or total resection of 3rd to 5th ribs. Result: Of those patients, 46 patients were transferred to ICU after extubation at operation room and 58 patients were extubated within 3 hours after operation. Average ICU staying periods was $26.8\pm11.5$ hours. Follow-up angiography during admission was done in 36 patients and showed 100% patency. Only one patient died on the 10$^{th}$ post operative day because of sudden CVA. Complications included wound problems in 4 patients, and constructing pericardial window using thoracoscopy due to continuous pericardial effusion in 1. Permanent pacemaker was inserted in one patient owing to sick sinus syndrome. In one patient with recurrence of angina 8 months after operation, stenosis at anastomic site was found and improved with balloon dilatation. Conclusion: We were satisfied with our results of MIDCAB in single and multi-vessel coronary artery disease. These results have made the cardiologists tried to operate positively and we expect widening operative indications including hybrid revascularization.

• Journal of Chest Surgery
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• v.37 no.9
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• pp.762-767
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• 2004

With the developement of non-invasive surgical techeniques, coronary artery bypass graft without cardiopulmonary bypass has become popular. We compared the preoperative risk factors and in-hospital outcomes of patients having off-pump CABG with these having on-pump CABG. Material and Method： From January 2001 to June 2003, 87 patients underwent CABG. Thirty-sin patients underwent on-pump CABG, fifty-one patients under-went off-pump CABG. Preoperative risk factors, extent of coronary disease, operative time, postoperative endotracheal intubation time, duration of ICU stay & hospital stay, the amount of bleeding and postoperative levels of cardiac enzymes were compared in both groups, Result: The were no differences in their sex ratios, ages, preoperative risk factors, preoperative Ml, Canadian classes, extent of coronary artery diseases and, echocardio-graphic ejection fraction between Off-pump CABG and On-pump CABG groups. Off-pump CABG group had significantly lower mean operative time (270$\pm$79.3 min vs 372$\pm$142.2 min, p＜0.001), mean ventilation time (17.1$\pm$13.4 hr vs 24.3$\pm$17.8 hr) and CK-MB level (8,9$\pm$18.7 IU/L vs 25.7$\pm$8.4 IU/L) than on-pump CABG groups, On-pump CABG group had more distal grafts (2.2$\pm$0.5 vs 1.7$\pm$0.71 than Off-pump CABG groups did. There were no differences in their postoperative complications and outcomes including amount of postoperative bleeding for 24 hrs, reoperation for bleeding control, mean in-hospital days, postoperative infection, renal failure and neurologic complications between Off-pump CABG and On-pump CABG groups. Conclusion: This study showed that patients who underwent Off-pump CABG had less operation time & intubation time and lower CK-MB level; however, they also have less distal graft. Even though CABG without CPB provided satisfactory results, more clinical experience & longer follow-up is required.

• Journal of Hospice and Palliative Care
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• v.18 no.4
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• pp.322-328
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• 2015

Purpose: The aging of society has rapidly progressed, especially in Korea. Therefore, the necessity of research on end-of-life (EOL) care in elderly patients has increased. However, there are few studies on EOL care intensity for non-cancer patients. This study was designed to compare the EOL care intensity between cancer and non-cancer patients. Methods: We retrospectively analyzed the EOL care intensity based on medical records of decedents of Kyung Hee University Medical Center, a tertiary referral hospital from December 2014 through March 2015. And we compared EOL care intensity between cancer patients and non-cancer patients using statistical analysis of the frequency of invasive procedures and logistic regression analysis for factors that affect the EOL care intensity. Results: Statistical analysis showed invasive procedures, such as intensive care unit admission, endotracheal intubation followed by mechanical ventilation and emergency dialysis, were performed more frequently in non-cancer patients than cancer patients (29.3% vs. 72.4%, P<0.001). And age (P=0.038) and morbidity of cancer (P<0.001) influenced the invasive procedural decision when analyzed by logistic regression analysis. Conclusion: The EOL care was more intensive in non-cancer patients, and age and morbidity of cancer were major factors for the treatment intensity.

• Journal of Korean Critical Care Nursing
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• v.3 no.2
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• pp.25-35
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• 2010

Purpose: The purpose of this pilot study was to investigate the effect of oral care using 0.1% chlorhexidine and tantum solution on oral status and incidence of oral pathogens among intubated ICU patients. Methods: The study subjects were 26 intubated patients of MICU in a university hospital. Oral care was provided with 0.1% chlorhexidine solution to the experimental group (n=12) and with tantum solution to the control group (n=14), 3 times a day for 6 days. After the intervention, the oral status of each subject was checked using structured method, and oral swab culture was done to count colonized bacterial pathogens. Results: The mean oral status score of experimental group was significantly higher than that of control group (U=42.50, p=.031). The mean incidence of oral pathogens in experimental group was smaller than that of control group, but the difference was not statistically significant. Conclusion: The oral care with 0.1% chlorhexidine solution is more effective than with tantum solution for improving oral status of intubated ICU patients. However, additional studies with larger sample size will be needed to figure out it's effects on the incidence of oral pathogens.

• Journal of Korean Critical Care Nursing
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• v.7 no.2
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• pp.45-57
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• 2014

Purpose: The purpose of this study was to examine the effect of a blood glucose control protocol for medical intensive care unit (ICU) patients. Methods: The subjects were recruited from medical ICU adult patients whose blood glucose levels exceeded 200 mg/dL in two consecutive tests. The experimental group (n=62) received the modified Yale (MY) insulin protocol, whereas the control group (n=64) was treated with the conventional insulin therapy methods. Results: In the experimental group, the mean blood glucose levels (p<.001) and the time to reach the target range of glucose (p<.001) decreased significantly while the incidence rates of a target range of glucose of 100-140 mg/dL (p<.001) increased significantly as compared to the control group. However, no statistically significant differences were found in the incidence of hypoglycemia(p=.644), or the number of glucose tests (p=.236) between the groups. The length of stays in the ICU (p=.001), ventilator care days (p=.038), and the Sequential Organ Failure Assessment (SOFA) score (p=.029) in the experimental group were significantly lower than those of the control group. Conclusion: Application of the protocol was effective in improving the state of blood glucose control in medical ICU patients. Therefore, this protocol is expected to be used as a part of nursing intervention in critical care nursing.

• Journal of Korean Critical Care Nursing
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• v.16 no.2
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• pp.1-14
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• 2023

Purpose : Sleep disturbances in patients in the intensive care unit (ICU) are related to health problems after discharge. Therefore, active prevention and management are required. Hence, identification of the factors that affect sleep in patients who are critically ill is necessary. Methods : The PubMed, Cochrane Library, CINAHL, EMBASE, and Web of Science databases were searched. Selection criteria were observational and experimental studies that assessed sleep as an outcome, included adult patients admitted to the ICU, and published between November 2015 and April 2022. Results : A total of 21,136 articles were identified through search engines and manual searches, and 42 articles were selected. From these, 22 influencing factors and 11 interventions were identified. Individual factors included disease severity, age, pain, delirium, comorbidities, alcohol consumption, sex, sleep disturbance before hospitalization, chronic obstructive pulmonary disease (COPD), cardiovascular disease, and high diastolic blood pressure (DBP), low hemoglobin (Hb), and low respiratory rate (RR). Environmental factors included light level, noise level, and temperature. Furthermore, treatment-related factors included use of sedatives, melatonin administration, sleep management guidelines, ventilator application, nursing treatment, and length of ICU stay. Regarding sleep interventions, massage, eye mask and earplugs, quiet time and multicomponent protocols, aromatherapy, acupressure, sounds of the sea, adaptive intervention, circulation lighting, and single occupation in a room were identified. Conclusion : Based on these results, we propose the development and application of various interventions to improve sleep quality in patients who are critically ill.

• Journal of Biomedical Engineering Research
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• v.20 no.4
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• pp.461-469
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• 1999

In this paper, an ECG-NIBP patient monitor is designed. This is an essential equipment to measure and monitor patient's physical condition - electrocardiogram(ECG) wave, heart rate(HR), and noninvasive blood pressure(NIBP) - in ICU, CCU, and operating room. The ECG is an electrical waveform produced by relaxation and contraction of the cardiac muscle. Most physicians diagnose patient's cardiac states from ECG pattern. A blood pressure is one of the clinical indexes measured in a emergency room or operating room. In this paper, the blood pressure is measured in artery by using the nonivasive oscillometric method. The developed patient monitor was inspected and compared with other instruments in operating rooms. The results were 1bpm of maximum difference in the heart rate, 15mmHg in the systolic pressure, 16mmHg in the diastolic pressure, and 25mmHg in the mean blood pressure. But the total results were 0.15bpm of the mean difference in the heart rate, 5mmHg in the systolic pressure, 10mmHg in the diastolic pressure, and 9mmHg in the mean blood pressure. The designed ECG-NIBP patient monitor can measure the ECG wave, HR, and BP. And the multi-tasking module of pulse oximetry . respiration . temperature monitor will be added in the near future.

• Pediatric Infection and Vaccine
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• v.27 no.2
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• pp.83-89
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• 2020

Purpose: Group A streptococcus (GAS) is a common pathogen in pediatric patients and often causes acute pharyngotonsillitis and skin and soft tissue infections. In addition, bacteremia with significant morbidity and mortality can also occur. This study was conducted to describe the clinical manifestations and treatment outcomes of pediatric GAS bacteremia patients in Korea. Methods: This was a single-center, retrospective study. From January 2000 to December 2016, pediatric patients aged ≤18 years with GAS bacteremia were studied. Clinical manifestations, underlying diseases, intensive care unit stay, and antibiotic susceptibility were evaluated. Results: During the study period, 19 patients had GAS bacteremia. Ten (53%) were male, and the median age was 7.4 years (range, 0.3-17.4 years). Fourteen (74%) had chronic underlying diseases. Five (26%) were immunocompromised (leukemia and chronic kidney disease). Eight (42%) had lymphatic or vascular malformations, of which seven had lesions with signs of inflammation. Three (16%) developed pneumonia, and two of them received ventilator care. The 30-day mortality rate was 6% (1/19), and the cause of death was bacteremic pneumonia. All GAS isolates were sensitive to penicillin. Fifteen (79%) were sensitive to both erythromycin and clindamycin. Conclusions: This study identified various clinical manifestations of GAS bacteremia. GAS should be considered as a potential pathogen that can cause bacteremia and result in a serious clinical course.