• Journal of Acupuncture Research
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• v.32 no.3
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• pp.95-105
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• 2015

Objectives : The purpose of this study is to review the characteristics of patients who visited the emergency room of a Korean medical hospital with musculoskeletal disorders during the last 5 years and to provide a potential basis for future studies and emergency medical practice. Methods : Patient visit records between May 1st, 2010 and February 28th, 2015 were reviewed and patients with musculoskeletal disorders were included in a retrospective analysis. Results : A total of 5,218 patient visit records were initially reviewed and 1,485 patients (28.46 %) were included in the analysis. S code group was the most frequently diagnosed coding group of Korean Standard Classification of Diseases. The male to female ratio was 1.05:1 and patients in their thirties represented the highest age group. When classified by time of visit, the distribution of patients was similar from 10:00 to 22:59. The most frequently visited day and month were Sunday and September. 879 patients (59.19 %) visited the emergency room within 24 hours from onset of symptoms. The most common symptom site was the low back (45.59 %), followed by ankle (13.94 %) and neck (13.80 %). The most frequently used treatment method was acupuncture (92.32 %), followed by infrared (45.45 %), TENS (30.03 %) and herbal medication (29.02 %). The follow-up and admission rates were 30.24 % and 13.00 % respectively. 343 patients (23.10 %) received Western medical treatment within a day before visiting the emergency room of the Korean medical hospital. Conclusions : This analysis provides the latest information on the characteristics of patients who visited the emergency room of a Korean medical hospital with musculoskeletal disorders. The results can provide the basis for further studies and for other attempts to improve the clinical setting of the emergency room.

• Journal of Korean Academy of Nursing
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• v.30 no.3
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• pp.549-559
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• 2000

The purpose of this study was to investigate the correlation between the knowledge and educational needs related to recurrent in coronary artery bypass graft patients as a basis to provide an individual nursing education for the population. The subjects consisted of 110 patients who had coronary artery bypass graft(CABG) at Asan Medical Center in Seoul and Sechong hospital in Buchon. Data was obtained from a knowledge questionnaire and a learning needs questionnaire between November 1998 and February 1999. Data were analyzed using SAS program for Wilcoxon rank sum test and Spearman correlation coefficient. The results were as follows : 1. With regard to the 18 items to measure knowledge, the mean (median) of items 'don't know' was 4.9(4) items. The mean (median) of items answered wrong was 3.2(3) items. The number of items answered 'don't know' tend to show higher in those who had less education, blue color jobs and myocardiac infarction history than in their counter parts. There were higher frequency of items answered 'don't know' in those who had no hypertension 2. With regard to the level of knowledge by questionnaire about CABG, The most "I dont know" (59.1%) highly response was 'He has to be treated with anticoagulant drug to prevent revasculized vessel from obstructing.' The seond highest response (56.4%) was 'If you were hypotensive, the coronary attack would collapse. 'During the hospitalized day, the patient has complete bedrest.' The highest error probability was cholesterol has not to intake.', 'After surgery, the sexual life is need controlled for 1 year. 3. The mean of educational needs was 3.38. With regard to the level of learning needs by sentence about CABG, 'Food that benefit heart disease', 'Recurrence possibility of heart disease', 'Management method of operation site', 'Risk symptom that visit hospital or report immediately' were higher than other sentenses. With regard to the level of learning needs by factor 'food(5 items)', 'disease(9 items)' and 'exercise(3 items)' showed the highest than other factors. The educational needs by patients characteristics tend to show higher in males, under the age of 49, middle or high school degree, previous experience of admission with coronary artery disease, history of myocardial infarction, expierience of PTCA, history of cerebro-vascular accident, previous expierience of smoking than in their counter parts. 4. The number of items answered 'don't know', wrong and correct weren't correlated with the level educational needs. As the results, the number of items answered 'don't know' tend to show higher in those who had less educated, blue color jobs and myocardiac infarction history than in their counter parts. There were higher frequency of items answered 'don't know' in those who had no hypertension .There were higher frequency of items answered 'don't know' on anti-thrombolitic theraphy, hypotension and pain relief. Also there were higher frequency of items answered wrong on bed rest period, cholesterol intake, and sexual life. Educational needs were higher in young age group, had previous experience of procesure and history of other disease. And when we educate CABG patients, education for diet, recurrence possibility of disease, management methods of operation site and risk symptom should be emphasized.

• Journal of Korean Academy of Nursing
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• v.17 no.2
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• pp.122-136
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• 1987

A group of studies revealed that family members of the seriously ill patient had some needs during the period of patient's hospitalization. Needs of the seriously-ill patient family could be classified into three aspect, i. e. needs on the prognosis of patient, needs on the well-being of family members themselves and needs on hospital environment. Several instrument were developed to measure the needs of the seriously ill patient, but their content tended to overemphasize the aspect of the prognosis of patient. The purpose of this study was to develop a new instrument to measure the needs in the aspect of the seriously ill patient's family themselves in details to increase the cummulative Percentage of the scale. Subjects were 134 family members of the seriously-ill patients, who were bung cared in ICU of seven university hospitals and data were collected from march 16, 1987 to April 11, 1987. The instrument used in this study was made by the author on the basis of results of literature review. Content valitity of the instrument was tested by a professor majoring in nursing and reliability by calculation of Cronbach's α with data of the respondents. Data was analyzed as follows, using SAS, computer system. Factor structures of the seriously ill patients' family needs were elicited by factor analysis. The programme was the Principal Component Factor Analysis Method of factoring employing Varimax Orthogonal Rotation. The influences of the demographic variables on the degree of the seriously-ill patients' family need were analyzed by t-test and P-test. Results were as follows. 1. Needs of the seriously-ill patients' family elicited and their cummulative percentage were: Needs to be supported emotionally, 29.2% Needs to be informed on facilities available, 9.6% Needs to be informed on the patient's prognosis, 7.7%. Needs to be supported spiritually, 5.1%. Needs to be informed on hospital environment, 4.2%. Needs to be helped to spare time, 3.9%. Needs to be informed on their role, 3.5%. Needs to be present near patient, 3.3%. 2. Educational background was found to influence on some factors. College-graduate group had higher Bevel of needs to be . informed on facilities available to be informed on the patient's prognosis, needs to be supported spiritually, needs to be helped to spare time, needs to be informed on their role than high school graduate group. 3. Among the parents, sons and daughters and the relative groups, the parents of the seriously ill patient had highest level of needs to be present near patient. Suggestions for further studies were as follows. 1. As the instruments used in the previous studies had high cummulative percentages in the aspect of the prognosis of patient and that in this study in the aspect of the prognosis of patient and that in this study in the aspect of the seriously ill patient's family themselves, development of a new instrument which combined the items of both of them is needed. 2. A study to clarify the influence of type and number of admission on need to be supported emotionally is needed.

• Korean Security Journal
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• no.17
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• pp.91-107
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• 2008

This study aims to grasp the general conditions regarding university students in security related majors in Korea. Followings will be covered here: what motivated them to choose those majors, hw much are they git jobs through the education, what is their conscioucness on their majors, jobs, and courses like, and what effects their job preference. And ths study also aims at helping the student with their future plans such as admission to a school of higher grade and choosing their job. For this study, we distributed 340 copies to the students in security related majors at 4 four-year colleges and 1 two-year college, and collected 298 copies by means of quota sampling method. For collected questionnaires, we used individual T-test verification and one-way ANOVA analysis to grasp the situation. Significance stabdard for the test results was set as p<0.05. Followings are the test results. The results on analysis of satisfaction rate on their curriculums, classes, and majors show that students in security-related majors showed different satisfaction rate and different averages according to their sex and the year of the college. In the analysis on the relationship between major education and employment of students in security-related majors, the result of curriculum improvement and scholaril attainments analysis showed statistically significant relation. When students in security-related majors were surveyed on their consciousness of their future plans such as getting jibs, two-year college students had more certificates of qualification for employment than four-year college students.

• Journal of Trauma and Injury
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• v.23 no.2
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• pp.75-82
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• 2010

Purpose: In Korea, trauma is the $3^{rd}$ most common cause of death. The trauma treatment system is divided into pre-hospital and hospital stages. Deaths occurring in the pre-hospital stage are 50% of the total death, and 20% of those are deaths that are preventable. Therefore, the purpose of our study is to calculate the preventable death rates caused by trauma in our current pre-hospital system, to analyze the appropriateness of the treatment of traumatized patients and to draw a conclusions about the problems we have. Methods: The study was done on traumatized patients who expired at the emergency department from January 1, 2005, to December 31, 2009, at the Korea University Medical Centers in Anam, Guro and Ansan. The data on the patients were reviewed retrospectively based on characteristics, conditions on admission and trauma severity. The patient's RTS (revised trauma score) and ISS (injury severity score) was calculated. Preventable death rate was calculated by TRISS (the trauma score-injury severity score). Results: A total of 168 patients were enrolled. All patients were intubated and underwent CPR. Of the total, 72% patients were male, and traffic accidents were the most common form of trauma (52.4%), falls being second (28.6%). Head injury, solitary or multiple, was the most common cause of death (55.4%). Thirty-eight (38, 22.6%) deaths were preventable. The 22.6% preventable death rate consisted of 15.5% potentially preventable and 7.1% definitely preventable deaths. Based on a logistic regression analysis, the relationship between the time intervals until transfusion and imaging and death was statistically significant in the hospital stage. In the pre-hospital stage, transit time from the site of the injury to the hospital showed a significant relationship with the mortality rate. Conclusion: One hundred sixty-eight (168) patients died of trauma at the 3 hospitals of Korea University Medical Center. The TRISS method was used to calculate the preventable death rate, with a result of 22.6%. The only factor that was significant related to the preventable death rate in the pre-hospital stage was the time from injury to hospital arrival, and the time intervals until transfusion and imaging were the two factors that showed significance in the hospital stage. Shortening the time of treatment in the field and transferring the patient to the hospital as quickly as possible is the most important life-saving step in the pre-hospital stage. In the hospital stage, the primary survey, resuscitation and diagnosis should proceed simultaneously.

• Journal of Trauma and Injury
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• v.26 no.4
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• pp.273-279
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• 2013

Purpose: In patients with splenic trauma, Computed Tomography (CT) scan is helpful in selecting treatment options and evaluating resolution after NOM (Non-Operative Management). The purpose of this study was to suggest a CT based hemoperitoneum (HP) scoring system that can easily be used by clinicians to evaluate the severity of injury and recovery. Methods: A retrospective review of patients with splenic trauma admitted to our hospital between May 2003 and January 2013 was conducted. Patients diagnosed with isolated spleen injury who had a CT scan on admission were included. 1 or 2 points were given according to location and amount of hematoma in the CT image. Using the existing ultrasonography (US) based HP scoring system, the same method was applied to obtain our CT based HP scoring (CBHS) system, which ranges from 0 to 8 points. The CBHS system can be easily used by clinicians for a quick assessment of splenic injury. Results: Of the 39 patients meeting the inclusion criteria, 6 patients were managed operatively and 33 nonoperatively. There was a significant difference in CBHS between the OM (operative management) group and the NOM group.(p=0.03) CBHS showed correlation with Hb (hemoglobin), Hct (hematocrit), spleen injury grade(AAST), and Hounsfield unit of ROI (Region of interest). (p=0.17, p=0.18, p<0.000, p=0.02, respectively) After successful NOM with stabilized Hb level, the amount of hemoperitoneum was scored in the follow-up CT. CBHS demonstrated correlation with decreased spleen injury grade, decreased Hounsfield unit of ROI (Region of interest) (p=0.039, p=0.049, respectively), and also objectively reflected patient recovery. Conclusion: CBHS can be used as an objective and intuitive tool for clinicians in grading the severity of splenic injury by scoring the amount of hemoperitoneum, and in assessing recovery.

• Journal of Chest Surgery
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• v.33 no.8
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• pp.662-668
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• 2000

Background: Many recent results of clinical trials show that pre-operative concurrent chemoradiotherapy and surgical resection could increase the survival of N2 positive stage IIIA non-small cell lung cancer. This study was performed to assess the feasibility, toxicity, and affect rates of concurrent chemoradiotherapy and surgical resection in N2 positive stage IIIA non-small cell lung cancer. Material and Method: Thirty-one patients who underwent preoperative concurrent chemoradiotherapy for N2 positive stage IIIA non-small-cell lung cancer from May 1997 to April 1999 were entered into the study. Mean age was 61 yrs(43∼70 yrs), There were 24 men and 7 women. The confirmation of N2 disease were achieved through mediastinoscopic biopsy(24) and CT scans(7). Induction was achieved by two cycles of cisplatin and etoposide(EP) plus concurrent chest radiotherapy to 45 Gy. Resections were done at 3 weeks after the complection of preoperative concurrent chemoradiotherapy. Resections were performed in 23 patients, excluding 5 refusals and 3 distant metastasis. Result: All patients were compled the thoracic radiotherapy except one who had distant metastasis. Twenty three patients were completed the planned 2 cycles of EP chemotherapy, and 8 patients were received only 1 cycle for severe side effects(6), refusal(1), and distant metastasis(1). There was one postoperative mortality, and the cause of death was ARDS. Three patients who had neutropenic fever and one patient who had radiation pneumonitis were required admission and treatment. Esophagitis was the most common acute side effect, but relatively well-tolerated in most patients. The complection rate of concurrent chemoradiotherapy was 74%, resection rate was 71%, pathologic complete remission rate was 13.6%, and pathologic down-staging rate was 68%. Conclusion: Morbidity related to each treatment was acceptable and many of the patients have benefited down staging of its disease. Further prospective, preferably randomized, clinical trials of larger scale may be warranted to confirm the actual benefit of preoperative concurrent chemoradiotherapy and surgical resection in N2-positive stage IIIA non-small cell lung cancer.

• The Korean Journal of Nuclear Medicine
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• v.29 no.1
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• pp.54-60
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• 1995

Medical Internal Radiation Dose(MIRD) schema was developed for calculating the absorbed dose from the administered radiopharmaceuticals. With the biological distribution data and the physical properties of the radionuclide we can estimate the absorbed dose by the MIRD schema. For the thyroid cancer patients received $^{131}I$ therapy, the absorbed dose to the bone marrow is the limiting factor to the administered dose, and the duration of admission is deter-mined by the retained activity in the whole body. To monitor the whole body radioactivity, we used Eberline Smart 200 system using ionization chamber as a detector. With the time activity curve of the whole body, total body residence time was obtained. From the ICRP publication 53, the residence times of the source organs, such as kidney, urinary bladder content and stomach, were used to calculate the absorbed doses of the target organs, such as stomach, red marrow, bladder wall and remaineder total body. In 8 thyroid cancer patients with 175 mci of $^{131}I$ administered orally, the mean absorbed dose in the bladder wall was 375.1, in the stomach 285.1, red marrow 25.4 and total body 22.4 rad respectively. For the monitoring of the large administered activity, this method seemed to be quite useful.

• Journal of Chest Surgery
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• v.41 no.1
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• pp.49-54
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• 2008

Background: Aortic diseases tend to involve the entire aorta. Hence, there is the constant possibility of the need for a secondary operation at the remnant aorta. This study analyzed our cases of secondary aortic surgery in order to determine its characteristics and problems. Material and Method: Between April 2003 and June 2007, 12 patients (6 male and 6 female) underwent thoracoabdominal aortic replacement as a secondary aortic operation. Their clinical courses were analyzed. Four of the patients underwent lower thoracobadominal aortic replacement under the normothermic femorofemoral bypass, and the others underwent an entire thoracobdominal aortic replacement under deep hypothermic circulatory arrest. Result: There was no death or paraplegia. As local complications, there were 3 cases of wound infection and 2 cases of an immediate reoperation caused by bleeding and one case of delayed wound. revision for a contaminated perigraft hematoma. As a systemic complication, there was one case of renal insufficiency, which required hemodialysis and one case of respiratory insufficiency that needed prolonged ventilator care. The mean admission period was $30{\pm}21$ days. All the patients were followed up for $626{\pm}542$ days without reoperation or other problems. Conclusion: Using properly selected patients and a careful approach, thoracoabdominal aortic replacement can be performed safely as a secondary aortic surgery.

• Tuberculosis and Respiratory Diseases
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• v.39 no.4
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• pp.343-347
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• 1992

Background: There are several causes that the total destruction of unilateral lung can occur. Pulmonary tuberculosis of these causes may lead to destruction through chronic inflammation and fibrosis. In such circumstances, the left to right ratio is supposed to be different. We performed the study with 224 cases for total destruction of unilateral lung, who were admitted at National Kongju Tuberculosis Hospital for recent 4 years. Method: On admission chest film, radiologic pattern was classified into 4 types. And we analyzed patients' age, sex, duration of illness, sputum AFB smear and culture. Result: 1) The male to female ratio was 2:1 and 74% of the patients were between 31 and 60 years of age. 2) One hundred and ninety eight cases(88%) had the duration of illness over 3 years. Namely, most of patients had long history. 3) Sputum AFB smear and/or culture were positive mostly (80%). 4) As for the radiologic pattern, 181 cases (81%) had the total destroyed lung in left and partial lesion in right lung, 31 cases (14%) total destroyed lung in right and partial lesion in left lung, 11 cases (5%) total destroyed lung in left only, and 1 case total destroyed lung in right only. 5) In the radiologic pattern, there is no significant difference in terms of age, sex, duration of illness and sputum examination. Conclusion: From these results, we found that the total destruction of unilateral lung in pulmonary tuberculosis occurred generally in the left side.