• Journal of Korean Neurosurgical Society
• /
• 제60권5호
• /
• pp.584-590
• /
• 2017

Objective : Traumatic brain injury (TBI) in children under age 24 months has characteristic features because the brain at this age is rapidly growing and sutures are opened. Moreover, children this age are completely dependent on their parents. We analyzed the demographic data and risk factors for outcomes in TBI patients in this age group to elucidate their clinical characteristics. Methods : We retrospectively reviewed the medical records and radiological films of children under 24 months who were admitted to Kyungpook National University Hospital from January 2004 to December 2013 for TBI. Specifically, we analyzed age, cause of injury, initial Glasgow coma scale (GCS) score, radiological diagnosis, seizure, hydrocephalus, subdural hygroma, and Glasgow outcome scale (GOS) score, and we divided outcomes into good (GOS 4-5) or poor (GOS 1-3). We identified the risk factors for post-traumatic seizure (PTS) and outcomes using univariate and multivariate analyses. Results : The total number of patients was 60, 39 males and 21 females. Most common age group was between 0 to 5 months, and the median age was 6 months. Falls were the most common cause of injury (n=29, 48.3%); among them, 15 were falls from household furniture such as beds and chairs. Ten patients (16.7%) developed PTS, nine in one week; thirty-seven patients (61.7%) had skull fractures. Forty-eight patients had initial GCS scores of 13-15, 8 had scores of 12-8, and 4 had scored 3-7. The diagnoses were as follows : 26 acute subdural hematomas, 8 acute epidural hematomas, 7 focal contusional hemorrhages, 13 subdural hygromas, and 4 traumatic intracerebral hematomas larger than 2 cm in diameter. Among them, two patients underwent craniotomy for hematoma removal. Four patients were victims of child abuse, and all of them had PTS. Fifty-five patients improved to good-to-moderate disability. Child abuse, acute subdural hematoma, and subdural hygroma were risk factors for PTS in univariate analyses. Multivariate analysis found that the salient risk factor for a poor outcome was initial GCS on admission. Conclusion : The most common cause of traumatic head injury in individuals aged less than 24 months was falls, especially from household furniture. Child abuse, moderate to severe TBI, acute subdural hematoma, and subdural hygroma were risk factors for PTS. Most of the patients recovered with good outcomes, and the risk factor for a poor outcome was initial mental status.

• 상하수도학회지
• /
• 제21권5호
• /
• pp.631-639
• /
• 2007

This study investigated the construction and operation status of sewer pipes and water-purifier tanks near densely populated areas like large apartment complexes, in order to find out cause for offensive orders. The study results revealed that the main cause arose from the water-purifier tank and public sewer pipes near ordinary residential areas. First, in case of independent water-purifier tanks, the air is forced into the rotten part of large tanks nearby which should be operated in an anaerobic state, so that the tank changes into an aerobic state, or dirty water, which is returned during the sludge return process, falls on the top of the rotten tank, preventing scum from forming within the tank. Such problems cause incompletely purified water in the purifier tank to be discharged, which in turn results in filthy water. Second, in case of public sewer pipes, deteriorated or aging pipes, or the mixture of rain water and dirty water by mixing up combined and separated sewers system can cause foul odors in residential areas. Therefore, offensive odors in residential areas can be radically reduced through the appropriate construction and management of facilities including water-purifier tanks. As well, if more separate sewers are installed as part of an improvement project for public sewer pipes, complaints about foul smell can be minimized.

• 한국시뮬레이션학회논문지
• /
• 제12권3호
• /
• pp.95-102
• /
• 2003

Lately CBD methodologies like as CBD96, Catalysis, Fusion, and SCIPIO have been introduced. These methodologies has their own proprietary component reference model. Using proprietary reference model falls interoperability among methodologies. Furthermore it can cause confusion and difficulty for component developers, In this paper, we propose a integrated component meta-model for support consistency and interoperability among component designs. Also, we compare our proposed meta model to existing component reference model by using component's characteristics. We expect that it is easy to add new meta model elements and extends meta-model by using integrated component meta-model.

• 한국의료질향상학회지
• /
• 제14권1호
• /
• pp.49-54
• /
• 2008

Background : This study was to reduce incidence of falls by analyzing actual problem and drawing out improvement plan applicable to the clinical practice through operation of the staff nurses-centered fall peer review group. Method : The fall peer review group was composed of 8 nurses having patient nursing experience for over 5 years, and each of fall cases was reviewed and the root cause was analyzed. As a result, it was found that the patients and their families did not fully understandthe content of the education, and the staff nurses did not completely inspect the risk factors of falls and perform immediate intervention when patient's condition changed. Based on the above-mentioned results, improvement activity was conducted for the purposes of consolidating patients education method and supplementing computerized system to support nurses' decision making as well as devices and facilities. Result : As a result of conducting improvement activity in the aspects of education for patients, support of nurse's decision-making, and devices and facilities through operation of the staff nurses-centered fall peer review group, falls decreased by 9.5% compared to before improvement activity. Conclusion : It is concluded that operation of the clinical nurses-centered fall peer review group played a role of promoter to draw out practical and applicable improvement plan to the clinical practice and apply directions of the field-centered, and increased nurses' interest in falls and ultimately, reduced incidence of falls. Therefore the Center will continue to operate the staff nurses-centered peer review group, and recommends participation of nurses who actually take the charge of nursing patients in further analysis of patients' safety accidents.

• 농촌의학ㆍ지역보건
• /
• 제36권4호
• /
• pp.251-263
• /
• 2011

본 연구는 농촌지역 재가 낙상경험 노인의 낙상 두려움을 살펴보고, 그 관련요인을 확인하고자 시도하였다. 본 연구는 2010년 2월 1일부터 3월 31일까지 경상남도 하동군의 1개 면과 산청군의 1개 읍에 거주하는 노인 중 지난 1년간 낙상 경험이 있는 노인을 대상으로 일대일 면접을 통해 수집한 735명의 자료를 분석하였다. 낙상두려움간의 차이를 보인 것은 성별, 연령별, 학력, 동거 여부, 이동수단, 음주, 경제수준, 낙상횟수, 의료 이용여부, 건강식품구입여부, 보조용품구입여부, 낙상계절, 낙상장소, 낙상이유, 신발종류, 손상정도, 활동제한, 일상생활수행능력 이었다. 농촌 지역 노인의 낙상두려움의 예측요인으로서 위계적 중 다회귀분석을 실시한 결과 낙상횟수가 가장 영향력이 높았으며, 성별, 입원여부, 건강식품구입, 일상생활수행능력 등이 낙상에 대한 두려움의 관련요인으로 나타났다. 이상의 결과를 종합해 볼 때 낙상을 자주 경험하는 노인일수록 낙상에 대한 두려움이 증가할 수 있으므로 낙상이 빈번한 노인을 대상으로 한 자신감 강화 교육 프로그램의 개발과 일상수행능력을 향상시킬 수 있는 방안을 모색하여 보급함으로써 낙상에 대한 두려움을 감소시킬 수 있을 것으로 사료된다.

• 한국노년학
• /
• 제30권4호
• /
• pp.1107-1116
• /
• 2010

신체는 연령이 증가하면서 자세조절에 관여하는 고유수용성 감각, 시각, 전정기능이 감소하고 근력이 약해지고 갑작스런 움직임의 변화에 대처하는 반사능력이 감소하여 균형조절에 영향을 주고 낙상을 유발하는 원인이 된다. 균형조절의 어려움은 낙상에 대한 두려움으로 인하여 낙상효능감에 영향을 주고 독립적인 일상생활에 많은 장애를 일으킨다. 본 연구는 요양원에 입소한 65세 이상의 노인을 대상으로 가상현실 프로그램이 노인의 정적균형 조절과 낙상효능감에 미치는 효과에 대한 연구이다. 연구방법은 65세 이상 노인 14명을 대상으로 하여 가상현실군(n=7)과 대조군(n=7)으로 매회 30분씩, 총8회 실시하였다. 가상현실군은 일반적 운동치료법근법과 가상현실 프로그램을 실시하였고, 대조군은 일반적 운동치료접근법을 실시하여 치료 전·후를 평가 비교하였다. 대상자의 정적균형 조절과 낙상효능감은 Bio-Rescue와 낙상효능감척도로 평가를 하였다. 결과에 따른 자료 분석은 Wilcoxon signed test와 Mann-Whitney U test를 실시하였다. 연구의 결과 가상현실군이 정적균형 조절 평가에서 눈을 뜬상태에서의 정적균형 조절이 향상되었으며, 안정성 한계 변화에서 움직임의 범위가 증가하였다. 낙상효능감의 변화에서도 증가하였다. 결론적으로, 가상현실 프로그램은 노인에게 정적균형 조절과 낙상효능감에 효과가 있으며, 노인에게 가상현실 프로그램을 이용한 다양한 치료 방법과 치료에 대한 객관적인 평가가 필요하다고 사료된다.

• 한국의류산업학회지
• /
• 제16권6호
• /
• pp.945-953
• /
• 2014

This study aims to develop protective pants to relieve impact from falls and to present basic data for the development. The survey results are as follows; First, 45% of the respondents were in their 60s and 55% of them were in their over 70s and older. Also, 64% of them have fallen once for the past year and 36% of them have fallen twice or more. The older they were, the more there were those who have fallen twice or more. This indicated the older people has experienced more fall accidents again after a initial fall accident. Second, as per accident situations, the survey showed that fall accidents happened the most in the winter and in the afternoon (12-18 pm). Also, it happened on a street mostly and they were wearing sneakers or hiking boots when they got a hurt slipped in a front or side by missing their step in a walk. The injury areas are mostly knee and ankle. They had the bruises or a sprain in their knee and ankle mostly. The rate of bone fracture was 19.5%. Therefore, the protection area to falls in lower body is the knee. But hip and hip joint should be protected with knee as well because those are usually be broken when it is damaged. Third, approximately 80% of those who were hospitalized for treatment had surgery. Patients who had surgery were rather in their over 70s than in their 60s. The older they were, the more serious their fracture was. The period of hospital or outpatient treatment is more than three weeks in many cases. They responded their health got worse after falls. Aftereffects of accidents were physical discomfort, anxiety and medical costs. Falls to the old makes physical damage, psychological damage, which cause reduced physical activity and the increased cost of health care with economic losses. So it results on a negative impact on the life of the old. Fourth, elderly females were rarely aware of impact protective clothing and they have never purchased such clothing. For impact protective pants, the major consideration was suitable design for their body types. They liked casual style with front or side pockets and simple designs without any patterns or decorations. As per pants materials, they responded that they need functionality, activity and elasticity. Among the functional points, insulation of cloths are considered importantly, so the heat reservance of material in the impact protective pants should be considered carefully.

• Journal of Trauma and Injury
• /
• 제19권1호
• /
• pp.1-7
• /
• 2006

Purpose: Injury is a leading cause of morbidity and mortality for children. As an injury prevention measure, the differences in external causes of severe pediatric injuries based on ICECI were analyzed according to age groups. Methods: A retrospective study was performed for pediatric patients under 15 years of age, who had been admitted to the emergency department with severe injuries from January 1998 to December 2004. The external causes of injury were investigated according to the ICECI: intent, mechanisms, places of occurrence, objects/substances producing injury, and related activities. The patients were divided into four groups based on age: infant (<0 year), toddler (1~4 years), preschool age (5~8 years), and school age (9~15 years). Results: The injury mechanisms, the places of occurrence and the related objects/substances vary with the age groups. The most common subtype of traffic accidents was pedestrian injury in pre-school age group. Falls most frequently occurred in the toddler group. But falls from a height of less than l meter height (6 patients) occurred only in the infant group. The most common place of occurrence in the infant group was the home, and that of other groups was the road. The related objects/substances for falls, for example, household furnitures and playground equipment depended on the age group. Conclusion: The age-group specific characteristics of severe pediatric injury were analyzed successfully through the ICECI. Therefore, when establishing a plan for the prevention of pediatric injury, consideration must be given to the differences in the external causes of injuries according to age group.

• 대한의용생체공학회:의공학회지
• /
• 제33권4호
• /
• pp.163-168
• /
• 2012

Elderly women are reported to have greater risk of falls. The purpose of this paper was to investigate the possible gender differences in the reaction performance of ankle joint muscles, which have dominant role in the control of sagittal plane balance. Twenty-six elderly men and women with comparable mean age participated in this study. Reaction times to the audible beeps were measured in the tibialis anterior muscle and gastrocnemius muscle. Reaction time variables included premotor time, electromechanical delay and total reaction time. Gender difference in each reaction time was investigated by independent t-test. In both muscles, premotor time was longer in men but the electromechanical delay was longer in women (p < 0.05). Resulting total reaction time was longer in men in tibialis anterior muscle (p < 0.01) and it tended to be longer in men also in gastrocnemius muscle (p = 0.25). The results demonstrates that the overall reaction performances of elderly women is better than or comparable to those of elderly men in ankle joint muscles. This suggests that the reaction performance of ankle muscles is hardly the cause of the greater risk of falls in elderly women.

• 대한간호학회지
• /
• 제42권2호
• /
• pp.248-257
• /
• 2012

Purpose: The purpose of this study was to identify accidental mortality during school activities of students in elementary, middle or high school in Seoul and consequent compensation payment. Methods: Fifty-eight students died due to accidents during the period 1988 through 2007. Data were obtained from the Seoul School Safety and Insurance Association, and Seoul Metropolitan Office of Education. Chi-square, t-test, and ANCOVA were used in the data analysis. Results: Among students, 75.9% were male and 37.9% were high school students. Accidental mortality was 1.61 per one million students (2.33 for male, and 0.82 for female students, and 0.93, 2.13 and 2.31 for elementary, middle and high school students, respectively). Mortality caused by drowning and falls per one million student was 0.85 and 0.74 for male, and 0.23 and 0.35 for female students. After age, year and cause were adjusted using ANCOVA, the mean compensation payment was 40,615 thousand won for male, and 62,000 thousands for female students. Highest compensation payment was 127,137 thousand for cerebral concussion after age, gender, year and cause were adjusted. Conclusion: To decrease student accidental mortality, especially drowning and falls, development of efficient safety-enforcing education is essential to prevent injuries and avoid preventable compensation costs.