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Usefulness of presepsin as a prognostic indicator for patients with trauma in the emergency department in Korea: a retrospective study

  • Si Woo Kim;Jung-Youn Kim;Young-Hoon Yoon;Sung Joon Park;Bo Sun Shim
    • Journal of Trauma and Injury
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    • v.37 no.1
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    • pp.13-19
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    • 2024
  • Purpose: Trauma is an important public health concern, and it is important to increase the survival rate of patients with trauma and enable them to return to society in a better condition. Initial treatment in the emergency department (ED) is closely associated with the prognosis of patients with trauma. However, studies regarding laboratory biomarker tests that can help predict the prognosis of trauma patients are limited. Presepsin is a novel biomarker of inflammation that can predict a poor prognosis in patients with sepsis. This study aimed to determine whether presepsin could be used as a prognostic indicator in patients with polytrauma. Methods: The study included patients with trauma who had visited a single regional ED from November 2021 to January 2023. Patients who had laboratory tests in the ED were included and analyzed retrospectively through chart review. Age, sex, injury mechanism, vital signs, surgery, the outcome of ED treatment (admission, discharge, transfer, or death), and trauma scores were analyzed. Results: Overall, 550 trauma patients were enrolled; 59.1% were men, and the median age was 64 years (interquartile range, 48.8-79.0 years). Patients in a hypotensive state (systolic blood pressure, <90 mmHg; n=39) had higher presepsin levels (1,061.5±2,522.7 pg/mL) than those in a nonhypotensive state (n=511, 545.7±688.4 pg/mL, P<0.001). Patients hospitalized after ED treatment had the highest presepsin levels (660.9 pg/mL), followed by those who died (652.0 pg/ mL), were transferred to other hospitals (514.9 pg/mL), and returned home (448.0 pg/mL, P=0.041). Conclusions: Serum presepsin levels were significantly higher in trauma patients in a hypotensive state than in those in a nonhypotensive state. Additionally, serum presepsin levels were the highest in hospitalized patients with trauma, followed by those who died, were transferred to other hospitals, and returned home.

Analysis of Clinical Features and Treatment of Patients Presenting Dyspepsia Related to COVID-19: Retrospective Chart Review (코로나 관련 소화불량을 호소하는 환자의 임상적 특징 및 치료 분석 : 후향적 차트 분석)

  • Nahyun Jeong;Chae-Rim Yoon;Su-Hyun Choi;Dahee Jeong;Yoohyun Sim;Hae-in Jeong;Na-Yeon Ha;Jinsung Kim
    • The Journal of Internal Korean Medicine
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    • v.45 no.3
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    • pp.381-395
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    • 2024
  • Objectives: The main purpose of this study is to investigate the clinical characteristics of patients complaining of indigestion after COVID-19 infection (CI) or COVID-19 vaccination (CV) and to confirm the effectiveness and safety of Korean medical treatment. Methods: We retrospectively collected and investigated the medical records of 39 patients admitted to the Kyung Hee University Korean Medicine Hospital with a chief complaint of dyspepsia from January 1, 2020 to February 29, 2024 who reported the onset or significant exacerbation of dyspepsia after CV or CI. Patients were divided into vaccination and infection groups, and their demographic characteristics, Ryodoraku results, presenting symptoms, traditional Korean medicine treatments, and treatment outcomes were analyzed. Results: When comparing the groups with dyspepsia after CV and after CI, it was observed that the CI group had significantly lower average body weight, and the measurements of LH6, LF1, and LF6 in the Ryodoraku test were significantly lower. Additionally, compared to the CV group, the CI group showed significantly more abdominal distension, nausea, and abdominal pain. Significant relief of upper gastrointestinal symptoms was observed in both the CV and CI groups after treatment. No adverse reactions were observed during the course of treatment. Conclusion: The CI group tended to complain more severely of various dyspeptic symptoms and had a tendency to lower body weight than the CV group, as was also reflected in the results of the Ryodoraku test. Korean medical treatment can be effective and safe in treating these patients.

Analysis of the application of image quality assessment method for mobile tunnel scanning system (이동식 터널 스캐닝 시스템의 이미지 품질 평가 기법의 적용성 분석)

  • Chulhee Lee;Dongku Kim;Donggyou Kim
    • Journal of Korean Tunnelling and Underground Space Association
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    • v.26 no.4
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    • pp.365-384
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    • 2024
  • The development of scanning technology is accelerating for safer and more efficient automated inspection than human-based inspection. Research on automatically detecting facility damage from images collected using computer vision technology is also increasing. The pixel size, quality, and quantity of an image can affect the performance of deep learning or image processing for automatic damage detection. This study is a basic to acquire high-quality raw image data and camera performance of a mobile tunnel scanning system for automatic detection of damage based on deep learning, and proposes a method to quantitatively evaluate image quality. A test chart was attached to a panel device capable of simulating a moving speed of 40 km/h, and an indoor test was performed using the international standard ISO 12233 method. Existing image quality evaluation methods were applied to evaluate the quality of images obtained in indoor experiments. It was determined that the shutter speed of the camera is closely related to the motion blur that occurs in the image. Modulation transfer function (MTF), one of the image quality evaluation method, can objectively evaluate image quality and was judged to be consistent with visual observation.

Analysis of Color Error and Distortion Pattern in Underwater images (수중 영상의 색상 오차 및 왜곡 패턴 분석)

  • Jeong Yeop Kim
    • Journal of Platform Technology
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    • v.12 no.3
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    • pp.16-26
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    • 2024
  • Videos shot underwater are known to have significant color distortion. Typical causes are backscattering by floating objects and attenuation of red colors in proportion to the depth of the water. In this paper, we aim to analyze color correction performance and color distortion patterns for images taken underwater. Backscattering and attenuation caused by suspended matter will be discussed in the next study. In this study, based on the DeepSeeColor model proposed by Jamieson et al., we verify color correction performance and analyze the pattern of color distortion according to changes in water depth. The input images were taken in the US Virgin Islands by Jamieson et al., and out of 1,190 images, 330 images including color charts were used. Color correction performance was expressed as angular error using the input image and the correction image using the DeepSeeColor model. Jamieson et al. calculated the angular error using only black and white patches among the color charts, so they were unable to provide an accurate analysis of overall color distortion. In this paper, the color correction error was calculated targeting the entire color chart patch, so an appropriate degree of color distortion can be suggested. Since the input image of the DeepSeeColor model has a depth of 1 to 8, color distortion patterns according to depth changes can be analyzed. In general, the deeper the depth, the greater the attenuation of red colors. Color distortion due to depth changes was modeled in the form of scale and offset movement to predict distortion due to depth changes. As the depth increases, the scale for color correction increases and the offset decreases. The color correction performance using the proposed method was improved by 41.5% compared to the conventional method.

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Effect of Korean Medical Treatment on Child and Adolescent with Depressive Disorder and Analysis of Correlations among Anxious and Anger Psychological Scale Changes: A Restrospective Chart Review (소아·청소년의 우울장애 환자에 대한 한의치료의 효과 및 불안, 분노 심리척도 상관성 분석: 후향적 관찰 연구)

  • Han-Byul Cho;Yeon-Ju Kim;Jong-Ho Yoo
    • Journal of Oriental Neuropsychiatry
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    • v.35 no.3
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    • pp.247-256
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    • 2024
  • Objectives: To examine effect of Korean medical treatment on child and adolescent patients with depressive disorder and correlations among changes in anxiety and anger psychological scales before and after treatment. Methods: Medical records of 28 adolescent and 9 child patients diagnosed with depressive disorder based on Diagnostic and Statistical Manual of Mental Disorders-V (DSM-V) who received Korean medical treatment (herbal-medication, acupuncture, Korean psychotherapy, and so on) for at least 8 weeks were retrospectively reviewed. Psychological scales including Beck Depression Inventory-II (BDI-II), State-Trait Anxiety Inventory (STAI), Beck Anxiety Inventory (BAI), State-Trait Anger Expression Inventory (STAXI), Children's Depression Inventory (CDI), State Anxiety Inventory for Children (SAIC), Trait Anxiety Inventory for Children (TAIC), and Children's Inventory of Anger (ChIA) were measured every four weeks and analyzed. Results: After eight weeks of treatment, STAI-X-1 (State Anxiety), STAI-X-2 (Trait Anxiety), BDI-2, BAI, STAXI-S (State Anger), AXI-K-I (Anger Expression-In) and AXI-K-O (Anger Expression-Out) showed statistically significant decreases in adolescent patients. In child patients, ChIA was significantly improved after eight weeks. For psychological scale pairs in adolescent patients, BDI-2 and STAI-X-1·STAI-X-2·BAI·STAXI-S·AXI-K-I, STAIX-T and STAXI-S·AXI-K-I showed significant positive correlations whereas AXI-K-O and AXI-K-C showed a negative correlation. In child paitents, there was a significant positive correlation for all psychological scales except for the relationship between SAIC and ChIA. In adolescent patients, low pretreatment BDI-2 predicted BAI, STAXI-S, and AXI-K-I score reduction after 8 weeks. Lower BAI scores significantly decreased STAI-X-2 and BDI-2 scores after 8 weeks but increased AXI-K-C. In child paitents, low pretreatment ChIA scores predicted a decrease in CDI score after treatment. Conclusions: Korean medical treatments including herbal medicine, acupuncture, and Korean psychotherapy were effective in improving depressive disorder and accompanying symptoms such as anxiety and anger of child and adolescent patients.

A Survey on the Perception of the Counterplans of Medical Accident and Dispute of Dental Hygienist (의료사고 및 의료분쟁에 대한 치위생사의 인식도 조사)

  • Oh, Jin-Ho;Kwon, Jeong-Seung;Ahn, Hyoung-Joon;Kang, Jin-Kyu;Choi, Jong-Hoon
    • Journal of Oral Medicine and Pain
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    • v.32 no.1
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    • pp.9-33
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    • 2007
  • In the field of dentistry, there existed relatively few emergency patients or patients who need intensive care and thus had low medical dispute rates. However, these days, there is a general tendency of increased medical disputes. Although many medical disputes are caused by medical accidents of the dentists, because dental assistants are also lawfully involved in practicing dentistry, there is a possibility of medical disputes or medical accidents caused by dental assistants. Therefore, the role of the dental assistants cannot be ignored. This study consists of a survey given to dental hygienists currently working in general hospitals, dental hospitals and private dental clinics. Following is the results of the analysis of 275 respondents' backgrounds, medical disputes rates including patients' complaints, their understanding of medical regulations and their general understanding of overall dental practice and medical disputes. 1. 251 of 274(91.6%) respondents doubted the risk of medical accident and dispute. 2. 81(29.5%) dental hygienist experienced complaint from patients. They have been working in the private dental clinic, the rate of this experience was high. 3. 349 case of 1805(19.3%) the complaints by patients, highest percentage among its category, were those regarding dental fees and poor service. 4. 129 case of 1805(7.1%) patients' complaints, highest percentage among it's subcategory, were those regarding the absence of explanations of precautions or request of agreements before dental treatment. 5. 252 of 267 (94.4%) dental hygienists chart after a scaling treatment. However, only 55(20.7%) dental hygienists chart the fact of explaining the precautions. 6. 6(2.2%) dental hygienists do not inspect patients' medical history, if patients don't mention it. 7. 104 of 274(38.0%) dental hygienists responded to be capable of administering first aid treatment. 8. 115(41.8%) dental hygienists have a first aid kit and equipment. 9. In case of medical dispute, 268(97.8%) dental hygienists respond that, charting plays a big role in resolving the dispute. 10. In case of medical dispute, 272(93.3%) dental hygienists respond that, explanation and agreement before treatment have an important role in settlement of dispute 11. Only 160(58.4%) dental hygienists responded correct answer that the duration of keeping medical records is 10 years. 12. 124(45.3%) respondents thought that it is legal for a dental hygienist to take a panoramic dental X-ray, 71(25.9%) respondents thought that it is legal practice cervical resin treatment by dental hygienist, and 37(13.5%) respondents thought that it is legal extract primary teeth by dental hygienist. 13. 24(18.76%) respondents thought that it doesn't matter to tell patient's state to others 14. 272(99.27%) responded that receiving education for the prevention of medical disputes was needed and of them, 61.0% thought it was urgent. 15. 186(64.2%) has never had classes regarding the prevention of medical disputes while in school and 212(77.4%) has not had the same type of classes after graduating from school. 16. 256(93.4%) responded that there will be even more of an increased number of medical disputes. Among them, 83.3% of respondents though that due to the increased opportunity of acquiring information through the internet and mass media. The study shows that 29.5 percentage of dental hygienists have experienced the medical disputes and complaints and they are lack of recognition of medical regulations and dental hygienist's official duty. So, there is a big potential of the percentage to increase. Therefore, the correct understanding of explaining precautions and requesting agreement before dental treatments and performing them are mandatory. Moreover, classes regarding the prevention and counterplans of medical disputes need to be widely offered.

Analysis of Nursing Care Activities of Nursing Students in Clinical Experience (간호학생의 임상실습 간호활동시간 분석)

  • Lee Chung-Hee;Sung Young-Hee;Jung Yoen-Yi;Kim Jung-Suk
    • The Journal of Korean Academic Society of Nursing Education
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    • v.4 no.2
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    • pp.249-263
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    • 1998
  • The competence of newly graduated nurses is based on various clinical expriences gained when they were students. Therefore, instructors of nursing students, professors in nursing schools or directors in hospitals must play a critical role in assisting them to obtain various knowledge and experienced nursing skills. The purpose of this study was to investigate nursing care activities and nursing care hours practiced by nursing students in a general hospital. The subject students were total 214 nursing students, 2nd graders(sophomores) and 3rd graders(juniors) from 5 Junior Nursing Colleges in Seoul and they practiced at S general hospital to gain clinical experience. The data were collected for 4 days. The tools for this study were the direct nursing care activity list consisted of 15 nursing areas and the indirect nursing care activity list consisted of 9 nursing areas. The subject students were supposed to record their own score. The results of this study are ; 1. The nursing care hours per nursing student 1) The average total nursing care hours a day per each nursing student are 362.65 mins(6.04hr), the direct nursing care hours per each nursing stuent are 202.09 mins(direct nursing care rate 56.0%) and it is higher than the indirect nursing care hours, 159.75mins(indirect nursing care rate 44.0%). The direct nursing care rate of each student by a team approach in the evening shift(56.3%) is higher than that in the day shift(55.8%). 2) The hours of checking vital signs are the longest(47.35mins) among the direct nursing care activites and next is in order of counseling 8l emotional support, nurse rounds, and accompaning a patient during examination. The hours of reporting are the longest(32.39mins) among the indirect nursing care activites, and next is the activities related to education such as reviewing chart, looking up references, etc. 3) The freqency of checking vital signs practiced by nursing student is the highest(the average of 55.7 times) among the direct nursing care activities and next is in order of nurse rounds, assistance of feeding, and counseling & emotional support. The required time for nursing students to accompany their patient during examination is the longest(20.7mins) and next are in order of restriction on patient' activity, orientated by a head nurse, skin care, sitz bath, bathing & hair shampoo, and assisting with patients' exercise. 2. The nursing care hours per grader 1) The average hours of total nursing care per a nursing student are 369.2mins(6.2hrs) to 2nd graders, 355.9mins(5.9 hrs) to third graders. The direct nursing care rate per each nursing student to 3rd graders(59.3%) was higher than that to End graders(52.8%). 2) For 2nd graders, the highly marked nursing activities are teaching associated with direct nursing care activities such as drawing up papers, looking up references, reviewing charts, and being orientated by staff nurses. For 3rd graders, measurments, observations, and nurse rounds in indirect nursing care activities are taken highly 3) The most frequent practice of the nursing care activites is checking vital signs : 65 times to 3rd graders and 46.5 times to 2nd graders. Our suggestions based on the results of this study are : 1. It is recommanded to repeat the same designed study in a variety of clinical fields for further study. 2. It is recommanded to collect data not by self-record method but by observated method. 3. It is needed for nursing instructors in Nursing Schools and in hospitals to develop the guidelines and check-list of clinical practice courses.

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Microbiological Hazard Analysis for HACCP System Application to Vinegared Pickle Radishes (식초절임 무의 HACCP 시스템 적용을 위한 미생물학적 위해 분석)

  • Kwon, Sang-Chul
    • Journal of Food Hygiene and Safety
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    • v.28 no.1
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    • pp.69-74
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    • 2013
  • This study has been performed for 150 days from February 1 - June 31, 2012 aiming at analyzing biologically hazardous factors in order to develop HACCP system for the vinegared pickle radishes. A process chart was prepared as shown on Fig. 1 by referring to manufacturing process of manufacturer of general vinegared pickle radishes regarding process of raw agricultural products of vinegared pickle radishes, used water, warehousing of additives and packing material, storage, careful selection, washing, peeling off, cutting, sorting out, stuffing (filling), internal packing, metal detection, external packing, storage and consignment (delivery). As a result of measuring Coliform group, Staphylococcus aureus, Salmonella spp., Bacillus cereus, Listeria Monocytogenes, E. coli O157:H7, Clostridium perfringens, Yeast and Mold before and after washing raw radishes, Bacillus cereus was $5.00{\times}10$ CFU/g before washing but it was not detected after washing and Yeast and Mold was $3.80{\times}10^2$ CFU/g before washing but it was reduced to 10 CFU/g after washing and other pathogenic bacteria was not detected. As a result of testing microorganism variation depending on pH (2-5) of seasoning fluid (condiment), pH 3-4 was determined as pH of seasoning fluid as all the bacteria was not detected in pH3-4. As a result of testing air-borne bacteria (number of general bacteria, colon bacillus, fungus) depending on each workplace, number of microorganism of internal packing room, seasoning fluid processing room, washing room and storage room was detected to be 10 CFU/Plate, 2 CFU/Plate, 60 CFU/Plate and 20 CFU/Plate, respectively. As a result of testing palm condition of workers, as number of general bacteria and colon bacillus was represented to be high as 346 $CFU/Cm^2$ and 23 $CFU/Cm^2$, respectively, an education and training for individual sanitation control was considered to be required. As a result of inspecting surface pollution level of manufacturing facility and devices, colon bacillus was not detected in all the specimen but general bacteria was most dominantly detected in PP Packing machine and Siuping machine (PE Bulk) as $4.2{\times}10^3CFU/Cm^2$, $2.6{\times}10^3CFU/Cm^2$, respectively. As a result of analyzing above hazardous factors, processing process of seasoning fluid where pathogenic bacteria may be prevented, reduced or removed is required to be controlled by CCP-B (Biological) and threshold level (critical control point) was set at pH 3-4. Therefore, it is considered that thorough HACCP control plan including control criteria (point) of seasoning fluid processing process, countermeasures in case of its deviation, its verification method, education/training and record control would be required.

Can the Sasang Constitutional Type Trait Act as an Independent Risk Factor for Dyslipidemia? (사상체질이 이상지질혈증의 위험인자가 될 수 있는가?)

  • Lee, Jiwon;Jang, Hyunsu;Park, Byungjoo;Lee, Euiju;Koh, Byunghee;Lee, Junhee
    • Journal of Korean Medicine for Obesity Research
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    • v.14 no.2
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    • pp.63-71
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    • 2014
  • Objectives: This study was designed to investigate the correlation between Sasang constitution and dyslipidemia and the possibility that Sasang constitution can be a risk factor of dyslipidemia. Methods: This study was a retrospective cross-sectional study based on chart review. Seventeen thousand sixty-nine charts which were collected from May 2007 to June 2010 in International Healthcare Service Center, Kyung Hee University Medical Center, were reviewed for the study. Fifteen thousand two hundred fifty charts including Sasang constitutional diagnosis and lipid profiling were selected and we examined the correlation between Sasang constitution and dyslipidemia. Results: After adjusted for body mass index, the levels of total cholesterol and triglyceride were highest in Taeeum group, and lowest in Soeum group. High-density lipoprotein was highest in Soeum group, and lowest in Taeeum group. After adjusted for age, sex, and body mass index, the odds ratios for 'high triglyceride' were 1.716 (1.411~2.087) in Soyang group and 2.021 (1.650~2.475) in Taeeum group compared to Soeum group. The odds ratio for 'high low-density lipoprotein' was 1.229 (1.006~1.501) in Soyang group compared to Soeum group. The odds ratios for 'low high-density lipoprotein' were 1.195 (1.033~1.381) in Soyang group and 1.414 (1.212~1.649) in Taeeum group compared to Soeum group. Conclusions: The lipid profiles and dyslipidemic risk differed across constitutional types, showing constitution type-specific patterns, so that we could infer the possibility that Sasang constitutional types can be a risk factor of dyslipidemia.

The Clinical Examination of Netspeg Lens for Good Visual Acuity (시력 개선을 위한 Netspeg 렌즈의 임상적 검증)

  • Kim, Douk-Hoon;Bae, Han-Young;Kim, Sun-Tae
    • Journal of Korean Ophthalmic Optics Society
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    • v.11 no.3
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    • pp.281-291
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    • 2006
  • The aim of this study was performed the clinical test using Netspeg lens for good visual acuity on subjects with abnormal refraction status. The subjects of one hundreds adults (fifty males, fifty females, mean=21 years, range=19 to 24) were recorded. The subjects were researched the history including the systemic health, medication, genetics, allergy, systemic disease and ocular disease. The refraction test was recorded the monocular and binocular using objective method. Visual acuity was performed the binocular status using the Netspeg lens and CR-39. Stereopsis test was performed the titmus fly and TNO at near distance using Netspeg lens and CR-39. The P-VEP test was used the 16 pattern size(Bausch Lomb, production in USA) with three channels. Also Subjects viewed the p-vep stimulus with binocular vision through the corrected visual acuity using the Netspeg lens and CR-39. The contrast sensitivity test was performed the contrast sensitivity chart(pelli-Robertson, USA) at 1m distance using the Netspeg lens and CR-39. The ultrastructure of surface on the Netspeg lens and CR-39 was observed the SEM(JMS-5800, made in Japan). The results of this study was as follows: 1. In corrected visual acuity of abnormal refraction using the Netspeg lens and CR-39, the Netspeg lens wearer were acquired the good visual field and clear visual acuity comparative to CR-39 wearer in the subject vision test. however the comfort of visual acuity was similar results in the Netspeg lens and CR-39. Also the subjects of Netspeg lens wearer was good visual acuity more than CR-39 wearer and in the analysis of P-VEP, the amplitude of wave on Netspeg lens used appears to be better through the CR-39(p>0.5). Besides, on the contrast sensitivity, the Netspeg lens wearer was good results than CR-39. The value on stereopsis with TNO by Netspeg lens wearer was better than CR-39 in results. However, in the stereopsis test with Titmus, the Netspeg lens and CR-39 wearer was similar results. 2. The ultrastructure of Netspeg lens surface was the smooth and fine shape more than CR-39. Also, Netspeg lens have a fine line structure in ultrastructure. In conclusion, the results of this study conformed that the surface ultrastructure of Netspeg lens used is more specific pin hole design structure than CR-39. This study indicated that the vision of Netspeg lens used have a better than CR-39 in the corrected visual acuity for abnormal refraction eye. Therefore, In this paper, we suggested that the ultrastructure and line structure of Netspeg lens was related to good visual function. However the visual function of the aspheric Netspeg and ultra waterproof Netspeg lens was similar results.

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