• 수면정신생리
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• 제24권1호
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• pp.19-23
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• 2017

Obstructive sleep apnea is a common disorder in which respiratory flow decreases or disappears despite respiratory effort due to occlusion of the upper respiratory tract during sleep. Oxidative stress and systemic inflammatory reaction induced by the obstruction cause complications such as hypertension, coronary artery disease, and diabetes and increase cancer incidence. Furthermore, in patients with interstitial lung disease, obstructive sleep apnea has a very high prevalence and is thought to have a close pathophysiological and clinical correlation. In other words, obstructive sleep apnea could be the cause or a complication of interstitial lung disease ; when these two afflictions coexist, the prognosis of the patient is worse. In patients with interstitial lung disease with obstructive sleep apnea, CPAP treatment significantly improved sleep and quality of life, as well as improved morbidity and mortality in a recent study. Therefore, early diagnosis and treatment of obstructive sleep apnea in patients with interstitial lung disease are very important, and additional studies designed to include patients with idiopathic pulmonary fibrosis as well as patients with advanced interstitial lung disease should be performed.

• Tuberculosis and Respiratory Diseases
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• 제78권3호
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• pp.289-292
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• 2015

Lemierre syndrome (LS) is a septic thrombophlebitis of the internal jugular vein (IJV) following an oropharyngeal infection. LS is commonly caused by normal anaerobic flora and treated with appropriate antibiotics and anticoagulation therapy. Although the incidence of disease is very rare, 15% cases of LS are fatal even in the antibiotic era because of disseminated septic thromboemboli. We reported a case of extensive bilateral LS due to methicillin-resistant Staphylococcus epidermidis in a 63-year-old female with lung adenocarcinoma. Initial examination revealed a retropharyngeal abscess; hence, intravenous ceftriaxone and steroid were initiated empirically. However, pulmonary thromboembolism developed and methicillin-resistant S. epidermidis was identified in the bacterial culture. Despite intensive antibiotic and anticoagulation therapies, extensive septic thrombophlebitis involving the bilateral IJV and superior vena cava developed. Adjunctive catheter-directed thrombolysis and superior vena cava stenting were performed and the patient received antibiotic therapy for an additional 4 weeks, resulting in complete recovery.

• Journal of Dental Anesthesia and Pain Medicine
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• 제22권5호
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• pp.349-356
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• 2022

Background: Awake fiberoptic intubation (AFOI) is the procedure of choice for securing the airway in patients with a difficult airway when undergoing surgeries under general anesthesia. An ideal drug would not only provide conscious sedation but also maintain spontaneous ventilation, smooth intubation conditions, and stable hemodynamics. We compared the effects of dexmedetomidine alone and dexmedetomidine in combination with fentanyl at a dose lower than the standard dose for achieving conscious sedation during AFOI in difficult airway patients undergoing oral cancer and dental surgeries. Methods: We included 68 adult patients undergoing AFOI. The patients were randomized in two groups, wherein Group D received intravenous dexmedetomidine 1 ㎍/kg and Group DF received dexmedetomidine 0.5 ㎍/kg and fentanyl 1 ㎍/kg. The outcomes measured were airway obstruction score, intubation scores, fiberoptic intubation comfort score, sedation score, and hemodynamic variables. Results: Low-dose dexmedetomidine with fentanyl showed similar results as those with the standard dose of dexmedetomidine in terms of airway obstruction, vocal cord movement, degree of cough, degree of limb movements, and intubation comfort. However, the sedation achieved and incidence of hypotension and bradycardia were higher in Group D than in Group DF. Conclusions: A low dose of dexmedetomidine-fentanyl provides satisfactory intubation conditions as those with a standard dose of dexmedetomidine in AFOI, thereby avoiding bradycardia, hypotension, and sedation.

• 중환자간호학회지
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• 제16권1호
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• pp.71-86
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• 2023

Purpose : This study aims to investigate the status of delirium intervention in adult intensive care unit (ICU) patients and the perception of this delirium by medical staff. Methods : This retrospective study involves 185 patients, whereas, a descriptive survey is conducted with 197 medical staff members. Results : The delirium group includes 100 patients (54.1%). The incidence of delirium is 64.9% in the medical ICU, 65.9% in the surgical ICU, 42.4% in the neuro ICU, and 46.5% in the cardiac ICU. The percentages of delirium prevention intervention differs between the two groups: 65.0% in the delirium group and 95.3% in the non-delirium group. The medical staff recognize that delirium is a common problem in the ICU (100.0%) and requires active medical intervention (98.5%). Conclusion : The length of stay at the ICU is longer in the delirium group than in the non-delirium group. It is necessary to standardize delirium prevention and treatment protocols to be equally applicable to all ICU patients.

• Journal of Trauma and Injury
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• 제36권3호
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• pp.187-195
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• 2023

Purpose: This study aimed to determine the risk factors associated with the severity of fall-related injuries among patients who suffered a fall from similar heights and analyze differences in injury sites according to intentionality and injury severity. Methods: The Emergency Department-based Injury In-depth Surveillance (EDIIS) data collected between 2019 and 2020 were used in this retrospective study. Patients with fall-related injuries who fell from a height of ≥6 and <9 m were included. Patients were categorized into the severe and mild/moderate groups according to their excessive mortality ratio-adjusted Injury Severity Score (EMRISS) and the intention and non-intention groups. Injury-related and outcome-related factors were compared between the groups. Results: In total, 33,046 patients sustained fall-related injuries. Among them, 543 were enrolled for analysis. A total of 256 and 287 patients were included in the severe and mild/moderate groups, respectively, and 93 and 450 patients were included in the intention and non-intention groups, respectively. The median age was 50 years (range, 39-60 years) and 45 years (range, 27-56 years) in the severe and mild/moderate groups, respectively (P<0.001). In multivariable analysis, higher height (odds ratio [OR] 1.638; 95% confidence interval [Cl], 1.279-2.098) and accompanying foot injury (OR, 0.466; 95% CI, 0.263-0.828) were independently associated with injury severity (EMR-ISS ≥25) and intentionality of fall (OR, 0.722; 95% CI, 0.418-1.248) was not associated with injury severity. The incidence of forearm injuries was four (4.3%) and 58 cases (12.9%, P=0.018) and that of foot injuries was 20 (21.5%) and 54 cases (12.0%, P=0.015) in the intention versus non-intention groups, respectively. Conclusions: Among patients who fell from a similar height, age, and fall height were associated with severe fall-related injuries. Intentionality was not related to injury severity, and patients with foot injury were less likely to experience serious injuries. Injuries in the lower and upper extremities were more common in intentional and unintentional falls, respectively.

• 한국시스템다이내믹스연구
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• 제17권1호
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• pp.25-40
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• 2016

This research aims to identify important variables and their effects on diabetes prevention or progression from prediabetes to diabetic complication using system thinking. Based on the existing studies, we have constructed a causal loop diagram explaining dynamics of diabetes and have found 7 important reinforcing loops and 3 balancing loops in the causal loop diagram. The CLD displays an effect of increasing prediabetes early detection and awareness on diabetes prevention. The findings indicate that the projects in Korea for reducing incidence of diabetes and potential risk of complication have focused on variables which are related only on diabetes even though prediabetes has been a critical point on diabetes prevention and management. Thus, it also concludes that the effect of projects focusing only on diabetes have faced limitation to manage diabetes accordingly.

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 2005년도 제57차 추계 학술대회 연제집
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• pp.31-44
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• 2005

In summary, air pollution issues in the United States are addressed by a core group of regulations supplemented by active Interventions as needed by public health agencies. The strategies employed by public health officials must be flexible and innovative to address the needs of the citizens, As you can see from the examples cited above, the collaboration of public health agencies can be critical in protecting communities from adverse exposures. In the US state and local governments have the primary responsibility for health and safety issues, including those associated with air pollution. The federal agencies have responsibilities when activities between states are involved and or the issues are of national significance. Significant challenges and opportunities remain to identify the relationship to air pollution and other environmental factors and the incidence of disease, and hence develop and implement Intervention strategies.

• Journal of Chest Surgery
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• 제28권3호
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• pp.247-252
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• 1995

The isolated coronary ostial stenosis is rare and a critical lesion which requires urgent surgical intervention. Recently direct angioplasty is assumed as a preferable approach to conventional bypass grafting. From Mar. 1990 to Aug. 1993, six patients underwent direct angioplasty in Sejong Heart Institute. The mean age of 6 patients was 48 years [range 37 to 63 and they consisted with 5 females and one male. All had severe angina [class III or IV of short duration [mean 5.3 months and a low incidence of risk factors. Despite the crucial location of the lesion, most patients had well preserved left ventricular function and normal wall motion. We performed direct angioplasty with autologous pericardium via anterior approach except one patient who underwent direct angioplasty and CABG. One patient died 4 hours after angioplasty probably due to acute coronary dissection. The survived 5 patients maintain normal life without symptoms during 26.2 months follow up [range 5 to 47 months .Our preliminary results suggest that angioplasty of isolated coronary ostial stenosis in highly selected patient can be carried out with good results and relatively low operative risks.

• 대한인간공학회:학술대회논문집
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• 대한인간공학회 1995년도 춘계학술대회논문집
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• pp.106-110
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• 1995

A local manufacturing companyin which low back pain(LBP) complaints were frequently reported was selected, and regularly perfomed lifting tasks were investigated using questionnaires and the 1991 NIOSH lifting guide. Among several processes of manufacture in the company, three processes-forming, heating and packing-were studied, where most of tasks were perfomed through manual materials handling (MMH). Questionnaire surveys showed that anthropometric data such as stature, weight and someatotype did not affect and weight of load influenced significantly the incidence of LBP, and workers who expwrienced LBP was older than the inexperienced. In addition, safety education conducted at the company was found to be ineffective in preventing LBP injuries. Lifting indexes(LI) was ranged from 0.86 to 17.0 with an average of 4.49, which revealed that tasks performing in the selected factory were in danger of LBP, and should be ertonomically redesigned. The critical factor reducing LI was found to be the horizontal component in all three processes, and most of weight of load was heavier than load constant(23kg) of the 1991 NIOSH lifting equation in heating process and packing.

• 한국경영과학회:학술대회논문집
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• 한국경영과학회 2000년도 추계학술대회 및 정기총회
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• pp.310-313
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• 2000

This paper develops a model of customer satisfaction in the mobile telecommunication services. We examine the relationships among customers'overall satisfaction and underlying dimensions； perceived service quality, service value, and brand image. Variables related to customer satisfaction and dissatisfaction are derived from customer critical incidence survey. The model is estimated with multi-variate data analysis. Results indicate that the (1) technical service quality is the main driver of customer overall satisfaction, (2) some peripheral services are rapidly evolving into the core services of mobile telecommunications, and (3) the current policy of service providers does not focus on customer satisfaction but on establishing churning barrier by increasing switching costs.