• Title/Summary/Keyword: Discharge method

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Clinical Characteristics of Asthmatic Patients Who Visited Emergency Room (응급실로 내원한 천식환자들의 임상적 특성)

  • Suh, Jung-Kyung;Lee, So-Ra;Lee, Sang-Youb;Lee, Sang-Hwa;Cho, Jae-Youn;Shim, Jae-Jeong;In, Kwang-Ho;Kang, Kyung-Ho;Yoo, Se-Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.2
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    • pp.290-297
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    • 1997
  • Background : Despite remarkable progress of understanding the pathophysiology and therapy of bronchial asthma, asthma morbidity and mortality are on the rise. Also hospitalization and attending rates of emergency department for asthma have been increasing gradually. We analyzed clinical characteristics and prognosis of patients who visited emergency room due to asthma attack in order to define clinical characteristics of these group of patients. Method : We reviewed 105 adult asthmatic patients who attended emergency department of Korea University Hospital between August 1995 and July 1996, retrospectively. Results : 103 patients(56 female, 47 males, mean age : 48.6 years) attended-68 self referral, 18 practitioner referral and 17 OPD transfer- and 86 patients(83.5%) were admitted. Attending emergncy department was clearly more frequent in December(13.6%) and May(12.6%). Time lag between onset of asthmatic attack and arrival at the hospital was $14.2{\pm}15.5$ hour and initial peak expiratory flow rate was $166.7{\pm}68.3L/min$.(43.3% predicted) The commonest cause for visiting emergency room was aggravation of asthma due to upper respiratory tract infection in mild asthmatics. About half of them had history of previous ER visits. Their prognosis was not bad, but after discharge, about half of patients escaped from OPD follow-up. Conclusion : As a group they merit detailed attention and follow up arrangement. Clinician need to monitor and review the treatment plans, the medications, the patient's management technique, and the level of asthma control. For this group, plans for longer term treatment, including asthma education program and adjustment of overall treatment plan should be made.

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Respiratory Failure of Acute Organophosphate Insecticide Intoxication (유기인제 중독에 의한 호흡부전)

  • Shin, Kyeong-Cheol;Lee, Kwan-Ho;Park, Hye-Jung;Shin, Chang-Jin;Lee, Choong-Ki;Chung, Jin-Hong;Lee, Hyun-Woo
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.3
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    • pp.363-371
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    • 1999
  • Background: Because of the widespread use and availability of agricultural insecticides, acute organophosphate poisoning as a suicide or an accident is becoming the most common type of poisoning and serious problem in Korea. The mortality of organophosphate poisoning varied from 10 to 86 percent. The cause of death was thought to be a combination of excessive bronchial secretion, bronchospasm, respiratory muscle paralysis and depression of respiratory center, summarily respiratory failure. We evaluated the respiratory complications in patients with acute organophosphate intoxication to determine the predisposing, factors to respiratory failure and to reduce the incidence of respiratory failure or mortality. Method: We conducted a retrospective study of 111 patients with the discharge diagnosis of organophosphate poisoning who were hospitalized at Yenugnam University Hospital during the 5 years. The diagnosis of organophosphate poisoning has based on the followings (1) a history of exposure to an organophosphate compounds. (2) the characteristic clinical signs and symptoms. (3) decrease in the cholinesterase activity in the serum. Results: Respiratory failure developed in 31(28%) of 111 patients with acute organophosphate poisoning. All cases of respiratory failure developed within 96 hours after poisoning and within 24 hours in 23 patients. The 80 patients who did not develop respiratory failure survived. In 31 patients with respiratory failure, 15(44%) patients were dead. The patients with respiratory failure had more severe poisoning, that is, the lower level of serum cholinesterase activity on arrival, the higher mean dosage of atropine administered within first 24 hours. In 16 patients with pneumonia, 14 patients developed respiratory failure. In 5 patients with cardiovascular collapse, 2 patients developed respiratory failure. There was no correlation to between age, sex, the use of pralidoxime and respiratory failure. The serum cholinesterase level in survivors at time of respiratory failure and weaning was $66.05{\pm}85.48U/L$, $441{\pm}167.49U/L$, respectively. Conclusion: All the respiratory failure complications of acute organophosphate poisoning occurred during the first 96 hours after exposure. The severity of poisoning and pneumonia were the predisposing factors to respiratory failure. Aggressive treatment and prevention of the above factors will reduce the incidence of respiratory failure.

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A Clinical Analysis of Femur Neck Fracture in Elderly Patients (노년층에서 대퇴경부 골절의 치료)

  • Ihin, Joo-Choul;Ahn, Myun-Whan;Seo, Jae-Sung
    • Journal of Yeungnam Medical Science
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    • v.2 no.1
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    • pp.11-22
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    • 1985
  • Femur neck fracture is well known as one of the major death cause after trauma in elderly patients, and unsolved fracture due to its frequent association with complications such as avascular necrosis and nonunion. Through meticulous evaluation of the patient, hip and surgeon's experiences, reduction of mortality and morbidity as well as rapid recovery of the patient to the preinjury social and ambulatory status without local complications and revision after treatment is urgently needed. Many factors about this fracture In itself were noted, but we have analyzed 18 femur neck fractures of the patients older than 50 years preliminarily according to age, fracture pattern, osteoporosis, etiology and method of treatment with its delay in association with major complications especially avascular necrosis and nonunion. The results are as follows; 1. Of these 18 fractures, 11 were in females, 8 were caused by minor trauma such as slip-down accident and 4 were associated with definite osteoporosis according to the Sing's classification. 2. Fracture pattern of these 18 are undisplaced in 4, displaced subcapital in 11, displaced transcervical in 3. 11 fractures in the patients older than 60 year are composed of 3 undisplaced or impacted fractures and 8 displaced subcapital fractures. 3. These 18 fractures were treated by closed reduction and Internal fixation with multiple pins in 13, and hemiarthroplasty in 4, but one was not treated to die after discharge from hospital. 4. 4 undisplaced or impacted fractures and 3 displaced transcervical fractures were not associated with any complications such as avascular necrosis or nonunion. But 4 of 6 displaced subcapital fractures were complicated by avascular necrosis, 3 of which were reduced in the varus position within 1 week, and the other was reduced in the good position on 1 week after trauma. There was no complication in 2 displaced subcapital fractures reduced in valgus position within 3 days after trauma. According to the above results, the prognosis of the femur neck fracture is dependent upon the fracture pattern and delay in its treatment. So it is inevitable to reduce the fracture in anatomical or valgus position as early as possible. But the arthroplasty may be needed in displaced subcapital fractures delayed for several days, with its reluction in extreme varus position or impossible and with pre-existing disease in the same hip Joint (total hip replacement).

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An Exploratory Study about the Importance of Selected Nursing Activities during the Puerperal Period, as Viewed by Women in the Puerperal Period and by Nurses Caring for Them (산모와 간호원이 본 선택된 산욕기 간호활동의 중요도에 관한 탐색적 연구)

  • 박주봉
    • Journal of Korean Academy of Nursing
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    • v.8 no.1
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    • pp.152-162
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    • 1978
  • The desire to maintain health is increasing, consequently the role of nursing which has as one chief aim the solving of man′s basic problems is more and more important. Today, in spite of a growing concern about the nursing activities which nurses provide for individual human having specific needs, clinically in fact, it is questionable that individual′s expectation of nursing activities agrees with nurse′s performance of nursing activities. In this study the importance and agreement of the importance of the nursing activities during the hospitalized puerperal period as viewed by women in the puerperal period and by nurses caring for them, were assessed. The present study was undertaken in an attempt to furnish the basic data for expediting the progress of research activities in this area and further to be helpful in planning maternity nursing practice. The study population defined and selected was nurses (13) caring for women in the puerperal period and doing duty on obstetric & gynecologic ward at Y. hospital, and the women in puerperal period (39) as sum of 3 women selected by each nurse during the period of May 13th-June 4th 1976. The study data was collected by the direct interview method based on the questionnaire which the investigator made out. The study result was analyzed by percentage, t - test. The findings can be summarized as follows: 1. General characteristics of nurses doing duty on puerperal ward: a. Nurses′average age was 24.8 years old. b. 84.6% had educational background of 4 years of college. c. 69.2% had a religion. d. 53.8% were married. e. 53.8% had clinical experience of 1 year -3 years. f, 61.5% did duty on puerperal ward during 1 year -3 years. g. 46.2% desired to do duty on obstetric ? gynecologic ward. 2. General characteristics of the women who were studied during their puerperal period: a. Women′s average age was 26.4 years old. b. 79.5% had educational background above high school. c. 56.4% had a religion. d. 84.6% had living standard above medium. e. 89.7% had no occupation. f, 53,8% had previous hospitalization experience. g. 56.4% had previous delivery experience. 3. Examining the importance of 39 nursing activities during puerperal period selected by investigator, studied group of women considered that the most important nursing activity was "Record precisely about condition, medical treatment and nursing activity results etc". Nurses considered that the most important nursing activity was "Notice whether having pain and care for that". Both groups considered that the least important nursing activity was "Talk with her about topics such as news, hobbies, other interests". 4. Examining the importance of nursing activities in 4 specific categories, studied group of women considered that the most important nursing activity in physical nursing category was "Be sure of safety measure to prevent accidents, injuries", and nurses considered that the most important nursing activity was "Make her sleep and rest sufficiently". Studied group of women considered that the most important nursing activity in psychological category was "Explain about medical treatment and nursing activity ahead of time so she knows what to expect" , and nurses considered that the most important nursing activity was "Explain about puerperal period so she understands". Studied group of women considered that the most important nursing activity in relation to medical care was "Record precisely about condition, medical treatment and nursing activity results etc.", and nurses considered that the most important nursing activity was "Observing, cleaning and protecting the perineum" Studied group of women considered that the most important nursing activity in nursing category in preparation for discharge was "Instruct about personnel hygiene during puerperal period", and nurses considered that the most important nursing activity was "Instruct self-care to protect the perineum". 5. The analysis of this study showed a significant amount of disagreement computed by subtracting the nurse′s score from the patient′s score. Studied group of women put greater importance on physical nursing category, psychological nursing category, nursing in relation to medical care, than the nurses. These results were statistically significant at 0.01 level.

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Marine Algal Flora and Community Structure of Igidea Area in Busan, Korea (부산 이기대 지역의 해조상 및 군집구조)

  • Shin, Bong-Kyun;Kwon, Chun-Jung;Lee, Suk-Mo;Choi, Chang-Geun
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.20 no.2
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    • pp.121-129
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    • 2014
  • Marine algal flora and community structure were seasonally investigated at four sites in the vicinity of the Igidae on the southern east coast of Korea from May 2010 to February 2011. A total of 66 species including 9 of Chlorophyta, 14 of Phaeophyta, 43 of Rhodophyta were found during the survey period. Among these species, 16 species were found throughout the year. Seasonal mean biomass in wet weight was 123.6 (spring), 2,061.6 (summer), 412.0 (autumn), 678.9 (winter) $g{\cdot}m^{-2}$. Maximum biomass was recorded in summer($2,061.6g{\cdot}m^{-2}$), and minimum was recorded in spring($123.6g{\cdot}m^{-2}$). Spatial maximum and minimum species number were recorded at station 3 and 4(50 species) and at station 1(47 species). At station 1, 2 directly exposure on Yongho and Daeyeon cheon (stream) run off, and discharge from Nambu sewage treatment plants near coastal area, species diversity was relatively low and dominant species were similar throughout four seasons. The R/P, C/P and (R+C)/P value reflecting flora characteristics were 3.07, 0.64 and 3.71, respectively. The flora investigated could be classified into six functional groups such as coarsely branch form 39.39 %, sheet form 30.30 %, thick leather form 13.64 %, filamentous form 12.12 %, crustose form 3.03% and jointed calcareous form 1.52 % during survey period. The number of marine algae species in Igidea were 96 species at 1996 to 1997 and 66 species at 2010 to 2011, respectively. The change of seaweed species is due to the pollution loaded from sewage treatment plant and stream. We thus recommend that the positive maintenance control method like sewage treatment, for the protection of seaweed bed should be proceeded to near coastal area.

In-Hospital Outcomes of Acute Renal Failure Requiring Continuous Renal Replacement Therapy in Patients with On-pump CABG (심폐기 가동하 관상동맥우회술 후 발생한 급성신부전 환자들에 있어 지속적 신대체요법의 병원 내 결과)

  • Kim, Young-Du;Park, Kuhn;Kang, Chul-Ung;Yoon, Jeong-Seob;Moon, Seok-Whan;Wang, Young-Pil;Jo, Kuhn-Hyun
    • Journal of Chest Surgery
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    • v.40 no.1 s.270
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    • pp.32-36
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    • 2007
  • Background: Although acute renal failure (ARF) after coronary artery bypass graft (CABG) is relatively rare, but devastating complication with high mortality. Our study aims to evaluate the effectiveness of early application of CRRT in patients with ARF which developed after on-pump CABG. Material and Method: Two hundred and eighty seven patients underwent isolated on-pump CABG between May 2002 and Feb. 2006 at our institution, of whom 15 (5.2%) needed CRRT (11 patients for postoperatively developed ARF and the remaining 4 patients with preexisting dialysis-dependent chronic renal failure (CRF) for postoperative hemodynamic and metabolic control). Criteria for early application of CRRT were as follows; decreased urine output less than 0.5cc/h/kg for 2 consecutive hours and elevated serum creatinine level greater than 2.0 mg/dL. Result: The incidence of ARF requiring CRRT after on-pump CABG was 3.9% (11/283) and the overall hospital mortality of patient with CRRT was 33.3% (5/15). Of 5 deaths, 4 were patients with postoperatively developed ARF, and 1 was a patient with pre-existing dialysis-dependent CRF patient. The mean time between the operation and the initiation of CRRT was $25.8{\pm}5.8$ hours and the mean duration of CRRT was $62.1{\pm}41.2$ hours. Of the 7 survivors who were not on dialysis-dependent preoperatively, 6 patients fully recovered renal function during hospital stay and 1 patient required permanent renal supportive treatment after discharge from hospital. Conclusion: Early application of CRRT could maintain stable postoperative hemodynamic status and make outcomes better than those of previous reports in patients with ARF which developed after on-pump CABG.

Plasma Levels of Brain Natriuretic Peptide Predict Postoperative Atrial Fibrillation in Patients Undergoing Heart Surgery (심장 수술 후 심방세동 발생의 예측 인자로서 혈중 BNP 농도)

  • Kwon, Jin-Tae;Jung, Tae-Eun;Lee, Jang-Hoon;Lee, Dong-Hyup
    • Journal of Chest Surgery
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    • v.40 no.6 s.275
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    • pp.407-413
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    • 2007
  • Background: The brain natriuretic peptide (BNP) level has been reported in some studies to be associated with the occurrence of atrial fbrillation (AF). The aim of this study is to evaluate the potential usefulness of the BNP level as a predictor of the occurrence of postoperative (postop) AF and to assess the relationship of the BNP level with the onset of AF and the restoration of sinus rhythm. Material and Method: From January 1, 2005 to February 28, 2006, 82 patients without a history of atrial arrhythmia that had undergone cardiac surgery were enrolled in the study. Blood samples for plasma BNP were drawn daily for all these patients from the preoperative (preop) day to the 7th postop day. The patient records were reviewed and postop EKGs were checked daily for AF until the time of discharge. Result: Patients were divided into two groups based on development of postop AF. Postoperative AF developed in 26 patients (31.7%). There was no significant statistical difference in age, sex distribution, preop left ventricle ejection fraction, hypertension, left ventricular hypertrophy, or the use of beta blockers between the non-postop AF and postop AF group. More patients in the AF group had undergone valve surgery (39.3% versus 76.9%, p=0.002). The preop left atrium size was significantly larger in the AF patients ($43.8{\pm}10.3 mm$ versus $49.8{\pm}11.5 mm$, p=0.029). The preop plasma BNP levels were higher in the postop AF patients ($144.1{\pm}20.8 pg/mL$ versus $267.5{\pm}68 pg/mL$, p=0.034). In the postop AF group, the plasma BNP level was the highest on the 3rd postop day. Postop AF developed in most patients by the 3rd postop day; restored sinus rhythm developed by the 7th postop day. Conclusion: Elevated plasma BNP levels may lead to the occurrence of postop AF in patients undergoing cardiac surgery. Patients who have a high risk of postop AF should be considered for aggressive prophylactic antiarrhythmic therapy.

Analysis and Design of Profiling Adaptor for XML based Energy Storage System (XML 기반의 에너지 저장용 프로파일 어댑터 분석 및 설계)

  • Woo, Yongje;Park, Jaehong;Kang, Mingoo;Kwon, Kiwon
    • Journal of Internet Computing and Services
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    • v.16 no.5
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    • pp.29-38
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    • 2015
  • The Energy Storage System stores electricity for later use. This system can store electricity from legacy electric power systems or renewable energy systems into a battery device when demand is low. When there is high electricity demand, it uses the electricity previously stored and enables efficient energy usage and stable operation of the electric power system. It increases the energy usage efficiency, stabilizes the power supply system, and increases the utilization of renewable energy. The recent increase in the global interest for efficient energy consumption has increased the need for an energy storage system that can satisfy both the consumers' demand for stable power supply and the suppliers' demand for power demand normalization. In general, an energy storage system consists of a Power Conditioning System, a Battery Management System, a battery cell and peripheral devices. The specifications of the subsystems that form the energy storage system are manufacturer dependent. Since the core component interfaces are not standardized, there are difficulties in forming and operating the energy storage system. In this paper, the design of the profile structure for energy storage system and realization of private profiling system for energy storage system is presented. The profiling system accommodates diverse component settings that are manufacturer dependent and information needed for effective operation. The settings and operation information of various PCSs, BMSs, battery cells, and other peripheral device are analyzed to define profile specification and structure. A profile adapter software that can be applied to energy storage system is designed and implemented. The profiles for energy storage system generated by the profile authoring tool consist of a settings profile and operation profile. Setting profile consists of configuration information for energy device what composes energy saving system. To be more specific, setting profile has three parts of category as information for electric control module, sub system, and interface for communication between electric devices. Operation profile includes information in relation to the method in which controls Energy Storage system. The profiles are based on standard XML specification to accommodate future extensions. The profile system has been verified by applying it to an energy storage system and testing charge and discharge operations.

Characteristics of Sea Exchange in Gwangyang Bay and Jinju Bay considering Freshwater from Rivers (하천유출수를 고려한 광양만과 진주만의 해수교환 특성)

  • Hong, Doung;Kim, Jongkyu;Kwak, Inn-Sil
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.28 no.2
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    • pp.201-211
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    • 2022
  • At the center of the Noryang waterway, the Gwangyang bay area (including the Yeosu Strait) is located at the west, and the Jinju bay area (including Gangjin bay and Sacheon bay) is located at the east. Freshwater from several rivers is flowing into the study area. In particula,r the event of flood, great quantities freshwater flow from Seomjingang (Seomjin river) into the Gwangyang bay area and from Gahwacheon (discharge from Namgang Dam) into the Jinju bay. The Gwangyang and Jinju bay are connected to the Noryang waterway. In addition, freshwater from Seomjingang and Gahwacheon also affect through the Noryang waterway. In this study, we elucidated the characteristics of the tidal exchange rate and residence time for dry season and flood season on 50 frequency, considering freshwater from 51 rivers, including Seomjingang and Gahwacheon, using a particle tracking method. We conducted additional experiments to determine the effect of freshwater from Seomjingang and Gahwacheon during flooding. In both the dry season and flood season, the result showed that the particles released from the Gwangyang bay moved to the Jinju bay through the Noryang waterway. However, comparatively small amount of particles moved from the Jinju bay to the Gwangyang bay. Each experimental case, the sea exchange rate was 44.40~67.21% in the Gwangyang bay and 50.37~73.10% in the Jinju bay, and the average residence time was 7.07~15.36days in the Gwangyang bay and 6.45~12.75days in the Jinju bay. Consequently the sea exchange rate increased and the residence time decreased during flooding. A calculation of cross-section water flux over 30 days for 7 internal and 5 external areas, indicated that the main essential flow direction of the water flux was the river outflow water from Seomjingang flow through the Yeosu strait to the outer sea and from Gahwacheon flow through Sacheon bay, Jinju bay and the Daebang waterway to the outer sea.

Assessment of the Contribution of Weather, Vegetation and Land Use Change for Agricultural Reservoir and Stream Watershed using the SLURP model (II) - Calibration, Validation and Application of the Model - (SLURP 모형을 이용한 기후, 식생, 토지이용변화가 농업용 저수지 유역과 하천유역에 미치는 기여도 평가(II) - 모형의 검·보정 및 적용 -)

  • Park, Geun-Ae;Ahn, So-Ra;Park, Min-Ji;Kim, Seong-Joon
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.30 no.2B
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    • pp.121-135
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    • 2010
  • This study is to assess the effect of potential future climate change on the inflow of agricultural reservoir and its impact to downstream streamflow by reservoir operation for paddy irrigation water supply using the SLURP. Before the future analysis, the SLURP model was calibrated using the 6 years daily streamflow records (1998-200398 and validated using 3 years streamflow data (2004-200698 for a 366.5 $km^2$ watershed including two agricultural reservoirs (Geumgwang8 and Gosam98located in Anseongcheon watershed. The calibration and validation results showed that the model was able to simulate the daily streamflow well considering the reservoir operation for paddy irrigation and flood discharge, with a coefficient of determination and Nash-Sutcliffe efficiency ranging from s 7 to s 9 and 0.5 to s 8 respectively. Then, the future potential climate change impact was assessed using the future wthe fu data was downscaled by nge impFactor method throuih bias-correction, the future land uses wtre predicted by modified CA-Markov technique, and the future ve potentiacovfu information was predicted and considered by the linear regression bpowten mecthly NDVI from NOAA AVHRR ima ps and mecthly mean temperature. The future (2020s, 2050s and 2e 0s) reservoir inflow, the temporal changes of reservoir storaimpand its impact to downstream streamflow watershed wtre analyzed for the A2 and B2 climate change scenarios based on a base year (2005). At an annual temporal scale, the reservoir inflow and storaimpchange oue, anagricultural reservoir wtre projected to big decrease innautumnnunder all possiblmpcombinations of conditions. The future streamflow, soossmoosture and grounwater recharge decreased slightly, whtre as the evapotransporation was projected to increase largely for all possiblmpcombinations of the conditions. At last, this study was analysed contribution of weather, vegetation and land use change to assess which factor biggest impact on agricultural reservoir and stream watershed. As a result, weather change biggest impact on agricultural reservoir inflow, storage, streamflow, evapotranspiration, soil moisture and groundwater recharge.