Kim, Byoung kwon;Shin, Dong Hyuk;Han, Sang Kuk;Choi, Pil Cho;Lee, Young Han;Park, Ha Young;Bae, Soo Ho;Song, Hyoung Gon
Journal of Trauma and Injury
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v.22
no.2
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pp.206-211
/
2009
Purpose: Abdominal CT (computed tomography) is a principal diagnostic imaging modality for torso trauma at the Emergency Department (ED). When acute osseous pelvic injuries are detected by abdominal CT, additional three-dimensional (3D) reconstruction pelvic CT is often performed. We compared abdominal CT with pelvic CT to provide information about acute osseous pelvic injuries. Methods: A retrospective investigation of patients'electronic medical records during the five year period between January 1, 2004 and December 31, 2008 among Korean soldiers who underwent pelvic CT after abdominal CT at the ED was conducted. Axial images of abdominal CT were compared with axial images and 3D reconstruction images of pelvic CT. Results: Sixteen patients underwent subsequent pelvic CT after abdominal CT. Axial images of abdominal CT showed the same results in terms of fracture detection and classification when compared to axial images and 3D reconstruction images of pelvic CT. Pelvic CT (including 3D reconstruction images) followed by abdominal CT neither detected additional fracture nor changed the fracture type. Conclusion: This study has failed to show any superiority of pelvic CT (including 3D reconstruction images) over abdominal CT in detecting acute osseous pelvic injury. When 3D information is deemed be mandatory, 3D reconstructions of abdominal CT can be requested rather than obtaining an additional pelvic CT for 3D reconstruction.
Purpose: This study aims to investigate treatment of cancer patients at a secondary hospital. Methods: A retrospective analysis was performed with electronic medical records of cancer patients admitted to a secondary hospital from January 1, 2009 through September 31, 2017. Results: A total of 223 patients were studied. Sixty-nine patients were hospitalized for supportive care after receiving a surgery, chemotherapy, and radiotherapy at a tertiary hospital, 58 patients for other supportive care, 53 patients for symptom control, 16 patients with a decision not to take active cancer treatment, and 27 patients for treatment of cancer that was diagnosed during their hospital stay. Among 75 patients who were discharged to other institutions, 50 were transferred to tertiary hospitals, 10 to long-term care hospitals, eight to hospice hospitals, four to nursing homes and two to secondary hospitals. Comorbidities were found in 120 patients (53.8%). For patients who consulted with more than one department, more consultations were for non-cancer diseases than cancer. Seventy-three patients had a do-not-resuscitate order. Conclusion: For treatment of cancer patients, it is needed to establish a cooperation system among medical institutions and provide comprehensive management including treatment of comorbidities.
Purpose: Nasal bone fractures are the most common childhood facial bone fractures, with an incidence of about 39%. While taking a nasal bone x-ray is a common modality used in the emergency department, reports have expressed concerns with its low sensitivity and low specificity. Our study was aimed at comparing accuracy of physical and x-ray examination with that of facial bone computed tomography (CT). Methods: Electronic medical records (EMR) were retrospectively reviewed for patients under the age of 15 who visited our emergency department from January 2010 to December 2011with a chief complaint of nasal pain due to trauma and who had also undergone a nasal bone x-ray and facial bone CT. Patients who had not taken facial bone CT, who had been transferred, and who did not have EMR were excluded. We divided the patients into 2 groups, those who had nasal bone fractures and those without a fracture on their facial bone CT. We analyzed other parameters such as age, sex, and type of fracture to find statistical differences between the two groups. Results: A total of 209 patients were included. The patients with nasal bone fractures on their facial bone CT were older, and their traumas were more violent. Ten patients who had apparent nasal bone fractures on their facial bone CT had no definite signs of a fracture on their plain x-ray. Conclusion: Though facial bone CT is an effective modality in detecting nasal bone fractures, in evaluating younger patients suspected of having nasal bone fractures, prudent use of facial bone CT is needed to reduce unnecessary exposure to radiation.
Purpose: Non-invasive blood pressure measurement is widely used as a pre-hospital triage tool for blunt trauma patients. However, scant data exits for using the mean arterial pressure (MAP), compared to the systolic blood pressure, as a guiding index. The aim of this study was to determine the association between adverse outcomes and mean arterial pressure (MAP) and to exhibit the therapeutic range of the MAP in adult blunt trauma patients. Methods: The electronic medical records for all trauma patients in a single hospital from January 2010 to September 2012 were retrospectively reviewed. Patients below 17 years of age, patients with penetrating injuries, and patients with serious head trauma (injuries containing any skull fractures or any intracranial hemorrhages) were excluded. Adverse outcomes were defined as one of the following: death in the Emergency Department (ED), admission via operating theater, admission to the intensive care unit, transfer to another hospital for emergency surgery, or discharge as hopeless. Results: There were 14,537 patients who met entry criteria. Adverse outcomes occurred for MAPs in range from 90 to 120 mmHg. Adverse outcomes were found, after adjusting for confounding variables, to occur increasingly as the MAP declined below 90 mmHg or rose above 120 mmHg. Conclusion: Not only lower but also higher mean arterial pressure is associated with increased adverse outcomes in adult blunt trauma patients. Thus, patients with a MAP above 120 mmHg should be considered as a special group requiring higher medical attention, just as those with a MAP below 90 mmHg are.
Recently, demographic studies of veterinary medical database have been conducted to understand patterns of disease occurrence. Understanding incidence of breed-related disease would provide appropriate guidance for future health care strategies and offer useful information for early diagnosis of disease. However, in veterinary medicine, theses research has not yet been investigated in the Republic of Korea. The purpose of this study was to investigate the prevalence of common medical disorders among dog breeds examined at primary-care veterinary clinics in Jeollabuk-Do, Republic of Korea. The data were analyzed based on World Health Organization's International Classification of Disease. A total 13,176 medical records of canine patients were analyzed from six primary veterinary clinics in Jeollabuk-Do from January to December 2016. Results showed that the most common health problems were 'disease of skin' (17.7%); followed by 'diseases of digestive system' (12.26%), 'preventive medicine' (10.08%), and 'diseases of ear and mastoid process' (10.4%). In seven out of ten breeds, the most common medical disorder was skin disease. For poodle such as Pomeranian and Chihuahua, digestive system disease was most prevalent. On the other hand, respiratory system disease was found to be higher in Pomeranian than other breeds; while ear and mastoid process disease was most common for Maltese and Poodle. This study can help owners, breeders, and veterinarians prevent and manage various diseases of popular breeds in Jeollabuk-Do in the future.
Journal of the Korea Academia-Industrial cooperation Society
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v.17
no.4
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pp.43-51
/
2016
Preventing the forgery and alteration of test reports is important, in order to maintain the reliability of military supplies. Based on a survey of reports on testing institutions and a case study of established electronic document systems in the public sector, we propose a system architecture, which helps prevent the forgery and alteration of test reports with legal force. The proposed architecture takes advantage of both the time stamp that records the time a document is received and a server synchronized with the testing institution. Using the proposed system architecture, the user is able to request a test and receive reports from the testing institution without delay. Also, a defense agency is able to conveniently prove the authenticity of the test reports and utilize the statistical data collected by the architecture. Therefore, we expect that the proposed system architecture will help defense agencies to prevent the forgery and alteration of test reports and ensure their reliability and quality.
Byeon, Gyeong-Jo;Park, Ju Yeon;Choi, Yun-Mi;Ri, Hyun-Su;Yoon, Ji-Uk;Choi, Eun-Ji
Journal of Hospice and Palliative Care
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v.23
no.1
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pp.5-10
/
2020
Purpose: The aim of this study was to investigate celiac plexus neurolysis (CPN) for the treatment of cancerous upper abdominal pain in a tertiary university hospital in Korea. Methods: At the tertiary university hospital in Korea, electronic medical records of cancer patients who underwent CPN and died in the hospital from November 2009 to June 2018 were retrospectively analyzed. Results: The total number of subjects was 51. The 17 patients were from the Department of Gastroenterology (33.0%), followed by 11 patients from the Department of Hemato-oncology (21.6%), 11 patients from the Department of Anesthesia and Pain Medicine (21.6%), 9 patients from the Department of General Surgery (17.6%). The diagnosis was pancreatic cancer in 15 patients (29.4%), stomach cancer in 8 patients (15.7%), hepatobiliary cancer in 20 patients (39.2%), colon cancer in 1 patient (2.0%), esophageal cancer in 2 patient (3.9%) and intra-abdominal metastasis in 5 patients (9.8%). The mean survival time after the surgery was 66.4±55.0 days. The pain intensity before and 1 week after the procedure significantly decreased, but the amounts of opioids consumed before and 1 week after the procedure were not statistically significant. Side effects occurred after the procedure including temporary localized pain in 24 patients (47.0%), hypotension in 12 (23.5%), and diarrhea in 6 (11.8%). Conclusion: CPN is an effective and safe procedure for reducing upper abdominal pain caused by cancer, and it is necessary to perform CPN within the appropriate time by establishing a system of interdepartmental cooperation.
This study aimed to determine the management and environmental factors affecting medical expense reduction. For analysis, medical expenses were divided into hospitalization expenses and outpatient treatment expenses, and the rate of medical expense reduction was classified into initial and final reduction rates. Data were collected through a direct survey among 205 directors of independent health insurance review departments of hospital-level medical institutions in Korea. The results of the study are discussed below: In the analysis, differences in the initial and final reduction rates of hospitalization expenses and outpatient treatment expenses were compared. The results showed that, in hospitalization expenses, the initial and final reduction rates were both significantly affected by the following management factors: number of beds, number of departments, number of personnel reviewing health insurance cases, and total number of employees. Further, in outpatient treatment expenses, the initial and final reduction rates were both affected significantly by the following management factors: management of medical records, number of beds, number of departments, number of personnel reviewing health insurance, and total number of employees. The management factors significantly affecting both the initial and final reduction rates were higher number of beds for hospitalization expenses and electronic medical record management for outpatient treatment expenses. The environmental factors significantly affecting both the initial and final reduction rates of hospitalization expenses were a highly cooperative work environment, better implementation of indicator management systems, and overtime pay. Better implementation of indicator management system and a committee for handling medical expenses had significant effects on the initial reduction rate for outpatient treatment expenses. A highly cooperative work environment, better implementation of indicator management system, and overtime pay had significant effects on the final reduction rate for outpatient treatment expenses.
The evaluation and analysis method of information system (IS) is studied from the system perspective, the user perspective, and the management viewpoint. The detailed analysis method performs qualitative evaluation by user questionnaire or expert opinion. In this study, Measures the productivity and the effect of building administrative information systems. In the previous study, qualitative productivity and universal effect indicators were used, but in this study, quantitative productivity indicators and indicators specific to administrative complaints were selected. KONEPS, an administrative service system, used electronic contract records and information recorded in the intermediate process. The information was converted into the number of days, and the productivity based on the input manpower was calculated. The effect analysis analyzed the questionnaire related to civil affairs, which is the goal of the administrative work system. Each factor was divided into reflective structural variable and formal structural variable, and internal consistency and multi-collinearity were diagnosed. In order to verify the model, the influence of the work was set as a hypothesis, the reliability was verified according to the descriptive statistics method, the influence was measured through the regression analysis, and the model was analyzed by the multiple regression model path coefficient. Model validation methods are Chi-square (df, p), RMR, GFI, AGFI, NFI, CFI and GFI as indicators according to CFA.
Park, HyunSuk;Park, Moon Soo;Kim, Min Jung;Kim, Kwi Suk;Cho, Yoon Sook;Bae, Seng Sim;Rhie, Sandy Jeong
Korean Journal of Clinical Pharmacy
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v.28
no.2
/
pp.101-106
/
2018
Objective: The purpose of the study was to investigate the time from the injection of muscle relaxants to the first spontaneous respiration between sugammadex and conventional reversal for patients undergoing laparoscopic cholecystectomy. Methods: This study was retrospectively conducted on patients who were diagnosed with gallbladder stone (N802) between January 2014 and April 2017. The data were collected from the electronic medical records of a total of 186 patients (84 patients in the neostigmine group and 102 patients in the sugammadex group). Results: The time required for the first spontaneous respiration in the sugammadex group was shorter than that in the neostigmine group (3.6 min vs 4.9 min; p<0.05). After the injection of intermediate muscle relaxants, the comparison of heart rate and mean arterial pressure in the sugammadex and neostigmine groups revealed that the heart rate in the neostigmine group was higher than in the sugammadex group after 5 min (p<0.05). The mean arterial pressure in the neostigmine group was higher than in the sugammadex group after 10 min (p<0.05). A significant adverse effect of tachycardia was observed in the neostigmine group (p<0.05), but the frequency of rescue antiemetic in the sugammadex group was significantly higher than in the neostigmine group (p<0.05). Conclusion: In this study, the unwanted effect of neostigmine group was tachycardia; therefore, in the case of patients with hemodynamic instability, sugammadex is recommended. At 12 hours after the injection of sugammadex to patients, more antiemetics were required than in the neostigmine group; therefore, more research should be conducted on postoperative nausea and vomiting.
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