• Journal of Trauma and Injury
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• v.34 no.4
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• pp.284-287
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• 2021

We report a case of delayed chest wall reconstruction after thoracotomy. A 53-yearold female, a victim of a motor vehicle accident, presented with bilateral multiple rib fractures with flail motion and multiple extrathoracic injuries. Whole-body computed tomography revealed multiple fractures of the bilateral ribs, clavicle, and scapula, and bilateral hemopneumothorax with severe lung contusions. Active hemorrhage was also found in the anterior pelvis, which was treated by angioembolization. The patient was transferred to the surgical intensive care unit for follow-up. We planned to perform surgical stabilization of rib fractures (SSRF) because her lung condition did not seem favorable for general anesthesia. Within a few hours, however, massive hemorrhage (presumably due to coagulopathy) drained through the thoracic drainage catheter. We performed an exploratory thoracotomy in the operating room. We initially planned to perform exploratory thoracotomy and "on the way out" SSRF. In the operating room, the hemorrhage was controlled; however, her condition deteriorated and SSRF could not be completed. SSRF was completed after about a month owing to other medical conditions, and the patient was weaned successfully.

• Journal of Trauma and Injury
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• v.31 no.1
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• pp.1-5
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• 2018

Purpose: Although there has been substantial progress for the treatment of thoracic trauma, the mortality of the penetrating neck injury is still high, has been reported about 10-15%. However, there has not been a report which is reflecting Korean medical present. We retrospectively analyzed the penetrating neck injury patients based on the Korean Trauma Data Base. Methods: Between December 2013 and June 2017 at the trauma center of the Pusan National University Hospital, Busan, Korea, total of 36 patients with isolated low-velocity penetrating neck injuries were included. We analyzed the patients' age, gender, injury mechanism and causes by medical chart review. Results: Among total of 36 patients, 26 (72.2%) were male and 10 (27.8%) were female. Homicidal neck injuries were most common, followed by accidental and suicidal injuries (47% vs. 33% vs. 19%, respectively). All penetrating injuries in our study were low-velocity trauma such as following: knife (n=16, 44.4%); glass or glass bottle (n=11, 30.6%); scissors (n=4, 11.1%); grinder (n=2, 5.6%); and three (8.3%) of miscellaneous injuries. Twenty-seven (75.0%) patients underwent emergency surgery, and only one (2.8%) patient underwent elective surgery. Eleven (30.6) patients were diagnosed with superficial injuries, including six patients who had conservative treatment. Twelve (33.3%) patients had arterial injuries and 10 (27.8%) patients had venous injuries. The patients who had deep injuries showed significant difference against the patient with superficial injury (98.0 vs. 129.1, p=0.008). Conclusions: Low velocity penetrating injury confined to the neck is able to be successfully treated with prompt surgical management. Regardless of the conditions which are evaluated at emergency department, all penetrating neck injury patients should be regarded as urgent surgical candidates.

• Health Policy and Management
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• v.22 no.2
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• pp.183-206
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• 2012

Changing social conditions have resulted in a situation where elderly patients are no longer cared for by family and where medical care hospitals play a more prominent role. In this study, the unique elements of the medical service required from a long term care hospital were identified using conventional and exploratory analysis, and the causal relationship between medical service quality, relationship quality, and Revist intent was confirmed. The intermediary role and the quantitative importance of relationship quality (including trust and commitment) were also characterized. This study identifies the key points and indicators that the administrators of a long term care hospital can use to effectively plan their medical service offering in order to secure the commitment of customers through relationship quality. The theoretical indications of this study are set out below. First, four factors are selected as being the key elements determining service quality: medics, administrative service, healthcare environment, and subsidiary facilities. Second, it seems that medics, administration service, and the healthcare environment have some effect on the evaluations made in relation to trust and satisfaction (subsidiary facilities are not considered to be a key element). Third, patient satisfaction has a positive impact on trust and commitment and can be regarded as a key element for establishing connections. Fourth, commitment is likely to be strengthened when trust is significant. Fifth, as trust and commitment increase, revist intent strengthens. Lastly, this study illustrates how the levels of trust and commitment play a modulating role between patient satisfaction and revist intention. There are many practical indications from the findings of this study. First, the influences of medics, the administrative service, and the healthcare environment on trust and satisfaction vary. Especially, the healthcare environment is likely to be more important than medics. Accordingly, it is essential to establish an elderly-friendly environment, to improve a hospital's structure, and to maintain a clean environment. Second, medics must show compassion to their patients and be patient when providing explanations to elderly patients who often lack powers of concentration. Third, in order to establish patient trust, it is essential that medics provide an excellent medical service. Ultimately, these elements of relationship quality may strengthen the revist intention of elderly patients.

• Journal of Korean Society of Rural Planning
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• v.12 no.2 s.31
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• pp.87-96
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• 2006

The purpose of this study is to increase the utility in terms of the elderly's welfare. The data introduced in this paper were collected by the constructed interview method, and 192 aged interviewees were selected from 4 rural areas: Namhaegun, Uiryeong-gun Imsil-gun and Sunchang-gun. From the descriptive analysis of the data, the results derived are as follows: 1) The financial supports are needed to remodel rural village community facilities as senior centers. 2) It is expected that the facility be a center for the aged people's living in a village, and that have multiple functions of general care service network health care, meal support and making friendship spaces for them. 3) Share housing function is also added to the facility in emergency conditions.

• The Journal of Korean Society for School & Community Health Education
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• v.22 no.2
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• pp.65-73
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• 2021

Objectives: In Japan, there are many disasters such as earthquakes and tsunamis, and because of the high temperature and humid climate, health education for food poisoning may be particularly important. In addition, sexual problems caused by precociousness of adolescents, smoking and drinking are already serious socially important problems, and addiction problems are also emerging. Methods: Various publications from Japanese governments, interest groups such as government officers, health center workers, and people from health educators. For the information of Korean health education conditions, a current health educator and people from middle and high schools. Results: In 2012, based on the "Investigation Report on the Mind Care of Children in Emergency Disasters" from the Ministry of Education, Culture, Sports, Science and Technology, the Post-traumatic stress disorder (PTSD) situation of children in East Japan affected areas was discovered, and health education became important. In 2014, the "School Health and Safety Act Enforcement Rule" was amended, and health checkups are emphasized as part of school health. Conclusions: School health education in Japan differs from other health care systems in many ways with the system of Korea in the context of non-existence of official health education curriculum. Therefore, the purpose of this study is to develope how the curriculum of school health education in Korea.

• The Korean Journal of Emergency Medical Services
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• v.15 no.3
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• pp.81-96
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• 2011

Purpose : The purpose of this study was to analyse early childhood teachers' perspectives and actual conditions of earthquakes and tsunami safety education. Methods : A total of 119 teachers were recruited from kindergarten and child-care center located in J city, all of whom gave consent to take part in these research. The data have been collected for 45 days from May to July in 2011. The data was analyzed by SPSS (version 17.0) and chi-square test. Results : The results of this study are summarized as follow. 1. 97.5% of the subjects considered earthquakes and tsunami safety education necessary, however, only 34.6% of them were given the education related to earthquakes and tsunami. 2. 63.9% of the early childhood teachers provided children in the kindergarten or childhood center with earthquakes and tsunami safety education, however, 30.3% of them were found to be without any experiences of earthquakes and tsunami safety education. 3. 68.5% of the teachers were informed earthquakes and tsunami safety knowledge. 4. 35.0% of respondents answered that the single session of earthquake and tsunami education was not efficient, thus expecting to receive continuing education. Conclusions : The study suggested that more teachers necessarily provide earthquake and tsunami safety education to reduce children's mortality rate in earthquakes and tsunami. The education program should be developed and systematized to improve teacher's knowledge. Moreover, the program should be continuously provided to teachers and children in the kindergarten or childhood center.

• Journal of Korean Clinical Nursing Research
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• v.16 no.3
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• pp.157-174
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• 2010

Purpose: This study aims to develop, verify, and suggest outcome indicators for advanced practice nurses (APNs) in order to clarify their usefulness. Methods: To develop outcome indicators, the following methods were applied: reviewing literature intended to identify preliminary outcome indicators; surveying outcome indicators currently used for APNs and collecting the opinions from representatives of the professionals in clinical practice; verifying the content validity of preliminary outcome indicators by professionals and verifying the preliminary outcome indicators with 252 APNs. Results: Suggested outcome indicators are categorized into 84 items in total. Of these, the number of outcome indicators commonly appearing across disciplines was 18, mostly related to satisfaction and education. A majority of other outcome indictors exhibiting high relevance to individual disciplines are associated with care, including critical care (19 items), oncologic care (9 items) and emergency care (10 items). Conclusion: As the outcome indicators identified in this study are available to demonstrate the usefulness of APNs, it is recommended that future studies need to select and use appropriate outcome indicators according to characteristics and conditions of the discipline under examination. In addition, it is necessary to validate whether the suggested outcome indicators reflect adequately the practices of APNs.

• Journal of the Health Care and Life Science
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• v.9 no.1
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• pp.195-201
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• 2021

The study was initiated to identify the causes of physical and mental harm to workers and provide basic data. It is an analysis study using raw data from the 5th Working Environment Survey, and the study analyzed the impact of gender, verbal violence, insults, sexual harassment, sexual interest, and bullying on working environment satisfaction. Most of the victims' sexual harassment offenders were their coworkers (83.6 percent), and it was confirmed that women experienced more damage from bullying and sexual interest than men. Insult and verbal abuse have been identified as factors that reduce working environment satisfaction. Based on this study, we hope to improve productivity and work-life balance as well as improve workers' satisfaction with the working environment as a program that takes into account workers' influence factors.

• Proceedings of the KSR Conference
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• 2007.11a
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• pp.135-142
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• 2007

The service running of driverless rail vehicle has been required by various social and commercial issue. Currently, the new domestic line between Bu-san and Gim-hae is plan to be provided the LRV(Light Rail Vehicle) with driverless operation firstly in domestic service. These driverless vehicle have some major properties to make it lower the operating and maintenance cost, however on the other side, it unavoidably raise some potential hazard to make it lower the passenger safety because it is hard to take care immediately in emergency state during vehicle running. Therefore it is highly requested that we should consider various conditions at design stage to manufacture and operate the safest vehicle. Therefore, in this paper, we will survey the design concept of vehicle interior facilities based on the previous experience, (1) The difference of interior facilities between normal and driverless vehicle, (2) design and operational concept of passenger side door function to find out best application for domestic line driverless vehicle.

• Korean Journal of Clinical Laboratory Science
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• v.37 no.2
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• pp.96-101
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• 2005

Status epilepticus is a medical emergency, so that rapid and vigorous treatment is required to prevent neuronal damage and systemic complication. Status epilepticus is generally defined as a continuous or intermittent seizure or an unconscious condition after the onset of seizure, lasting for 30 minutes or more. We report here the outcome of status epilepticus. We retrospectively reviewed medical record of 15 patients who were diagnosed with status epilepticus at the Asan Medical Center from January 2003 to February 2004. This outcome was evaluated considering various factors such as age of patients, history of seizures, neurologic impairment, etiology, mortality, return to baseline and initial electroencephalogram (EEG) findings. The range of age was between 1 to 79 years old and the longest duration of treatment was 118 days. Most patients were treated by using pentobarbital, midazolam, phenobarbital and other antiepileptic drugs. The overall mortality was 5 (33%) out of 15 patients. The mortality was related to etiology, underlying other medical conditions and initial EEG findings. 5 (55%) out of the 9 patients with acute etiology, 5 (71%) out of the 7 patients with a multifocal or burst-suppression EEG activity, and 3 (60%) out of the 5 patients with other medical disease were related to mortality. This data demonstrate high mortality due to status epilepticus. Mortality is related to etiology, other medical conditions and abnormalities on the initial EEG.