• Title/Summary/Keyword: Emergency death

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SVM Classifier for the Detection of Ventricular Fibrillation (SVM 분류기를 통한 심실세동 검출)

  • Song, Mi-Hye;Lee, Jeon;Cho, Sung-Pil;Lee, Kyoung-Joung
    • Journal of the Institute of Electronics Engineers of Korea SC
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    • v.42 no.5 s.305
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    • pp.27-34
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    • 2005
  • Ventricular fibrillation(VF) is generally caused by chaotic behavior of electrical propagation in heart and may result in sudden cardiac death. In this study, we proposed a ventricular fibrillation detection algorithm based on support vector machine classifier, which could offer benefits to reduce the teaming costs as well as good classification performance. Before the extraction of input features, raw ECG signal was applied to preprocessing procedures, as like wavelet transform based bandpass filtering, R peak detection and segment assignment for feature extraction. We selected input features which of some are related to the rhythm information and of others are related to wavelet coefficients that could describe the morphology of ventricular fibrillation well. Parameters for SVM classifier, C and ${\alpha}$, were chosen as 10 and 1 respectively by trial and error experiments. Each average performance for normal sinus rhythm ventricular tachycardia and VF, was 98.39%, 96.92% and 99.88%. And, when the VF detection performance of SVM classifier was compared to that of multi-layer perceptron and fuzzy inference methods, it showed similar or higher values. Consequently, we could find that the proposed input features and SVM classifier would one of the most useful algorithm for VF detection.

The Influence of How the Trauma Care System Is Applied at the Trauma Center: The Initial Experience at Single Trauma Center (외상 센터에서의 외상 진료 시스템 도입에 따른 변화: 단일 외상 센터에서의 초기 경험)

  • Kim, Hyung Won;Hong, Tae Hwa;Lee, Seung Hwan;Jung, Myung Jae;Lee, Jae Gil
    • Journal of Trauma and Injury
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    • v.28 no.4
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    • pp.241-247
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    • 2015
  • Purpose: To evaluate the influence of how the trauma care system is applied on the management of trauma patients. Methods: We divided the patients into a pre-trauma system group and a post-trauma system group according to the time when we began to apply the trauma care system in our institution. We compared the general characteristics, injury severity score, initial response time to the trauma patients, number of preventable deaths, and clinical outcomes between the two groups. Results: The numbers of patients in the pre-trauma system group and the post-trauma system group were 188 and 257, respectively. No differences in the patient's median ages, trauma scores (ISS, RTS, TRISS) and proportions of severe trauma patients (ISS>15) were observed between the two groups. The number and the proportion of patients who were admitted to our hospital were increased in the post-trauma system group. The time interval from trauma CP activation to emergency surgery or angio-embolization, and the patient's time spent in emergency room were shortened in the post-trauma system group. However, the lengths of the ICU stay and the hospital stay, and the number of in-hospital mortalities were not improved in the post-trauma system group. In severe trauma patients (ISS>15), there were no differences between the two groups in the number and the proportion of admitted patients, and the time interval from trauma CP activation to performing a diagnostic and therapeutic procedure was not shortened in the post-trauma system group. Conclusion: Application of the trauma care system has shortened the time between the initial response and patient management. However, this improvement was not enough to result in better clinical outcomes. More trauma physicians, multidisciplinary cooperation, and a well-organized trauma management process will be needed if the maximum efficacy of the trauma system is to be achieved.

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A study on the Development of Surveillance System for Agricultural Injuries in Korea (농작업재해 감시체계 개발)

  • Koh, Jae-Woo;Kwon, Soon-Chan;Kim, Kyung-Ran;Lee, Kyung-Suk;Jang, Eun-Chul;Kwon, Young-Jun;Ryu, Seung-Ho;Lee, Soo-Jin;Song, Jae-Chul
    • Journal of agricultural medicine and community health
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    • v.32 no.3
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    • pp.139-153
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    • 2007
  • Injury in agriculture is a serious public health issue with a major impact on the lives of Korean farmers. It is one of the leading causes of death and is also a major cause of longand short-term disability. In 2001, the social cost of one accident in agricultural machinery was estimated as 97.7-97.8 million won that is 4 fold of farm household income in Korea. Effective prevention and control of injuries requires a system of surveillance that monitors the incidence of injuries, their causes, treatment and outcomes. This requires an integrated system of data collection, analysis and interpretation and communication. Creating effective injury surveillance system in Korea requires to establish a framework for a national agenda. Discussions regarding the development of the framework should address, but not be limited to issues related to Data Holdings and Linkages; Capacity and Skills; Communication; Interconnection; and Surveillance Products. Ideally, an injury surveillance system would meet the information requirements across all sectors, while allowing each to have the ongoing information it needs for its policy and programming needs. This study was carried out to develop a surveillance system of agricultural injuries in Korea. Study subjects were residents who lived in a typical agricultural area (Yangpyung area in Kyung-gi province). The main data sources were reports of village headmen, compared with data of 'National Emergency Management Agency', 'National Health Insurance Corporation', 'Insurance of National Agricultural Cooperative', and 'Emergency Medical Centers'. Each data were reviewed to validate the strengths and weaknesses.

A Study on the Patients Who Attempted Suicide with Drug Intoxication (약물중독 자살환자에서 사망군과 생존군의 비교)

  • Han, Jung-Su;Yun, Seong-Woo;Choi, Sung-Soo
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.4
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    • pp.1863-1870
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    • 2013
  • The purpose of this study is when the cases will be found, used as a basic data for clinical severity prediction, and research on suicide prevention. By classifying the group of survival and death about the patients who visit the Emergency Medical Center by attempt suicide by drug addiction, identifying the condition when visiting and results of the treatment after visiting. From June 2009 to May 2011, last two years data that among the drug abusers who visited the Emergency Medical Center in C-University Hospital in Gwang-Ju, only suicidal patients, except with unintentional accidents were collected. The findings, among the drug addiction patients who high age, lower level of education and living alone were the mortality rate was higher. And if who drunk the agricultural chemicals, the convalescence was not good. If the causes of suicide were economic problems and depression, the mortality rate was higher. And when visit hospital, if the consciousness was stupor and semi-coma/coma, the convalescence was not good. As grasp the risk for suicide patients of drug addiction, help on the Prediction of clinical severity, also stamp the appropriate drug education with psychological support is more important on them.

Critically Ill Patients with Pandemic Influenza A/H1N1 2009 at a Medical Center in Korea

  • Choi, Eun-Young;Huh, Jin-Won;Lim, Chae-Man;Koh, Youn-Suck;Kim, Sung-Han;Choi, Sang-Ho;Kim, Won-Young;Kim, Won;Kim, Mi-Na;Hong, Sang-Bum
    • Tuberculosis and Respiratory Diseases
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    • v.70 no.1
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    • pp.28-35
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    • 2011
  • Background: The aim of the study was to describe the characteristics, treatments, and outcomes of critically ill patients with pandemic Influenza A/H1N1 2009 at a major medical center in Korea. Methods: This retrospective observational study examined critically ill adult patients with pandemic Influenza A/H1N1 2009, who were admitted to the AMC between August and December 2009. Results: 27 patients with confirmed pandemic Influenza A/H1N1 2009 were admitted to the intensive care unit (ICU) at the Asan Medical Center (AMC). The median age (IQR) was 59 years (41~67), and 66.7% of the patients were older than 51 years. A total of 81.5% of the patients had 2 or more co-morbidities. The median time (IQR) from symptom onset to presentation was 2 days (1~4), and the median time from presentation to ICU admission was 0 days (0~1.5). All patients received oseltamivir (300 mg/day) and 13 patients received triple combination therapy (oseltamivir, amantadine, ribavirin). Twelve patients required mechanical ventilation on the first day of ICU admission. A total of 6 patients (22.2%) died within 28 days of admission. The patients who died had significantly higher acute physiology and chronic health evaluation (APACHE) II and sequential organ failure assessment (SOFA) scores at presentation. There were no significant differences in age, co-morbidities, or antiviral regimens between survivors and non-survivors. Conclusion: Critical illness related to pandemic Influenza A/H1N1 2009 was common in elderly patients with chronic co-morbidities. All patients were given high-dose oseltamivir or triple combination antiviral therapy. Nonetheless, patients with critical illnesses associated with pandemic Influenza A/H1N1 2009 had a death rate of 22.2%.

Cranial Irradiation in the Management of Childhood Leukemic Hyperleukocytosis (극심한 백혈구 증가증을 보이는 소아 백혈병 환자에서 전두개 방사선치료)

  • Hong, Se-Mie;Kim, Il-Han
    • Radiation Oncology Journal
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    • v.19 no.2
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    • pp.142-145
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    • 2001
  • Purpose : Acute leukemia with hyperleukocytosis (more than $10^5/mm^3$) is at high risk of early sudden death, usually from intracerebral hemorrhage. Emergency cranial irradiation is a relatively simple approach to solve this the problem. We summarized our experience of cranial irradiation in 24 leukemic children who presented with hyperleukocytosis. Methods and Materials : Between 1990 and 1998, 40 children with acute leukemia presenting with hyperleukocytosis were referred for emergency cranial irradiation. Among these patients, 24 children were evaluable. There were 16 boys and eight girls, their ages ranged from 2 to 13 years (median 9.5 years). The initial leukocyte counts ranged $109,910/mm^3\;to\;501,000/mm^3$. Peripheral blood smear was peformed in all patients and noted the morphology of the blast. Introduction of emergency cranial irradiation was determined by the leukocyte counts (more than 100,000/mm) and the existence of the blast in peripheral blood smear. All patients were treated with intravenous hydration with alkaline fluid and oral allopurinol. Cranial irradiation started on the day of diagnosis. With 2 Gy in one fraction in 4 patients, 4 Gy in two fractions in 20 patients. Results : The WBC count had fallen in 19 patients (83%) and no intracerebral hemorrhage occurred after irradiation. There were five cases of early deaths. Four patients died of metabolic complications, and one patient with intracerebral hemorrhage. He died 5 hours after cranial irradiation. No patient had any immediate side effect from cranial irradiation. Conclusion : Our data suggest, that emergency cranial irradiation can be safely chosen and effective in childhood leukemic patients presenting with high leukocyte counts.

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Regional cooperation of NOWPAP MERRAC against marine litter from sea-based activities in the Northwest Pacific region (북서태평양 지역의 해상기인 해양쓰레기 저감을 위한 NOWPAP 방제지역활동센터의 지역협력 활동현황 분석 및 향후 발전방향)

  • Noh, Hyon-Jeong;Oh, Jeong-Hwan;Kang, Seong-Gil;Kang, Chang-Gu
    • Journal of the Korean Society for Marine Environment & Energy
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    • v.11 no.3
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    • pp.150-159
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    • 2008
  • The marine litter generated as by-products of human activities and economic development enters to the sea through rivers or stream Indirectly, and through sea-based activities directly. It is commonly comprised of materials that degrade very slowly, such as various plastic products, polystyrene, glass, rubber, metal, wood, derelict fishing nets, wire, rope and so on. Such litter is found in the water column and on the seafloor as well as coastal areas In the Northwest Pacific region. It causes injury or death of human and other living organisms and also accident or damage of the vessel. It is not only a problem of country but also regional and/or global problem because it is transported by currents and winds from one country to another. In this regard, Northwest Pacific Action Plan (NOWPAP) Marine Litter Activity (MALITA) project had been carried out during 2006-2007 biennium and NOWPAP Regional Action Plan on Marine Litter (RAP MALI) has been also continuously implemented in the 2008-2009 biennium as next phase step of MALITA. MERRAC, one of four Regional Activity Centres (RACs) of NOWPAP, has developed monitoring guidelines, sectoral guidelines, and brochures related to sea-based marine litter and port reception facilities and services through MALITA project. Based upon these output, MERRAC will continuously implement relevant activities of RAP MALI in order to help to establish and improve a regional mechanism to deal with the sea-based marine litter problem. This paper aims to introduce MERRAC activities under MALITA and RAP MALI, and to suggest several recommendations to reduce marine litter in the NOWPAP region.

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Fatal plastic bronchitis with eosinophilic casts in a previously healthy child (건강하였던 소아에서 발생한 치명적인 호산구성 증식성 기관지염)

  • Cho, Young Kuk;Oh, Soo Min;Choi, Woo-Yeon;Song, Eun Song;Han, Dong-Kyun;Kim, Young-Ok;Ma, Jae Sook
    • Clinical and Experimental Pediatrics
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    • v.52 no.9
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    • pp.1048-1052
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    • 2009
  • Plastic bronchitis is a rare disease characterized by the recurrent formation of branching mucoid bronchial casts that are large and more cohesive than those that occur in ordinary mucus plugging. Casts may vary in size and can be spontaneously expectorated, but some require bronchoscopy for removal. Plastic bronchitis can therefore present as an acute life-threatening emergency if obstruction of the major airways occurs. Three of 22 reported patients with eosinophilic casts were fatal, with death due to central airway obstruction. Here, we report a child with no history of atopy, allergy, or congenital heart disease who was diagnosed with plastic bronchitis with eosinophilic casts. Although he was administered intravenous (iv) antibiotics; iv corticosteroids; and a vigorous pulmonary toilet regimen, including chest physiotherapy and routine bronchoscopic removal of casts, he had brain death secondary to hypoxic brain damage. Plastic bronchitis can be fatal when casts obstruct the major airways, as in the present case. Clinicians should intervene early if a patient exhibits signs and symptoms consistent with plastic bronchitis.

Inhibition of Transient Receptor Potential Melastain 7 Enhances Apoptosis Induced by TRAIL in PC-3 cells

  • Lin, Chang-Ming;Ma, Ji-Min;Zhang, Li;Hao, Zong-Yao;Zhou, Jun;Zhou, Zhen-Yu;Shi, Hao-Qiang;Zhang, Yi-Fei;Shao, En-Ming;Liang, Chao-Zhao
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.10
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    • pp.4469-4475
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    • 2015
  • Transient receptor potential melastain 7 (TRPM7) is a bifunctional protein with dual structure of both ion channel and protein kinase, participating in a wide variety of diseases including cancer. Recent researches have reported the mechanism of TRPM7 in human cancers. However, the correlation between TRPM7 and prostate cancer (PCa) has not been well studied. The objective of this study was to investigate the potential the role of TRPM7 in the apoptosis of PC-3 cells, which is the key cell of advanced metastatic PCa. In this study, we demonstrated the influence and potential function of TRPM7 on the PC-3 cells apoptosis induced by TNF-related apoptosis inducing-ligand (TRAIL). The study also found a novel up-regulated expression of TRPM7 in PC-3 cells after treating with TRAIL. Suppression of TRPM7 by TRPM7 non-specific inhibitors ($Gd^{3+}$ or 2-aminoethoxy diphenylborate (2-APB) ) not only markedly eliminated TRPM7 expression level, but also increased the apoptosis of TRAIL-treated PC-3 cells, which may be regulated by the phosphatidylinositol 3-kinase/protein kinase B (PI3K/AKT) signaling pathway accompany with up-regulated expression of cleaved Caspase-3, (TRAIL-receptor 1, death receptors 4) DR4, and (TRAIL-receptor 2, death receptors 5) DR5. Taken together, our findings strongly suggested that TRPM7 was involved in the apoptosis of PC-3 cells induced by TRAIL, indicating that TRPM7 may be applied as a therapeutic target for PCa.

Medico-Legal Consideration of Hemopneumothorax - Closing Claim Study- (${\cdot}$기흉과 관련된 의료법학적 문제에 대한 고찰 -종결된 사건을 중심으로-)

  • Bae, Hyu-Na;Cheon, Young-Jin
    • Journal of Chest Surgery
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    • v.39 no.2 s.259
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    • pp.117-126
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    • 2006
  • Background: The purpose of this study is to describe the characteristics of malpractice claims related to hemopneumothorax and to identify the causes and potential preventability of such claims. Material and Method: A retrospective study was performed by reviewing the records in the Lawnb website and Lx CD-rom: the records on closed malpractice claims involving hemopneumothorax were abstracted from the files available for analysis. The records were reviewed and were analysed to determine the etiology of hemopneumothorax, patient age, results of lawsuit and indemnity payment, underlying diseases, cause of death or complications, and the factors associated with a successful defense. Result: Seven closed claim involving hemopneumothorax were founded in the data for malpractice. Three claims were supreme court decision, one was a high court decision and three claims were district court decision. The most common cause of death was tension pneumothorax. Four of which resulted in indemnity payments. Conclusion: While malpractice claims involving hemopneumothorax were uncommon, they resulted in a high rate and amount of indemnity payments. Claims are more common in pediatric patients. In case of iatrogenic hemopneumothorax, post-procedural X-ray can improve patient outcome and is also associated with decreased indemnity risks. Informed consent is also important.