• Title/Summary/Keyword: Emergency death

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Interventional radiology of Bronchial artery embolization due to massive hemoptysis (대량객혈로 인한 기관지 동맥 색전의 중재적 방사선시술)

  • Min, Byoung-Yun;Lee, Sang-Bock
    • Journal of the Korean Society of Radiology
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    • v.4 no.4
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    • pp.17-24
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    • 2010
  • Hemoptysis which is comparatively common symptom in respiratory disease patients is a clinical symptom which has high risk of death in spite of many curative means. Bronchial tube embolization is a very useful medical procedure when hemoptysis does not stop for treatment of internal medicine or surgery and in addition to the purpose of instant hemostasis, for patients for whom surgical operation is impossible or for the purpose of gaining time to improve the state of the patient before surgical operation. In relation to this, this study is to know of the usefulness of bronchial tube artery embolization. The objects were 60 persons for whom bronchial tube artery embolizations are conducted because of large hemoptysis occurred from March 2007 to December 2009 in J hospital. They had large hemoptysis of 400ml or more per day and 200ml or more at a time or though the quantity of hemoptysis was less than 400ml they did not respond to the treatment of internal medicine for 10 days or longer. The average age was 60.5 years and cause diseases were tuberculosis, bronchiectasis, and pneumonia and lung cancer. Embolus parts were Rt bronchial artery 19 examples, Lt bronchial artery, both bronchial artery, Rt Intercostobronchial artery, and they were the case where embolization for many blood vessels were simultaneously carried out. As embolus materials, PVA (conteour) and microcoil were used. In 76.6% of 60 persons of patients hemorrhage stopped with the lapse of time after the procedure and in 4 examples (6.6) re-embolization was carried out due to re-bleeding after the procedure. Bronchial tube artery embolization has high early success rate and effectively controls hemoptysis in the treatment of hemoptysis and is an effective emergency remedy for hemorrhage due to large hemoptysis and will be a good medical procedure which reduces death rate. In addition, primarily if it is conducted together with the treatment of internal medicine it will be, as an effective curative means for hemorrhage due to large hemoptysis, a good mediate radial rays medical procedure which reduces death rate.

The Effect of the Simple Fogarty Thromboembolectomy (단순 Fogarty 혈전색전 제거술의 효과)

  • Oh, Joong-Hwan;Park, Il-Hwan;Lee, Chong-Kookk
    • Journal of Chest Surgery
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    • v.42 no.4
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    • pp.480-486
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    • 2009
  • Background: The Fogarty thromboembolectomy catheter technique was devised to extract distal arterial emboli and it represents a milestone for the treatment of patients with acute arterial occlusion since the 1960s. The major causes of arterial occlusion have changed from emboli of a heart origin to atherosclerosis over the past 30 years. Accordingly, questions have been raised about the effectiveness of simple Fogarty thromboembolectomy. Material and Method: During the period from March 1990 through August 2008, 156 patients who requiring Fogarty thromboembolectomy were analyzed. The patients were divided into two groups: those with simple Fogarty thromboembolectomy (Group 1, 79 patients) and those with additional vascular bypass graft surgery (Group 2, 77 patients). The duration of symptoms, the cause of thrombi, admission via the emergency room, a history of acupuncture or misdiagnosis, combined diseases, the anatomic occlusion site and the cause of death were analyzed using T-tests, cross tab tests, Chi square tests and Kaplan-Meier tests, respectively. Result: The mean age was 64$\pm$10 years in the 2 groups. The duration of symptoms (pain) in Group 1 vs Group 2 was 12$\pm$4 days vs 71$\pm$14 days (p=0.001). 50 (63%) patients in Group 1 were admitted via the emergency room vs 18 (23%) patients in Group 2 (p=0.005). Misdiagnosis and the treatment for herniated intervertebral disc or acupuncture were given to, 20 (25%) patients in Group 1 vs 30 (39%) patients in Group 2. Anticoagulation treatment before admission was performed in 22 (28%) patients in Group 1 vs 11 (14%) patients in Group 2. The causes of thrombi were heart disease in, 24 (30%) patients in Group 1 vs 6 (8%) patients in Group 2 (p=0.001), atherosclerosis in 46 (58%) patients in Group 1 vs 67 (87%) patients in Group 2 (p=0.001) and trauma in 9 (11%) patients in Group 1 vs 6 (8%) patients in Group 2. The combined diseases were cerebrovascular accident, hypertension and diabetes mellitus in 22 $\sim$ 37% of the total patients. The occlusion sites were mainly in the iliac and femoral arteries. Endarterectomy was performed in 7 (9%) patients in Group 1 vs 18 (23%) patients in Group 2 (p=0.012). Treatment was successful in 27 (34%) patients in Group 1 and in 40 (52%) patients in Group 2 (p=0.019). Reocclusion occurred in 37(47%) patients in Group 1 vs 20 (26%) patients in Group 2 (p=0.000), Amputation was done in 4 (5%) patients in Group 1 vs 12 (16%) patients in Group 2 (p=0.012) and death occurred in 10 (13%) patients (Group 1) vs 3(4%) patients (Group 2) (p=0.044). Conclusion: The recent past has shown a decline in the effectiveness of simple Fogarty thromboembolectomy with a changing pattern of acute arterial occlusion from a rheumatic heart origin to atherosclerosis. Additional bypass procedures play a role for the treatment of arterial occlusion instead of always performing simple Fogarty thromboembolectomy.

Traumatic Asphyxia with Compressive Thoracic Injuries -4 Cases Report- (흉부손상에 의한 외상성 가사 4예)

  • 김현순
    • Journal of Chest Surgery
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    • v.13 no.3
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    • pp.212-218
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    • 1980
  • A severe crushing injury of the chest produce a very striking syndrome referred to as traumatic asphyxia. This syndrome is characterized by bluish-red discoloration of the skin which is limited to the distribution of the valveless veins of the head and neck. And also if it is characterized by bilateral subconjunctival hemorrhages and neurological manifestations. But these clinical entities faded away progressively in a few weeks. Apporximately 90% of the patients who live for more than a few hours will recover from traumatic asphyxia when it occurs as a single entity. And so, death results from either severe associated injuries of from subsequent infection, rather than from pulmonary or cardiac insufficiency in traumatic asphyxia. We have experienced 4 cases of traumatic asphyxia with severe crushing thoracic injuries at department of the chest surgery, Captial Armed forces General Hospital during about 3 years from April 1977 to Aug. 1980. The 1st 22 year-old male was struct 2$\frac{1}{2}$ ton truck on the road and was transferred to this hospital immediately. He had taken tracheostomy due to severe dyspnea with contusion pneumonia and for removal of a large amount of bronchial secretion. The 2nd case was 23 year-old male who was got buried in a chasm. In this case, the heavy metal post tumbled over him back while at work. The 3rd case was 39 year-old male who leapt out of a window in 5th story while fire broke out in living room by oil stove heating. He had multiple rib fracture with right hemothor x and right colle's fracture and pelvic bone fracture. The last 22 year-old male was run over by a gun carriage. The wheel of this gun carriage passed over his thorax and right chin. He was brought to this hospital by helicopter. when he was first examined at emergency room, he was in semicomatose state and has pneurmomediastinum with multiple rib fracture and severe subcutaneous emphysema. As soon as he arrived, bilateral closed thoracostomy was performed and cardiopulmonary resuscitation was done. In hospital 8th weeks, chest series showed fibrothorax in right side even if chest wall stabilized. All 4 cases had multiple petechiae over their facees and chest and bilateral subconjunctival hemorrhages referred to as traumatic asphyxia. 3 cases except one case who received splenectomy, had been suffered from contusion pneumonia and had been treated with respiratory care. In these 3 cases, they had warning of impending injury before accident, and took a deep breath hold it and braces himself. And also, even if he had not impending fear in remaining one case, he had taken a deep breath and had got valsalva maneuver for pulling off the heavy metal post. Intrathoracic pressure rose suddenly and resulted to traumatic asphyxia in this situation. All these cases were recovered completely without sequelae except one fibrothorax, right.

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A Study on the Application of Universal Design Principles to Collective Housing for Senior citizen who lives alone - Focused on the 'Carnation House' in Gyeounggi-do ara - (독거노인을 위한 노인공동생활시설의 유니버설 디자인 적용성 평가 연구 - 경기도 지역 '카네이션하우스'를 중심으로 -)

  • Moon, Ja-Young;Nam, Kyung-Sook
    • Korean Institute of Interior Design Journal
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    • v.23 no.6
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    • pp.95-104
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    • 2014
  • Today, the number of the elderly living alone without any family members is on a sharp rise, and those aged people living alone are making these social issues such as solitary death, depression and suicide more popular. In order to resolve the issues, some of the local governments have been supporting the elderly living alone in common houses that would be used by senior citizens only. This study became interested in this 'carnation house' which has been carried out targeting the elderly living alone in Gyeonggi-do, and selected elementary universal design factors that should be applied to general residential environments of the aged people and analyzed the factors. As a case study, this research investigated four carnation houses as research subjects and came up with these following ideas about how to make improvements. First, the study found out that all the entrances did not have raised letters and that UD has not been satisfactorily applied to both the thresholds and the effective widths, and that is considered something to be fixed. Second, in case of regular rooms and living rooms, none of the rooms failed to have safety doorknobs which should have been installed and plus, thresholds and stepped pulleys need to be removed, Third, it goes the same with the kitchens, and the thresholds should be eliminated while cabinets are secured. In addition, furniture that understands the elderly's measurements should be used. Fourth, in terms of restrooms, they should be designed to be spacious enough not to cause anyone in wheelchairs inconvenience, and the study suggests that the effective widths should be widened and that both the safety doorknobs and the emergency calls must be installed. Basically, after the test on the UD adaptability, the study concluded that the application rates in connection with the adaptability were low which led the study to assume that such result has been gained due to the lack of installation standards in relation to the common living facilities of the elderly. The study now argues that purposes of buildings should be first clarified and then, these detailed space planning guidelines that deal with general characteristics of the aged people should be established.

Characteristics of Korean Trauma Patients: A Single-center Analysis Using the Korea Trauma Database

  • Park, Youngeun;Chung, Min;Lee, Gil Jae;Lee, Min A;Park, Jae Jeong;Choi, Kang Kook;Hyun, Sung Youl;Jeon, Yang Bin;Ma, Dae Sung;Yoon, Yong-Cheol;Lee, Jungnam;Yoo, Byungchul
    • Journal of Trauma and Injury
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    • v.29 no.4
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    • pp.155-160
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    • 2016
  • Purpose: Two years have passed since a level I trauma center was officially opened in the Gacheon Gil Hospital, South Korea. We analyzed 2014 and 2015 registered patient data from the Korean Trauma Data Base (KTDB) to identify trends in trauma patient care and factors that influence the quality of trauma care at the Gacheon Gil trauma center. Methods: Data was extracted from the KTDB included patient age, sex, systolic blood pressure at emergency room arrival, revised trauma score, injury severity score, trauma injury severity score, transfusion amount, and the cause of death was analyzed. Results: A total of 3269 trauma patients were admitted to our trauma center in 2014 and 3225 in 2015. Demographics and mechanism of injury were not significantly different between years. The severity of trauma injury was decreased in 2015 although the mortality rate was slightly increased. This requires further analysis. Conclusion: The aim of this study was to determine the general status and trends in trauma incidence and management outcomes for the Incheon area. We noted no significant changes in trauma status from 2014 to 2015. We need to collect and review trauma patient data over a long period in order to elucidate trauma incidence and management trends in the trauma field. Finally, studies using trauma patient data will indicate appropriate quality control factors for trauma care and help to improve the quality of trauma management.

Parishioner's role Expectations of Parish Nursing (한국 교인들의 목회간호 역할기대)

  • Kim, Chung-Nam;Kwon, Young-Sook
    • Research in Community and Public Health Nursing
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    • v.11 no.1
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    • pp.231-244
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    • 2000
  • Parish nursing is a community health nursing role developed in 1983 by Lutheran Chaplain Granger Westberg. An increasing emphasis on holistic care, personal responsibility for a healthy lifestyle, and changes in healthcare delivery systems have undoubtedly facilitated the establishment of an innovative nursing role in the community. Parish nurses are functioning in a variety of church congregations of various denominations. The parish nurse is a educator, a personal health counselor, a coordinator of volunteers. The parish nurses helps people relate to the complexed medical care system and assists people to integrate faith and health. The purpose of this study is to investigate what the korean parishioners want in parish nursing and what type of role expectation from parish nurse. The subjects were 1138 parishioners of 23 churches of various denominations in nationwide Korea. Data were collected by self-reported question naires from Feb 4 to June 25. 1999. The data were analyzed by using percentage. frequency. $x^2-test$. multiple Response set with SPSS program. The results are as follows: 1. Desired parish nursing contents by parish nurses are: psychological counselling(23.4%) out of private counselling. stress management(21.1 %) out of private health education. Emergency care(14.1%) out of group health education. Blood Pressure check-ups (19.0%) out of Health check ups. home visiting(44.9%) out of patient visiting method. B T. pulse, respiration and blood pressure check(15.0%) in Care to serve in home visiting. spiritual preparation to accept the death(41.7%) in hospice care, advices to choice of medical treatment using guide(50.1%) in introducing and guiding of health care facilities, pray(21.7%) in spiritual care' faith support. 2. Desired Health Teaching Content According to Period of Clients by Parish Nurse are: Vaccination(22.5%) in infant and toddler health management. sexual education(25.3%) in adolescent health management. prenatal care (29.5%) in pregnant health management. osteoporosis prevention and management (22.4%) in Middle aged health management. dementia prevention and management(25.5%) in elderly health management. 3. The expectant role from parish nurse is spiritual care faith support(14.1%). patient visiting care(13.2%), hospice care(12.9%), private counseling(12.8%), health check ups (11.1 %), volunteer organization and training out of believer(11.0%), private health education (9.3%), group health education (8.3%). 4. In Necessity of Performing Parish Nursing according to Region, Most(over 95%) responded that nursing program is needed. so there is no significance between regions. In Performing Parish Nursing in their church, Most(92.2%) responded they want to perform program. 5. In case of performing parish nursing, 52% out of the subjects responded they want to participated in parish nursing volunteer's activity, for example. to be in active to be a companion to chat(42.1%), necessity support (25.3%), donation support(25.0%), exercise support(18.2%), vehicles support (9.9%). As a result. in holistic care and spiritual care, the need of parish nursing and the role expectation from parish nurse are very high among korean believers. Therefore, I suggest parish nursing centering around Taegu and Kyungbuk province should be extended to nationwide. For extending parish nursing program. more active advertisement and research is needed. After performing parish nursing program through out the country, further comparative research between regions should be practiced and Korean parish nursing program will be developed and activated.

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A Study on 'Dangdokyeok' Epidemics in the Early 17C of the Joseon -Focusing on Heojun's 『Byeokyeoksinbang』- (17세기 초 조선에서 유행한 '당독역'에 대한 연구 -허준의 『벽역신방』을 중심으로-)

  • Chough Won Joon;Kim Young Ik;Yeom Kee Bok;Lim Hyo Jong;Jeong Woo Yeal;Jean Byung Hun
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.18 no.2
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    • pp.311-343
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    • 2004
  • Various aspect of epidemics broke out continually from the middle of Joseon Dynasty due to the famine and drought caused by abnormal climate of the sixteenth century and the war. Thus the Dynasty performed sacrificial rites, isolated the patients and published plenty of medical books related epidemics in order to cure of the patients, and Heojun edited 『Byeokyeoksinbang』 as 'Dangdokyeok' broke out at Gwanbuk(關北) districts in 1613, Heojun explained the cause of Dangdokyeok as meteorology under the feudal conditions, and concluded Simhwa(心火) by fever toxin, Therefore he selected the method of puting out Simhwa by attack of fever toxin. In addition he presented emergency treatment that can maintain the airway by bleeding. To treat Dangdokyeok, Heojun presented lots of prescriptions so as Seungmagalgeuntang(升麻葛根湯), Cheongyeolhaedoksan(淸熱解毒散), Yeongyopaedok-san(連翹敗毒散), Bangpungtongsaongsan(防風通聖散), Jowiseunggitang(調胃升氣湯) and Hwangryeonhaedoktang(黃連解毒湯) etc. And he proposed Samdueum (三豆飮), Realgar(石雄黃) and so on to prevent infection from that. They presume from 120 to 150 years as the period of human adaptation to the first epidemics. Dangdokyeok put a large number of people to death at first, but it wasn't referred at the history any more after Byeokyeoksinbang. So we can say that the treatment of Heojun may be effective. Common cold and dyspeptic cold broke out in our country differently from 'Shanghan(傷寒)' in the China, so we had settled 'pestilence infectious epidemic disease(瘟疫)' while 'epidemic febrile disease(溫病)' of the China. Dangdokyeok of Heojun is similar to 'Scalet fever' belonging to 'virulent heat pathogen(溫毒)', 'newly epidemic febrile disease(新感溫病)'. As a cure of Dangdokyeok, the Korean medicine uses the treatment of removing fever state whereas the western medicine uses the antibiotics to kill the streptococcus. The symptoms of Dangdokyeok are remarkably similar to those of the Scarlatina, so this occupies a high position on the world history of medicine in aspects of the period and details of symptoms. These days we have the problems that the tolerance of antibiotics increases and disease of unknown cause is prevalent. It means the western medicine get to limits. So if we progress epidemiography based on Heojun's medicine, we may contribute to the world history of medicine.

Flavonoids from Orostachys Japonicus A. Berger Induces Caspase-dependent Apoptosis at Least Partly through Activation of p38 MAPK Pathway in U937 Human Leukemic Cells

  • Lee, Won Sup;Yun, Jeong Won;Nagappan, Arulkumar;Jung, Ji Hyun;Yi, Sang Mi;Kim, Dong Hoon;Kim, Hye Jung;Kim, GonSup;Ryu, Chung Ho;Shin, Sung Chul;Hong, Soon Chan;Choi, Yung Hyun;Jung, Jin-Myung
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.2
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    • pp.465-469
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    • 2015
  • Background: Orostachys japonicus A. Berger (A. Berger) is commonly used as a folk remedy for cancer therapy. However, the mechanisms of its anti-cancer activity are poorly investigated in human cancer cells. In this study, we investigated whether flavonoids extracted from Orostachys japonicus A. Berger (FEOJ) might have anticancer effects in human leukemia cells, focusing on cell death mechanisms. Materials and Methods: U937 human leukemic cancer cells were used. Results: FEOJ induced apoptosis in a dose-dependent manner in human U937 cancer cells. Flow cytometry revealed significant accumulation of cells with sub-G1 DNA content at the concentrations of $200{\mu}g/mL$ and $400{\mu}g/mL$. FEOJ-induced apoptosis was caspase-dependent through loss of mitochondrial membrane potential (MMP, ${\Delta}{\Psi}m$) in human U937 cancer cells, which might be associated with suppression of Bcl-2 and XIAP proteins. FEOJ induced the p38 MAPK signaling pathway, playing at least in part an important role in FEOJ-induced apoptosis. Conclusions: This study suggested that FEOJ may induce caspase-dependent apoptosis in human leukemic cells by regulating MMP (${\Delta}{\Psi}m$) through suppressing Bcl-2 and X-IAP. In addition, the results indicated that upstream p38 MAPK signaling regulates the apoptotic effect of FEOJ. This study provides evidence that FEOJ might have anti-cancer potential for human leukemic cells.

Study on Review of e-Call Introduction Plan and Analysis of Introduction Effect (e-Call 도입방법 및 도입 효과분석 연구)

  • Han, Kyeung-hee;Hwang, Jae-Seong;Kim, Do-Kyeong;Lee, Choul-Ki
    • The Journal of The Korea Institute of Intelligent Transport Systems
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    • v.18 no.6
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    • pp.211-221
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    • 2019
  • The death toll for every 10,000 cars registered in Korea is 1.4, which is still the lowest among OECD members, and the need for rescue and response systems is emerging. In response, the company is developing a vehicle ICT-based emergency rescue system (e-Call) that can handle accidents such as rapid and accurate life saving by automatically sending accident detection and related information to the central center in the event of a traffic accident. However, ordinary citizens are negative about the installation and cost of e-Call services. To solve these problems, various introduction and operation methods of e-Call were proposed for activation of terminal distribution. In addition, the effect of introducing e-Call was analyzed by predicting the penetration rate of e-Call terminals. Analysis shows that 463 to 926 deaths and 3,335 to 6,66.9 billion won will be saved in 10 years after the introduction of e-Call terminals.

Characteristics of Pediatric and Adolescent Trauma-Database Review of Single Level Trauma Center in Gangwon Province

  • Lee, Tae Han;Jung, Pil Young;Kwon, Hye Youn;Shim, Hongjin;Jang, Ji Young;Bae, Keum Seok;Kim, Seongyup
    • Journal of Trauma and Injury
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    • v.30 no.3
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    • pp.75-79
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    • 2017
  • Purpose: Although trauma is the most common cause of death under age 18, Korean national pediatric trauma data has lack of clinical data. This study is to prepare manpower resources, equipment, and make a correct policy decision on pediatric trauma victims Methods: The study enrolled 528 patients under age 16 with traumatic injury visited Wonju Severance Christian Hostpital Trauma Center, from February 12, 2015 to December 31, 2016. We analyzed the distribution of gender, age, place and time of the accident, injury mechanism, injury severity, and injured organ by medical record. Results: The major injury mechanisms were blunt injury in 485 (91.90%), penetrating injury in 27 (5.10%), burn in 13 (2.50%), near drowning in 2 (0.40%), and foreign body ingestion in 1 (0.20%). Ninety-seven (18.4%) patients were injured at home and 67 (12.7%) patients were injured at school. The overall mortality rate was 1.13% (n=6). 5 mortalities were related to automobile accident and one was fall down. Mean Injury Severity Score (ISS) was 4 (2, 8). No statistical significance was observed in the mean ISS between each age group. The peak time of accident occurrence was between 16 and 17 o'clock. The mean ISS was higher in blunt injury group than penetrating injury with statistical significance ($6.50{\pm}7.60$ vs. $3.00{\pm}8.10$; p<0.05). The most common injury site was upper extremity. Mean ISS was highest in thorax injury. However, mean ISS of thorax injury was higher with statistical significance only compared with face, neck and upper extremity injury. Conclusions: We reported our pediatric trauma patients data of our hospital level I trauma center, which is the only one level I trauma center of Gangwon Province. These data is useful to prevent and prepare for pediatric trauma.