This study was designed to investigate the effects of high concentration of (-)-epigallocatechin-3-gallate(EGCG) on the neuronal activity of rat substantia nigra dopaminergic neurons. Sprague-Dawley rats aged 14 to 16 days were decapitated under ether anesthesia. After treatment with pronase and thermolysin, the dissociated dopaminergic neurons were transferred into a chamber on an inverted microscope. Spontaneous action potentials and potassium currents were recorded by standard patch-clamp techniques under current and voltage-clamp modes respectively. 18 dopaminergic neurons(80%) revealed inhibitory responses to 40 and 100 ${\mu}M$ of EGCG and 4 neurons(20%) did not respond to EGCG. The spike frequency and resting membrane potential of these cells were decreased by EGCG. The amplitude of afterhyperpolarization was increased by EGCG. Whole potassium currents of dopaminergic neurons were increased by EGCG(n=10). These experimental results suggest that high concentration EGCG decreases the neuronal activity of the dopaminergic neurons by altering the resting membrane potential and afterhyperpolarization.
The rate of suicide is the 5th leading cause of death in Korea. Moreover, suicide is the 1st cause of death in from 2nd to 4th decade. In order to treat suicide attempters who have visited the emergency room and to prevent retries, it is necessary to understand the nature of the suicide and to take the right approach. Suicide is more than doubled in women, and retry rates are high among patients with a history of suicide. Suicidal means are throat, fall, gas poisoning, poisoning and drowning. All suicide attempters should suspect and treat cervical spine injury and airway management, and rapid hyperbaric oxygen therapy is recommended for carbon monoxide addicts. Interviewing a suicide attempter requires a sympathetic attitude and examines the underlying depression or adaptation disorders. Interdisciplinary care with mental health departments is necessary, and interventions in emergency roombased suicide attempt management work can be helpful to connect with the community.
Journal of The Korean Society of Clinical Toxicology
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v.6
no.2
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pp.142-145
/
2008
Lamotrigine is a newer anti-epileptic drug for adjunctive treatment of refractory epilepsy, partial seizures, generalized tonic-clonic seizures, and bipolar disorder. Lamotrigine overdose causes serious central nervous and cardiovascular problems, but reports are uncommon. Few lamotrigine overdoses have been described because anti-epileptic drug use is limited and usually used with combination of other anti-epileptic drugs. In addition, most patients visit emergency departments with multi-drug overdoses, so few cases of lamotrigine poisoning alone exist. We had a female patient visit our emergency department a couple of hours after a lamotrigine overdose treated with intravenous hydration and urine alkalization by NaHCO3. She recovered successfully without any evidence of renal injury. However, she developed profound rhabdomyolysis, a previously unreported complication of this medication. We suggest that serial creatine kinase levels should be measured after lamotrigine poisoning.
Objectives: This study aimed to test our hypothesis that a raise in the emergency fee implemented on March 1, 2013 has increased the proportion of patients with emergent symptoms by discouraging non-urgent emergency department visits. Methods: We conducted an analysis of 728 736 patients registered in the National Emergency Department Information System who visited level 1 and level 2 emergency medical institutes in the two-month time period from February 1, 2013, one month before the raise in the emergency fee, to March 31, 2013, one month after the raise. A difference-in-difference method was used to estimate the net effects of a raise in the emergency fee on the probability that an emergency visit is for urgent conditions. Results: The percentage of emergency department visits in urgent or equivalent patients increased by 2.4% points, from 74.2% before to 76.6% after the policy implementation. In a group of patients transferred using public transport or ambulance, who were assumed to be least conscious of cost, the change in the proportion of urgent patients was not statistically significant. On the other hand, the probability that a group of patients directly presenting to the emergency department by private transport, assumed to be most conscious of cost, showed a 2.4% point increase in urgent conditions (p<0.001). This trend appeared to be consistent across the level 1 and level 2 emergency medical institutes. Conclusions: A raise in the emergency fee implemented on March 1, 2013 increased the proportion of urgent patients in the total emergency visits by reducing emergency department visits by non-urgent patients.
The Journal of Korean Academic Society of Nursing Education
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v.15
no.1
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pp.44-52
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2009
Purpose: This study was done to investigate emergency nurses' perceived competency and frequency of 17 educational interventions. Methods: A mail survey was administered to a convenience sample of 744 nurses in 143 emergency departments across the nation. Results: The mean score for overall competency was 2.90 out of 4. The competency score for staff education (2.40 out of 4) was lower than that of patient/family education (3.40 out of 4). The mean score for overall frequency was 3.34 out of 5. The frequency score for staff education (2.27 out of 5) was lower than that of patient/family education (4.39 out of 5). Emergency nurses' perceived competency was significantly correlated with frequency of educational interventions. Overall competency score was different according to the nurses' age, education, position, hospital experience, emergency experience and the type of emergency department. Conclusions: Although the overall competency is high, the competency on some areas of educational intervention remains insufficient. Educational programs to reinforce emergency nurses' educational competency and evidenced based protocols on education should be developed.
Lee, Eun Nam;Kim, Bog Ja;Kim, Sung Sook;Kang, Kyung Hee;Kim, Young Soon
Journal of Korean Clinical Nursing Research
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v.14
no.1
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pp.99-111
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2008
Purpose: This study was done to provide basic data for developing an in-service education program to improve nurses' quality. First, frequency of nursing activities and competency levels of emergency nurses according to their career ladders were compared through job analysis and then practical education programs were presented on based of the results. Method: Data were collected from 335 nurses working in emergency rooms in 31 tertiary hospitals. Data collection was done from September to November 2005 using the job analysis questionnaire. Results: There were 41 nursing activities that showed differences in frequency and 78 activities that showed differences in perceived competency level. Irrespective of emergency nurses' careers, activities that show high frequency but low competency were sputum liquefying therapy, assessment of cranial nerve function, identification of diagnostic radiology, and communication with various departments. In-service education content according to nurse's career ladders was presented by adding high frequency nursing activities and activities with low competency level even though having high frequency. Conclusion: There is a need to develop and provide in-service education programs, which consider nurses' difference in frequency and competency level for their career ladders.
The current study aims to propose a reorganization plan for the national emergency management system to improve the current organizational structure for responding to national disasters and emergency situations. As a theoretical framework, the current study identified four key elements of successful disaster response systems: responsiveness, controllability, expertise, and devotedness. On the basis of the four key elements of disaster response systems, this study critically reviewed the current state of the organizational structure of the Korean national emergency response system by discussing the issues inherent in the current structure and by doing a comparative analysis of two high-profile national disaster cases-the Sewol ferry disaster in 2014 and the Gwangsan Rescue of buried people in 2013. Then, this study proposed the reorganization plan for the national disaster response system in which the NEMA is under direct control of the Prime Minister of Korea. It coordinates and controls the related government departments, such as the police, maritime police, and military during the national disaster and emergency situation. This study also proposed a reorganizational plan for the regional disaster response system in Korea. Finally, it was suggested that the status of firefighters should be elevated to the national public servant level in order to achieve organizational efficiency and solve existing problems that come from the current separated systems.
Journal of Korean Academy of Fundamentals of Nursing
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v.18
no.3
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pp.411-420
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2011
Purpose: The aim of this study was to exam differences in awareness and ethical attitudes associated with Do-Not- Resuscitate (DNR) among emergency department's team. Method: The participants in this study were 402 emergency department's team working in the 41 hospitals. The data was collected by using "awareness measuring tool" by Kang (2003) and "ethical attitudes measuring tool" by Ko (2004) from May 1 to September 15, 2009. Collected data were analyzed by descriptive statistics, t-test, Pearson correlation coefficient using SPSS WIN 14.0 program. Results: 74.4% of subjects was responded that they had never been educated about DNR, but 73.9% of subjects was responded that they had experienced DNR in the emergency room. The majority of subjects responded that the patients and their families should make a decision about the DNR. There was a difference in an appropriate time for explanation of DNR among emergency department's team. There was a difference in ethical attitudes associated with Do-Not- Resuscitate among emergency department's team. Conclusion: For a professional and systematic approach to the problem, DNR guideline sufficient to elicit a social consensus is needed.
Purpose: The purpose of this study is to understand currently active Korean paramedics' disaster response abilities, including immediate response, severity classification, patient treatment, and patient transfer, in a disaster situation with multiple casualties. Methods: A structured questionnaire consisting of a total of 25 questions was used, including 5 questions on the subject's general characteristics and 20 questions on disaster-related emergency response abilities. Results: Among the disaster response abilities of the participants, the patient transport ability scores were high and the cooperative support ability scores were low. In terms of general characteristics, there was a significant difference in age, and it was high in the 40s, and there was a significant positive correlation between each competency. Conclusion: These results suggest that there is an urgent need to develop a systematic and specialized educational system with components inside and outside fire departments related to multiple casualty disasters to improve overall abilities.
Journal of Korean Academy of Fundamentals of Nursing
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v.6
no.3
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pp.522-531
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1999
This research identifies the ingress to egress primary factors that causes a patient to receive delayed emergency medical care. This material was collected between February 1st to 28th, 1998. Research envolved 4,118 people who visited the college emergency medical center in Kyeongido Province, South Korea. Medical records were examined, using the retrospective method. to determine the length of stay and the main cause for waiting. Results are as follows : 1. The age group with the highest admission rate was 10 and under, approximately 1,394 (33.9%). Followed by an even distribution for ages between 11-50 at 10-15% for their respective ranges. The lowest admission rate was 50 years and above. 2. From the 4,118 records examined, 3,489 received outpatient treatment (84.7%); 601 were admitted for inpatient care (14.6%); 25 arrived dead on arrival (0.6%); and 4 people died at the hospital. 3. Between 7PM to 12AM, 42.9% were admitted to the EMC. The hours from 9PM to 11PM recorded the highest admission rate and 5AM to 8AM was the lowest From 8PM to 12AM, the most beds were occupied. 4. For most patients. the average length of stay was approximately 2.2 hours. By medical department, external medicine was the longest for 2.8 hours. Pediatrics was the shortest for 1.6 hours. The average waiting period for inpatient admission was 2.6 hours. Inpatient admission for pediatrics and external medicine was 3.4 hours and 2.2 hours respectively. 5. Theses are primary factors for delay at EMC: 1) pronged medical consultations to decide between inpatient versus outpatient treatment, and delaying to be inpatient, 2) when you call physicians they are delayed to come 3) Understaffing during peak or critical hours, 4) Excessive consulting with different medical departments, 5) some patients require longer monitoring periods, 6) medical records are delayed in transit between departments, 7) repeated laboratory tests make delay the result, 8) overcrowded emergency x-ray place causes delay taking x-ray and portable x-ray, 9) the distance between EMC and registration and cashier offices is too far. 10) hard to control patient's family members. The best way to reduce EMC waiting and staying time is by cooperation between departments, both medical and administrative. Each department must work beyond their job description or duty and help each other to provide the best medical service and satisfy the patient needs. The most important answer to shortened the EMC point from ingress to egress is to see things from a patient point of view and begin from there to find the solution.
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