• Title/Summary/Keyword: First death experience

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Surgical Treatment of Aortoiliac Arterial Occlusion: Report of 2 Cases (대동맥하단부-장골동맥의 급,만성 폐쇄성 동맥질환 2례)

  • 마중성
    • Journal of Chest Surgery
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    • v.5 no.1
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    • pp.19-24
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    • 1972
  • The recent development of cardiovascular surgery as well as aortoarteriogaphy has been established excellent operative result with great aid of limb-salvage. However, less consideration or less experience still exists on the regard of vascular accident and vascular disease, as well as vascular surgery in Korea. During the last 13 years, we experienced only two cases of aorto-iliac occlusion,acute and chronic, regardless of having had more than 300 cases of mitral valvotomy and gradual increasing tendency of arteriosclerosis and hypertension in Korea. Therefore it is noteworthy to report the cases in order to promote the consideration for vascular surgery. Case 1; 52 year old female who had 20 years history of mitral stenosis with uricular fibrillation and received medical treatment for recent 1 year in the medical department. 10 days before admission, acute saddle emboli developed and 15 days after the onset, embolectomy through both common femoral arteries on the groin and abdominal approach was made. The progression of emboll to the right popliteal bifurcation was found by arteriography on operating table and retrograde flushing with heparin solution by the polyethylene catheter inserted through posterior tibial artery. The operation was successful, but 9 hours after operation sudden death occurred. Considering this case, first, mitral valvotomy already before might prevent peripheral embolizatlon, secondarily, the more early detection and surgery might also prevent the progression of emboli. Thirdly, although preoperative or postoperatlve heparinization is controversial for mitraI stenosis, heparinization might prevent additional emboli to vital organs in this case Cases 2; 66 year old female who had 4 years history of left hip and calf intermittent claudication and has had rest pain, inability to walk and ischemic necrosis on the the left leg since last 3 months prior to admission to the orthopedic department under the suspicion of herniated disc. Absence of pulsation on the groin and aortography evidenced aortoillac occlusion predominantly on the left side. Thromboendarterectomy was made and the operative result was successful with absence of claudication, healing of ulcer and aortographic patency of occlusive site. This chronic occlusion is considered to result from arteriosclerosis in origin with the evidence of moderate hypertension, x-ray evidence of calcified plaque on the aortic knob and operative finding of palpable plaques.

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Behaviors of Providers of Traditional Korean Medicine Therapy and Complementary and Alternative Medicine Therapy for the Treatment of Cancer Patients

  • Yu, Jun-Sang;Kim, Chun-Bae;Kim, Ki-Kyong;Lee, Ji-Eun;Kim, Min-Young
    • Journal of Pharmacopuncture
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    • v.18 no.1
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    • pp.27-35
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    • 2015
  • Objectives: In Korea, cancer is one of the most important causes of death. Cancer patients have sought alternative methods, like complementary and alternative medicine (CAM) together with Western medicine, to treat cancer. Also, there are many kinds of providers of CAM therapy, including providers of Korean oriental medicine therapy. The purpose of this study is to identify the behaviors of Korean oriental medicine therapy and CAM therapy providers who treat cancer patients and to provide background knowledge for establishing a new policy with the management and quality control of CAM. Methods: Structured and well organized questionnaires were made, and 350 persons were surveyed concerning the providers of CAM or Korean oriental medicine. The questionnaires were collected and analyzed. Results: The questionnaires (182) were collected. The questionnaires identified a total of 73 known providers, such as medicinal professionals or other providers of CAM suppliers, 35.6% of whom had had experience with treating cancer patients (52.6% vs. 29.6%). The treatment methods were a little different: alternative therapy and nutritional therapy being preferred by medicinal professionals and mind body modulation therapy and alternative therapy being preferred by other CAM providers. Four patients (7.4%) experienced side effects, and 6 patients (12.5%) experienced legal problems. As the method for managing the therapy, CAM providers, medicinal professionals, and other CAM providers had different viewpoints. For example, some CAM providers stated that both legislation and an official education on CAM or a national examination were needed as a first step to establish the provider's qualifications and that as a second step, a license test was needed for quality control. To the contrary, medicinal professionals stated that a license test was needed before legislation. Conclusion: Adequate management and quality control of CAM providers is thought to involve both education and legislation.

A Study on the Relationship between the Spatial Cluster Patterns of Male Suicide Rate and the Regional Characteristics in South Korea (남성 자살률의 공간 군집패턴 변화와 지역특성요인의 관계 분석)

  • Choi, Soyoung;Lee, Kwang-Soo
    • Health Policy and Management
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    • v.29 no.3
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    • pp.312-322
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    • 2019
  • Background: Since 2003, Korea has consistently shown the highest suicide rate among the Organization for Economic Cooperation and Development countries, and suicide remains the major cause of death. In particular, men are 2-3 times more likely to commit suicide than women, which called the 'gender paradox of suicide.' The areas with frequent suicide have spatially clustered patterns because suicide with a social contagion spreads around the neighborhood. The purpose of this study was twofold. The first was to estimate the hotspot areas of age-standardized male suicide mortality from 2008 to 2015. The second was to analyze the relationship between the hotspot areas and the regional characteristics for study years. Methods: The data was collected through the Korean Statistical Information Service. The study areas were 227 si gun gu administrative districts in Korea. The hotspot area was used as a dependent variable. Socio-demographic variables (number of marriages per 1,000 population, number of divorces per 1,000 population, and urbanization rate), financial variables (financial independence and social security budget), and health behaviors (EuroQol-5 dimension [EQ-5D], and depression experience rate) were used as independents variables. Results: The hotspot areas were commonly located in Gangwon-do, Chungcheongnam-do, Gyeongsangbuk-do, and Chungceongbuk-do. According to the results of panel logit regression, the number of divorces per 1,000 population, social security budget, and EQ-5D were statistically significant variables. Conclusion: The results of hotspot analysis showed the need for establishing a prevention zone of suicide using hotspot areas. Also, medical resources could be considered to be preferentially placed in the prevention zone of suicide. This study could be used as basic data for health policymakers to establish a suicide-related policy.

Experience of a Disaster Medical Assistant Team activation in the fire disaster at Jecheon sports complex building: limitation and importance of rescue (제천 스포츠복합건물 화재 재난에서의 권역재난의료지원팀 활동 경험 고찰: 한계점과 구조의 중요성)

  • Jung, Seung Gyo;Kim, Yoon Seop;Kim, Oh Hyun;Lee, Kang Hyun;Kim, Kwan-Lae;Jung, Woo Jin
    • Journal of The Korean Society of Emergency Medicine
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    • v.29 no.6
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    • pp.585-594
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    • 2018
  • Objective: This study was designed to report on the progress of the fire at Jecheon sports complex and to assess the adequacy of Disaster Medical Assistant Team (DMAT)'s activities in response to the fire disaster. Methods: We conducted a retrospective review based on camera recordings and medical records that were recorded at the disaster site for assessment of activities. We cooperated with firefighters, police officers, local hospital medical staffs and public health personnel in Jecheon in order to classify patients in the disaster field and to understand the patients' progress. Results: At 15:53, the first request for emergency rescue came to the 119 general emergency call center, and a request for DMAT activation came at 16:28. DMAT arrived at the site at 17:04 and remained active until the following day at 00:43. The total number of casualties was 60, including 27 minimal (Green) patients, 29 expectant (Black) patients, three delayed (Yellow) patients, and one immediate (Red) patient. There were 32 patients who received on-site care by DMAT. Two patients were transferred from a local hospital to Wonju Severance Christian Hospital for hyperbaric oxygen therapy. Conclusion: Twenty-nine victims were found in the sports complex building, and there were 31 mildly to moderately injured patients in this fire disaster. The main cause of death was thought to be smoke suffocation. Although DMAT was activated relatively quickly, it was not able to provide effective activity due to the late rescue and difficulty with fire suppression.

Clinical features and prognostic factors of early-onset sepsis: a 7.5-year experience in one neonatal intensive care unit

  • Kim, Se Jin;Kim, Ga Eun;Park, Jae Hyun;Lee, Sang Lak;Kim, Chun Soo
    • Clinical and Experimental Pediatrics
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    • v.62 no.1
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    • pp.36-41
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    • 2019
  • Purpose: In this study, we investigated the clinical features and prognostic factors of early-onset sepsis (EOS) in neonatal intensive care unit (NICU) patients. Methods: A retrospective analysis was conducted on medical records from January 2010 to June 2017 (7.5 years) of a university hospital NICU. Results: There were 45 cases of EOS (1.2%) in 3,862 infants. The most common pathogen responsible for EOS was group B Streptococcus (GBS), implicated in 10 cases (22.2%), followed by Escherichia coli, implicated in 9 cases (20%). The frequency of gram-positive sepsis was higher in term than in preterm infants, whereas the rate of gram-negative infection was higher in preterm than in term infants (P<0.05). The overall mortality was 37.8% (17 of 45), and 47% of deaths occurred within the first 3 days of infection. There were significant differences in terms of gestational age (26.8 weeks vs. 35.1 weeks) and birth weight (957 g vs. 2,520 g) between the death and survival groups. After adjustments based on the difference in gestational age and birth weight between the 2 groups, gram-negative pathogens (odds ratio [OR], 42; 95% confidence interval [CI], 1.4-1,281.8) and some clinical findings, such as neutropenia (OR, 46; 95% CI, 1.3-1,628.7) and decreased activity (OR, 34; 95% CI, 1.8-633.4), were found to be associated with fatality. Conclusion: The common pathogens found to be responsible for EOS in NICU patients are GBS and E. coli. Gram-negative bacterial infections, decreased activity in the early phase of infection, and neutropenia were associated with poor outcomes.

Empirical Analysis on the Disparity between Willingness to Pay and Willingness to Accept for Drinking Water Risks : Using Experimental Market Method (비시장재에 대한 WTP와 WTA 격차에 대한 실증분석 : 실험시장접근법을 이용한 음용수 건강위험을 사례로)

  • Eom, Young Sook
    • Environmental and Resource Economics Review
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    • v.17 no.3
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    • pp.135-166
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    • 2008
  • This paper reports the empirical results of comparing the willingness to pay(WTP) for health risk reductions and the willingness to accept(WTA) for risk increases using experimental market methods in the first time in Korea. Health risks were defined as probabilities of premature death from exposure to one of As, Pb, and THM in tap water. A total of six experimental markets with 15 participants in each experiments were held using 20 repetitive Vickrey second-price sealed-bid auctions. To compare the effects of market experiences, trading a marketed good, candy bar, was introduced before the trading the non-marketed good, drinking water risks. Moreover, an objective risk information was provided after the first 10 trials to incorporate learning processes. Regardless of marketed or non-marketed goods, the mean of WTA exceeded the mean of WTP at the first auction trial. As experimental trials proceeded, the disparity between WTA and WTP for marketed goods disappeared. However results for non-marketed goods were rather mixed to the extent that WTA for health risks from As (relatively high risk leves) were significantly larger than WTP, while there were no significant difference between WTA and WTP for health risks fro Pb and THM (relatively low risk levels). On the other hand, participants seemed to respond in a 'rational' manner to the objective risk information provided, with positive learning effects of market-like experience(especially in the WTA experiments).

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A Phenomenological Study on Pregnancy Experience of Unmarried Korean Mothers (한국 미혼모의 임신 체험 연구)

  • Han, Jin-Sook;Moon, Young-Sook
    • Korean Parent-Child Health Journal
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    • v.5 no.2
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    • pp.206-223
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    • 2002
  • The purpose of this study was to discuss the nature of pregnancy experience among unwed Korean mothers and to figure out what it meant for them, by asking some of them to reflect on themselves in a written form from interpretative and phenomenological perspective, based on van Manen's research method of the same approach. The subjects in this study were seven unmarried mothers in Korea. The data were collected from July through December 2000 through in- depth interview and observation. The statements of the participants were taped, recorded, analyzed and select essential themes. To have a phenomenological understanding of the pregnancy unmarried mothers, literary works, including essays and novels, were reviewed. The findings of this study were as below: The selected substantial themes about the pregnancy and birth experiences of the single mothers included 'hatred for boy friend,' 'hatred for the fetus,' and 'hatred for myself.' The unmarried mothers met their boy friends through the introduction of friends. At first, they were good friends, but they soon went on a date and had sexual relation with no common knowledge about sex. Most of them were aware of their pregnancy after they felt fetal movement, but they put off taking the test because they didn't want to accept the fact and feared it. Such an attitude was rare among married pregnant women, and being pregnant with no prior preparation or sexual knowledge is not common in Western countries. They felt guilty and informed their boy friends of the fact, but the boy friends didn't admit their responsibility and rejected the babies. This made the poor girls hate them, and it turned into severe abhorrence. They thought their lives were ruined by the babies, and wished they would disappear. They reproached the babies, hitting their own bellies or making a kick. They considered themselves to be abandoned and didn't want to live any more. Giving themselves up to despair, some attempted to commit a suicide. They hoped to die, thinking their death would solve the problem. When they lost a chance of abortion and were about to have the babies adopted, they felt sorry for them. The unwanted pregnancy gave them a pain, but they keenly felt they were loved by their mothers, and learned the value of family. It's attempted in this study to clearly show how much unmarried Korean mothers suffered from pregnancy, and this effort paved the way for seeing unwed mothers in a new light and having a better understanding of them, instead of sticking to general perception.

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A Study on Media Therapy Experience for Individuation and Treatment of Social Trauma Focusing on Jung's Collective Unconsciousness and Individuation (사회적 트라우마의 개성화와 치유를 위한 미디어 테라피 가능성 연구 융(Jung)의 집단 무의식과 개성화 사유를 중심으로)

  • Yoo, Sook;Kang, Jin Suk
    • Korean journal of communication and information
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    • v.80
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    • pp.167-192
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    • 2016
  • This study examined the social trauma experienced by direct victims of accidents and each member of the society affected by grand-scale disasters based on the concepts of collective unconsciousness, archetype, and individuation from Jung's analytical psychology, and their experience of therapy through media. For this purpose, the survivors of the disaster of Sewol that occurred on April 16, 2014, family of the deceased, psychological professionals, and general volunteers were selected as the subjects for one-on-one in-depth interviews and focus group interviews. The findings can be summarized as follows: first, the subjects are suffering from different forms of social trauma such as seclusion and anxiety due to primary/secondary incidents, but there is possibility for them to overcome the social trauma as a social community. Second, the archetypes of life and death, mourning and remembrance are showing in the subjects' everyday lives. In particular, it was found that various archetypes are appearing symbolically through the craft activities in which the survivors are participating most actively. Third, the media therapy program for the victims of the Sewol has limitations in various aspects. However, the fact that the craft activities that are not bound by time and space are highly effective manifests that anyone can take advantage of trauma therapy through digital media that are easily found around them. Finally, this study is significant as it verified the possible individuation of social trauma and identified the limitations of media therapy to suggest its development directions.

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Family Members' Caregiving Experience for Middle-aged and Elderly Breast Cancer Survivors at Early Stages (중·고령 초기 유방암 생존자를 돌보는 가족의 경험)

  • Park, So-Young;Park, Hyangkyung;Koo, Hyang Na;Baek, Jung Yun;Noh, Eunjeong
    • 한국노년학
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    • v.40 no.1
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    • pp.111-130
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    • 2020
  • This qualitative study aims to understand family members' caregiving experience for middle-aged and elderly breast cancer survivors at early stages. A total of four families of breast cancer survivors were given focus group interviews(FGI), and an additional family was interviewed individually. The thematic analyses of the FGI and individual in-depth interview discussions revealed the following four themes: first, day-to-day feelings like walking on thin ice (entangled emotions with each treatment stage, regret of watching a survivor's pain, fear of recurrence and death, concerns of changes in family relationships, and various feelings experienced as a daughter), second, caregiving has become a mainstay in my life (unfamiliar and unskilled care, losing my life), third, beginning to recover and different experiences between a survivor and a family caregiver (not understanding a survivor's pain from the abyss, forgetting that the survivor is still a cancer patient and that treating him or her casually), and fourth, moving forward (hope that things will be better, taking care of myself to prevent exhaustion). Based on the results of this study, we proposed social welfare services and policy measures to reflect the psychosocial needs of family caregivers of breast cancer survivors and support family caregivers during the care process.

Colorectal Cancer Treatment and Survival: the Experience of Major Public Hospitals in South Australia over three Decades

  • Roder, David;Karapetis, Christos S;Wattchow, David;Moore, James;Singhal, Nimit;Joshi, Rohit;Keefe, Dorothy;Fusco, Kellie;Powell, Kate;Eckert, Marion;Price, Timothy J
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.6
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    • pp.2431-2440
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    • 2015
  • Background: Registry data from four major public hospitals indicate trends in clinical care and survival from colorectal cancer over three decades, from 1980 to 2010. Materials and Methods: Kaplan-Meier productlimit estimates and Cox proportional hazards models were used to investigate disease-specific survival and multiple logistic regression analyses to explore first-round treatment trends. Results: Five-year survivals increased from 48% for 1980-1986 to 63% for 2005-2010 diagnoses. Survival increases applied to each ACPS stage (Australian Clinico-Pathological Stage), and particularly stage C (an increase from 38% to 68%). Risk of death from colorectal cancer halved (hazards ratio: 0.50 (0.45, 0.56)) over the study period after adjusting for age, sex, stage, differentiation, primary sub-site, health administrative region, and measures of socioeconomic status and geographic remoteness. Decreases in stage were not observed. Survivals did not vary by sex or place of residence, suggesting reasonable equity in service access and outcomes. Of staged cases, 91% were treated surgically with lower surgical rates for older ages and more advanced stage. Proportions of surgical cases having adjuvant therapy during primary courses of treatment increased for all stages and were highest for stage C (an increase from 5% in 1980-1986 to 63% for 2005-2010). Radiotherapy was more common for rectal than colonic cases. Proportions of rectal cases receiving radiotherapy increased, particularly for stage C where the increase was from 8% in 1980-1986 to 60% in 2005-2010. The percentage of stage C colorectal cases less than 70 years of age having systemic therapy as part of their first treatment round increased from 3% in 1980-1986 to 81% by 1995-2010. Based on survey data on uptake of adjuvant therapy among those offered this care, it is likely that all these younger patients were offered systemic treatment. Conclusions: We conclude that pronounced increases in survivals from colorectal cancer have occurred at major public hospitals in South Australia due to increases in stage-specific survivals. Use of adjuvant therapies has increased and the patterns of change accord with clinical guideline recommendations. Reasons for sub-optimal use of radiotherapy for rectal cases warrant further investigation, including the potential for limited rural access to impede uptake of treatments at metropolitan-based radiotherapy centres.