• Archives of Plastic Surgery
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• v.47 no.3
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• pp.223-227
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• 2020

Background After the laws regulating emergency medicine were amended in 2012, regional trauma centers were established in South Korea. Plastic surgeons specialize in the simultaneous surgical care of patients with facial trauma, burns, and complicated wounds. The objective of this study was to evaluate the role of the plastic surgery department in treating severe trauma patients. Methods From January 2012 to December 2018, we enrolled 366 severe trauma patients with an Injury Severity Score (ISS) over 15 who received treatment by specialists in the plastic surgery department. Of these patients, 298 (81.4%) were male, and their mean age was 51.35 years (range, 6-91 years). The average ISS was 22.01 points (range, 16-75 points). Results The most common diagnosis was facial trauma (95.1%), and facial bone fracture (65.9%) was most common injury within this subgroup. Patients were referred to 1.8 departments on average, with the neurosurgery department accounting for a high proportion of collaborations (37.0%). The most common cause of trauma was traffic accidents (62.3%), and the average length of stay in the general ward and intensive care unit was 36.90 and 8.01 days, respectively. Most patients were discharged home (62.0%) without additional transfer or readmission. Conclusions Through this study, we scoped out the role of the specialty of plastic surgery in the multidisciplinary team at regional trauma centers. These results may have implications for trauma system planning.

• Journal of Chest Surgery
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• v.36 no.4
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• pp.280-284
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• 2003

Creation of an axillary arteriovenous fistula (AVF) was performed in two patients with high risks of Fontan operation after a cavopulmonary shunt. The patients complained of progressive cyanosis and decrease in exercise tolerance, and they showed pulmonary arteriovenous fistula on the pulmonary angiography. They were uneventfully transferred to the general ward on the first postoperative day and discharged 3 and 4 days after the operation respectively. There was no evidence of fistula-related volume loading and the other post-operative complications. An 8-month follow-up revealed improved symptoms such as, cyanosis and exercise intolerance, but not sufficient regression of pulmonary arteriovenous fistula on a lung perfusion scan and contrast echocardiography, which should be carefully checked hereafter.

• Pediatric Infection and Vaccine
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• v.25 no.2
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• pp.101-106
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• 2018

A 6-year-old boy with underlying hemolytic anemia of unknown etiology, atopic dermatitis, and recurrent urticaria visited our hospital because of acute respiratory failure induced by influenza A. Despite mechanical ventilation after endotracheal intubation along with inhalation of nitric oxide, respiratory acidosis and hypoxemia persisted. Veno-venous extracorporeal membrane oxygenation (VV ECMO) insertion was performed to provide respiratory support. After performing flexible bronchoscopy, we found that thick mucus plugs were obstructing the right bronchus intermedius and the upper lobe orifice. After bronchial washing and removal of the plugs, we were able to wean the patient off VV ECMO and transfer him to the general ward. He was discharged without any neurologic or pulmonary sequelae.

• Journal of Chest Surgery
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• v.46 no.4
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• pp.289-292
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• 2013

Through the use of a dual chamber (DDD) pacemaker, we achieved a cardiac resynchronization effect in a 51-year-old female patient who was transferred to our hospital from another hospital for an operation for three-vessel coronary artery disease. Her electrocardiogram showed a left bundle branch block (LBBB) and a prolonged QRS interval of 166 milliseconds. Severe left ventricle (LV) dysfunction was diagnosed via echocardiography. Coronary artery bypass grafting (CABG) was then performed. In order to accelerate left atrial activation and reduce the conduction defect, DDD pacing using right atrial and left and right ventricular pacing wires was initiated postoperatively. The cardiac output was measured immediately, and one and twelve hours after arrival in the intensive care unit. The cardiac output changed from 2.8, 2.4, and 3.6 L/min without pacing to 3.5, 3.4, and 3.5 L/min on initiation of pacing. The biventricular synchronization using DDD pacing was turned off 18 hours after surgery. She was transferred to a general ward with a cardiac output of 3.9 L/min. In patients with coronary artery disease, severe LV dysfunction, and LBBB, cardiac resynchronization therapy can be achieved through DDD pacing after CABG.

• Journal of Digital Convergence
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• v.14 no.9
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• pp.369-378
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• 2016

The purpose of this study was conducted to determine the working conditions, post-traumatic stress syndrome and the self-resilience of nurses, and find out the relationship between the post-traumatic stress syndrome and the self-resilience. Data were collected by questionnaire method among 220 General Hospital nurses at Gyeongnam G and J city. Data were analyzed by using SPSS 21.0 program WIN. The results of working conditions of the nurses majority were shift work 70.5%, currently working in the ward 54.6%. Scores were shown as Post-traumatic stress syndrome (28.20) and self resilience (39.98). There is a negative correlation (r =.226, p=.001) between the post-traumatic stress syndrome and the self-resilience. Based on the result, since working conditions of nurses caused psychological stress and nurses with high self-resilience eased the degree of post-traumatic stress, in terms of the personnel management of hospitals, a psychological intervention strategy should be considered.

• Tuberculosis and Respiratory Diseases
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• v.78 no.4
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• pp.455-458
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• 2015

Excessive dynamic airway collapse (EDAC) is a disease entity of excessive reduction of the central airway diameter during exhalation, without cartilage collapse. An 80-year-old female presented with generalized edema and dyspnea at our hospital. The patient was in a state of acute decompensated heart failure due to pneumonia with respiratory failure. We accordingly managed the patient with renal replacement therapy, mechanical ventilation and antibiotics. Bronchoscopy confirmed the diagnosis of EDAC. We scheduled extubation after the improvement of pneumonia and heart condition. However, extubation failure occurred due to hypercapnic respiratory failure with poor expectoration. Her EDAC was improved in response to high flow nasal oxygen therapy (HFNOT). Subsequently, the patient was stabilized and transferred to the general ward. HFNOT, which generates physiologic positive end expiratory pressure (PEEP) effects, could be an alternative and effective management of EDAC. Further research and clinical trials are needed to demonstrate the therapeutic effect of HFNOT on EDAC.

• Journal of Korean Academy of Nursing Administration
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• v.8 no.3
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• pp.457-474
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• 2002

Purpose : The purpose of this study was to construct the Organizational Effectiveness Model that explains and predicts the effectiveness of a nursing unit from the organizational-behavioral perspective. Furthermore, this study arms to develop a comprehensive organizational effectiveness model. Method : The subjects of this study consist of two groups: 455 nurses and 538 patients. Staff nurses who were employed and twenty patients from each ward in four university hospitals located in Seoul, Pusan and Kyungki were involved. Data were collected from October 4th to October 14th in 2000 by self-report questionnaire. Data were analyzed by the SAS for the general characteristics of the subjects, descriptive statistics, test for the reliability and correlations. Fitness of the hypothetical model were tested using Lisral 8.12(a) program. Result : With the findings from this study, duration of employment and the locus of control among the characteristics of the nurses, job enrichment among the characteristics of nursing job were direct or indirect predictors of the organizational effectiveness of the nursing units. Group dynamics in the nursing units and the characteristics of organizational behavior were mediating variables for the organizational effectiveness of the nursing units, and affect directly and indirectly on the individual outcome and group outcome to the great extends. Conclusion : Therefore, nursing managers ought to develop career ladder program and based job enrichment program in order to improve the organizational effectiveness of the nursing units. Additionally, programs to improve organizational effectiveness via improve group dynamics and characteristics of the organizational behaviors should be developed.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.3 no.2
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• pp.259-271
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• 1996

This reserch has been done in order to improve quality of nursing and medical service. In order to improve those qualities the study has been done to know inpatient perception of kindness and meaning of kindness which patients receive from nurse and also what effect inpatient have when they experience kindness from nurse. The subjects were 454 people who admitted in K Hospital. Time period was from October to December 1995. This survey has been done by personal interview with a written questionnaire. Analysis of data has been done by $X^2-test$ and percentage. The results of the research may be summarized as follows. 1. The inpatients perception of kindness on nurse were explanation(26.8%), tolerance(16.3%), warm-heartedness(12.8%), interest(9.5%), ability(8.4%), confidence(6.4%), respect(4.0%), support(2.65%). 2. In order to find out general moaning of kindness, study classified by age, sex, education, job, experience of hospitalization, inpatient ward. As a result of $X^2-test$, no special meaning of kindness was presented in inpatient perception of kindness. 3. Contents kindness which inpatient experienced were, warm-heartedness(23%), understanding(18.1%), interest(17.8%), ability(12.8%), tolerance(5.7%), confidence(2.6%), 4. Over half of subjects(59.1%) answered stability to effect on kindness of Nurse. Next are self-confidence(7.9%), respect(5.3%), confidence(4.6%), warm-heartedness(3.5%), understanding(2.6%). According to above results inpatient feels that meaning of kindness were explanation, tolerance, warm-heartedness. This meaning has no distinctive difference other than consistent meaning. Likewise, inpatient experience about contents of kindness is similar to meaning of kindness. As a result of this research, which show that kindness of nurse gives patient stability, respect and confidence, we would kindness is important for recovery of inpatient. Therefore, this research outcome could be able to help to improve quality of nursing and medical service.

• Archives of Plastic Surgery
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• v.34 no.4
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• pp.531-534
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• 2007

Purpose: Plastic surgeons are responsible for the management of spinal cord injury patients with upper and lower extremity reconstruction, pressure sore, and wounds. Derailment of autonomic nervous systems caused by injury to the spinal cord may result in fatal autonomic dysreflexia. Autonomic dysreflexia is a syndrome of massive imbalance of reflex sympathetic discharge occurring in patients with spinal cord lesion above the splanchnic outflow(T6). It is characterized by a sudden onset and severe increase in blood pressure and is potentially life threatening. The other classic symptoms are headache, chest pain, sweating, and bradycardia. In order to lower the blood pressure, it is important to remove the noxious stimulus for autonomic dysreflexia. If such symptoms last for more than 15 minutes despite conservative interventions, antihypertension drugs are recommended. Methods: In this case study, we report an autonomic dysreflexia case that developed in a 45 year-old tetraplegia patient with sacral pressure sore. When he got bladder irrigation, his blood pressure went up very high and his mentality became stuporous. He was sent to ICU for his blood pressure and mental care. ICU care made his vital sign stabilized and his mentality alert. Results: After the patient underwent proper treatment like inotropic agent, he was transferred to the general ward and his pressure sore on sacral area was coveraged with gluteus maximus myocutaneous advancement flap. Conclusion: If treatment is not effective, the patients have to undergo sudden, severe hypertension, which can cause stroke or death. To provide safe and effective care, plastic surgeons should be able to recognize and treat autonomic dysreflexia.

• Women's Health Nursing
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• v.26 no.2
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• pp.171-179
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• 2020

Purpose: This study aimed to investigate the effects of exposure to endocrine disruptors, burnout, and social support from peers on premenstrual syndrome (PMS) in nurses. Methods: This descriptive correlational study was conducted among 122 nurses under the age of 49 working at a university hospital. The participants answered self-report questionnaires. The data were analyzed using the t-test, analysis of variance, Pearson or Spearman correlation coefficients, and hierarchical multiple regression in IBM SPSS version 23.0. Results: The mean age of the nurses was 28.9 years. Of these nurses, 49.2% were working in a general ward, 24.6% in the intensive care unit, 14.8% in the emergency room, and 11.4% in an outpatient department. The explanatory power of the model was 38.3%, and it was statistically significant (F=11.74, p≤.001). Exposure to endocrine disruptors (β=0.32, p<.001) was the most powerful variable affecting PMS, followed by burnout (β=0.27, p=.001), working in the intensive care unit or emergency room (β=0.22, p=.003), family history of PMS (β=0.19, p=.009), and support from coworkers (β=-0.15, p=.043). Conclusion: Based on these findings, it is necessary to develop an intervention program to reduce the symptoms of PMS. Additionally, further studies are needed to develop and evaluate measures to minimize exposure to endocrine disruptors and burnout in order to alleviate PMS among nurses.