• Title/Summary/Keyword: Intensive Care Unit (ICU)

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National Level Response to Pandemic (H1N1) 2009 (정부의 신종인플루엔자 A(H1N1) 대응)

  • Lee, Dong-Han;Shin, Sang-Sook;Jun, Byung-Yool;Lee, Jong-Koo
    • Journal of Preventive Medicine and Public Health
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    • v.43 no.2
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    • pp.99-104
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    • 2010
  • The World Health Organization (WHO) announced the emergence of a novel influenza on April 24, 2009, and they declared pandemic on June 11. In Korea, the proportion of influenza-like illness and the consumption of antiviral agents peaked in early November. The government established the Central Headquarters for Influenza Control and operated the emergency response system. In the quarantine stations, we checked the body temperature and collected quarantine questionnaires from all the arrivals from infected countries. We also isolated the confirmed cases in the national isolation hospitals. However, as the community outbreaks were reported, we changed strategy from containment to mitigation. We changed the antiviral agent prescription guideline so that doctors could prescribe antiviral agents to all patients with acute febrile respiratory illness, without a laboratory diagnosis. Also the 470 designated hospitals were activated to enhance the efficacy of treatment. We vaccinated about 12 million people and manage the adverse event following the immunization management system. In 2010, we will establish additional national isolation wards and support hospitals to establish fever clinics and isolation intensive care unit (ICU) beds. We will also make a computer program for managing the national isolation hospitals and designated hospitals. We will establish isolation rooms and expand the laboratory in quarantine stations and we will construct a bio-safety level 3 laboratory in each province. In addition, we plan to construct a bio-safety level 4 laboratory at a new Korea Centers for Disease Control and Prevention (KCDC) facilities in Ossong.

A Study on Airborne Microorganism in Hospital (일부 병원 실내에서의 공기중 미생물 오염에 관한 연구)

  • Jung, Sun Hoi;Paik, Nam Won
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.8 no.2
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    • pp.231-241
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    • 1998
  • To assess biological indoor air quality in hospital, concentrations of viable airborne microbes were determined at intensive care unit(ICU), patient room (PR), outpatient waiting room(OPWR) in hospitals of large(1000 beds), middle(500 beds), small(100 beds) hospitals, respectively. Gram positive bacteria, gram negative bacteria, fungi were sampled using suctional sampling method by RCS sampler (Reuter centrifugal air sampler) and RCS GK-A agar plate. In gram positive bacteria groups, CNS(Coagulase Negative Staphylococcus), Micrococcus, Lactobacillus, S. aureus, Enterococcus, St. viridans identified. In gram negative bacteria groups, A. baumannii, Kl. peumoniae and E. coli were identified, and Penicillium was identified in fugi groups. Results of the study were as follows. 1. The highest concentrations of airborne microbes was $971CFU/m^3$ at 5:00 PM in small hospital patient room, and average concentrations of airborne microbes in large, middle and small hospitals were $282CFU/m^3$, $289CFU/m^3$ and $625CFU/m^3$, respectively. Average concentrations of airborne microbes in office(control) was $90CFU/m^3$. Thus, the small hospital showed the worst condition. 2. Representatives of 8 different genera were identified in 150 samples. The most frequently isolated organisms were Staphylococcus (73.0%), Micrococcus (20.7%) and Lactobacillus (4.7%), respectively. Pathogenic microbes isolated were A. baumannii, E. coli, Enterococcus, Kl. peumoniae, S. aureus, St. viridans and Penicillium as fungi. In office, no pathogenic microbes were identified. Average concentrations of airborne pathogenic microbes in large, middle and small hospital were $5CFU/m^3$ (2%), $11CFU/m^3$ (4%) and $12CFU/m^3$ (2%), respectively. Thus, condition in a large hospital was better than those in a middle and a small hospital.

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Clinical Analysis of Patients Who Visited the Emergency Room of an Oriental Medical Center (한의과대학 부속 한방병원 한방응급실 내원환자에 대한 임상적 분석)

  • Ryu, Jae-Hwan;Kim, Young-Chul;Lee, Beom-Jun;So, Hyung-Jin
    • The Journal of Korean Medicine
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    • v.28 no.3 s.71
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    • pp.197-206
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    • 2007
  • Objectives : By recording basic data of patients visiting the emergency room of the oriental medicine center, we can understand their characteristics and gain better insight about them. Methods : We performed a retrospective study of 2,674 patients who visited the emergency room of Kyunghee Oriental Medical Center, from June 1, 2006 to May 31, 2007. Results : 1. Of 2,674 total patients, the male to female ratio was 0.94:1 and the 6th decade of life was the peak age group. 2. The majority of patients visited our emergency room between 06:00 and 24:00(midnight). 3. Most patients visited on a Saturday or Sunday. 4. By monthly distribution, the patients increased slightly during June, July, August and October. 5. The majority of patients visited the emergency room within 24 hours of onset. 6. The patients were categorized as follows: neurological diseases 71.15%, musculoskeletal diseases 16.02%, internal medical disease 9.04%, psychiatric and related disease 3.79%. 7. The average transit time was about 1 hour 30 minutes. 8. Admission rate was 48% and the rate of admission to the intensive care unit (ICU) was 5% of total visiting patients. Conclusion : Assuming that this research will continue adding patient's data continuously, this work will help us to understand the features of patients who visiting the emergency room of the oriental medical center.

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Effects of Delirium Prevention Program in Patients after Hip Joint Surgery (고관절 수술환자에게 적용한 섬망 예방프로그램의 효과)

  • SaGong, Eun Mi;Kim, Sook Young
    • The Journal of the Korea Contents Association
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    • v.18 no.10
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    • pp.134-144
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    • 2018
  • The purpose of this study was to examine the effects of delirium prevention program in patients after hip joint surgey. A non equivalent control group post-test only design was utilized. Sixty four patients aged 65 and older who admitted to a surgical intensive care unit after hip joint surgery were assigned to either a experimental group (n=33) or a control group (n=31). The experimental group was provided with delirium prevention program consisting of orientation intervention, activity intervention, physiological intervention, nutritional intervention, sleep intervention, environmental intervention. Data were analyzed using ${\chi}^2-test$ and independent t-test. The experimental group showed lower incidence of delirium than the control group(${\chi}^2=7.048$, p=.008). The experimental group showed lower ICU stay and length of hospitalization than the control group although the difference was not statistically significant. Findings indicate that the dilirium prevention program is effective in reducing incidence of delirium in patients after hip joint surgery and delirium prevention program is recommended as a guide for the prevention of delirium.

Study on the Perceived Stress Degree and Content of Mother of High-Risk Infants in Neonatal Intensive Care Unit (신생아 집중실에 입원한 고위험 신생아 어머니의 스트레스 정도 및 내용에 관한 연구)

  • Sung Mi-Hae
    • Child Health Nursing Research
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    • v.8 no.1
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    • pp.97-109
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    • 2002
  • This study was conducted to understand the degree and contents of stress which the mothers of high-risk infants can be experienced from the hospitalization of ICU for their new borns, and thus to offer the basic program to he nursing intervention program for these. Subjects were the 171 mother of hospitalized newborn in NICU of 1 University Hospital in Busan from June, 20, 2001 to September, 15, 2001, who agreed to take part in this study. The instruments used in this study were Parental Stressor Scale:NICU(PSS:NICU) developed by Miles et al. The questionnaire has 4 dimensions and 45 items ; sight and sounds of NICU(5 items), babies' appearance and behavior nursing intervention(19 items), parental role alteration and relationship with their baby(10 items), health team communication(11 items). The data was analysed as average, frequency, Standard Deviation, t-test, ANOVA, Pearson correlation coefficient by use of SPSS/PC+. The results of this study are as follows ; 1. The total perceived stress level score of mothers of high-risk infants was slightly high(3.44±0.71). The highest scored dimension was 'appearance and behavior of the baby'(4.06±0.80), and next were 'relationship with their baby and parental role change'(3.55±0.98), 'sight and sounds of NICU'(3.22±1.01), 'communication with health team'(2.93±0.91). 2. The total perceived stress level score was significantly correlated with birth weight (F=2.35, p<.05). 3. In sight and sounds of NICU, the perceived stress level score was significantly correlated with nursing in the incubator(t=2.28, p<.05) and birth weight(t=2.26, p<.05). In summary, information about physical environment of NICU, birth weight and nursing in the incubator must be included in nursing intervention program of mother's of high-risk infants in reducing the patents stress level. And, it is suggested that there need to find the coping mechanism of mother of high-risk infants.

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Change of Blood Magnesium Level in Diabetes Patients Undergoing Off-pump Coronary Artery Bypass Grafting

  • Seo, Si-Young;Moon, Seong-Min;Hyun, Kyung-Yae;Kim, Chong-Rak;Choi, Seok-Cheol
    • Biomedical Science Letters
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    • v.15 no.3
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    • pp.207-215
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    • 2009
  • We carried out this study to investigate differences of physiological variables between patients with (DM group) and without type II diabetes mellitus (Non-DM group) undergoing off-pump coronary artery bypass grafting (OPCABG). Postoperative $Mg^{++}$ and $Ca^{++}$ levels were lower, whereas $Na^+$ level was higher in DM group than those in Non-DM group. ICU (intensive care unit) stay time in DM group was longer than that of Non-DM group. Postoperative platelet counts tended to decrease, whereas C-reactive protein (CRP) and cardiac troponin-I (cTNI) levels tended to increase in DM group compared with Non-DM group. Postoperative albumin level was lower, while blood urea nitrogen (BUN) and creatinine levels were greater in DM group than those in Non-DM group. DM group had higher incidence of post-operative arrhythmias than Non-DM group. These results reveal that type II DM patients undergoing OPCAB may have higher incidences of postoperative hypomagnesemia, hypocalcemia and arrhythmias, and increases of CRP, cTNI, BUN, and creatinine levels than in Non-DM patients undergoing OPCAB. The perioperative check and control (supplement) of $Mg^{++}$ levels should be considered in cardiovascular surgery combined with DM.

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Single Hospital-based Clinical Analysis of 1,119 Patients visited Oriental Medical Hospital Emergency Room (일개 한방병원 한방응급실 내원환자에 대한 임상적 분석)

  • Yoon, Da-Rae;Lee, Jee-Sook;Noh, Hyun-In;Yi, Seo-Ra;Ryu, Jae-Hwan
    • The Journal of Internal Korean Medicine
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    • v.33 no.2
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    • pp.188-196
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    • 2012
  • Objectives : This study was aimed to provide the basic characteristic of patients who visited an Oriental medical hospital emergency room. Methods : We performed a retrospective study on 1,119 patients who visited Kyunghee University Oriental Medical Hospital Emergency Room from June 1, 2011 to March 31, 2012. Results and Conclusions : 1. In distribution of sex, the rate of males was 44.1%, and that of females was 55.9%. The male to female ratio was thus 1:1.26. The patients' average age was 54.64 and the 6th decade of life was the peak age group. 2. Most of the patients visited the Oriental medical hospital emergency room between 11:00 and 23:00. 3. In distribution by days of the week, the most common was Sundays (24.5%), followed by Mondays (16.7%). 4. In the month distribution, the most was December (12.4%), followed by November (10.0%). 5. The patients were grouped as follows: neurological diseases 58.9%, musculoskeletal disease 27.5%, internal medical disease 10.4%, and others 3.2%. 6. Admission rate of patients being treated was 38.8%, and the admission to the intensive care unit (ICU) was 4.5%. of total visiting patients.

Trends Analysis of Suicidal Poisoning in Korea- Comparison before and after the IMF Crisis and the Economic Recession (IMF와 경기침체 전후 음독자살 환자에 대한 분석 -1997년부터 2004년까지 일개 대학병원 응급센터 연구조사를 중심으로-)

  • Lee Won Jae;Park Kyu Nam;Choi Seung Pil;Lee Mi Jin
    • Journal of The Korean Society of Clinical Toxicology
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    • v.3 no.1
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    • pp.33-39
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    • 2005
  • Purpose: Nowadays the Korean society is in the center of time of the social change. Because of dissociation of traditional family, IMF (International Monetary Fund) crisis and economic recession, the mortality rate of suicidal attempts are increasing annually. The majority of suicidal attempts were by poisoning considering the characteristics of korean society. Therefore we studied to find out the characteristics of suicidal poisoning before and after social economic stress, and to suggest the direction for the proper management. Methods: We reviewed medical records of 547 patients of suicide by poisoning who visited the emergency medical centers of St. Mary's hospitals from 1997 to 2004. For the annual trends analysis, we analyzed the demographic and toxicologic data of these patients compared with before and after IMF crisis (1998) and the economic recession ($2003\~2004$). Results: At the time of IMF and the economic recession, the number of suicidal poisoning increased, especially in fifth decade. The refusal rate of toxicological emergency treatment increased. Also the mortality rate and the admission rate to ICU (Intensive Care Unit) increased during the same period. In the result of the comparison analysis, clinical severity and mortality of social problem group were higher. However they couldn't be treated appropriately because of financial problem and the family indifference. Conclusion: At the economic recession period, the severity of suicidal poisoned patients was high. But the refusal rate of toxicologic treatment also increased, so the patients had lost the chance for proper toxicologic treatment. Therefore they would be supported by medical institution and public health.

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Preoperative Levels of Uric Acid and Its Association to Some Perioperative Parameters in the Patients with Unstable Angina or Myocardial Infarction

  • Kang, Chan-Sik;Seok, Seong-Ja;Choi, Hwa-Sik;Kim, Dae-Sik;Choi, Seok-Cheol;Moon, Seong-Min
    • Biomedical Science Letters
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    • v.17 no.2
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    • pp.113-122
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    • 2011
  • Several studies have reported a relation between serum levels of uric acid and a wide variety of cardiovascular conditions. But, the relationship between serum levels of uric acid and coronary artery disease (CAD) is still controversial. The present study was retrospectively designed to investigate whether CAD can be stratified by the level of uric acid and there are the relationships between preoperative levels of uric acid and perioperative biochemical markers in fifty-adult patients that underwent coronary artery bypass grafting surgery (CABG) and twenty-normal subjects. They were divided into the control, the unstable angina (UA-group) and the myocardial infarction group (MI-group). In preoperative levels of uric acid, the MI-group was higher than control and the UA-group. The MI-group had significantly higher correlations than the UA-group between preoperative levels of uric acid and left ventricular ejection fraction, cardiac markers (creatine kinase, lactate dehydrogenase and brain natriuretic peptide), renal markers (blood urea nitrogen and creatinine) or total leukocyte levels. At postoperative periods, the MI-group had higher relationships of uric acid with aspartate aminotransferase, blood urea nitrogen or creatinine levels. Although there was not statistically significant, the UA-group tended to have higher correlation coefficients than the MI-group between preoperative levels of uric acid and intensive care unit-stay (ICU), or postoperative mechanical ventilation time. These results reflect that increased levels of serum uric acid may be a tool for the diagnosis of coronary heart disease and may be considered as a good predictor in assessing the cardiac and renal functions in patients with myocardial infarction or unstable angina at the preoperative period. However, further studies should be performed in a large patient population.

Abdominal Wall Closure Using Artificial Mesh for Patients with an Open Abdomen (복부개방(Open abdomen) 환자에서 인공막(Artificial Mesh)를 이용한 근막봉합술)

  • Cha, Sung Whan;Shim, Hong Jin;Jang, Ji Young;Lee, Jae Gil
    • Journal of Trauma and Injury
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    • v.25 no.4
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    • pp.172-177
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    • 2012
  • Purpose: After damage control surgery, abdominal wall closure may be impossible due to increased intra-abdominal pressure (IAP), and primary closure may induce abdominal compartment syndrome. The purpose of this study was to investigate changes in the IAP and the feasibility of abdominal wall closure using artificial mesh. Methods: From July 2010 to July 2011, 8 patients with intra-abdominal hypertension underwent abdominal wall closure using artificial mesh. Medical data such as demographics, diagnosis, operation, IAP, postoperative complications, mortality and length of hospital stays were collected and reviewed, retrospectively. One patient was excluded because of inadequate measurement of the IAP. Results: Seven patients, 4 males and 3 females, were enrolled, and the mean age was 54.1 years old. Causes of operations were six traumatic abdominal injuries and one intra-abdominal infection. The IAP was reduced from $21.9{\pm}6.6mmHg$ before opening the abdomen to $15.1{\pm}7.1mmHg$ after fascial closure. Fascial closure was done on $14.9{\pm}17.5$ days after the first operation. The mean lengths of the hospital and the intensive care unit (ICU) stays were 49.6 days and 29.7 days respectively. Operations were performed $3.1{\pm}1.5$ times in all patients. Two patients expired, and one was transferred in a moribund state. Three patients suffered from complications, such as retroperitoneal abscesses, enterocutaneous fistulas, and bleeding that was related to the negative pressure wound therapy. Conclusion: After abdominal wall closure using artificial mesh, intra-abdominal pressure was well controlled, and abdominal compartment syndrome does not occur. When the abdominal wall in patients who have intra-abdominal hypertension is closed, artificial mesh may be useful for maintaining a lower abdominal pressure. However, when negative pressure wound therapy is used, the possibility of serious complications must be kept in mind.