• Title/Summary/Keyword: Medical management

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Composite Behavior and Shear Strength of DH-Beams with Steel Deck Plates (무해체 데크플레이트 철판을 사용한 DH-beam의 합성거동과 전단강도)

  • Moon, Jeong-Ho;Oh, Young-Hun
    • Journal of the Korea institute for structural maintenance and inspection
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    • v.20 no.3
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    • pp.1-9
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    • 2016
  • The purpose of this study is to examine the shear strength and structural performance of DH-Beams. The DH-Beam construction method uses thin steel plates as form-works and structural elements. Steel plates and rebars for DH-Beams were prefabricated at factory and then erected before casting concrete at construction sites. In this study, the contribution of steel plates to the shear strength of DH-Beam was evaluated since the plates were expected to work as reinforcements. Five test specimens were made for experimental and analytical studies. They consisted of two DH-Beams for the positive loading test and two DH-Beams for the negative loading test and a RC beam for the comparison purpose. Test results on DH-Beams were compared with design equations and the RC beam test result. It was proven that DH-Beams demonstrated the good shear behavior showing sufficient strengths and deformation capacities. Nonlinear analyses with test specimens were also used to evaluate the contribution of DH plates to strengths. Analytical models included various cases such as beams with lateral plates only or beams without any plates. These analyses also showed that steel plates can contribute to the enhancement of shear strength of DH-Beams. Based on experimental and analytical studies, it was concluded that steel plates of DH-Beams can be used as good shear reinforcements.

The Effectiveness of Bladder Training on Self Voiding after Removal of Catheter in Female Patients with Craniotomy (개두술 여성환자에게 시행한 방광훈련이 유치도뇨관제거후 자가배뇨에 미치는 효과)

  • Lee, Jung-Lim;Kim, Keum-Soon
    • The Korean Journal of Rehabilitation Nursing
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    • v.2 no.1
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    • pp.72-84
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    • 1999
  • The purpose of this study was to identify the effectiveness of bladder training on self voiding after removal of catheter in female patients with craniotomy, finally to develop a bladder rehabilitation program for cognitive impaired patients. Nonequivalent control group posttest design was used. The population of this study consisted of 34 hospitalized neurosurgical patients, all patients have been received craniotomy. 17 patients were assigned to the experimental group and another 17 patients to the control group. The homogeneity of general characteristics of the subjects was no significant difference. Bladder training program consisted of pre-training education, the bladder training, positive verbal reinforcement. The experimental group has been received bladder training and the control group has been received gravity drainage. The dependent variable, the frequency of voiding trial untill self voiding achieves, the frequency of urinary retention, the amount of residual urine, the occurrence, of urinary incontinence, were measured during 3 days after catheter removed. The data analyzed with SPSSWIN ; frequency, percentage, t-test and $X^2$-test were used to analyze homogeneity of general characteristics of subjects between the experimental and the control group. T-test, Mann-Whitney U test, and $X^2$-test were used to determine the effect of bladder training. The result of the study were as follows : There was significant difference in the frequency of voiding trial untill self voiding achieves between the experimental group and the control group. There was no significant difference in the frequency of urinary retention between the experimental group and the control group. There was no significant difference in the amount of residual urine between the experimental group and the control group. However, there was significant difference in the amount of residual urine in urinary retention patients. There was significant difference in the occurrence of urinary incontinence between the experimental group and the control group. In conclusion, bladder training program as a nursing intervention was effective in conclusion, bladder self voiding ability after removal of catheter for craniotomy patients. Therefore, it is recommended to use the bladder training program clinically for the bladder management of cognitive impaired patients.

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Study on Performance Evaluation of Dental X-ray Equipment (치과 방사선 발생기의 성능평가에 관한 연구)

  • Jung, Jae-Eun;Jung, Jae-Ho;Kang, Hee-Doo;Lee, Jong-Woong;Ra, Keuk-Hwan
    • Korean Journal of Digital Imaging in Medicine
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    • v.11 no.2
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    • pp.115-119
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    • 2009
  • I think this will be valuable reference for assuring consistency and homogeneity of clarity and managing dental radiation equipment by experimentation of dental radiation equipment permanent which based on KS C IEC 61223-3-4 standard and KS C IEC 61223-2-7. Put a dental radiation generator and experiment equipment as source and film(sensor) length within 30 em, place the step-wedge above the film(sensor). Tie up tube voltage 60 kVp, tube current 7 mA and then get an each image through CCD sensor and film by changing the exposure time as 0.12sec, 0.25sec, 0.4sec. Repeat the test 5times as a same method. Measure the concentration of each stage of film image, which gained by experiment, using photometer. And the image that gained by CCD sensor, analyze the pixel value's change by using image J, which is analyzing image program provided by NIH(National Institutes of Health). In case of film, while 0.12sec and 0.25sec show regular rising pattern of density gap as exposure time's increase, 0.4sec shows low rather than 0.12sec and 0.25sec. In case of CCD sensor density test, the result shows opposite pattern of film. This makes me think that pixels of CCD's sensor can have 0~255 value but it becomes saturation if the value is over 255. The way that getting clear reception during decreasing human's exposed radiation is one of maintaining an equipment as a best condition. So we should keeping a dental radiation equipment's condition steadily through cyclic permanent test after factor examination. Even digital equipment doesn't maintain a permanent, it can maintain a clarity by post processing of image so that hard to set it as standard of permanent test. Therefore it would be more increase the accuracy that compare a film as standard image. Thus I consider it will be an important measurement to care for dental radiation equipment and warrant homogeneity, consistency of dental image's clarity through comparing pattern which is the result from factor test against cyclic permanent test.

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Clinical Analysis of Intractable Diabetic Foot Ulcers: Accessing Risk Factors (난치성 당뇨 족부 궤양에 대한 임상적 고찰: 치료에 영향을 미치는 인자 분석)

  • Park, Se-Jin;Lee, Seung-Hee;Park, Hun-Yong;Kim, Jang-Hwan;Shin, Hun-Kyu;Kim, Eu-Gene;Choi, Jae-Yeol
    • Journal of Korean Foot and Ankle Society
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    • v.15 no.4
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    • pp.232-239
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    • 2011
  • Purpose: Diabetic foot ulcer is one of the most important diabetic complications because it increases the risk of amputations. Moreover, it lowers the quality of patients' life and increases the social medical expenses. Authors analyzed risk factors of intractable diabetic foot ulcer using retrospective study. Materials and Methods: From January 2007 to December 2010, 40 patients who could not achieve complete healing despite more than 12 weeks of proper management among who had been diagnosed and treated as diabetic foot ulcer at our hospital were included and evaluated retrospectively. We compared the risk factors between two groups who were finally treated by amputation and non-amputation. Results: The sample was composed of 31 male patients (77.5%) and 9 female patients (22.5%). Comorbidity including hypertension and hyperlipidemia were 77.5% and 80% each. By Wagner classification, 30 patients (80%) had ulcerative lesion over the grade 3. From bacteriology results, 29 patients (72.5%) had polybacteria infection. 35 patients (87.5%) had neuropathy and 26 patients (65%) had vascular stenosis at least one level. The mean initial ankle-brachial index and toe-brachial index were 0.982 and 0.439. In comparison between amputation group and non-amputation group, ulcer severity, number of stenotic vessel and initial ankle-brachial index/toe-brachial index had statistical significance. Conclusion: The most commonly risk factor of intractable diabetic foot ulcer was peripheral neuropathy reaching 87.5% of cases. In comparison with non-amputation group, ulcer severity according to Wagner classification, number of stenotic vessel and initial ankle-brachial index/toe-brachial index were demonstrated as a risk factor of amputation in intractable diabetic foot ulcer.

High Frequency Noise Reduction in ECG using a Time-Varying Variable Cutoff Frequency Lowpass Filter (시변 가변차단주파수 저역통과필터를 이용한 심전도 고주파 잡음의 제거)

  • 최안식;우응제;박승훈;윤영로
    • Journal of Biomedical Engineering Research
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    • v.25 no.2
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    • pp.137-144
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    • 2004
  • ECG signals are often contaminated with high-frequency noise such as muscle artifact, power line interference, and others. In the ECG signal processing, especially during a pre-processing stage, numerous noise removal techniques have been used to reduce these high-frequency noise without much distorting the original signal. This paper proposes a new type of digital filter with a continuously variable cutoff frequency to improve the signal quality This filter consists of a cutoff frequency controller (CFC) and variable cutoff frequency lowpass filter (VCF-LPF). From the noisy input ECG signal, CFC produces a cutoff frequency control signal using the signal slew rate. We implemented VCF-LPF based on two new filter design methods called convex combination filter (CCF) and weight interpolation fille. (WIF). These two methods allow us to change the cutoff frequency of a lowpass filter In an arbitrary fine step. VCF-LPF shows an excellent noise reduction capability for the entire time segment of ECG excluding the rising and falling edge of a very sharp QRS complex. We found VCF-LPF very useful and practical for better signal visualization and probably for better ECG interpretation. We expect this new digital filter will find its applications especially in a home health management system where the measured ECG signals are easily contaminated with high-frequency noises .

Clinical Epidemiologic Study of Facial Bone Fractures in Daegu (대구지역 안면골 골절의 임상역학적 연구)

  • Kwon, Hyuk Joon;Han, Joon;Kim, Jun Hyung;Jung, Ho Yoon;Kim, Jong Yeop;Yoon, Sin Hyuk;Song, Cheol Hong;Ryu, Min Hee;Kim, Yong Ha;Seo, Man Soo
    • Archives of Plastic Surgery
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    • v.34 no.3
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    • pp.365-370
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    • 2007
  • Purpose: There are many reports about facial bone fractures, but limited to retrospective data of a single hospital. Etiology and severity of the facial bone fracture have been changed and treatment method and materials have been advanced. In order to reflect those changes and provide up-to-date data of the facial bone fractures in Daegu, we gathered the data and analyzed the epidemiologic study. Methods: The medical records of 1058 fractures in 895 patients were gathered from 5 general hospitals in Daegu during last year and these data were analyzed by following parameters: age, sex, place of residence, occupation, cause of injury, time of injury, location of fracture, length of in-hospital stay, time of operation, treatment method, associated injury, complication. Statistical analysis was performed using the Chi-square test. Results: Most commonly involved age group was 20s(26%) and the sex ratio was 3.4:1(male predominance). Fractures were occurred more in unban and white-color workers. Among variable etiology of injury, traffic accident was the most common cause. Time of injury was heighest at 6 to 7 P.M., on Sunday, in July. Locations of fractures were following sequence: nasal, zygoma, mandible, orbit, maxilla. Mean length of in-hospital stay and time of operation after injury were 6.3 and 3.2 days, respectively. In treatment methods, operative methods were dominant than conservative management and general anesthesia were favored than local anesthesia. Associated injuries were noticed in 188 cases(21.2%) and complications were in 94 cases(8.9%) and among them, ocular problem were common. Conclusion: Compared to previous studies, mean age of occurrence was lowered and the etiologies showed age-specific pattern and reflected the change of lifestyle. In young age groups, sports injury, violence were more dominant and the other hand, traffic accident and fall were dominant in older groups.

Development of Simple Prediction Method for Injury Severity and Amount of Traumatic Hemorrhage via Analysis of the Correlation between Site of Pelvic Bone Fracture and Amount of Transfusion: Pelvic Bleeding Score (골반골절 환자의 골절위치와 출혈량간의 상관관계 분석을 통한 대량수혈 필요에 대한 간단한 예측도구 개발: 골반골 출혈 지수)

  • Lee, Sang Sik;Bae, Byung Kwan;Han, Sang Kyoon;Park, Sung Wook;Ryu, Ji Ho;Jeong, Jin Woo;Yeom, Seok Ran
    • Journal of Trauma and Injury
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    • v.25 no.4
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    • pp.139-144
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    • 2012
  • Purpose: Hypovolemic shock is the leading cause of death in multiple trauma patients with pelvic bone fracures. The purpose of this study was to develop a simple prediction method for injury severity and amount of hemorrhage via an analysis of the correlation between the site of pelvic bone fracture and the amount of transfusion and to verify the usefulness of the such a simple scoring system. Methods: We analyzed retrospectively the medical records and radiologic examination of 102 patients who had been diagnosed as having a pelvic bone fracture and who had visited the Emergency Department between January 2007 and December 2011. Fracture sites in the pelvis were confirmed and re-classified anatomically as pubis, ilium or sacrum. A multiple linear regression analysis was performed on the amount of transfusion, and a simplified scoring system was developed. The predictive value of the amount of transfusion for the scoring system as verified by using the receiver operating characteristics (ROC). The area under the curve of the ROC was compared with the injury severity score (ISS). Results: From among the 102 patients, 97 patients (M:F=68:29, mean $age=46.7{\pm}16.6years$) were enrolled for analysis. The average ISS of the patients was $16.2{\pm}7.9$, and the average amount of packed RBC transfusion for 24 hr was $3.9{\pm}4.6units$. The regression equation resulting from the multiple linear regression analysis was 'packed RBC units=1.40${\times}$(sacrum fracture)+1.72${\times}$(pubis fracture)+1.67${\times}$(ilium fracture)+0.36' and was found to be suitable (p=0.005). We simplified the regression equation to 'Pelvic Bleeding Score=sacrum+pubis+ilium.' Each fractured site was scored as 0(no fracture) point, 1(right or left) point, or 2(both) points. Sacrum had only 0 or 1 point. The score ranged from 0 to 5. The area under the curve (AUC) of the ROC was 0.718 (95% CI: 0.588-0.848, p=0.009). For an upper Pelvis Bleeding Score of 3 points, the sensitivity of the prediction for a massive transfusion was 71.4%, and the specificity was 69.9%. Conclusion: We developed a simplified scoring system for the anatomical fracture sites in the pelvis to predict the requirement for a transfusion (Pelvis Bleeding Score (PBS)). The PBS, compared with the ISS, is considered a useful predictor of the need for a transfusion during initial management.

Injury Characteristics of Self-injury Patients Who Visit the Emergency Department (응급실로 내원한 자의 손상 환자의 특징)

  • Kwak, Young Soo;Lee, Kang Hyun;Shin, Hyung Jin;Park, Kyung Hye;Choi, Han Joo;Kim, Hyun;Hwang, Sung Oh
    • Journal of Trauma and Injury
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    • v.22 no.1
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    • pp.65-70
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    • 2009
  • Purpose: Many studies have addressed a psychiatric analysis of self-injury patients who have self-injurious behavior and who have attempted suicide. Few studies on the injury characteristics of self-injury related trauma patients have been conducted. We analyzed the injury characteristics of self-injury patients. Methods: A retrospective review of the medical records extracted from the injury surveillance system of Wonju Christian Hospital for the period from August 2006 to February 2008 was conducted. Of the 121 cases extracted, 103 were included in this study. We analyzed the sex ratio, age group, place of injury, injury mechanism, location of injury, management results, injury severity, and relation with drinking. Results: One hundred three cases were included (sex ratio: 1.06), and the mean age was $33.9{\pm}14.2$ years old. Fifty-six patients (54.4%) were discharged from the emergency department (ED) on the day of injury after primary care, and 9 patients (8.7%) were discharged, because they refused treatment. Seven patients (6.8%) died. Of these, 4 patients (3.9%) died after attempted cardio-pulmonary resuscitation in the ED, 1 patient (1%) was dead on arrival, and 2 patients (1.9%) died after admission. Sixteen patients (15.5%) were admitted to the hospital, including 2 patients (1.9%) needing emergency surgery. Sixteen patients (15.5%) were transferred to other hospitals. Sixty-one cases (59.2%) involved drinking, and 31 (30.1%) did not; for 11 cases (10.7%), the involvement of drinking was unknown. The mean revised trauma score (RTS) was $11.26{\pm}2.52$, and 88 cases (85.4%) hat a RTS of 12. The mean injury severity score (ISS) was $5.80{\pm}14.56$, and 9 (8.7%) severely injured patients had scores of more than 15. Conclusion: Most self-injuries were mild traumas related to drinking and occurred at a young age. Most cases were not so severe, and the patients were discharged from the ED, but some patients needed hospitalization. Other patients had injuries so severe that they died.

Clinical Characteristics of Patients Treated in an Emergency Center for Vascular Trauma (일개 응급센터에 내원한 외상성 혈관손상 환자의 임상적 특성)

  • Park, Yong Myeon;Yeom, Seok Ran;Jeong, Jin Woo;Han, Sang Kyun;Jo, Suck Ju;Ryu, Ji Ho;Kim, Yong In;Chung, Sung Woon
    • Journal of Trauma and Injury
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    • v.22 no.1
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    • pp.5-11
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    • 2009
  • Purpose: The mortality and the amputation rates due to vascular trauma remain high despite advanced vascular surgical techniques and supportive management. The clinical features of patients with vascular trauma have not been well studied in the Korean population. The aim of this study was to analyze the clinical characteristics of patients with vascular trauma and to develop a database and guidelines for improving the outcomes of treatment. Methods: The medical records of 37 patients with traumatic vascular injuries who had visited in an emergency center between January 2002 and December 2006 were retrospectively reviewed and statistically analyzed. Results: The mean age was 37.8 years, and the male-to-female ratio was 5.2 : 1. The mechanism of vascular trauma was penetrating in 18 patients and blunt in 19 patients. Upper extremities were most frequently injured (39.4%). The treatment methods were primary repair in 21 patients, exploratory laparotomies in 7, radiological interventions in 3, resections and graft interpositions of the pseudoaneurysm in 3, observations in 3 and a bypass graft in 1. Four out of the 37 patients died, and three of these who died had injuried abdominal vessels. Twenty-five of the patients recovered completely, four expired, seven had neuropathy in the course of treatement, one had his limb amputated, and one experienced wound necrosis. Conclusion: Peripheral vessel injuries are commonly accompanied by nerve, muscle, or tendon injuries. Patients without associated fractures or compartment syndrome had good prognosis. Although the time intervals from hospital arrival to definite treatment were the shortest among patients with blunt abdominal vascular injuries, three expired. Therefore, we offer a 'ritical pathway'to improve the outcomes of patients with blunt abdominal vascular injury.

Treatment Strategy of Transcatheter Arterial Embolization after Pelvic CT Angiography in Traumatic Pelvic Hemorrhage : A Single Regional Emergency Center's Experience (외상성 골반 출혈환자에서 CT 혈관조영술 후 동맥 색전술을 시행하는 치료방침의 유용성: 단일 권역응급센터의 경험)

  • Lee, Yu Jin;Jae, Hwan Jun;Cha, Won Chul;Seo, Jun Seok;Kim, Hyo Cheol;Shin, Cheong-Il;Shin, Sang Do
    • Journal of Trauma and Injury
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    • v.22 no.2
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    • pp.184-192
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    • 2009
  • Purpose: This study was conducted to evaluate the effectiveness of the treatment strategy of transcatheter arterial embolization after pelvic CT angiography (CTA) in cases of traumatic pelvic hemorrhage. Methods: This is a retrospective analysis of pelvic hemorrhage patients who underwent transcatheter arterial embolization after pelvic CTA at our regional emergency center during a 31-month period. We reviewed the medical records and imagings of all these patients. Results: Transcatheter arterial embolization was performed in 17 patients (M:F=7:10, mean age=53.9) who underwent pelvic CTA for the evaluation of traumatic pelvic hemorrhage. Arterial bleeding was demonstrated on pelvic CTA in all patients, and the combined injury was also noted in 13 patients. The admission-to-CTA time was $84.53{\pm}66.92$ minutes, and the CTA-to-embolization time was $147.65{\pm}99.97$ minutes. Extravasation of contrast media or pseudoaneurysm was demonstrated on conventional angiography in all patients. Unilateral iliac artery embolization was performed in 8 patients, and bilateral iliac artery embolization was performed in 9 patients. Additional embolizations other than in the iliac arteries were performed in 7 patients. Initial hemostasis was achieved in 16 patients. One patient died of ongoing pelvic bleeding. Rebleeding occurred in only one patient and hemostasis was achieved with the second embolization. Another patient died of intracranial and facial bleeding in spite of pelvic hemostasis. The overall mortality was 11.8%, and there was no significant adverse effects in the other patients. Conclusion: Transcatheter arterial embolization after pelvic CTA is an effective treatment strategy in the management of traumatic pelvic hemorrhage patients.