• Journal of Chest Surgery
• /
• v.35 no.11
• /
• pp.842-846
• /
• 2002

A rare case of acute descending necrotizing mediastinitis(DNM) secondary to spontaneous rupture of hypopharynx is reported. Due to the right lower cervical abscess the patient had undertaken limited right anterior cervical drainage at other department. After transferring to our department he undertook combined wide cervical mediastinal drainage and mediastinal drainage via right thoracotomy. However mediastinal drainage was ineffective. So the second operation was performed and chest tubes were relocated. He had an uneventful postoperative course. As far as the cause of acute descending necrotizing mediastinitis was concerned, we couldn't find any literature in Korean or English except one case that dealt with spontaneous rupture of the hypopharynx.

• The Journal of Korean Academic Society of Nursing Education
• /
• v.17 no.2
• /
• pp.235-245
• /
• 2011

Purpose: The purpose of this study was to identify effectiveness of fundamental nursing practices in clinical settings. Method: This study adopted the triangulation method. Using one group pre-post test design, this study identified differences in self efficacy between pre and post clinical practice. The study was also designed to describe the nursing student's experience of clinical practice by using content analysis Results: 1) All students experienced bedmaking, BST check, V/C check, positioning, transferring, assisting with moving and positioning, and ROM. Sixty percent of students experienced giving oral care, and forty percent experienced shampooing patient's hair. 2) While the mean score of self efficacy was 3.88 in the pre-test, it decreased to 3.76 in the post-test. They were statistically different from each other. 3) Seven categories were elicited from the result of content analysis on the nursing student's experience, which were 'ignorant stranger', 'facing the gap between theory and practice', 'resolving the uncertainty of clinical setting', 'getting used to fundamental nursing practice', 'motivated by a desire to study and self-development', 'understanding the nursing profession's job', and 'being helpful for the future career'. Conclusion: Fundamental nursing practice in clinical settings is a useful strategy that improves fundamental nursing skills and motivates student's self-development.

• Journal of Trauma and Injury
• /
• v.36 no.4
• /
• pp.322-328
• /
• 2023

Purpose: Patients with multiple trauma necessitate assistance from a wide range of departments and professions for their successful reintegration into society. Historically, the primary focus of trauma treatment in Korea has been on reducing mortality rates. This study was conducted with the objective of evaluating the current state of multidisciplinary treatment for patients with severe trauma in Korea. Based on the insights of trauma specialists (i.e., medical professionals), we aim to suggest potential improvements. Methods: An online questionnaire was conducted among 871 surgical specialists who were members of the Korean Society of Traumatology. The questionnaire covered participant demographics, current multidisciplinary practices, perceived challenges in collaboration with rehabilitation, psychiatry, and anesthesiology departments, and the perceived necessity for multidisciplinary treatment. Results: Out of the 41 hospitals with which participants were affiliated, only nine conducted multidisciplinary meetings or rounds with nonsurgical departments. The process of transferring patients to rehabilitation facilities was not widespread, and delays in these transfers were frequently observed. Financial constraints were identified by the respondents as a significant barrier to multidisciplinary collaboration. Despite these hurdles, the majority of respondents acknowledged the importance of multidisciplinary treatment, especially in relation to rehabilitation, psychiatry, and anesthesiology involvement. Conclusions: This survey showed that medical staff specializing in trauma care perceive several issues stemming from the absence of a multidisciplinary system for patient-centered care in Korea. There is a need to develop an effective multidisciplinary treatment system to facilitate the recovery of trauma patients.

• Journal of the Society of Disaster Information
• /
• v.20 no.1
• /
• pp.206-212
• /
• 2024

Purpose: This study conducted research on the sharing of information to enhance the survival rate of emergency patients by swiftly transferring them to appropriate hospitals through sharing the patients' conditions, treatment histories, and transportation information with the Maritime Police Agency and relevant agencies when emergencies occur in the marine environment. Methods: In this study, emergency patient information classified in a smartphone app was received, stored, and transmitted using the LoRa communication method by electronic triage tags, and the transmitted emergency patient information was implemented to be collected in real-time through a hybrid triage system along with LoRa receivers. Results: Through the hybrid triage system, it was possible to receive emergency patient information according to the distance or confirm delayed reception. It was observed that most data were received when the distance was short, while data reception was unsuccessful in relatively longer distances. Conclusion: It was confirmed that in mass disaster environments where internet communication is impossible, rapid and accurate understanding of casualty information at disaster sites and appropriate disaster responses can be achieved using self-networking methods such as LoRa communication. However, limitations inherent in communication methods were also recognized. Further research on various communication methods is required to collect emergency patient information and transfer them to appropriate hospitals in situations where internet communication is unavailable.

• Health Policy and Management
• /
• v.28 no.4
• /
• pp.411-422
• /
• 2018

Background: Whether there is a difference in outcomes for trauma patients transferring to the helicopter emergency medical service (HEMS) according to their previous team composition is controversial. The purpose of this study is to evaluate the effectiveness of trauma team-staffed-HEMS (TTS-HEMS) when transferring to a trauma center. Methods: A retrospective comparison was conducted on patients transported to a trauma center over a 6-year period by the TTS-HEMS and paramedic-staffed-HEMS (119-HEMS). Inclusion criteria were blunt trauma with age ${\geq}15years$. Patient outcomes were compared with the Trauma and Injury Severity Score (TRISS) (30-day mortality) and the Cox proportional hazard ratio of mortality (in hospital). Results: There were 321 patients of TTS-HEMS and 92 patients of 119-HEMS. The TTS-HEMS group had a higher Injury Severity Score and longer transport time but a significantly shorter time to emergency surgery. The prehospital data showed that the trauma team performed more aggressive interventions during transport. An additional 7.6 lives were saved per 100 TTS-HEMS deployments. However, the TRISS results in the 119-HEMS group were not significant. In addition, after adjusting for confounders, the hazard ratio of mortality in the 119-HEMS group was 2.83 times higher than that in the TTS-HEMS group. Conclusion: HEMS was likely to improve the survival rate of injured patients when physicians were involved in TTS-HEMS. Survival benefits in the TTS-HEMS group appeared to be related to the fact that the trauma team performed both more aggressive prehospital resuscitation and clinical decision making during transportation.

• The Journal of Korean Academy of Prosthodontics
• /
• v.22 no.1
• /
• pp.72-78
• /
• 1984

The notion that the axis of the shaft of the articulator must coincide the patient's mandibular transverse axis tells us the importance of locating the axis precisely. When using kinematic axis to transfer a cast to an articulator, the anatomic asymmetry of the contralateral points will result in certain distortion when the axis transferred to an articulator where the mechanical axis produces symmetry. In this study, after locating the true hinge axis point with Denar hinge axis locator, the discrepancies between true hinge axis point and arbitrary hinge axis point that was 13mm anterior from the posterior margin of center of trangus to the outer canthus of eye were measured. And the discrepancies between left and right true hinge axis point in the superoinferior and anteroposterior directions were measured. For this study, 20 dental students who have no missing teeth and no difficulties of mandibular movement were selected. Upper and lower cast of subjects were mounted on Denar Mark II articulator uisng Denar Slidematic face-bow and centric relation record for the measurement of discrepancies between left and right true hinge axis points. The results obtained as follows. 1. The mean distance from the arbitrary hinge axis point to the true hinge axis point was as follows. Right: horizontal distance; 1.99mm, vertical distance; 2.12mm, linear distance; 3.36 mm. Left: horizontal distance; 1.39mm, vertical distance; 2.06mm, linear distance; 2.09mm. Total: horizontal distance; 1.69mm, vertical distance; 2.09mm linear distance; 3.06 mm. 2. The 87.5% of true hinge axis points were within 5mm of the arbitrary hinge axis point. 3. The mean discrepancies between the right and left hinge axis point were 2.92mm in superoinferior direction and 4.74mm in anteroposterior direction. 4. When transferring the axis to the articulator, anatomic asymmetry between right: and left axis point produces in dislocation of cast on the articulator, and undesirable shift in esthetic tooth position will be resulted.

• Restorative Dentistry and Endodontics
• /
• v.24 no.4
• /
• pp.639-646
• /
• 1999

The dental care delivery system and the dental specialty system have a very close relationship each other. Compared to Korea. Western European countries with predominant public sector in dental service have recognized merely 2 or 3 dental specialties, while North American countries with predominant private sector, 8 or 9 ones. It is desirable to adopt the dental specialty system as soon as possible in Korea to encourage scientific development in various dental specialties and qualitative advance in dental service. We, however, have to establish equitable dental care delivery system which can use limited dental resources efficiently as follows. 1. clarifying the different roles in assignments between general dentists and specialists by the amendment of the related laws such as the Medical Act and establishing the organic patient-referral system. 2. adopting the dental specialty system and expanding personnel and equipments so that the dental college hospitals, especially dental divisions of general hospitals, night function as secondary care facilities with specialties. 3. determining the size of dental specialists according to the national needs for dental specialized service's, whose number is to be not more than 10% of the total dentists. 4. transferring the function of accredating dental specialists to the efficient, self-controlled professional organization such as the Korean Dental Association rather than putting it under the governmental control. 5. conducting a comprehensive review of specialty education and practice for re-recognition, and maintaining competence of specialists by re-accredating them periodically. I expect this article to contribute to further discussion about the dental specialty system in Korea in productive and practical way. I am sure that we can Establish this system in the near future when people in every walks of life-the academic circle, the press, the authority concerned, consumer groups and the Korean Dental Association-take part in the discussion with special concern.

• Journal of the Ergonomics Society of Korea
• /
• v.30 no.5
• /
• pp.613-619
• /
• 2011

Objective: The purpose of this study is to compare the muscle activities of lumbar and lower extremity muscles between left and right sides using EMG(Electromyogram) when patients are transferred by physical therapists. Background: Asymmetrical lift was recognized as a major cause of musculoskeletal disorder. Several studies show that physical therapists' transferring patients needs caution as it could cause a lumbar pain to patients but there is not sufficient data to support. Method: Forty healthy rehabilitation hospital physical therapists joined for this study. The subjects were transferred from wheelchair to treatment mat(from left to right) by connecting the EMG device to the patients' body both on erector spine and rectus fermoris. At the moment when subjects were being transferred, the EMG device collected data from both erector spine and rectus femoris and it was normalized as %MVC. Then the EMG data was statistically analyzed using paired t-tests. Results: The EMG data show that the left erector spinae and rectus femoris are more activated than right erector spinae and rectus femoris in all position(p<.05) in a significant degree. Conclusion: The result implies that physical therapists' asymmetrical lifting when patients are transferred by them has a potential cause of musculoskeletal disorder of patients. Further studies will be conducted to find out a same tendency in other muscles of a body and to see if there are other factors to affect to patients during asymmetrical lifting. Application: These results can be used to provide baseline information for more understanding to asymmetrical lift loading.

• The Journal of Korean Academy of Prosthodontics
• /
• v.56 no.4
• /
• pp.330-337
• /
• 2018

In edentulous patients, implant - supported fixed prosthesis treatment has been proved to be useful, but involves complex treatment process. On the other hand, in the modern dentistry, digital technology has been developed day by day and it has expanded its range to the implant restoration of edentulous patients. In this case, a digital system was used for all stages of diagnosis, surgery, design and fabrication of provisional implants fixed prosthesis restoration in 66-year-old mandibular edentulous patients. In the preoperative diagnosis stage, a provisional restoration was designed based on the mucosal scan using the intraoral scanner and the stable occlusion of prefabricated complete denture of the patient. After flapless implant surgery using the surgical guide, the prefabricated interim restoration was connected to the implant and used as immediate provisional restoration. The final restoration was designed and fabricated by transferring the vertical dimension and the centric relation of the provisional restoration with stable occlusion using digital technology. We report a simple protocol of implant treatment in edentulous patients by using digital techniques to preserve the patient's vertical dimension and occlusion.

• Journal of Radiation Protection and Research
• /
• v.20 no.1
• /
• pp.25-36
• /
• 1995

The purpose of this research is to develop stereotactic localization and radiation measurement system for the efficient and precise radiosurgery. The algorithm to obtain a 3-D stereotactic coordinates of the target has been developed using a Fisher CT or angio localization. The procedure of stereotactic localization was programmed with PC computer, and consists of three steps: (1) transferring patient images into PC; (2) marking the position of target and reference points of the localizer from the patient image; (3) computing the stereotactic 3-D coordinates of target associated with position information of localizer. Coordinate transformation was quickly done on a real time base. The difference of coordinates computed from between Angio and CT localization method was within 2 mm, which could be generally accepted for the reliability of the localization system developed. We measured dose distribution in small fields of NEC 6 MVX linear accelerator using various detector; ion chamber, film, diode. Specific quantities measured include output factor, percent depth dose (PDD), tissue maximum ratio (TMR), off-axis ratio (OAR). There was small variation of measured data according to the different kinds of detectors used. The overall trends of measured beam data were similar enough to rely on our measurement. The measurement was performed with the use of hand-made spherical water phantom and film for standard arc set-up. We obtained the dose distribution as we expected. In conclusion, PC-based 3-D stereotactic localization system was developed to determine the stereotactic coordinate of the target. A convenient technique for the small field measurement was demonstrated. Those methods will be much helpful for the stereotactic radiosurgery.