Mitochondria play essential role in eukaryotic cells including in the oxidative phosphorylation and generation of adenosine triphosphate via the electron-transport chain. Therefore, defects in mitochondrial DNA (mtDNA) can result in mitochondrial dysfunction which leads to various mitochondrial disorders that may present with various neurologic and non-neurologic manifestations. Mutations in the nuclear gene polymerase gamma (POLG) are associated with mtDNA depletions, and Alpers-Huttenlocher syndrome is one of the most severe manifestations of POLG mutation characterized by the clinical triad of intractable seizures, psychomotor regression, and liver failure. The hepatic manifestation usually occurs late in the disease's course, but in some references, hepatitis was reportedly the first manifestation. Liver transplantation was considered contraindicated in Alpers-Huttenlocher syndrome due to its poor prognosis. We acknowledged a patient with the first manifestation of the disease being hepatic failure who eventually underwent liver transplantation, and whose neurological outcome improved after cocktail therapy.
Nakajima, Isao;Nawaz, Muhammad Naeem;Juzoji, Hiroshi;Ta, Masuhisa
Journal of Multimedia Information System
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v.6
no.1
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pp.23-30
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2019
A communications profile is a system that acquires information from communication links to an ambulance or other vehicle moving on a road and compiles a database based on this information. The equipment (six sets of HDTVs, fish-eye camera, satellite antenna with tracking system, and receiving power from the satellite beacon of the N-star) mounted on the roof of the vehicle, image data were obtained at Yokohama Japan. From these data, the polygon of the building was actually produced and has arranged on the map of the Geographical Survey Institute of a 50 m-mesh. The optical study (relationship between visibility rate and elevation angle) were performed on actual data taken by fish-eye lens, and simulated data by 3D-Map with polygons. There was no big difference. This 3D map system then predicts the communication links that will be available at a given location. For line-of-sight communication, optical analysis allows approximation if the frequency is sufficiently high. For non-line-of-sight communication, previously obtained electric power data can be used as reference information for approximation in certain cases when combined with predicted values calculated based on a 3D map. 3D maps are more effective than 2D maps for landing emergency medical helicopters on public roadways in the event of a disaster. Using advanced imaging technologies, we have produced a semi-automatic creation of a high-precision 3D map at Yokohama Yamashita Park and vicinity and assessed its effectiveness on telecommunications and ambulatory merits.
Objectives: Using as a sleep evaluation tool the Pittsburgh Sleep Quality Index (PSQI), this paper studied the effects of earthing on the amount and quality of sleep by examining a patient population of people who used and did not use earthing mats and a group of general healthy people. Methods: From September to November 2019, 30 patients who voluntarily used an earthing mat, 40 patients who did not use an earthing mat, and 40 healthy people who did not use an earthing mat were selected. A questionnaire applying the PSQI (Pittsburgh Sleep Quality Index) after being translated into Korean was distributed starting November 29, 2019 to 110 subjects. Out of them, 101 subjects who completed the questionnaire were examined. All statistics used SPSS 25.0. Results: The first overall score showed that all three groups had problems sleeping, with five points or more, but the general population had better sleep quality than the patient group. It also showed that the using matgroup had better quality of sleep than the ones that did not use the earthing mat In addition, the analysis of the third group through the variance analysis showed significance at >0.05 for the general population and the patient group. Based on this, a multi-comparison analysis of the third group showed significantly less than 0.05 in patients who do not use an earthing mat compared to the public. First of all, there are no statistically significant differences between the three groups in subjective sleep quality, sleep latency, and sleep time, but an analysis of multiple comparison analysis with the general population group showed that the quality of sleep was worse compared to those that used the mat. In addition, sleep efficiency, sleep disorder, sleeping pills, and daytime dysfunction were found to be less than >0.05 in the three groups. Conclusions: These results suggest that if you ground your body to Earth during sleep, the secretion of cortisol will decrease night levels, sync more with the natural 24-hour circulation rhythm profile, and that when you sleep, sleep is better and pain and stress are associated with the study. While the preceding study cannot confirm that contact with the ground affects the quality of sleep, it suggests that it is relevant as shown in this paper.
Kim, Min-Woo;Oh, Sang-Hoon;Park, Kyu-Nam;Lee, Jung-Min;Lee, Young-Mee;Kim, Han-Joon;Kim, Soo-Hyun;Kang, Dong-Jae
Quality Improvement in Health Care
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v.20
no.1
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pp.12-24
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2014
Objectives: The aim of this study was to explore whether emergency bell could shorten door to electrocardiograms (ECG) time in chest pain patients presenting to emergency department (ED) by self-transport. Methods: This was a planned 6-month before-and-after interventional study design. We set up the emergency bell in walk-in patients' waiting room. Prior to the change, patients were triaged before an ECG was obtained. In new process, as soon as patient with chest pain push the emergency bell, emergency physicians examined patient and prioritized performing ECG. We analyzed door to electrocardiograms (DTE) times for patients with chest pain and ST segment elevation myocardial infarction (STEMI) patients between two periods. Results: During the enrollment period, a total of 63 patients called emergency bell. The median DTE time was 6 min (interquartile range: 3.0 - 9.0) and 82.5% received an ECG within 10 minutes, and only three patients were STEMI. DTE time in patient with chest pain was not different between two periods (p=0.980). Before intervention period, 15 walk-in patients admitted in ED for STEMI and 53.8% of STEMI patients received an ECG within 10 minutes. After intervention period, total 19 walk-in patients admitted in ED for STEMI. Of these, 89.5% met the time requirement. Conclusion: Because a small portion of patients with chest pain activated the emergency bell, new strategy for promotion of emergency bell must be needed.
Journal of the Korea Academia-Industrial cooperation Society
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v.19
no.2
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pp.530-547
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2018
This study examines the importance of location and transportation in the operation of small- and medium-sized hospitals in the rapidly changing clinical environment. Approximately 350 persons were surveyed for approximately 40 days from July-August 2017, and responses were analyzed using SPSS and AMOS Statistical Package for 335 parts excluding 8 parts of 343.The main research results were as follows: First, a hypothesis was adopted that the attractiveness of building materials will positively affect customer satisfaction. Second, the hypothesis that transport infrastructure has a significant impact on customer satisfaction was rejected. Third, the hypothesis that the building appeal will positively affect the site was supported. Fourth, the hypothesis that transport infrastructure will have a significant impact on location marketability was supported. Fifth, the hypothesis that location marketability will significantly impact customer satisfaction was supported. Sixth, the hypothesis that the relationship between the site and customer satisfaction with the relationship between the client and the client is explained is partly attributable to the fact that there is a partial function. The assumption that the relationship between traffic infrastructure and customer satisfaction was confirmed. The hypothesis that the relationship between traffic infrastructure and customer satisfaction was supported. This research focuses on small- and medium-sized hospitals located in Seoul, which does not include the recognition of patients' awareness of the location and transportation of small- and medium-sized hospitals. Moreover, this study has the limitation in analyzing patient satisfaction, rather than the objective data of the financial management performance of the hospital. The results of this study could provide the basis for selecting the future locations of health care facilities.
Kim, Tea-youn;Lee, Sang Ah;Park, Eun-Cheol;Huh, Yo;Jung, Kyoungwon;Kwon, Junsik;Moon, Jonghwan;Kim, Jiyoung;Kim, Juryang;Hwang, Kyungjin;Yun, Seong Keun;Lee, John Cook-Jong
Health Policy and Management
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v.28
no.4
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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.
Purpose: To secure the safety of firefighters who are dispatched to emergency activities for patients with suspected infectious diseases during an epidemic, and to identify the current status of suspected infectious disease patients by region based on the information collected at the site, and manage firefighting infectious diseases that can be controlled and supported I want to develop a system. Method: Develop a smartphone app that can classify suspected infectious disease patients to check whether an infectious disease is suspected, and develop a disposable NFC tag for patient identification to prevent infection from suspected infectious disease patients. Develop a management system that collects and analyzes data related to emergency patients with suspected infectious disease input from the field and provides them to relevant business personnel to evaluate whether the transport of emergency patients with suspected infectious disease is improved. Result: As a result of the experiment, it was possible to determine whether an infectious disease was suspected through the algorithm implemented in the smartphone app, and the retransfer rate was significantly reduced by transferring to an appropriate hospital. Conclusion: Through this study, the possibility of improving emergency medical services by applying ICT technology to emergency medical services was confirmed. It is expected that the safety of paramedics will be actively secured.
Journal of the Korea Academia-Industrial cooperation Society
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v.14
no.2
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pp.744-750
/
2013
This study is to collect a basic data of how Cardiopulmonary Resuscitation (CPR) procedure can influence to cardiac arrest patient with and without the Depth Device during the average transport time period. The data has achieved by comparing result sheet of CPR procedure by hands only versus with Depth Device by twenty 1st and 2nd class Emergency Medical Technician (EMT) from five different fire stations in city of Chong-Ju, and twenty Emergency Rescue major students who completed the BLS provide course. The experiment participators experienced loss of compression depth and rate increase over time. However, the CPR procedure with Depth Device shows that both EMT and students to allow maintaining both the compression depth and rate. The experiment leaves a positive result for CPR operators and considers being valuable domain for cardiac arrest patient.
Purpose : Bartter syndrome is a renal tubular defect in electrolyte transport characterized by hypokalemia, metabolic alkalosis and other clinical signs and symptoms. The aims of this study were to analyze the clinical manifestations and the short- and long-term outcomes of Bartter syndrome. Methods : We retrospectively reviewed clinical history, laboratory finding of blood and urine, renal ultrasonography, and hearing tests of five patients who were diagnosed and managed with Bartter syndrome at Asan Medical Center from April 1992 to May 2007. We also evaluated height and body weight periodically after institution of therapy. Results : All patients had poor oral intake, failure to thrive and polyuria. Three of them had maternal history of polyhydramnios and premature delivery. The mean age at diagnosis was 11.8 months. All children presented with hypokalemia, metabolic alkalosis, hyperreninemia. Their blood pressures were normal. One patient had nephrocalcinosis on renal ultrasonography and all of them had normal result in hearing tests. After treatment with indomethacin or other prostaglandin inhibitors and potassium supplementation,their clinical features improved with catch-up growth and improvement in the development during long-term follow-up. Conclusion : We emphasize that early diagnosis and proper treatment in patient with Bartter syndrome are related to better prognosis.
Journal of the Korean Society of Marine Environment & Safety
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v.26
no.6
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pp.606-614
/
2020
The administrative ship, Chuja-ho, is the only mode of transportation between manned islands in the Chuja-do, Jeju. Chuja-ho is a 25-year-old age, which is identified to pass the persisting period (25 years) for public ships, and there is an urgent need for a replacement. The residents of the island are also requesting that the new administrative ship be outfitted with medical functions because there is no sea transportation system for medical emergencies in Chuja-do. The purpose of this study is to examine the required functions of a new administrative ship outfitted with medical functions and to suggest a conceptual design. In order to review the necessity of an emergency patient transport system, user requirements were surveyed and analyzed, and the ship's condition assessed by ship experts who carried out an on-site survey and analysis of ship survey data. Thereafter, a conceptual design for a new administrative ship with medical functions was presented. The results of this study can be used during a review of a new budget plan and for basic ship designs during the replacement project by the local government. It is also expected to improve the safety and medical environment of Chuja-do residents.
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