• Journal of Trauma and Injury
• /
• v.27 no.4
• /
• pp.115-125
• /
• 2014

Purpose: Stable vital signs (SVSs) are thought to be the most important criteria for successful non-operative management (NOM) of blunt spleen injury (BSI). However, a consistent definition of SVSs has been lacking. We wanted to evaluate the diversity of the definitions of SVSs by using a nationwide survey. Methods: A questionnaire regarding the definition of SVSs was sent to the trauma surgeons working at the Department of Trauma Surgery and Emergency Medicine at a level-I trauma center between October 2011 and November 2011. Data were compared using analyses of the variance, t-tests, ${\chi}^2$ tests and logistic regressions. Results: Among 201 surgeons, 198 responded (98.2%). Of these 198 responses, 45 were incomplete, so only 153 (76.1%) were analyzed. In defining the SVSs, significant diversity existed on the subjects of type of blood pressure (BP), cut-off value for hypotension, technique for measuring BP, duration of hypotension, whether or not to use the heart rate (HR) as a determinant, cut-off value of hypotension when the patient had a comorbidity or when the patient was a child. Of the 153 surgeons whose responses were analyzed, 91.5% replied that they were confused when defining SVSs. Conclusion: Confusion exists regarding how to define SVSs. Most surveyed surgeons felt that a need existed to clarify both the definition of SVSs and the use of SVSs to determine hemodynamic stability for NOM.

• Korean Journal of Human Ecology
• /
• v.15 no.6
• /
• pp.1037-1047
• /
• 2006

In this paper, various structures of the healthcare smart clothing for real-time measurement of vital sign were suggested. The wearing efficiency was evaluated to find out the best ergonomic clothing in the suggested design. The supplementary effects of the clothing components (princess line, double fabric, cushion) on the stable and tight positioning of sensors to the body were evaluated with wear test. Five experimental clothing for male subject were made with closely-fitted shape and they included two representative structure: one was the integrated type of inner and outer garments and the other was the separated type with two garments. Eight subjects in their twenties were participated in the wear test to evaluate the wearing efficiency of experimental clothing. As results, the clothing structure of the separated garments with the inner and the outer shells were evaluated as more efficient and comfortable. However, the effects of clothing components on the light positioning of the sensors to the body surface were not differentiated each other in the subjective evaluation.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.16 no.2
• /
• pp.1189-1199
• /
• 2015

This study examined the effects of favorite music therapy on the anxiety and vital signs at each point in gynecologic surgery using the general anesthesia. The research design was a non-equivalent control group non-synchronized design. The data were collected from May 1 to July 30, 2013 and the participants were 44 patients (experimental group, 21, control group, 23) received music therapy while waiting for anesthetic induction and PACU (Post Anesthesia Care Unit). Repeated measures ANOVA was performed to analyze the data by SPSS 18.0. Music therapy reduced the anxiety level at inducing the anesthetic time, and awakening time (p=.003; p=.011). The systolic blood pressure maintained stability at discharge from the PACU (p=.023), and pulse rate was stable at the awakening time (p=.016). This findings support the use of music as a nursing intervention to reduce anxiety and maintain the vital signs for gynecologic surgery patients under general anesthesia.

• Journal of Trauma and Injury
• /
• v.30 no.2
• /
• pp.47-50
• /
• 2017

A 21-year-old male visited our emergency room. He could not remember the mechanism of injury. He was found beside a motorcycle. Initial vital sign was stable. Observation and conservative treatment were planned at the intensive care unit (ICU). On the third day at ICU, he complained sudden flank pain. It was colicky and hard to control. Without the pain, he had no specific symptom, sign, or laboratory findings. On computed tomography, renal pelvis was filled with hematoma which induced hydronephrosis. Double-J catheter and percutaneous nephrostomy was implemented by an intervention radiologist. Hematome in the renal pelvis was aspirated during the procedure. Symptom of the patient was subsided after the procedure. He was discharged without specific complications.

• Journal of The Korean Dental Society of Anesthesiology
• /
• v.7 no.2
• /
• pp.120-125
• /
• 2007

Background: Propofol has been used extensively for short-acting intravenous sedative agent during monitored anesthesia care (MAC). This study was designed to evaluate the safety and availability of MAC using propofol in implant surgery of the one-day admission patients. Methods: In this study, subjects were divided into two groups according to ASA physical status. The heart rate, blood pressure, peripheral oxygen saturation and ECG of a patient were estimated under MAC by an anesthesiologist and the vital signs were recorded in recovery room periodically afterwards. The subjective satisfaction with regard to outpatient ambulatory surgery under MAC procedure was evaluated the next day. Results: Systolic and diastolic blood pressure were significantly decreased during MAC in ASA I group, but other remarkable changes in vital sign were not observed. There was no significant difference in pain and anxiety level between ASA I and ASA II, III group. Satisfaction rate was high in both groups. Conclusion: Monitored-Anesthesia Care using propofol during implant surgery of the one-day admission patients might be safe and available procedure because heart rate, blood pressure and oxygen saturation are stable before and during surgery, and adequate control of pain and anxiety is supported.

• Advances in pediatric surgery
• /
• v.14 no.1
• /
• pp.37-47
• /
• 2008

Recently, the survival rates of extremely low-birth-weight (ELBW) infants have improved with the development of neonatal intensive care. However, these infants were susceptible to intestinal perforation due to prematurity, fluid restriction, and injection of indomethacin, etc. Because of the risks of transportation, anesthesia and surgery itself, peritoneal drainage has been compared with laparotomy. Through our experience, we investigate the usefulness of peritoneal drainage retrospectively. From 1997 to 2007, six ELBW (M:F=5:1) underwent primary peritoneal drainage for intestinal perforation. Their median birth weight was 685g (405~870) and gestational age was $25^{+1}$ weeks ($24^{+3}{\sim}27^{+0}$). We noticed the intestinal perforation at median 10.5 days (8~18) after birth, and placed Penrose drain or Jackson-Pratt drain through right lower quadrant incision under local anesthesia. The cause of intestinal perforation was necrotizing enterocolitis in one patient, but that of the others was not clear. Three patients who showed normal platelet count and stable vital signs recovered uneventfully. Two patients (birth weight less than 500g) who showed unstable vital signs and low platelet count (12,000 / $mm^3$ to 30,000 / $mm^3$)expired despite aggressive resuscitation. One patient required laparotomy due to persistent intestinal obstruction after drain removal and survived. Our experience shows that peritoneal drainage was an acceptable treatment for ELBW infants and the prognosis was related to vital sign and platelet count at the time of intestinal perforation, and birth weight.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.26 no.3
• /
• pp.513-519
• /
• 1999

Chloral hydrate is one of the most widely used sedative agents to control the difficult to treat young age group in the dental clinic. We are often frustrated to see the patient still awake and cry with agitation even after far more than the normal onset time. In such a case, the patient has to be rescheduled for another sedation visit with different agents and/or routes which greatly disappoints the guardians. This case report presents a sedative regimen that can possibly help the clinician complete scheduled treatment without postponement. We have tried sleep induction with Enflurane (1-1.5vol%) for 60 seconds to 37 patients of those who failed to respond properly to the dose(70mg/kg)of oral Chloral hydrate. The average age and weight of the patients was 34.3 months(22-43mo.) and 14.9kg(11-21kg) respectively. It is suggested that sleep induction with low dose Eflurane produced a stable state during dental treatment with respect to vital sign and behavior. Evidence of adverse effect was not detected or reported during and/or after the procedures.

• Journal of Acupuncture Research
• /
• v.24 no.4
• /
• pp.225-235
• /
• 2007

Amyotrophic Lateral Sclerosis(ALS) is Motor Neuron Disease(MND) that reveals muscle relaxation, bulbar palsy, extremities weakness, Pneumonia, in severe case, leads to death. Objectives : Amyotrophic Lateral Sclerosis is one of the incurable disease. In Oriental medicine, Wei symptom is similar as Amyotrophic Lateral Sclerosis, so we diagnosed it as Wei symptom and treated in Oriental medical system. Methods : The patient was treated by acupunture, moxibustion, herb medication, physical treatment. The improvement of the patient was judged by Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS), Grasping power on right arm, circumference of thigh and calf. Result : The patient had better condition for a while but the sputum irritated breathing and the day before he discharged vital sign was not stable and could not breath well. Conclusion : It is necessary to have more examination about the incurable syndromes such as Amyotrophic Lateral Sclerosis, and keep the patient's life better and expand their lives.

• Journal of Home Health Care Nursing
• /
• v.6
• /
• pp.5-18
• /
• 1999

This study was attempt to encourage for developing on rehabilitation delivery system and programs as a substitute service instead of hospitalization for accident patients at work, such as hospital based home health care nursing service. It needs vary substitutes service of hospitalization to curtail the length of stay for inpatients who were hospitalized with workers compensation insurance. It focused on developing an estimation of early discharge day of accident inpatients based on a detail statement of treatment for 115 inpatients who were hospitalized at General Hospital in 1997. This study has four specific purpose as follows. First, to find out the status of health service utilization. Second, to estimate the early discharge days and income increasing effect based on the early discharge for those patients. Third, to identify the factors to affect total medical expenditure and the length of stay for those inpatients. Forth, to figure out the need of utilizing home health care nursing service for accident patients. In order to analyze of the length of stay and medical expenditure for inpatients who were hospitalized due to the accident, the authors conducted with micro-analysis and macroanalysis from medical records and medical expenditure records. Micro-analysis was done by nominal group discussion of 4 expertise with the critical criteria. such as a decrease in the amount of treatment after surgery, treatments, tests, drugs and changes in the tests consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, stable conditions. In addition to identify affected variables for medical expenditure. the length of stay and income effect due to early discharge day, the data was analyzed with multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study as follows. First, the mean length of stay was 37.1 days, whereas the mean length of stay due to early discharge was 28.2 days at the hospital. The estimation of early discharge days were shown that depends on the length of stay. The longer length of stay, the longer length of early discharge days, such as under 7 days length of stay patients was to estimated the mean length of stay was 4.9 days and early discharge days was 4.6. whereas the mean length of stay was 122.6 days and early discharge days was 92.0 respectively. The mean medical expenditure per day were found to be 133.409 Won. whereas the mean medical expenditure per day was shown negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to 11 early discharge days per bed was around 2,150,000 won. However, it means not the real benefits from early discharge, but the income increasing amount without considering medical prime cost in general hospital. Therefore, it needs further analysis on the cost containments and benefits under the considering as well turn over rates per bed as the medical prime costs. The length of stay was most significant and the sign was positive to the total medical expenditure, as expected. Surgery and patient's residential area also an important variable in explaining medical expenditure. The level of complications was most significant variable in explaining the length of stay. The level of the needs on horne health care nursing service which can be used for early discharge accident patients were shown very high. The needs distribution varied from 65.5% of patients and 88.9% of caregivers, to 96.4% of doctors, and 99.1% of nurses. In addition horne health nurse responded that they can be managed the accident inpatients from early discharge. From these research findings. the following suggestions has been drawn it needs to develop strategies on rehabilitation delivery system in order to focused on consumer's side which is planned for 21 century health policy in Korea. Vary intermediate facilities and horne health care would have been developed in the community based for comprehensive rehabilitation services as a substitutes of hospitalization for shortening the length of stay of hospitalizations. In hospital based horne health care nursing service, it's available immediately to utilize for the patients who wanted rehabilitation services as a substitutes of hospitalization under the cooperations with workers compensation insurance company.

• Journal of Korean Orthopaedic Sports Medicine
• /
• v.2 no.2
• /
• pp.168-175
• /
• 2003

Fracture about proximal humerus may be classified as the articular segment or the anatomical neck, the greater tuberosity, the lesser tuberosity, and the shaft or surgical neck. Now, usually used, Neer's classification is based on the number of segments displaced, over 1cm of displaced or more than 45 degrees of angulation , rather than the number of fracture line . Absolute indication of a operative treatment a open fracture, the fracture with vascular injury or nerve injury , and unreductable fracture-dislocation . Inversely, the case that are severe osteoporosis, and eldly patient who can't be operated by strong internal fixation is better than arthroplasty used by primary prosthetic replacement and early rehabilitation program than open reduction and internal fixation. The operator make a decision for the patient who should be taken the open reduction and internal fixation, because it's different that anatomical morphology, bone density, condition of patient. The operator decide operation procedure. For example, percutaneous pinning, open reduction, plate & screws, wire tension bands combined with some intramedullary device are operation procedure that operator can decide . The poor health condition for other health problem, fracture with unstable vital sign and severe osteoporosis , are the relative contraindication. The stable fracture without dislocation is not the operative indication . The radiologic film of the prokimal humerus before the operation can not predict for fracture evaluation. It's necessary to good radiologic film for evaluation of fracture form. The trauma serise is better than the other radiologic film for evaluation. The accessary radiologic exam is able to help for evaluation of bone fragment and anatomy. The CT can be helpful in evaluating these injury, especially if the extract fracture type cannot be determined from plain roenterogram of the proximal humerus, bone of humerus head. If the dislocation is severe anatomically , we could consider to do three dimentional remodelling. The MRI doing for observing of bony morphology before the operation is not better than CT If we were suspicious of vascular injury, we could consider the angiography.