• Journal of Trauma and Injury
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• 제26권3호
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• pp.233-237
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• 2013

Delayed traumatic intracerebral hemorrhage (DT-ICH) is a rare event in head trauma patients. However, it develops unexpectedly and results in very severe brain damage. Thus, close monitoring of the neurologic status is needed for every trauma patient. Sometimes, however, neurologic monitoring cannot be done because of sedation, especially in cases of abdominal surgery. In this case report, we describe the case of a 37-yr-old, male patients who had hemoperitoneum because of spleen and renal injury. At the initial operation, massive bleeding was found, so gauze-packing surgery was done first. After the first operation, we sedated the patient for about two days, after which the packed gauze was removed, and the abdominal wound was closed. Immediately after the second operation, we found pupil dilation. Emergent CT was performed. The CT revealed DT-ICH with severe brain edema and midline shifting. However, the patient condition deteriorated progressively despite emergency operation, he expired 2 days after hematoma evacuation.

• 간호행정학회지
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• 제9권2호
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• pp.265-282
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• 2003

Purpose : This study was conducted to provide for a basic resource, which can be used to set up a efficient management system in Cardiac Surgery Intensive Care Units(CSICU). Method: 1) Questionnaires were administered and observation methods were used, to examine the nursing activities performed in the CSICU after having reviewed related literatures and a review by the experts. Thus, the nursing activities were designating 254 activities and classified into 28 categories. 2)The 22 nurses in the 2 CSICUs filled out questionnaires about nursing activities from 12 April, 2002 to 17 April, 2002. The frequency of the nursing activities in the 28 categories counted and new nursing activities added by directly observing 12 nurses by two trained research staffs for 4 day. 3)In terms of validity, the 264 nursing activities were analysed by the 25 experts. As a result, 231 nursing activities were found valid and remained as appropriate nursing activities to be used for the careful analysis of the nursing activities in CSICUs. Result: The 22 categories are as below: assessment, monitoring, respiration management, nutrition management, elimination/drainage management, mobility management, sanitation management, safety management, temperature management, specimens collection, preparation and assistance of treatment, skin/wound management, infection management, medication management, education/support, dying patient care, recording/keeping, supplies management, environment management, communications, evaluations, professional development Conclusion : The manifest job description of the staff nurse will contribute to improving the efficiency of the nursing activities and to reducing the role conflicts among the medical staffs.

• 한국임상수의학회지
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• 제24권3호
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• pp.449-452
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• 2007

A 2 year-old intact male Shih-tzu dog was presented with a history of snakebite on the left upper lip. He was depressed and had swelling, erythema and pain around the left muzzle. Both mandibular lymph nodes were swollen. Fang marks were not clear, but there were scratch wounds and prolonged bleeding. Hemogram revealed neither thrombocytopenia nor echinocytosis. Increased CK value in serum chemistry and myoglobinuria in urine analysis meant muscle injury. With careful monitoring, fluid, corticosteroid, antihistamine and antibiotics were administered. After the application of ice pack and suction, local symptoms changed for the worse. However, any other systemic disorders were not identified. After 5 days, the facial swelling had resolved completely.

• 해양환경안전학회지
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• 제28권6호
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• pp.1044-1053
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• 2022

시간영역반사계(TDR)는 케이블의 물리적 결함을 검사하는 기법이며 누수 탐지 분야로의 응용영역을 확대하고 있다. 본 연구는 시간영역반사계 기법을 활용하여 선박 기관실 해수 배관의 누설 감지용 케이블형 센서를 개발하였다. 케이블 센서의 형상은 꼬임형상과 흡습부재를 이용하여 제작하였으며 개발된 센서의 누수 감지 여부와 위치 탐지 가능성을 확인하였다. 개발된 센서는 실제 배관 시험 장치에 부착하여 평가하였으며 해수 누설에 따른 다양한 TDR 신호를 취득하였다. 센서는 꼬임횟수, 피복 두께를 변수로 하여 제작하였으며 TDR 신호에 미치는 효과를 분석하였다. 실험 결과, 꼬임형 센서는 평행한 띠 형상의 센서에 비해 평활한 신호 취득이 가능하였으며 최적 꼬임 횟수는 단위길이 당 10회 이상인 것으로 나타났다. 절연 피복두께의 경우 적정 민감도 확보가 가능한 절연 피복부재의 두께는 도선직경의 80%~120%로 확인되었다. 누수 위치 추정을 위해 회귀분석 실시 결과, 결정계수는 0.9998로 실제 누설 위치와 높은 상관관계를 나타내었다. 결과적으로 제안된 TDR 기반의 누수 감지용 꼬임형 센서는 해수 배관 시스템의 누수 감시 센서로의 충분한 적용성을 확인하였다.

• Archives of Reconstructive Microsurgery
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• 제9권1호
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• pp.15-22
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• 2000

One hundred & seventy four consecutive free-flap transfers were reviewed to analyze distribution of the type of reconstructions, kinds of donor flaps as well incidence of complications. The role of emergent exploration and the effect of preoperative wound conditions in flap survival were evaluated. Free flap transfer for head and neck reconstruction was most common as 93 cases, followed by for upper extremity of 30 cases, for lower extremity 30 cases, 18 penile reconstructions and for trunk & breast 3 cases. Nine flaps exhibited signs of ciruclatory insufficiency between 5 hours and 7 days. Three were managed conservatively with ultimate partial necrosis of the flaps. Eight flaps required return to the operating room. On exploration, early arterial occlusion was revealed in 1 flap, late arterial occlusion in 2 flaps, early venous occlusion in 1 flap, late venous thrombosis in 2 flaps, prolonged venous spasm in 1 and hematoma in 1 flap. The average time from the first abnormal examination to exploration was 2.6 hours. There were no false-positive explorations. Four free flaps failed in spite of the correction of the cause of circulatory compromise. The remaining 4 flaps were salvaged following the correction the casuse. Recipient vessel problems such as irradiation and infection were the most common cause of circulatory crisis. Among the eight flaps requiring return to the operating room, single vein was anastomosed in three flaps and two veins in the remaining five. In the totally failed four flaps only single vein was anastomosed in three cases. The results of this study demonstrate the efficacy of clinical monitoring and the role of early exploration. Precautious selection of recipient vessels and two vein anastomosis are recommended for safe and better prognosis.

• Archives of Plastic Surgery
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• 제45권1호
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• pp.45-50
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• 2018

Background Free muscle flaps are a mainstay for reconstruction of distal third leg wounds and for large lower extremity wounds with exposed bone. However a major problem is the significant postoperative flap swelling, which may take months to resolve. We studied the efficacy and safety of immediate application of a vacuum assisted closure (VAC) dressing after a free muscle flap to the lower extremity. Methods Over a 19 months period, all consecutive free muscle flaps for lower extremity reconstruction at a Level I trauma center were evaluated prospectively for postoperative flap thickness, complications and flap survival. Immediate application of a VAC dressing was performed in 9 patients, while the flap was left exposed for monitoring in 8 patients. Results There was no statistically significant difference in flap survival between both cohorts. Mean flap thickness at postoperative day 5 for the VAC group was $6.4{\pm}6.4mm$, while flap thickness for the exposed flap group was $29.6{\pm}13.5mm$. Flap thickness was significantly decreased at postoperative day 5 for the VAC dressing group. Conclusions Immediate application of VAC dressing following free muscle flaps to the lower extremity does not compromise flap survival or outcomes and results in decreased flap thickness and a better aesthetic outcome.

• Archives of Plastic Surgery
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• 제48권5호
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• pp.553-558
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• 2021

The diagnosis of the main complications resulting from lipoabdominoplasty has not yet been standardized. Infrared thermal imaging has been used to assess possible complications, such as necrosis and changes in micro- and macro-circulation, based on perforator mapping techniques, among others. The objective of this study was to present two clinical cases involving thermal imaging monitoring of the healing process of lipoabdominoplasty in the immediate postoperative evaluation and its preliminary results. Infrared thermography was performed 24 hours after the operation and on postoperative days 5, 25, and 27. In clinical case 1, it was found that the delta-R (∆T_R)-defined as the difference in minimum temperature between the highest and lowest points in the SA3 region (caution suction area) following the classification established by Matarasso-was 0.4℃ at 24 hours after surgery and decreased to 0.1℃ on a postoperative day 5. There were no complications in this case. In contrast, in clinical case 2, the ∆T_R was 1.7℃ at 24 hours after surgery (upon hospital discharge) and remained high, at 2.2℃, on postoperative day 5. A higher ∆T_R was found in the second patient, who developed necrosis of the surgical wound. The ∆T_R thermal index may be a new tool for predicting possible complications, complementing the clinical evaluation and therapeutic decision-making.

• 한국컴퓨터정보학회논문지
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• 제24권3호
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• pp.175-179
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• 2019

This study is a descriptive research of paramedic students who could be exposed to blood and body fluids during the clinical practicum to analyze the risk factors. From June 1 to June 30, 2018, 172 paramedic students who attended the University in Jeolla-do region were analyzed. The collected data were analyzed by using the SPSS WIN 21.0 program. The general characteristics of subjects, the exposure level of blood and body fluids, and etc were obtained for frequency and percentage analysis. The study found that 72.7 percent of students had experience to blood or body fluids exposure during the clinical practicum. Except for any needle injury, 70.4 percent of student were exposed to blood or body fluids. 28.8 percent of them which was the highest percentage of injection injury were exposed during the venous blood draw. 36.5 percent of exposure were related to wound dressings which was the highest percentage related to clinical procedures. 71.2 percent of students mentioned that they did not report this exposure because 68.5 percent students thought that it has no danger. According to the survey on hepatitis B, 50.6% of students had antibodies, but 31.8 percent of students did not confirm that the antibodies were formed. Even though paramedic students do practical training in a hazardous environment with repeated exposure to blood and body fluids due to the nature of job characteristics, the systemic infection control education program is insufficient. In order to prevent exposure and to protect paramedic students who do practical training with patients, it is necessary to make more systematic and active efforts in the continuous monitoring and the preventive education.

• 임상간호연구
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• 제15권1호
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• pp.107-122
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• 2009

Purpose: The purpose of this study was to identify nursing interventions frequently used with cancer patients. Nursing records from 5 general hospitals for patients with stomach, liver, lung or colon cancer were analyzed. Method: A descriptive study methodology was used and nursing records for 15 patients in each disease category at each hospital, who were admitted and discharged during June 2007 were analyzed. Results: Five domains of NIC were found and the physiological(basic) domain was most frequent (31.52%). Twenty two classes of NIC were identified with risk management for safety being most frequent (22.49%). For the 119 nursing interventions identified, the most frequent was pain management with 7,827 (12.31%), followed by prevention of falls (11.76%), surveillance (6.79%) and wound care (5.12%). Nursing activities of pain management and prevention of falls were comparable to activities listed in literature on guidelines for evidence based and best practices in nursing care. Eight of the 17 nursing activities for pain management, and 9 of 14 for fall prevention were consistent with these guidelines. Conclusion: In this study, nursing interventions were found to be focused on physical care, monitoring patients' condition and education. We have to develop diverse nursing interventions and a convenient recording process.

• 농업과학연구
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• 제48권4호
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• pp.1003-1013
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• 2021

Thioredoxin (TRX) protein is an antioxidant responsible for reducing other proteins by exchanging cysteine thiol-disulfide and is also known for its anti-allergic and anti-aging properties. On the other hand, epidermal growth factor (EGF) is an important material used in the cosmetics industry and an essential protein necessary for dermal wound healing facilitated by the proliferation and migration of keratinocytes. EGF also assists in the formation of granulation tissues and stimulates the motility of fibroblasts. Hence, genetically modified soybeans were developed to overexpress these industrially important proteins for mass production. A single-dose oral-toxicity-based study was conducted to evaluate the potential toxic effects of TRX and EGF proteins, as safety assessments are necessary for the commercial use of seed-specific protein-expressing transgenic soybeans. To achieve this rationale, TRX and EGF proteins were mass purified from recombinant E. coli. The single-dose oral-toxicity tests of the TRX and EGF proteins were carried out in six-week old male and female Institute of Cancer Research (ICR) mice. The initial evaluation of the single-dose TRF and EGF treatments was based on monitoring the toxicity signatures and mortality rates among the mice, and the resultant mortality rates did not show any specific clinical symptoms related to the proteins. Furthermore, no significant differences were observed in the weights between the treatment and control groups of male and female ICR mice. After 14 days of treatment, no differences were observed in the autopsy reports between the various treatment and control groups. These results suggest that the minimum lethal dose of TRX and EGF proteins is higher than the allowed 2,000 mg·kg^-1 limit.