• Journal of Preventive Medicine and Public Health
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• 제17권1호
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• pp.5-24
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• 1984

There has been an immense need for elaborate studies on the complications and the neuological sequelae generated by acute carbon monoxide (CO) poisoning which is highly prevalent in Korea due to widespread adoption of the anthracite coal briquette as domestic fuel for heating and for cooking. For this epidemiological study, a total of 444 subjects who received hospital emergency care for acute CO poisoning during the period of March 1982 to February 1983 were randomly selected from the emergency patients's lists of 13 general hospitals in Seoul area. Informations on the neurological sequelae were elucidated by means of home visiting with prearranged questionnaire consisting questions and concise neurological examination. The findings obtained were summarized as follows; 1. The complications were found in 18% of the surveyed and acute decubitus was comprised 67.5% of the complications. 2. The total cumulative incidence of the neurological sequelae was 41.2 per 100 patients and the absolute incidence rate regardless of the duration after poisoning was 40.8%. 3. The incidence of the neurological sequelae was higher in the older age than in the younger and also higher in female than in male. Twice higher incidence was observed in the admitted patients than in the non-admitted patients and the incidence became higher in proportion to the duration of CO exposure, coma and admission. The poorer the consciousness level of patients found, at emergency room and at discharge, the higher the incidence. The incidence of the neurological sequelae by emergency care was higher in hyperbaric oxygen therapy group(51.9%) than in 100% $O_2$ group(38.0%) 4. A total of five variables significantly associated with the occurrence of the neurological sequelae were selected by the stepwise discriminant analysis. The variables were following course of emergency care, age, consciousness level at discharge, admission duration, and consciousness level at emergency room in their sequence of discriminant power. Eight variables were selected as those associated with the degree of the neurological sequelae through the stepwise multiple regression analysis. Of these variables, the acute decubitus alone explained 21.1% of the total variation ana all the eight variables could explain 36.5% of the same. The remaining seven variables listed in the order of their relative importance were: age, consciousness level at discharge, admission duration, coma duration and consciousness level at emergency room. 5. It was postulated that unexpectedly high incidence of the neurological sequelae of the CO poisoning in this epidemiological study was mainly due to the inadequate emergency care and the lack of efficient and sophisticated treatment measure. In the effort to minimize the incidence of grave neurological sequelae of acute CO poisoning, new guidelines for the emergency care and treatment should be pursued with efficient ways.

• 대한간호학회지
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• 제39권5호
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• pp.741-750
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• 2009

Purpose: The purpose of this study was to identify the prevalence of cognitive impairment, behavioral problems, and the state of mental health for elderly Korean people who have been institutionalized. Methods: A cross-sectional, nationwide survey was performed using an anonymous questionnaire. The participants in this study were 2,521 institutionalized elderly Korean people. A proportional stratified random sampling method was employed. Results: 1) Elders admitted to subacute hospitals and long term care (LTC) facilities showed a higher level of cognitive impairment compared to elders admitted to acute care hospitals. 2) Elders confined in LTC facilities showed a higher level of behavioral problems compared to elders in acute or subacute hospitals. 3) Elders admitted to subacute hospitals and LTC facilities showed more serious mental health problems, such as depression or suicidal ideation, compared to elders in acute care hospitals. Conclusion: The results of this study indicate that the severity of cognitive-behavioral or mental health problems do not match well with type of care setting. Therefore, health personnel working with elderly people should be provided guidance on detection and management of cognitive-behavioral and mental health problems. The necessity of a decision support system for eligibility and placement in long-term care is also discussed.

• Clinical and Experimental Pediatrics
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• 제58권4호
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• pp.154-157
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• 2015

Plastibell is one of the three most common devices used for neonatal circumcision in the United States, with a complication rate as low as 1.8%. The Plastibell circumcision device is commonly used under local anesthesia for religious circumcision in male neonates, because of cosmetic reasons and ease of use. Occasionally, instead of falling off, the device may get buried under the skin along the shaft of the penis, thereby obstructing the normal flow of urine. Furthermore, the foreskin of neonates is highly vascularized, and hence, hemorrhage and infection are possible when the skin is cut. Necrosis of penile skin, followed by urethral obstruction and renal failure, is a serious surgical mishap requiring immediate corrective surgery and medical attention. We report a case of fulminant urosepsis, acute renal failure, and pyelonephritis in a 4-day-old male neonate secondary to impaction of a Plastibell circumcision device. Immediate medical management was initiated with fluid resuscitation and mechanical ventilation; thereby correcting life threatening complications. Pediatricians and Emergency Department physicians should be cognizant of the complications from Plastibell circumcision device in order to institute appropriate and timely management in neonates.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제30권1호
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• pp.34-42
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• 2004

The appropriate care to the dental emergency patients is much important in the aspect of community dental service. To attain such a purpose, the sacred duty of the training of oral and maxillofacial surgeons is required. So, a retrospective study on the characteristics of dental injuries and diseases in emergency care unit will be very meaningful. This study was carried by reviewing the charts and radiographic films of 3,394 patients, treated for dental emergency at Wonju Christian Hospital, Republic of Korea, from January 1, 1993 to December 31, 2002. All patients were classified to 6 groups including trauma, toothache, infection, hemorrhage, TMJ disorder and the others. The clinical characteristics of diseases and treatment modalities according to each group were analyzed. The trauma (73.9%) was the most frequent cause in dental emergency patients, and acute toothache, odontogenic infection, oral hemorrhage, and TMJ disorder were next in order. Gender prediction was male (68%), there were many patients on May and December in the monthly frequency, and the most frequent age group was from 0 to 9 years. In the trauma group, male (68.6%) was predominant, and soft tissue injuries and primary closures were the most frequent type of injury and treatment. In jaw fractures, traffic accidents were the most cause and the weakest site was mandibular symphysis area, and mandibular angle, condyle, and body area were next in order. In the acute toothache group, the cause was dental pulpitis mostly and treatment for that was drug administration mainly. Buccal space abscess in infection group had the largest incidence (24.5%), and common treatments were incision and drainage and medications. In the hemorrhage group, a major cause was postoperative bleeding (60.3%) and hemostasis was obtained by pressure dressing, curettage and suture. For the TMJ disorder group, the peak incidence (63.8%) was shown in the post-traumatic myofascial pain dysfunction syndrome and its primary care was medication such as analgesics and sedatives. In the other group, the various specific symptoms were complained due to acute sialadenitis, trigeminal neuralgia, acute stomatitis, chemical burn, terminal stage neuritis of head and neck cancer, and foreign body aspiration. In conclusion, for the rapid and proper care of the emergency dental diseases, well-trained education should be presented to the intern and resident course of oral and maxillofacial surgery. And it is demanded that oral and maxillofacial surgeons must be prepared in knowledge and skill for such emergency care.

• Tuberculosis and Respiratory Diseases
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• 제79권2호
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• pp.53-57
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• 2016

Severe sepsis or septic shock is characterized by an excessive inflammatory response to infectious pathogens. Acute respiratory distress syndrome (ARDS) is a devastating complication of severe sepsis, from which patients have high mortality. Advances in treatment modalities including lung protective ventilation, prone positioning, use of neuromuscular blockade, and extracorporeal membrane oxygenation, have improved the outcome over recent decades, nevertheless, the mortality rate still remains high. Timely treatment of underlying sepsis and early identification of patients at risk of ARDS can help to decrease its development. In addition, further studies are needed regarding pathogenesis and novel therapies in order to show promising future treatments of sepsis-induced ARDS.

• Childhood Kidney Diseases
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• 제24권1호
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• pp.19-26
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• 2020

Acute kidney injury (AKI) is common in critically ill children, and is associated with increased mortality and long-term renal sequelae. The definition of pediatric AKI was standardized based on elevation in serum creatinine levels or decrease in urine output; accordingly, epidemiological studies have ensued. Although new biomarkers appear to detect AKI earlier and predict prognosis more accurately than traditional markers, they are not frequently used in clinical setting. There is no validated pharmacological intervention for AKI, so prevention and early detection are the mainstays of treatment. For high risk or early stage AKI patients, optimization of volume status and blood pressure, avoidance of nephrotoxins, and sufficient nutritional support are necessary, and have been demonstrated to be effective in preventing the occurrence of AKI and improving prognosis. Nevertheless, renal replacement therapy is needed when conservative care fails.

• 대한신경집중치료학회지
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• 제11권2호
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• pp.129-133
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• 2018

Background: A few cases of moyamoya syndrome associated with thyrotoxicosis have been reported. However, studies on the association of hyperthyroidism with moyamoya syndrome are insufficient. Case Report: Here we report a case of hyperthyroidism associated with moyamoya syndrome in a 41-year-old woman with aphasia and right side weakness. Brain imaging revealed acute cerebral infarction of left middle cerebral artery territory and occlusion of bilateral distal internal carotid arteries. Conclusion: Antithyroid medication stabilized the patient's neurologic deterioration, suggesting that thyrotoxicosis could aggravate acute cerebral infarction caused by moyamoya syndrome.

• Journal of Hospice and Palliative Care
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• 제20권1호
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• pp.37-45
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• 2017

목적: 본 연구의 목적은 요양병원 간호사의 죽음불안과 임종간호 수행정도와의 관련성을 파악하여 임종간호 교육의 기초자료를 제공하기 위함이다. 방법: 대상자는 B광역시 전체 111개 요양병원 중 건강보험심사평가원의 적정성 평가에서 1등급 판정을 받은 12개 요양병원에서 6개월 이상 근무한 148명의 간호사로서 2016년 3월16일부터 5월16일까지 자료를 수집하였다. 자료는 SPSS Win 18.0 프로그램을 이용하여 t-test, one-way ANOVA, $Scheff{\acute{e}}$ 사후검정 및 Pearson's correlation coefficient로 분석하였다. 결과: 타인의 죽음에 대한 불안과 자신이 죽어가는 존재라는 것에 대한 불안 정도가 높을수록 임종간호 수행도가 높았다. 결론: 요양병원 간호사의 죽음불안을 감소시키고 임종간호 수행을 향상시키기 위해 체계적인 임종간호 교육프로그램을 개발하여 적용하는 것이 필요하다.

• 임상간호연구
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• 제29권1호
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• pp.56-66
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• 2023

Purpose: This study aimed to investigate whether the comprehensive nursing care service positively affected accidental falls and pressure injuries. Methods: This study was a retrospective study that analyzed the accidental falls and pressure injuries cases in an acute care hospital located in Seoul and compared the rates of accidental falls and pressure injuries before and after the comprehensive nursing care service was operated. Results: Comparing the accidental fall incidence rates per 100 person-months between a comprehensive nursing care ward and a general ward, it showed fewer accidental falls by 0.44 in comprehensive nursing care wards, but the result was not statistically significant. In the case of pressure ulcers, the incident rate per 100 person-month was 6.17 in general wards and 4.77 in comprehensive nursing care wards, which showed that the number of pressure ulcer patients was lower in comprehensive nursing care wards, however it was also not statistically significant. Conclusion: It is not confirmed that the operation of the comprehensive nursing care service contributes to the reduction of accidental hospital falls or pressure injuries. Follow-up studies are recommended to determine the effectiveness of comprehensive nursing services in quality indicators.

• 가정∙방문간호학회지
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• 제31권2호
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• pp.136-146
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• 2024

Purpose: This study aimed to identify the influence of marital conflict and family function on fatigue in mothers of young children hospitalized for acute diseases. Method: Via a cross-sectional design utilizing structured questionnaires, fatigue, marital conflict, and family function data of 120 South Korea mothers of such hospitalized children were collected and surveyed. The data were analyzed via t-test, ANOVA, Pearson's correlation coefficients, and multiple regression using SPSS Statistics. Results: Fatigue level was found to positively correlate with marital conflict and negatively correlate with family function. Overall, marital conflict, was significant predictor of maternal fatigue, explaining 33.0% of the model, with physical fatigue level being the highest type of fatigue. Conclusion: Therefore, a family-centered care program for families of hospitalized children needs to be developed. Comprehensive family nursing interventions that reduce fatigue levels and help reinforce marital relationships in families of hospitalized children are essential.