We report a case of delayed chest wall reconstruction after thoracotomy. A 53-yearold female, a victim of a motor vehicle accident, presented with bilateral multiple rib fractures with flail motion and multiple extrathoracic injuries. Whole-body computed tomography revealed multiple fractures of the bilateral ribs, clavicle, and scapula, and bilateral hemopneumothorax with severe lung contusions. Active hemorrhage was also found in the anterior pelvis, which was treated by angioembolization. The patient was transferred to the surgical intensive care unit for follow-up. We planned to perform surgical stabilization of rib fractures (SSRF) because her lung condition did not seem favorable for general anesthesia. Within a few hours, however, massive hemorrhage (presumably due to coagulopathy) drained through the thoracic drainage catheter. We performed an exploratory thoracotomy in the operating room. We initially planned to perform exploratory thoracotomy and "on the way out" SSRF. In the operating room, the hemorrhage was controlled; however, her condition deteriorated and SSRF could not be completed. SSRF was completed after about a month owing to other medical conditions, and the patient was weaned successfully.
Park, Eunyoung;Sim, Bo Min;Kim, Yoon Seo;Kang, Min Ju
Human Ecology Research
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v.59
no.2
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pp.233-243
/
2021
This study examined the longitudinal effects of media usage by early school-age children and of maternal parenting stress on children's school adjustment. The study focused on the mediating effect of executive function difficulty. Longitudinal data to examine the hypothetical model were drawn from the eighth (2015) through tenth (2017) waves of the Panel Study of Korean Children (PSKC) collected by the Korea Institute of Child Care and Education (KICCE). A total of 581 children (293 boys and 288 girls) and their mothers were included. Confirmatory factor analysis, structural equation model, and bootstrapping analysis were applied using SPSS 25.0 and Amos 26.0. The results are as follows. First, no significant correlation was found between early school-age children's media usage and maternal parenting stress. Second, neither media usage by early school-age children nor maternal parenting stress were found to directly affect children's school adjustment. Third, media usage by early school-age children and maternal parenting stress were shown to indirectly affect children's school adjustment via executive function difficulties. In other words, higher levels of media usage by early school-age children and maternal parenting stress during the first grade lead to greater executive function difficulties after a year, which, in turn, lead to a lower level of school adjustment in the third grade. This study indicates the need to develop practical support for the psychological wellbeing of mothers while they are performing their role as a parent and for children in maintaining suitable levels of media usage during early childhood.
Park, Jang-Soon;Yu, Seung-Hum;Sohn, Tae-Yong;Park, Eun-Cheol
Korea Journal of Hospital Management
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v.8
no.1
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pp.112-134
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2003
The purpose of this study is to analyze the consumer's expectation before the health care service and the consumer's satisfaction after it. The participants of the study are inpatients in a general hospital located in Seoul. The resources were collected from the self-administration questionnaire survey run parallel with face to face interview. In order to measure the degree of the consumer's expectation, 349 samples were collected from the first questionnaire survey on the date of admission to the hospital. The second questionnaire survey was carried out on the date of discharge to the hospital with the participants responding to the first questionnaire survey. There are 154 samples collected from this survey. The results from the analysis of these resources are as follow. First, the survey shows that one of the highest consumers' expectations was about the generosity, kindliness and sincerity from the staff at the hospital, specially from doctors. Second, according to the analysis of the factors affecting the expectations of the consumers, with regard to path of admission to a hospital relating to patient's features, outpatient who gets into a hospital expected good medical care much more than the other patients. In regard of doctor's features, patients usually and highly expect good medical care from doctors who have good carrier and much experience. Third, according to the second questionnaire survey, what patients are satisfied most with is about the generosity and sincerity from staff at a hospital, especially from doctors and their gem attitudes. The results from survey show that the differences among the degree of consumers' satisfaction are very variable, depending on surrounding environments and facilities. The only fact that expectation didn't meet with satisfaction appeared to the case about technology and skill of medical care and the case about updated medical skills and equipments. Fourth, comparing the degree of expectation with the degree of satisfaction of consumers, correlative analysis was concerned significantly and specifically about the part of overall cleanliness relating to facilities and surrounding environments, the items about medical examination and test plan procedure relating to skill of medical care, professional specialties and convenience for procedure, and the items about satisfying explanations and concern about patients from doctors relating to staff's generosity and sincerity. Fifth, the analysis of the factors affecting the degree of how much patients are satisfied with shows that relating to sociodemographical features, patients are not satisfied with the case when the time and process of medical treatment are getting longer. It is surveyed that consumer were satisfied with the motivation to visit a hospital and the insurance type in patient's feature and so were the medical department and the factor of the degree of the expectation in disease's feature. Sixth, according to analysis based on the survey, patients would join again a hospital when they get satisfaction from the medical care and also they want to come again regarding to doctor's capability. For example, when doctors are old, have a good carrier and much experience, patients would come again. As seen from the above, consumers are usually satisfied with the medical treatment more than that they expected before. They would intend to use again when they get satisfaction from the medical care provided at a hospital. Patients and consumers highly expect good attitude as well as capacity from medical doctors and they are also generally satisfied with those things. Therefore, in order to increase the degree of consumer's satisfaction and their intention to come again, the hospital staff would have to commit themselves to achieve high quality service continuously and would have to make an effort to offer the finest quality service.
Journal of agricultural medicine and community health
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v.28
no.2
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pp.87-105
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2003
Objectives: The purpose of this study was to examine the health care utilization pattern and its related factors of low-income population with abnormal results through health examination. Methods: Analysed data were collected through a questionnaire survey, which was given to 263 persons who 30 years or over with abnormal results through health examination at Health Center. This survey was conducted in March, 2003. This study employed Andersen's prediction model as most well known medical demand mode and data were analysed through 2-test, and multiple logistic regression analysis. Results: The proportion of medical utilization for thorough examination or treatment among study subjects was 51.0%. In multiple logistic regression analysis as dependent variable with medical utilization, the variables affecting the medical utilization were 'feeling about abnormal result(anxiety versus no anxiety: odds ratio 2.25, 95% confidence intervals 1.07-4.75)', 'type of health security(medicaid type I versus health insurance: odds ratio 2.82, 95% confidence intervals 1.04-7.66; medicaid type II versus health insurance: odds ratio 3.22, 95% confidence intervals 1.37-7.53)', 'experience of health examination during past 2 years(odds ratio 2.39, 95% confidence intervals 1.09-5.21)' and 'family member's response for abnormal result(recommendation for medical utilization versus no response: odds ratio 4.90, 95% confidence intervals 1.75-13.75; family member recommended to utilize medical facilities with him/her versus no response: odds ratio 19.47, 95% confidence intervals 5.01-75.73)'. The time of medical utilization was 8-15 days after they received the result(29.9%), 16-30 days after they receive the result(27.6%), 2-7 days after they received the result(20.9%) in order. The most important reason why they didn't take a medical utilization was that it seemed insignificant to them(32.4%). Conclusions: In order to promote medical utilization of low-income population, health education for abnormal result and its management would be necessary to family member as well as person with abnormal result. And follow-up management program for person with abnormal result through health examination such as home-visit health care would be necessary.
Journal of Korean Home Economics Education Association
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v.12
no.2
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pp.65-79
/
2000
The purpose of this study was to suggest the most effective method of group formation necessary fro the cooperative learning of the home economics in the middle school. For this purpose, 12 classes students in the 3rd grade of a middle school in Inchon City have been divided as 3 groups: 4 classes were consisted of the groups by the records, 4 classes by close friend. and 4 classes by lot. The STAD method of the cooperative learning methods has been evenly introduced to all 12 classes for 10 hours in 10 weeks. After those sessions. some questionnaires asking . and were collected from all students, Data, which were analyzed by the method of group formation for male and female students groups, showed following results: 1. The most effective group forming method was the group consisted by lot. This group was more effective than the group by close or the group by records. 2. While male students were influenced by the group forming method in the cooperative learning. female students were not. 3. More activity of the groups resulted more effects of the cooperative learning and made more positive attitude to the study of the home economics, and thus. teachers should care for the activity of each to make the students cooperative and to activate in the class.
Based on residents' survey data in Seoul, this study attempts to empirically answer to four research questions regarding neighborhood relations (NR) which are necessary for community building: How important NR is compared to other social relations, what factors establish NR, how large NR's geographical extent is, and what are major meeting places among neighbors. A series of statistical analyses demonstrates that characteristics of NR vary greatly by family life cycle. In the stage of couple without child, NR has no significant meaning. NR becomes important from the stage of child care, and it is formed through the medium of children, particularly children's schools in the stage of child of elementary school as well as secondary schools. As the result, NR's geographical boundary extends beyond residential block or multi-family housing (apartment) estate while cafe and restaurant serve as dominant meeting places in these life cycle stages. On the contrary, after children are married and leave home, casual encounters resulted from spatial proximity become an important cause of NR. Likewise neighbors' geographical distribution is relatively concentrated within residential block or apartment estate, while community facilities play a role of meeting places as originally planned and designed.
Kim, Gwang-Suk;Cho, Yoon-Hee;Ra, Jin-Suk;Park, Ju-Young
Journal of Korean Public Health Nursing
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v.22
no.2
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pp.211-223
/
2008
Purpose: The principal objective of this study was to assess correlations among the self-efficacy, social support networks, and health behavior of undergraduate students. Methods: The data were collected via questionnaires that investigated self- efficacy, social support networks, health behaviors, health-related factors, and general characteristics. A total of 310 subjects were selected and evaluated for a 3-week period. The data of 300 subjects were analyzed using descriptive analysis, t-test, ANOVA, and correlation, after 10 questionnaires had been excluded due to incomplete data. Results: We noted significant differences and impacts on self-efficacy according to the grade, perceived health status, and BMI. Social support networks differed significantly according to dwelling type and pocket money. Health behavior differed depending on the gender, major, dwelling type, religion, health status, and BMI. We noted a significant positive correlation between self-efficacy & social support networks, and between social support networks & health behavior, but we noted no significant correlation between self-efficacy & health behavior. Conclusion: Health care providers should focus on self-efficacy and social support networks in order to prevent bad health behavior among undergraduates.
Objective : The present study attempts to address the change of management results over time during the past 13 years in good-grade patients with intracranial aneurysm. Methods : Six hundred twenty five [Hunt-Hess grade I to III] out of 826 patients with ruptured intracranial aneurysms operated by the same operator within 3 days after the attack from 1990 to 2002 were selected. Since 1998, endovascular aneurysmal occlusion was done in selected cases of 21 patients. The change of management results over time, including rebleeding rate, delayed ischemic neurologic deficit[DIND] as a cause of morbidity and mortality and surgical outcome were examined. Results : The ratio of poor-grade patients in all patients tended to decrease over the years. The early rebleeding rate declined from 5.0% to 1.2% with the use of tranexamic acid and computed tomography angiogram DIND as a cause of mortality and morbidity has decreased from 12.5% in 1990 to approximately 0% currently. Surgical outcome began to improve significantly in 1994 [poor outcome : 25% in 1990, 12.2% in 1994,6.8% in 2002]. Conclusion : These results suggest that the advances in care and increased experience of the operator significantly affect the change of overall outcome, and early detection of the aneurysm is needed for reducing the ratio of poor-grade patients.
Kim, Hyeun-Sung;Ju, Chang-Il;Kim, Seok-Won;Kim, Jong-Gue
Journal of Korean Neurosurgical Society
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v.45
no.3
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pp.192-195
/
2009
We present a case of an acute psoas muscle hematoma following percutaneous endoscopic lumbar discectomy. A 60-year-old female who presented with far lateral lumbar disc herniation underwent endoscopic discectomy on the right side at the L4-5 level. On the second postoperative day, the patient complained of severe right flank and leg pain and her blood pressure decreased. A computed tomography scan showed a large acute psoas muscle hematoma at right L4-5 level. The patient was transfused with packed red blood cells and placed at absolute bed rest. After observing the patient in intensive care, the severe flank and leg pain subsided, but the mild back pain persisted. Although percutaneous endoscopic lumbar discectomy is an effective minimally invasive surgical technique for the treatment of lumbar disc herniation, this case highlights the inherent risks of acute lumbar segmental vessel injury.
Journal of the Korean Society of Physical Medicine
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v.2
no.2
/
pp.135-142
/
2007
Purpose : To investigate the effectiveness of local vibration and interferential therapy for patient with acute low back pain. Methods : A randomized trial designed to compare interferential therapy and local vibration therapy for acute low back pain in primary care setting Results : A total of 60 patients were recruited. The two treatment groups had similar demographic and clinical baseline characteristics. The mean VAS scores before treatment was 8.290 for interferental therapy group and 8.572 for local vibration therapy groups. After treatment, this VAS score had dropped to 4.812(interferental therapy group, at 7 days), and 4.945(local vibration group, at 7 days). Conclusion : This study shows a progressive fall in visual analog scale scores in patients with acute low back pain treated with either interferential therapy and local vibration therapy. There was some difference in the improvement between the two groups at 1 to 4 days, VAS score of vibration therapy groups was low better than interferential therapy groups.
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