• Title/Summary/Keyword: care and repair

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Comparison of Infective Endocarditis between Children and Adults with Congenital Heart Disease: A 16-Year, Single Tertiary Care Center Review (선천성 심장병을 가진 소아와 성인에서 발생한 감염성 심내막염의 비교: 1개 3차 병원의 16년간 경험)

  • Kwon, Jung Eun;Kim, Yeo Hyang
    • Pediatric Infection and Vaccine
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    • v.23 no.3
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    • pp.209-216
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    • 2016
  • Purpose: This study aimed to evaluate and compare the characteristics of infective endocarditis (IE) between children and adults with congenital heart disease (CHD) at a single tertiary care center. Methods: In this retrospective medical record review, we extracted the demographic characteristics, diagnostic variables, and outcomes of patients diagnosed with IE and CHD between 2000 and 2016. Results: We identified a total of 14 pediatric patients (nine male; median age at diagnosis, 3 years). Of the 14 patients, six had a history of previous open heart surgery, while four had undergone tetralogy of Fallot repair, with transannular patch or Rastelli procedure. Among the 10 children with positive blood cultures, the most common isolated organism was Staphylococcus spp. (8/10, 80%). Eleven adult patients had IE and CHD. Among the adult patients, only four were diagnosed with CHD before IE, and ventricular septal defect was the most common CHD. The most common isolated organism was Streptococcus spp. (6/11, 55%). Compared with adult patients, pediatric patients had a higher incidence of previously diagnosed CHD (P=0.001), with Staphylococcus spp. as the causative organism (P=0.027). The median duration between the onset of symptoms and diagnosis of IE was 9 days in children and 42 days in adults (P=0.012). Conclusions: Significant differences with regard to the diagnosis and progress of IE were observed between children and adults. Age-adjusted and systematic reassessment may be necessary for the diagnosis and management of IE.

Concept Map Development of 'Eco-friendly Clothing Life and Reform Clothes' Unit in Middle School Technology·Home Economics Textbooks Based on 2009 Revised Curriculum (2009 개정 기술·가정 교과서 '친환경적 의생활과 옷 고쳐입기' 단원의 개념도 개발)

  • Yang, Ji Sun
    • Journal of Korean Home Economics Education Association
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    • v.29 no.3
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    • pp.161-183
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    • 2017
  • The purpose of this study is to develop a concept map in a visual instructional strategy so that meaningful learning can be done by structuring knowledge in the section of eco-friendly clothing life and reform clothes. For this purpose, ten textbooks for the 2009 revised were analyzed, and 10 sub-area were selected to develop the concept map. The development was done by using Cmap Tools V6.02 and the study process has progressed content analysis, concept extraction, and concept map development. The analysis process and results of this study are as follows. First, in the course of setting standards, the analytical standards were set for the 2007 revision and 2009 revision curriculum achievement standards. Second, in the process of content analysis and concept extracting, through the analysis of textbooks, 'clothing selection and purchase', 'clothing care and management' and 'clothing reuse and eco-friendly'. The concept was extracted by subdividing on the basis of general and comprehensive core concepts. Third, the development process of concept map was developed and revised based on the extracted concepts, and the concept map developed was the 'clothing purchase plan', 'points to consider when buying clothing' 'quality', 'handle with care', 'classify laundry', 'remove stain', 'water washing', 'repair clothing', 'reform clothing', 'eco-friendly clothing life'.

A Study on the Actual Condition of Community-Oriented Services, Focusing on Senior Well-Being Villages (지역사회서비스 네트워크 모형 개발을 위한 실태조사 - 농촌건강장수마을을 대상으로 -)

  • Yoon, Seong-In;Park, Gong-Ju;Yoon, Soon-Duck
    • The Korean Journal of Community Living Science
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    • v.17 no.4
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    • pp.67-80
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    • 2006
  • This study conducted research on the actual state of community-oriented services for elderly rural inhabitants and their desire related to them to develop a local community service network model suitable to the characteristics of rural longevity villages. The research was conducted on 906 elderly people over 65 living in 20 rural longevity villages through questionnaires assessing filming and economy, economic activity, health care, learning and leisure activities as well as asking their wants and needs relative to local community services. As a result, it was found rural elderly people showed a high desire for local community services such as health, transportation and economy activity. In addition, they were mainly cultivating farm products as their economic activity and showed a high demand in the future as well. Most were found to take a walk in the healthcare field and showed a high demand for health examinations, health education, health consulting, hot spring bathing and basking in the woods. Respecting learning, social and leisure activities, they were mostly found to watch TV and do house chores, and showed a high desire for village environment repair, traditional farm music, visiting and tourism. With the above results, it is expected that the desire of rural elderly for such services can be satisfied, and the development of a local community service network model suitable to the characteristic of a local community is recommended.

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Semitendinosus Muscle Transfer Flap for the Treatment of Canine Fecal Incontinence

  • Cho, Hyoung-sun;Lee, Dong-bin;Kwon, Yong-hwan;Kim, Young-ung;Kang, Jin-su;Lee, Ki-chang;Kim, Nam-soo;Kim, Min-su
    • Journal of Veterinary Clinics
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    • v.33 no.2
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    • pp.131-134
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    • 2016
  • A 4-year-old intact female Maltese was referred to the Animal Medical Center of Chonbuk National University with a history of consistent fecal incontinence over 4 months following sacculectomy surgery. We suspected that anal sacculectomy resulted in loss of the external anal sphincter. On physical examination, the external anal sphincter muscle on the left side was intact, while the external anal sphincter muscle on the right side could not be detected and exhibited severe laceration. To repair the defect, the left semitendinosus muscle was transposed around the anus. The left semitendinosus muscle was isolated and transected near the stifle, reflected dorsally and passed around the ventral rectum into the pararectal fossa. Care was taken to preserve the integrity of the vasculature and nerve supply. The muscle was secured dorsally with simple interrupted sutures to the levator ani and coccygeus muscles to simulate the external anal sphincter. Nine days after surgery, the dog was defecating normally with no evidence of incontinence. The use of semitendinosus muscle flaps is a good option for the treatment of fecal incontinence secondary to loss of sphincter muscle in dogs.

Surgical Treatment of a Submitral Left Ventricular Aneurysm and the Patient Present with Recurrent Ventricular Tachycardia (재발성 심실성 빈맥이 동반된 승모판하 좌심실류의 외과적 치료)

  • Kim, Young-Sam;Cho, Jung-Soo;Yoon, Yong-Han;Kim, Joung-Taek;Baek, Wan-Ki;Kim, Kwang-Ho
    • Journal of Chest Surgery
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    • v.43 no.2
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    • pp.180-183
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    • 2010
  • Submitral left ventricular aneurysm (SMLVA) is a rare disease entity that exclusively occurs in the black population. We herewith report on a surgical case of SMLVA in a 68-year-old male who presented with ventricular tachycardia. He underwent surgical repair under standard hypothermic cardiopulmonary bypass. In the state of apical elevation, a vertical ventriculotomy was made directly over the aneurysm, which was located at the posterobasal aspect of the left ventricle. Radiofrequency ablation was performed on the endocardium all around the neck of the aneurysm and then patch endoaneurysmorrhaphy was carried out with particular care not to injure the mitral valve and subvalvular structure. His postoperative recovery was uneventful. There has been no dysfunction of the mitral valve or recurrence of the ventricular tachycardia at 2 years' follow-up.

Policy Direction in Responses to Demand for Apartment Remodeling (공동주택 리모델링 수요에 대응한 정책 추진방안)

  • Lee, Yeo-Kyung;Kim, Eun-Hee
    • Journal of the Architectural Institute of Korea Planning & Design
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    • v.36 no.1
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    • pp.125-136
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    • 2020
  • This study aims to seek a proper policy direction in response to the demand for apartment remodeling. As the research methods, we diagnosed the current status of the remodeling policy and analyzed the demand for apartment remodeling nationwide. According to the result of analysis, we suggested the fundamental direction and tasks for remodeling policies to be pursued at the government level. The results of the study are summarized as follows. First, the result of analysis showed that the demand for environmental improvement(performance improvement) remodeling project was much higher than other types of remodeling projects. The percentage of unit increased-type remodeling that can secure business feasibility is about 10% and only 30% when it comes to reducing project costs. The remaining 70-90% need to be promoted in environmental improvement remodeling projects which dependent on the residents' payment. Second, in order to prepare a policy action plan in response to the demand for apartment remodeling, it is necessary to set up clear policy goals and strategies for apartment remodeling in advance at the national level. Along with proactive goals and strategies, graded policy support should be accompanied per type of remodeling and business demand. We also suggest to simplify administrative procedures and support the R&D research to develop technologies. It would help to utilize the unit increased-type remodeling. On the other hand, for utilizing the environmental improvement remodeling which takes up a relatively high proportion, the policy should take care of as follows: offering housing performance information, rationalizing long term repair reserve, fostering small companies and experts. Finally, apartment management system should be advanced from the perspectives of managing old apartments and institutional foundations such as new construction and customized regulations for differentiated remodeling should be accompanied.

A Study on Implications and Planning Directions for the Development of a Modular Airborne Infection Isolation Ward (모듈러 음압병동 개발을 위한 시사점 및 계획방향에 관한 연구)

  • Choi, Kwangseok;Yun, Hyungjin
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.28 no.3
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    • pp.7-16
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    • 2022
  • Purpose: This study aims to establish the basic directions of the modular airborne infection isolation(AII) ward. Considering a specific function and purposed use as a modular AII ward, it is a chance to derive an address of current modular technology by overview the limitation and improvement of the existing modular architecture. Methods: In addition to the literature analysis on the configuration system of mobile hospitals, research cases on the operational effectiveness of the domestic and foreign mobile construction systems are analyzed. Results: In order to meet the various and strict space guidelines of the AII ward and a chance to improve limitations of uniformed existing modulars, AII modular the negative pressurized care setting should be minimized a structural restriction for reflecting its system on a architectural plan. For this unique requirements, it could be possible to apply various space boxes called infill box which needs to secure a large-scale space. So, a rahmen structure system could be adaptable for this purpose. A dead space between beams of the rahmen structure is to be used for MEP installation. Partial separation, dismantling, and repair should be possible by separating the MEP and infill box from the structure. The infill box must keep 3.5m width under the current Road Traffic Act. Implications: It is necessary to utilize and develop an improved construction method that can reduce the problems of existing steel modular and PC modular.

Emergency Surgical Management of Traumatic Cardiac Injury in Single Institution for Three Years

  • Joo, Seok;Ma, Dae Sung;Jeon, Yang Bin;Hyun, Sung Youl
    • Journal of Trauma and Injury
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    • v.30 no.4
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    • pp.166-172
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    • 2017
  • Purpose: Thoracic traumas represent 10-15% of all traumas and are responsible for 25% of all trauma mortalities. Traumatic cardiac injury (TCI) is one of the major causes of death in trauma patients, rarely present in living patients who are transferred to the hospital. TCI is a challenge for trauma surgeons as it provides a short therapeutic window and the management is often dictated by the underlying mechanism and hemodynamic status. This study is to describe our experiences about emergency cardiac surgery in TCI. Methods: This is a retrospective clinical analysis of patients who had undergone emergency cardiac surgery in our trauma center from January 2014 to December 2016. Demographics, physiologic data, mechanism of injuries, the timing of surgical interventions, surgical approaches and outcomes were reviewed. Results: The number of trauma patients who arrived at our hospital during the study period was 9,501. Among them, 884 had chest injuries, 434 patients were evaluated to have over 3 abbreviated injury scale (AIS) about the chest. Cardiac surgeries were performed in 18 patients, and 13 (72.2%) of them were male. The median age was 47.0 years (quartiles 35.0, 55.3). Eleven patients (61.1%) had penetrating traumas. Prehospital cardiopulmonary resuscitations (CPR) were performed in 4 patients (22.2%). All of them had undergone emergency department thoracotomy (EDT), and they were transferred to the operating room for definitive repair of the cardiac injury, but all of them expired in the intensive care unit. Most commonly performed surgical incision was median sternotomy (n=13, 72.2%). The majority site of injury was right ventricle (n=11, 61.1%). The mortality rate was 22.2% (n=4). Conclusions: This study suggests that penetrating cardiac injuries are more often than blunt cardiac injury in TCI, and the majority site of injury is right ventricle. Also, it suggests prehospital CPR and EDT are significantly responsible for high mortality in TCI.

Patterns of wrist cutting: A retrospective analysis of 115 suicide attempts

  • Cho, Jakwang;Choi, Youngwoong
    • Archives of Plastic Surgery
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    • v.47 no.3
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    • pp.250-255
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    • 2020
  • Background Rosenthal et al. classified female, habitual, non-suicidal wrist cutters as a group and introduced the concept of wrist-cutting syndrome. We investigated the characteristics of wrist-cutting patients at our institution in comparison with results reported previously. Methods We conducted a retrospective study involving 115 patients who had cut their wrists and been examined at the emergency department of a single hospital in Seoul, Korea, between March 2014 and August 2018. Results There were more women (73 patients; 63.5%) than men (42 patients; 36.5%), and the women (mean age, 34.42 years) were significantly younger than the men (mean age, 50.07 years). The patients who had cut their wrists repeatedly were mainly women (22 of 26 patients; 84.6%); however, men caused more severe damage than women. Substance use before a suicide attempt did not significantly increase the severity of wrist cutting. Our institution planned and implemented a suicide prevention intervention program to improve the continuity of outpatient care. The number of patients who continued psychiatric treatment increased significantly after program completion. Conclusions We confirmed that most patients were young women who were not suicidal in the true sense because their wounds were not severe. Our study showed a protective role of the barrier tendons (flexor carpi radialis, palmaris longus, flexor carpi ulnaris), and we suggest careful repair of the barrier tendons to protect neurovascular structures against subsequent cutting events. We found that it was possible to improve the continuity of patient counseling by managing patients through a psychiatric treatment program.

Congenital Bochdalek hernia: report of 4 cases (선천성 Bochdalek hernia4례 보고)

  • Jin, Jae-Gwon;Park, Ju-Cheol;Yu, Se-Yeong
    • Journal of Chest Surgery
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    • v.15 no.4
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    • pp.432-439
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    • 1982
  • Congenital posterolateral diaphragmatic hernia [Bochdalek hernia] is the result of a congenital diaphragmatic defect in the posterior costal part of the diaphragm in the region of the tenth and eleventh ribs. There is usually free communication between the thoracic and abdominal cavities. The defect is most commonly found on the left [90%], but may occurs on the right, where the liver often prevents detection. The male to female ratio is 2:1. Owing to the negative intrathoracic pressure, herniation of abdominal contents through the defects occurs, with resultant collapse of the lung. Shifting of mediastinum to the opposite side and compression of the opposite lung occurs. Most often these hernias are manifestated by acute respiratory distress in the newborn. A second, but less well recognized, group of patient with Bochdalek hernia survive beyond the neonatal period, usually present at a later time with "failure of thrive, intermittent vomiting, or progressive respiratory difficulty. " The diagnosis can often be made on clinical ground from the presence of respiratory distress, absence of breath sounds on the chest presence of bowel sounds over the chest . Roentgenogram of the chest confirm the diagnosis. Obstruction and strangulation have been reported but are rare. Treatment consists of early reliable identification of these congenital diaphragmatic hernia with high risk and surgical repairment. and postoperative pharmacological management with extracorporeal membranous oxygenation [=ECMO] support in the period of intensive care. On the surgical approach, for defects on left side, an abdominal incision is preferred, because of the high incidence of malrotation and obstructing duodenal bands. In the neonate, the operative mortality may be appreciable, but, later repair almost always is successful. During the period from 1972 to 1982, 4 cases of congenital Bochdalek hernia were experienced at the Kyung-Hee University Hospital.

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