• Journal of Korean Neurosurgical Society
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• v.47 no.4
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• pp.252-257
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• 2010

Objective : Barbiturate coma therapy (BCT) is a useful method to control increased intracranial pressure (IICP) patients. However, the complications such as hypotension and hypokalemia have caused conditions that stopped BCT early. The complications of low dose BCT with $Bispectral^{TM}$ index (BIS) monitoring and those of high dose BCT without BIS monitoring have been compared to evaluate the efficacy of low dose BCT with BIS monitoring. Methods : We analyzed 39 patients with high dose BCT group (21 patients) and low dose BCT group (18 patients). Because BIS value of 40-60 is general anesthesia score, we have adjusted the target dose of thiopental to maintain the BIS score of 40-60. Therefore, dose of thiopental was kept 1.3 to 2.6 mg/kg/hour during low dose BCT. However, high dose BCT consisted of 5 mg/kg/hour without BIS monitoing. Results : The protocol of BCT was successful in 72.2% and 38.1% of low dose and high dose BCT groups, respectively. The complications such as QT prolongation, hypotension and cardiac arrest have caused conditions that stopped BCT early. Hypokalemia showed the highest incidence rate in complications of both BCT. The descent in potassium level were $0.63{\pm}0.26$ in low dose group, and $1.31{\pm}0.48$ in high dose group. The treatment durations were $4.89{\pm}1.68$ days and $3.38{\pm}1.24$ days in low dose BCT and high dose BCT, respectively. Conclusion : It was proved that low dose BCT showed less severe complications than high dose BCT. Low dose BCT with BIS monitoring provided enough duration of BCT possible to control ICP.

• Korean Journal of Biological Psychiatry
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• v.2 no.2
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• pp.169-176
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• 1995

두부 외상은 많은 발생율과 사망율을 차지하고 있으며, 건강한 생활을 위해 큰 관심을 갖게 되었다. 신경방사선영상은 외상성 뇌손상 환자들의 진단과 치료에 필수적인 방법이다. 뇌손상의 기본 기전, 병리, 그리고 영상 소견을 이해 하는 것은 매우 중요하다. 1970년대에 Glasgow coma scale의 형상과 전산화단층촬영(CT)의 발달은 임상의사들이 두부외상에 대한 평가와 환자들의 경과를 예상하는데 극적인 변화를 주었다. 최근 자기공명영상(MRI)의 발달로 외상성 뇌손상의 형태를 더욱 이해 하게 되었고, 두부 외상의 발견율이 높아지게 되었다.

• Journal of the Korean Operations Research and Management Science Society
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• v.28 no.3
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• pp.169-184
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• 2003

In the IS-95 packet service system, the radio channels are generally classified into the dedicated and the common traffic channels. In this paper, a common traffic channel access method is proposed for the COMA packet service system to enhance the radio resource utilization while guaranteeing QoS to the users. The proposed method is based on the permission probability for the common traffic channel user. To derive permission probability, optimization models are developed for two different QoS constraints. Approximation methods are also developed.

• Proceedings of the Korean Institute of Communication Sciences Conference
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• 2006.07a
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• pp.528-528
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• 2006

• Electronics and Telecommunications Trends
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• v.10 no.1 s.35
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• pp.19-32
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• 1995

COMA 방식의 CMS가 이용하게 될 핸드오버 규격과 관련하여 기존 EIA/TIA IS-41규격의 발전 과정을 분석하였고, TSB-51 및 64를 바탕으로 변경될 IS -41 Rev. C 규격의 개정 방향을 고찰하였다. 아울러 이러한 분석결과를 TDX-10MX의 핸드오버 처리 절차에 반영하여 새로운 핸드오버 처리 절차에 대한 규격(안)을 제시하였다.

• Current Optics and Photonics
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• v.3 no.1
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• pp.72-77
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• 2019

This study was performed to analyze the optical aberrations of the cornea induced by myopic refractive surgery. Corneal total higher-order aberrations, spherical aberration and coma for 4-mm and 6-mm pupils were measured using a wave-front analyzer. The amount of aberrations of the oblate corneal optics by the achieved correction was found to be larger than for the prolate corneal shape with complete eye, in an emmetropia control group. The change in corneal shape acts as an optical factor that degrades the quality of the retinal image; it seems to be one of the important factors related to quality of vision.

• Journal of The Korean Society of Clinical Toxicology
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• v.12 no.1
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• pp.14-21
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• 2014

Purpose: The objective of this study was to develop a new scoring tool that is comprehensively applicable and predicts fatality within 24 h of intoxication. Methods: This was a cohort study conducted in two emergency medical centers from 2011 to 2012. We identified factors associated with severe/fatality. Through a discriminant analysis, we devised the aBIG (age, Base deficit, Infection, and Glasgow coma scale) score. To compare the ability of aBIG to predict intoxication severity with that of previous scoring systems such as APACHE II, MODS, SAPS IIe, and SOFA, we determined the receiver operating characteristic curves of each variable in predicting severe-to-fatal toxicity. Results: Compared with the mild/moderate toxicity group (n=211), the severe/fatal group (n=143) had higher incidences of metabolic acidosis, infection, serious mental change, QTc prolongation and hepato-renal failure. Age, base deficit, infection-WBC count, and Glasgow Coma Scale were independently associated with severe/fatal poisoning. These variables were combined into the poisoning "aBIG" score [$0.28{\times}$Age group+$0.38{\times}WBC$ count/$10^3+0.52{\times}$Base deficit+$0.64{\times}$(15-GCS)], which were each calculated to have an area under the curve of 0.904 (95% confidence interval: 0.868-0.933). The aBIG poisoning score had an equivalent level of severity predictability as APACHE II and a superior than MODS, SOFA, and SAPS IIe. Conclusion: We developed a simplified scoring system using the four variables of age, base deficit, infected leukocytosis, and GCS. The poisoning aBIG score was a simple method that could be performed rapidly on admission to evaluate severity of illness and predict fatal severity in patients with acute intoxications.

• Journal of Korean Academy of Nursing
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• v.36 no.4
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• pp.621-629
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• 2006

Purpose. The purpose of this study was to identify the clinical variables that predict functional and cognitive recovery at 1- and 6-month in both severe and moderate/mild traumatic brain injury patients. Methods. The subjects of this study were 82 traumatically brain-injured patients who were admitted to a Neurological Intensive Care Unit at a university hospital. Potential prognostic factors included were age, motor and pupillary response, systolic blood pressure, heart rate, and the presence of intracranial hematoma at admission. Results. The significant predictors of functional disability in severe traumatic brain injury subjects were, age, systolic blood pressure, the presence of intracranial hematoma, motor response, and heart rate at admission. In moderate/mild traumatic brain injury patients, motor response, abnormal pupil reflex, and heart rate at admission were identified as significant predictors of functional disability. On the other hand, the significant predictors of cognitive ability for severe traumatic brain injury patients were motor response and the presence of intracranial hematoma at admission, whereas those for moderate/mild patients were motor response, pupil reflex, systolic blood pressure at admission, and age. Conclusions. The results of the present study indicate that the significant predictors of TBI differ according to TBI severity on admission, outcome type, and outcome measurement time. This can be meaningful to critical care nurses for a better understanding on the prediction of brain injury patients. On the other hand, the model used in the present study appeared to produce relatively low explicabilities for functional and cognitive recovery although a direct comparison of our results with those of others is difficult due to differences in outcome definition and validation methods. This implies that other clinical variables should be added to the model used in the present study to increase its predicting power for determining functional and cognitive outcomes.

• Journal of the Optical Society of Korea
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• v.19 no.4
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• pp.403-408
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• 2015

To evaluate the effects of spherical aberration (SA) correction on optical quality in pseudophakic eyes, we simulated the optical quality of the human eye by computation of the modulation transfer function (MTF). We reviewed the medical records of patients who underwent cataract surgery in Asan Medical Center, retrospectively. A Zywave aberrometer was used to measure optical aberrations at 1-12 postoperative months in patients with AR40e intraocular lens implants. The MTF was calculated for a 5 mm pupil from measured wavefront aberrations. The area under the MTF curve (aMTF) was analyzed and the maximal aMTF was calculated while changing the SA ($-0.2{\sim}+0.2{\mu}m$) and the defocus (-2.0 ~ +2.0 D). Sixty-four eyes in 51 patients were examined. The maximal aMTF was $6.61{\pm}2.16$ at a defocus of $-0.25{\pm}0.66D$ with innate SA, and $7.64{\pm}2.63$ at a defocus of $0.08{\pm}0.53D$ when the SA was 0 (full correction of SA). With full SA correction, the aMTF increased in 47 eyes (73.4%; Group 1) and decreased in 17 eyes (26.6%; Group 2). There were statistically significant differences in Z(3, -1) (vertical coma; P = 0.01) and Z(4, 4) (tetrafoil; P = 0.04) between the groups. The maximal aMTF was obtained at an SA of $+0.01{\mu}m$ in Group 1 and an SA of $+0.13{\mu}m$ in Group 2. Optical quality can be improved by full correction of SA in most pseudophakic eyes. However, residual SA might provide benefits in eyes with significant radially asymmetric aberrations.

• Tuberculosis and Respiratory Diseases
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• v.58 no.3
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• pp.213-229
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• 2005

The first and the longest criminal indictment case of Korean medico-legal battle, so called BORAMAE Hospital Incident, was finally on its end by Korean Supreme Court's decision on June 24, 2004, after 7 years long legal dispute via Seoul District Court and Seoul Superior Appeal Court's decision. Boramae Hospital case was the first Korean legal case of Withdrawing Life-sustaining treatment of mechanical respirator on 58 years old Extradural Hematoma victim who was on Respirator under Coma after multi-organ failure postoperatively(APACHE II score: 34-39). Two physicians who have involved patient's care and had helped to make discharge the Near-death patient to home after repeated demand of patient's wife, due to economic reason, were sentenced as homicidal crime. This review article will discuss the following items with the review of US cases, Quinlan(1976), Nancy Cruzan(1990), Barber (1983), Helen Wanglie(1990), Baby K (1994) and Baby L cases, along with Official Statement of ATS and other Academic dignitaries of US and World.: [1] Details of Boramae Hospital incident, medical facts description and legal language of homicidal crime sentence. [2] The medical dispute about the legal misinterpretation of patient's clinical status, regarding the severity of the victim with multi-organs failure on Respirator under coma with least chance of recovery, less than 10% probability. [3] Case study of US, of similar situation. [4] Introduction of ATS official Statement on Withdrawing/ Withholding Life sustaining treatment. [5] Patient Autonomy as basic principle. [6] The procedural formality in Medical practise for keeping the legitimacy. [7] The definition of Medical Futility and its dispute. [8] Dying in Dignity and PAS(Physician Assisted Suicide)/and/or Euthanasia [9] The Korean version of "Dying in Dignity", based on the Supreme Court's decision of Boramae Hospital incident (2004.6.24.) [10] Summary and Author's Note for future prospects.