• Journal of Chest Surgery
• /
• v.39 no.2 s.259
• /
• pp.117-126
• /
• 2006

Background: The purpose of this study is to describe the characteristics of malpractice claims related to hemopneumothorax and to identify the causes and potential preventability of such claims. Material and Method: A retrospective study was performed by reviewing the records in the Lawnb website and Lx CD-rom: the records on closed malpractice claims involving hemopneumothorax were abstracted from the files available for analysis. The records were reviewed and were analysed to determine the etiology of hemopneumothorax, patient age, results of lawsuit and indemnity payment, underlying diseases, cause of death or complications, and the factors associated with a successful defense. Result: Seven closed claim involving hemopneumothorax were founded in the data for malpractice. Three claims were supreme court decision, one was a high court decision and three claims were district court decision. The most common cause of death was tension pneumothorax. Four of which resulted in indemnity payments. Conclusion: While malpractice claims involving hemopneumothorax were uncommon, they resulted in a high rate and amount of indemnity payments. Claims are more common in pediatric patients. In case of iatrogenic hemopneumothorax, post-procedural X-ray can improve patient outcome and is also associated with decreased indemnity risks. Informed consent is also important.

• Journal of The Korean Society of Integrative Medicine
• /
• v.8 no.2
• /
• pp.199-209
• /
• 2020

Purpose : This study used a sarcopenia diagnostic algorithm proposed by the Asia working group in adults over 50 to diagnose sarcopenia and analyze body function. The purpose of this study is to prepare basic data for the management and prevention of sarcopenia. Methods : We performed a diagnostic evaluation of sarcopenia in 97 adults over the age of 50 years with the cooperation of the Seongnam senior experience complex in Seongnam-si, Gyeonggi-do. As a result of the diagnostic process, 24 subjects were placed into the sarcopenia group, while 73 subjects were placed into the normal group. We measured each subject's body, performed the timed up and go test to evaluate functional mobility, and conducted a questionnaire on the pre-symptom of locomotive syndrome and locomotive syndrome. Results : There were statistically significant differences in height, weight, and skeletal muscle mass between the two groups. There was also a statistically significant difference in the timed up and go test, which confirmed the difference in functional mobility between the two groups. In addition, there was a statistically significant difference between the two groups in the proportion and the mean score of subjects with pre-symptom of locomotive syndrome and locomotive syndrome. In the correlation analysis, grip strength was statistically significantly correlated with height, weight, skeletal muscle mass, waist circumference, timed up and go test, pre-symptom of locomotive syndrome and locomotive syndrome. Gait speed was significantly correlated with the timed up and go test and locomotive syndrome. Appendicular skeletal muscle index was significantly correlated with height, weight, waist circumference, hip circumference, and the pre-symptom of locomotive syndrome. Conclusion : In conclusion, sarcopenia is closely related to height, weight, skeletal muscle mass and functional mobility, as well as the pre-symptom of locomotive syndrome and, locomotive syndrome. In consideration of this, the prevention and management of sarcopenia should be made accordingly.

• Journal of Preventive Medicine and Public Health
• /
• v.40 no.6
• /
• pp.487-494
• /
• 2007

Objectives : Little is known about the physician-related factors that are associated with the management of Hypertension. The purpose of this study was to determine the physician-related factors associated with blood pressure control in hypertensive patients. Methods : We surveyed 154 physicians at 117 public health (subhealth) centers in Gyeonggi-do, Forty-one physicians completed the survey (response rates : 26.6%) and 31 physicians were finally included as the study subjects. Using the information obtained from the self-reported survey, we measured the physician-related factors associated with hypertension control, including their perception of hypertension, prescription patterns (combination prescription rates, specific antihypertensives prescription rates among patients with diabetes mellitus), and sociodemographic factors. We then collected data on blood pressure and medication use in patients seen by these physicians from the health center#s information system. We compared the physicians# perceived hypertension control rates with the actual rates, and then evaluated the rate of high overestimation (overestimation by more than 25% of the median degree of hypertension control rate overestimation) among the physicians. The physicians# antihypertensive prescription patterns were also evaluated. Multiple logistic regression analysis was used to evaluate the independent association between hypertension control and physician-related factors. Results : The physicians tended to overestimate the proportion of their patients with controlled blood pressure (79.5% perceived vs. 57.8% actual). The percentage of physicians with high overestimation was 35.5% (11 physicians). The physicians with lower control rates were more likely to highly overestimate their patients# control rates. Physicians with below-median actual control rates tended to prescribe fewer combination treatments for patients with uncontrolled blood pressure and angiotensin-converting enzyme inhibitors or fewer angiotensin receptor blockers for patients with diabetes mellitus. The rate of high overestimation by physicians was 1.31 times higher in patients with uncontrolled blood pressure than in patients with other conditions (OR=1.31, 95% CI : 1.17-1.48). Conclusions : Physicians have a tendency to overestimate the rates of hypertension control in their patients. Because physicians have a direct role in treatment outcomes, physicians# overestimation about hypertension management contributes to inadequate blood pressure control. Thus, interventions for improving physician# awareness regarding the management of patients with hypertension are needed.

• Journal of Chest Surgery
• /
• v.8 no.1
• /
• pp.37-44
• /
• 1975

Authors have reviewed the records of seven patients of multiple rib fractures with severe flail chest who were admitted to Hanyang University Hospital during the 3 years period from 1972 through 1975. Of the seven patients studied, automobile accidents led to the injuries in 4 cases, two patients were injured in fall from a tree and on the ox-heading. All who had a blunt trauma without any open wound on the chest. The numbers of the fractured ribs accounted for 6 to 9 of the ribs including double fractures from 3 to 5 ribs. The left side fractures occurred in the 6 patients and in the right only one patient. Thus the flail segment was more often located in the left antero-lateral position than in the right lateral position [the ratio was 6:1].. All cases had associated injuries. The injuries and multiple fractures were the most common associated injuries occurring in four and five of the patients respectively. The patients were classified as having associated head injuries when they were admitted in comatose or semicomatose state. When a major degree of instability of the thoracic cage exists, adequate respiratory change is not possible. For this reason the tracheostomy was performed in five patients in an acutely injured patient with flail chest only after an endotracheal tube has been inserted or after an endotracheal suction. All patients had secondary complications in the pleural cavity, such as hemothorax or hemopneumothorax with or without intrapulmonary hemorrhage and subcutaneous emphysema. Therefore, closed thoracostomy was performed in five patients in the emergency room. The thoracotomy was required in four patients: immediate operation without closed thoracostomy was performed in two patients and the thoracotomy was indicated in two patients after closed thoracostomy, because of increasing intrathoracic hemorrhage. As to the fixation of the flail segments, authors employed two techniques; one was towel clip traction of the flail segments and the other was intramedullary insertion of Kirschner`s wire in to the double fractured rib fragments for the fixation of the flail segments [Kirschner`s wire fixation]. Because` of an different results in the course of treatment between two techniques, data from patients with towel clip traction was compared with those from patients with thoracotomy and Kirschner`s wire fixation of the flail segments. Of the three patients with towel clip traction, two patients required bronchoscopic toilet due to lung atelectasis which developed because of inadequate motion of thoracic cage and poor expectoration. This was in contrast to the four patients with thoracotomy and Kirschner`s wire fixation, who didn`t these complication because of adequate motion of the thoracic cage and subsequent good expectoration.

• Journal of the Society of Disaster Information
• /
• v.7 no.4
• /
• pp.266-272
• /
• 2011

This study is focused on guard major collegians who are composed of factor in medical emergency system. In the case of cardiac failure, it is to make its basic data develop its education program of CPR which can increase the patient's survival rate before his hospitalization. The subject of study is composed of 120 persons who are 94 boy-collegians(78.3%) and 26 girl-collegians(21.7%) in sex and 66 first-grade collegians(55.0%) and 54 second-grade collegians(45.0%) in a school year. There is significant difference in the practices of artificial respiration and the thorax pressure after the education of basic CPR in sex(p<0.01). The practices of artificial respiration in boy-collegians($93.72{\pm}4.21$) is higher than in girl-collegians($82.31{\pm}6.36$) and the practices of thorax pressure in boy-collegians($92.45{\pm}4.44$) is higher than in girl-collegians($88.08{\pm}6.49$). The satisfaction degree of boy-collegians($4.33{\pm}0.59$) is higher than that of girl-collegians($3.73{\pm}0.67$) after theory & practice education of basic CPR(p<0.01). It is necessary to develop the education program and educate its knowledge & technology in proportion to collegians characteristics of sex and school year. Also, education authorities should develop a subject of the accident provided the practical education of CPR for guard major collegians.

• Health Policy and Management
• /
• v.29 no.4
• /
• pp.513-522
• /
• 2019

Background: South Korea operates a Medical Aid (MA) program targeting selected low-income individuals to ensure medical service delivery to the disadvantaged while enhancing self-sufficiency of work-capable beneficiaries. However, as reasons behind welfare exits are diverse and do not always infer poverty relief or the provision of appropriate levels of health care services, this study aimed to investigate the association between changes in MA status and health care utilization. Methods: This study used the 2006 to 2015 National Health Insurance claims data. The impact of changes in annual MA status on health care utilization (yearly number of outpatient visits, inpatient visits, length of stay, and emergency department [ED] visits) was investigated using the generalized estimating equation model. Results: In 117,943 adult subjects aged 20 to 64, compared to the 'MA to MA' group, the 'MA to MA exit' group showed general decreases in utilization (outpatient visits: β=-3.93, p<0.0001; hospital admissions: relative risk [RR], 0.87; 95% confidence interval [CI], 0.83-0.91; length of stay: β=-3.64, p<0.0001; ED visits: RR, 0.83; 95% CI, 0.77-0.90). Similar patterns were found in the 'MA exit to MA exit' group (outpatient visits: β=-5.72, p<0.0001; admissions: RR, 0.91; 95% CI, 0.87-0.94; length of stay: β=-5.87; p<0.0001; ED visits: RR, 0.81; 95% CI, 0.75-0.88). Likewise, in 74,747 older adult subjects aged 65 or above, the 'MA to MA exit' group showed reduced levels of utilization (outpatient visits: β=-1.51; p=0.0020), as well as the 'MA exit to MA exit' group (admissions: RR, 0.92; 95% CI, 0.89-0.95; length of stay: β, -5.45; p<0.0001; ED visits: RR, 0.90; 95% CI, 0.83-0.97). Conclusion: MA exit was associated with general decreases in health care utilization. Utilization patterns of individuals with experiences of receiving MA benefits should be monitored to promote the ideal use of health care services while preventing potential financial barriers present in accessing medical care.

• Journal of Internet Computing and Services
• /
• v.16 no.1
• /
• pp.1-8
• /
• 2015

Ultra-wide-angle wireless endoscopes are demonstrated in this paper. The endoscope is composed of an ultra-wide-angle camera module and wireless transmission module. A lens unit with the ultra-wide FOV of 162 degrees is designed and manufactured. The lens, image sensor, and camera processor unit are packaged together in a $3{\times}3{\times}9-cm3$ case. The wireless transmission modules are implemented based on UWB- and WiFi-based platform, respectively. The UWB-based module can transmit HD video to a computer in resolution of $2048{\times}1536$ (QXGA) and the frame rate of 15 fps in MJPEG compression mode. The maximum data transfer rate reaches 41.2 Mbps. The FOV and the resolution of the endoscope is comparable to a medical-grade endoscope. The FOV and resolution is ~3X and 16X higher than that of a commercial high-performance WiFi endoscope, respectively. The WiFi-based module streams out video to a smart device with th maximum date transfer rate of 1.5 Mbps at the resolution of $640{\times}480$ (VGA) and the frame rate of 30 fps in MJPEG compression mode. The implemented components show the feasibility of cheap medical-grade wireless electronic endoscopes, which can be effectively used in u-healthcare, emergency treatment, home-healthcare, remote diagnosis, etc.

• Journal of the Korean Society for Marine Environment & Energy
• /
• v.12 no.2
• /
• pp.104-110
• /
• 2009

This study tries to give improvement directions of the law of oil spill focusing on the view that satisfying remuneration for victims should be considered. And it looks through the existing remuneration system provided by P&I Club and IOPC Fund. It also covers with issues related to remuneration in order to find the best for victims. The major contents of this study are as follows. First, the present law of compensation security to Marine oil pollution accident should be revised. Maximum value of remuneration needs to be raised and subjects liable to pay reparation need to be expanded. Second, in case the damage is widely different comparing to similar cases in foreign countries, it's hard to get complete remuneration from international corporations responsible for reparation. That's the reason the national emergency system for oil pollution must be established. Third, this study says the law that certainly defines a liability subject and that the liability is not necessarily caused by fault should be enacted. Last, it suggest that victims should have their object income data to facilitate establishment of the law of compensation for damages from marine oil pollution. To calculate proper remuneration, government should consider to choose one of public organizations as an investigator to damages and should collect accurate statistics relating to fishery. Furthermore, compensation system which can provide rapid reparation to victims needs to established by founding professional maritime organization of arbitration.

• Journal of Digital Convergence
• /
• v.14 no.8
• /
• pp.363-370
• /
• 2016

This study aimed to evaluate correlation between self-evaluation factors and academic achievement of medical students according to introduction of explanation meeting in cadaveric dissection. The students explained cadaveric structure to health allied sciences students and discussed with each other. Just after the meeting, 102 medical students filled out a self-reported questionnaire on impact of self-evaluation factors and communication. The data were analyzed by frequency analysis, t-test and analysis of variance. Regardless of their gender, age, previous experience, the majority of the students gave high scores in all of self-evaluation factors. Among them, linkage with major and verbal communication factor were closely related to their academic achievement(p<0.05). The verbal and non-verbal communication factors also had a high correlation of 0.580(p<0.01). The explanation meeting provided a chance to learn further with positive attitude to medical students and motivated them academically.

• Journal of Veterinary Clinics
• /
• v.29 no.5
• /
• pp.384-390
• /
• 2012

Echocardiographic measurements of cardiac output, including the modified Simpson's method, Automated Contour Tracking(ACT) method, and left ventricular outflow method are well described methods of evaluating cardiac function due to its reliability and the benefits of its non-invasive technique in human medicine. The purpose of this study was to evaluate the accuracy of an echocardiography estimate of cardiac output in isoflurane-anesthetized beagle dogs and was to compare the ACT method to the other methods used in measurement of cardiac output. In healthy beagle dogs, cardiac output results by echocardiography estimate methods showed an excellent correlations with those by the thermodilution method (The modified Simpson's method : r = 0.815, $r^2=0.665$, y = 0.434x + 0.311 ; ACT method : r = 0.86, $r^2=0.748$, y = 0.391x + 0.242 ; ventricular outflow method : r = 0.691, $r^2=0.478$, y = 0.593x + 0.242). Among the results obtained, the ACT method showed the highest correlation coefficient. In conclusion, our study demonstrated that echocardiography estimate methods did not prove to be suitable in accurately measuring absolute cardiac output values but showed an excellent correlation with thermodilution method. Therefore, by using the measurement of cardiac output as supplemental data, echocardiography estimate methods can be used for detection and correction of hemodynamic disturbances during emergency and anesthesia in veterinary practice.