• Journal of Chest Surgery
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• 제32권11호
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• pp.1017-1022
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• 1999

Background: An increasing number of elderly are referred for open heart surgeries(OHS). These patients are assumed to have significantly increased morbidity and mortality because of compromised functional reserves in their vital organs. We reviewed the results of OHS patients who were 70 years old or older. Material and Method: Thirty six consecutive septuagenarians underwent OHS from 1995 to 1997. Operations were coronary artery bypass grafting(CABG) in 26 including 3 left main surgical angioplasty, valve replacement in 7, MVR+CABG in 2, and ASD closure+TAP in 1. Statistical tests were carried out to compare survivor group with nonsurvivor group in respect to risk factors including NYHA functional class, LVEF, emergent operation, IABP support, CPB/ACC time, ventilator time cardiac index, ICU stay and hospital stay for operative mortality. Result: Operative mortality rate and postoperative complication were 16%(6/36) and 50%(18/36). One-year and 3-year actuarial survival rates were 76%. Nine patients(25%) had major complications including third-degree A-V block(2), respiratory failure(1), stroke(3), renal failure requiring dialysis(3) and postoperative hemorrhage(2). The causes of death were pneumonia(1), bleeding(1), acute renal failure(1), low cardiac output(1), third-degree A-V block(1), and ventricular tachycardia(1). The univariate analysis of mortality shows that NYHA class IV, LVEF<40%, lesser values for C.I, and longer time for ventilatory support were associated with the risk factors(p value=0.03, 0.001, 0.007, and 0.014). The emergent operation, CPB/ACC time, IABP support, ICU stay and hospital stay were not significant. Conclusion: We conclude that cardiac operation can be performed in septuagenarians with acceptable outcomes when done in patients with normal to moderately depressed left ventricular function and adequate functional reserves in their vital organs.

• 한국환경복원기술학회지
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• 제13권1호
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• pp.82-92
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• 2010

Removal rates of NO3-N and TN in a free water surface wetland system during emergent plant growing season and non-growing were investigated. The system was established on floodplain in the down reach of the Gwangju Stream in 2008. Its dimensions were 46 meters in length and 5 meters in width. Typha angustifloria L. growing in pots about two years were planted on the half area of the system and Zizania latifolia Turcz on the other half. Water of the stream was funneled into it by gravity flow and its effluent was discharged back into it. Volumes and water quality of inflow and outflow were analyzed from October 2008 to September 2009. Inflow into the system averaged approximately 715 $m^3$/day and hydraulic residence time was about 1.5 hr. Average influent and effluent $NO_3$-N concentration was 3.37 and 2.74 mg/L, respectively and $NO_3$-N retention amounted to 18.7%. Influent and effluent TN concentration averaged 4.67 and 3.69 mg/L, respectively and TN abatement reached to 20.9%. $NO_3$-N removal rate (%) during plant growing season ($22.67{\pm}3.70$, mean ${\pm}$ standard error) was significantly high (p<0.001) when compared with that during plant non-growing one ($15.02{\pm}3.23$). TN abatement rate (%) during plant growing season ($27.42{\pm}5.98$) was also significantly high (p<0.001) when compared with that during plant non-growing one ($13.66{\pm}3.08$).

• International Journal of Knowledge Content Development & Technology
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• 제4권2호
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• pp.49-65
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• 2014

This paper investigates how strategy formulation and implementation processes used by the University of Cape Coast (UCC) in building its digital collections compare with the Andrew's strategic formulation and implementation theoretical framework. Theory-testing case study methodology was used. The data collection instruments were the key informant interview technique and document reviews. During the formulation phase, two aspects (resources and aspirations of senior management) were emergent. During the implementation phase, five aspects (achieving results, processes and behaviour, standards, motivation, personal) were emergent. All other elements of building the UCC digital collections were planned during both the formulation and implementation phases. Although the emphasis on students and learning is laudable and apt, there seems to be lack of focus on research support beyond digital collection building, despite the fact that research excellence is one of the UCC's key priorities. Opportunities exist for improving feedback mechanisms between the users, digital library staff and the university management; and inclusion of social media tools in the digital library project. Since only the experience of a single institution of higher learning is considered, it cannot be definitively stated that strategy formulation and implementation will be similar in every institutional context. However, the results provide a basis for academic digital libraries to draw lessons from this case. In African public universities, there is little earlier research on strategy formulation and implementation in digital library management. Strategy formulation and implementation is a critical issue for higher education academic libraries especially in developing countries like Ghana, due to limited financial resources and the rapid change in the information environment during the last several decades.

• 디지털융복합연구
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• 제11권6호
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• pp.159-167
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• 2013

병원에서 Infusion Pump를 사용하여 환자에게 자동적으로 지속적이고 정밀하게 약물을 투여하는 것이 가능해졌다. 그러나 Infusion Pump를 부착한 환자가 이동하는 도중 응급 상황이 발생할 경우, 이에 대한 대처가 신속 정확하게 이루어지지 않고 있는 실정이다. 이러한 문제로 인하여 Infusion Pump를 통해 정맥 내로 투여되는 약물 양에 약간의 오차라도 생기면 환자에게 치명적일 수 있다. 따라서 본 연구에서는 무선 네트워크와 RFID 기술을 이용한 원격 Infusion Pump 모니터링 시스템을 제안하였다. 제안한 시스템은 Infusion Pump에 이상이 발생한 경우 Infusion Pump에 대한 상태 정보(고장 종류)와 환자의 위치 정보를 간호사 station에 자동으로 알려줌으로써 Infusion Pump를 사용하는 환자들에게 신속하고 정확한 의료 서비스를 제공할 수 있을 뿐만 아니라 Infusion Pump로 인한 의료사고를 사전에 예방할 수 있다.

• Journal of Trauma and Injury
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• 제25권4호
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• pp.109-114
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• 2012

Purpose: Deep vein thrombosis and pulmonary thromboembolism are major causes of death after severe multiple trauma. Although various means of prevention have been presented and utilized, still, there are no standard guidelines for anticoagulation of multiple trauma because of some contraindications. Methods: A retrospective study of adult major trauma patients whose injury severity scores (ISSs) were over 16 and who had visited one university hospital in Daegu city was performed. We compared some features of patients diagnosed DVT or PTE with those of patients without DVT by computed tomography or ultra sonography. Those features included accompanying various kinds of intracranial hemorrhages, possibility of ambulation, emergent operation, early transfusion, and suspicious symptoms. Results: The mean age of the 58 subjects included in this study was $50.9{\pm}17.2years$, the mean ISS was $22.7{\pm}6.0$, and the mean hospital stay was $55.2{\pm}37.9days$. Ten(17.2%) patients had emergent surgery, and 44(75.9%) experienced delayed surgery. Early transfusion was needed in 34(58.6%) patients. Among the 18 patients diagnosed with DVT, accompanying intracranial hemorrhages were noted in 8(44.4%) patients; one of the 8 also had PTE. Among the same 18 patients, early transfusions were required in 11(61.1%) patients; one of the 11 also had PTE. Conclusion: The risk of DVT is increased in cases of severe multiple trauma, and many difficulties in applying anticoagulants are experienced. Though we need additional studies to decide proper prophylaxis for DVT and PTE, if the patient's general condition permits, a screening test for DVT as soon as possible could be an effective method to reduce the possibility of a bad outcome.

• Journal of Chest Surgery
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• 제41권2호
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• pp.273-276
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• 2008

심장 정지에 있어서 체외 심폐 보조가 1983년도에 도입된 이래로 심장 정지의 치료에 응급 경피적 심폐 보조가 사용되어 왔다. 다량의 급성 폐동맥 색전증은 사망률이 높고, 특히 수술 중 발생한 경우는 외과의와 마취의에게 힘든 문제를 제기한다. 본 증례는 수술 도중에 발생한 다량의 폐동맥 색전증으로 인한 심장 정지에 대하여 효과적인 치료수단으로써 응급 체외 순환기를 사용한 56세의 여자 환자에 대하여 기술하였다. 환자는 와파린을 복용하면서 퇴원하였고, 패동맥 색전증의 재발없이 외래추적 중이다.

• 한국방재학회 논문집
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• 제9권6호
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• pp.69-75
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• 2009

본 연구의 목적은 2006년 평창 수해를 겪으면서 마을 대표인 이장이 수행한 역할과 업무 스트레스를 조사하는데 있다. 전화 설문과 인터뷰에 기반한 연구 결과를 보면, 공식적으로 이장의 역할은 행정기관과 마을 주민을 연결하는 역할을 수행하는 것으로 제한되어 있으나, 실제 재난 과정에서 이장은 주민들을 대피시키고, 자원을 배분하고, 복구를 지휘하는데 있어서 중요한 역할을 수행하였음을 알 수 있다. 게다가 예기치 않은 과도한 부담으로 인하여 상당수의 이장들은 심각한 업무 스트레스를 겪은 것으로 밝혀졌다; 60 퍼센트의 이장들은 이장 업무를 그만두고 싶었고, 약 4분의 3에 해당하는 이장들은 전화 벨이 울릴 때마다 놀랐거나, 몸무게 변화가 있었다고 응답하였다. 또한 카이 제곱 검정 결과에 의하면, 사전 교육, 마을 주민들로부터 욕을 들었는가의 여부, 재난 피해는 업무 스트레스와 통계적으로 의미있게 연관되어 있는 것으로 밝혀졌다. 이러한 결과는 농촌 지역의 재난 관리 계획을 수립하는데 있어서 명령 통제 모델보다는 발현적 인적 자원 모델이 더 효과적인 접근이 될 수 있음을 제시한다.

• 한국재난정보학회 논문집
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• 제11권2호
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• pp.183-190
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• 2015

병원 처치 전 급성 심정지 환자 발생 시 현장에서의 일반인 심폐소생술 시행률은 환자의 소생률과도 직결되어 있다. 하지만 현재 우리나라는 선진국에 비해 일반인 CPR 시행률은 저조하여 소생률도 낮은 실정이다. 따라서 본 연구에서는 이를 개선하기 위해 스마트 폰의 위치기반서비스 앱을 활용한 응급의료시스템의 적용가능성을 고려, 우선 일반인 3,800명을 대상으로 사전 설문조사를 시행하였다. 연구결과로 첫째, 심폐소생술 교육 경험은 높게 나타났으나 반대로 심폐소생술에 대한 보편성은 낮은 것으로 인식되었다. 둘째, 심폐소생술 자신감에 대해서는 연령, 학력, 직업에 따라 상의한 결과가 나왔으며 전체적으로 낮은 자신감을 보였다. 셋째, 위치기반서비스 앱을 활용한 응급의료시스템 참여도는 높게 나타났으며 심폐소생술 시행의지와 심폐소생술 자신감, 심폐소생술 교육경험에 대해서 상관관계가 있는 것으로 나타났다.

• 혜화의학회지
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• 제10권1호
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• pp.237-245
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• 2001

I have come to next conclusions in consequnce of documentary study about medical books of many generations regarding Jung point venesection therapy. 1. Jung point is significant as the beginning of pulse energy flow on meridian, the origin of all meridional pulse energy being located at extrimity terminal, confluence of three yin and three yang, and emergent treatment point. 2. Jung point venesection therapy was much used for the first-aid treatment for acute and thermic disease, and that is the combination of the meaning as of restoration from death and emergent treatment of Jung point and function of openning of orifice, leakage of fever, circulation of blood, remove of edema of venesection therapy. 3. It is very much used for emergency case, five sensory organ disease and CVA, heating shock and so on. Besides that digestive disease, cough, fever with cold, childhood disease, cardiac ache, thoracic disease, numbness of digitus terminal, mental disorder follow that in order. 4. Sosang, Jung point of Arm Greater Yin Lung meridian, is very much used for five sensory organ disease. Sosang is for orbital disease, sangyang for auditory disease, sosang for nasal disease, and sosnag for introitus-throat disease. 5. Ten Jung point is most used for first-aid diseases of CVA, heating shock. 6. Ten Jung point is most used for digestive disease of stomach ache, vomiting, diarrhea, intestinal convulsion. 7. Ten Jung point is most used for cold disease of cough, fever, malaria. 8. Ten Jung point, sosang, kwanchung are much used for childhood disease of acute convulsion and fever. 9. Among Jung point, sosang is most used, 34 times. Next there are Ten Jung point, kwanchung, sangyang, sotaek, jungchung, unbaek, taedon in order. In the order of frequency in use, arm channel is more used than leg channel.

• 대한물리치료과학회지
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• 제3권1호
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• pp.919-927
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• 1996

Recently sports injuries are increasing due to the development of sports leisure industries as well as the increase of exercising population, and the study for sports injuries is needed more than before. Then the author studied the reasons for injuries, incidence rate, sites and sorts of sports injuries for the middle and high school football players during one year period from Jan. to Dec. 1994. The study subjects were 319 middle and high school players in Pusan and the method was questionnaire method. The results were as follows; 1. The average injury rate due to football play was 3.3 times per person for the 319 subjects during the last one year, and it was highest in goalkeeper as 4.6 times by position. 2. 68 % of the subjects did not receive periodic health examination, 74.9 % wore body protectors. The sports injuries due to football play occurred most commonly in soil play-ground(79.6 %), during training(52.3 %), and in winter time(33.7 %). 3. The commonly occurred injuries by motion were coalition(39.2 %), tackle(12.9 %), dribble (11.4 %) in order; those by sorts were contusion(34.4 %), sprain (32.9 %), spasm(9.0 %) ; and those by body portions lower extremities(82 %), trunk(17.6 %), upper extremities(12.5 %). 4. The frequently used treatment area was home care as in 42.7 % ; treatment methods were physical therapy, acupuncture/moxacautery, rest, operation in order; choices of treatment method were recommendation by coach/manager, and that by medical professional was the lowest as in 2.2 %. 5. If sports injury occurred during play, coach or manager let the players take rest in 56.2 %, but emergent management by medical professional was done only in 1.9 %. The return to play was decided mostly by the player himself(52.8 %), but that decided by a doctor was only in 1.0 %. In conclusion, to lessen the sports injuries due to football play, annual physical check-up, strengthening of play rules, improvement of playground, conditioning exercise, regulation of body protectors, and preventive training for expected injuries behaviors should be done and the decision to return to play and emergent management should be done by a medical professional as well. Football player, sports injury, injured body portions, sorts of injury, treatment method.