• Title/Summary/Keyword: medical support system

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Does Additional Aortic Procedure Carry a Higher Risk in Patients Undergoing Aortic Valve Replacement?

  • Kim, Tae-Hun;Park, Kay-Hyun;Yoo, Jae Suk;Lee, Jae Hang;Lim, Cheong
    • Journal of Chest Surgery
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    • v.45 no.5
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    • pp.295-300
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    • 2012
  • Background: With growing attention to the aortopathy associated with aortic valve diseases, the number of candidates for accompanying ascending aorta and/or root replacement is increasing among the patients who require aortic valve replacement (AVR). However, such procedures have been considered more risky than AVR alone. This study aimed to compare the surgical outcome of isolated AVR and AVR combined with aortic procedures. Materials and Methods: A total of 86 patients who underwent elective AVR between 2004 and June 2010 were divided into two groups: complex AVR (n=50, AVR with ascending aorta replacement in 24 and the Bentall procedure in 26) and simple AVR (n=36). Preoperative characteristics, surgical data, intra- and postoperative allogenic blood transfusion requirement, the postoperative clinical course, and major complications were retrospectively reviewed and compared. Results: The preoperative mean logistic European System for Cardiac Operative Risk Evaluation (%) did not differ between the groups: $11.0{\pm}7.8%$ in the complex AVR group and $12.3{\pm}8.0%$ in the simple AVR group. Although complex AVR required longer cardiopulmonary bypass ($152.4{\pm}52.6$ minutes vs. $109.7{\pm}22.7$ minutes, p=0.001), the quantity of allogenic blood products did not differ ($13.4{\pm}14.7$ units vs. $13.9{\pm}11.2$ units). There was no mortality, mechanical circulatory support, stroke, or renal failure requiring hemodialysis/filtration. No difference was found in the incidence of bleeding (40% vs. 33.3%) which was defined as red blood cell transfusion ${\geq}5$ units, reoperation, or intentional delayed closure. The incidence of mediastinitis (2.0% vs. 0%), ventilator ${\geq}24$ hours (4.0% vs. 2.8%), atrial fibrillation (18.0% vs. 25.0%), mean intensive care unit stay (34.5 hours vs. 38.8 hours), and median hospital stay (8 days vs. 7 days) did not differ, either. Conclusion: AVR combined with additional aortic or root replacement showed an excellent outcome and recovery course equivalent to that after isolated AVR.

A Previous Study on Customized Visualization Expression of Personal Health Record (개인건강기록의 맞춤형 시각화 표현을 위한 선행연구)

  • Yang, Junggi;Lee, Yong-Jun;Kim, Hae-Na;Lee, YoungHo
    • Journal of the Korea Society of Computer and Information
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    • v.19 no.11
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    • pp.115-126
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    • 2014
  • In order to improvement of the perceptive of health state and the motivation, this study suggests the ways and design forms which provide PHR information customizing individual attributes as well as guidelines through a decision support system and services which integrate medical information visualization. Expression methods using the color, form, position in order to visualization based on images improved performance of information awareness by changing radar chart from existing information which provide only numerical figure. The methods providing a graphic figure which seems like beads of blood which shows the result of blood tests would also arise patient's attention. They gives the patient's information which is able to compare their health status and normal status and visualizes the records as a human figure in order to perceiving their status as well. The visualization showing the position of human body figures marks in inspection elements located in position of relevant organs. The method also uses icons represent examination results so they improve attention of the results and shorten recognize times.

A Study on the Special Needs of the Hearing-Impaired Person for Disaster Response (청각장애인 재난대응 욕구에 관한 연구)

  • Kim, Soungwan;Kim, Hey Sung;Roh, Sungmin
    • 재활복지
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    • v.21 no.2
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    • pp.63-88
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    • 2017
  • This study evaluated the actual status of special needs of the hearing-impaired person for disaster response. The analysis revealed a significant level of unmet needs in disaster response for hearing-impaired person. The 5 special needs in disaster response include: 1) communication needs, which involve securing the means to make an emergency rescue request and communicating information during the rescue process; 2) transportation needs, which indicate the effective evacuation capacity and the level of training; 3) medical needs, which address the degree of preparedness for physical and mental emergency measures and the delivery of health information for rescue and first aid process; 4) maintaining functional independence needs, which refer to the level of self-preparedness to minimize damage in disaster situations, and; 5) supervision needs, which correspond to a personalized support system provided to disaster-vulnerable groups.

A Study on the Experience of Non-face-to-face Lecture by College Freshmen Using Focus Group Interview (포커스 그룹 인터뷰를 활용한 대학 신입생들의 비대면 강의 경험에 대한 연구)

  • Kang, Jin-Ho;Son, Sung-Min;Han, Sueng-Tae
    • Journal of Korea Entertainment Industry Association
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    • v.14 no.7
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    • pp.397-408
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    • 2020
  • This study conducted a focus group interview with 15 college freshman from J college to find out their experiences in non-face-to-face lectures with COVID-19. The contents of the interview were recorded and conducted, and the meaning was analyzed according to the focus group interview procedure through repeated listening. Components were 'Operation of non-face-to-face lectures in unprepared situations', 'Loss of orientation in lectures and departure from learning', 'One way listening', 'The convenience of taking a lectures'. The experience of 'Operating non-face-to-face lectures in unprepared situations' included the start of mixed non-face-to-face lectures, cumbersome and inconvenient online systems, and the demand for tuition refunds. The experience of 'Loss of orientation in lectures and departure from learning' has experienced difficulty in concentrating on lectures, Deficiency in the degree of recognition of learning content, and burden of assignments and exams. The experience of 'One way listening' has experienced lack of interaction between professors and learners and non reflection of liveliness in the field. Finally, participants experienced satisfaction with being able to lectures and repeat lectures at anytime and anywhere they wanted with the convenience of taking lectures. Based on this study, participants called for improvements in the quality lecture contents and interaction between professors and learners, and it is thought that universities will need administrative and financial support and education design and system construction to construct high-quality lecture contents.

The Effect of Height of Cane for Health Promotion on Mobility of Patients with Stroke (뇌졸중 환자의 건강증진을 위한 지팡이 높이가 보행과 체중지지율에 미치는 영향)

  • Seo, Tae-Hwa;Kwon, Sang-Min;Jeong, Yeon-Woo
    • Journal of Korea Entertainment Industry Association
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    • v.13 no.1
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    • pp.207-215
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    • 2019
  • This study examines the effect of the height of cane that hemiplegic patients due to stroke use on their plantar pressure in standing position, gait speed. The study suggests a new standard for appropriate cane height that considers the change of average height of population. Research subjects included 12 patients hospitalized in S Medical Care Hospital located in Gwangju Metropolitan City in South Korea who were diagnosed with stroke. Group A uses a cane of the height of the greater trochanter of femur, group B uses a cane of 5cm above the height of the greater trochanter of femur, and group C is a cane of 10cm above the height of the greater trochanter of femur. In the study result, non-affected side plantar pressure and affected side plantar pressure showed a significant difference among the cases where the cane height was the same as the A group, B group, C group. In the post-hoc analysis result, a significant difference was observed between the case of A group and C group. Gait speed showed no significant difference among the case of the A group, B group, C group. The asymmetry of the stroke affects not only the posture but also the walking that is related to daily life. Changes in the height of the cane did not affect walking speed. The change in the height of the cane showed a change in the weight support ratio, which is thought to have a positive effect on the asymmetry. In future clinical setting, this study result will be able to provide fundamental data regarding the cane height in the standing or walking therapy for hemiplegic patients due to stroke with cane application.

Firefighting and Cancer: A Meta-analysis of Cohort Studies in the Context of Cancer Hazard Identification

  • Nathan L. DeBono;Robert D. Daniels ;Laura E. Beane Freeman ;Judith M. Graber ;Johnni Hansen ;Lauren R. Teras ;Tim Driscoll ;Kristina Kjaerheim;Paul A. Demers ;Deborah C. Glass;David Kriebel;Tracy L. Kirkham;Roland Wedekind;Adalberto M. Filho;Leslie Stayner ;Mary K. Schubauer-Berigan
    • Safety and Health at Work
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    • v.14 no.2
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    • pp.141-152
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    • 2023
  • Objective: We performed a meta-analysis of epidemiological results for the association between occupational exposure as a firefighter and cancer as part of the broader evidence synthesis work of the IARC Monographs program. Methods: A systematic literature search was conducted to identify cohort studies of firefighters followed for cancer incidence and mortality. Studies were evaluated for the influence of key biases on results. Random-effects meta-analysis models were used to estimate the association between ever-employment and duration of employment as a firefighter and risk of 12 selected cancers. The impact of bias was explored in sensitivity analyses. Results: Among the 16 included cancer incidence studies, the estimated meta-rate ratio, 95% confidence interval (CI), and heterogeneity statistic (I2) for ever-employment as a career firefighter compared mostly to general populations were 1.58 (1.14-2.20, 8%) for mesothelioma, 1.16 (1.08-1.26, 0%) for bladder cancer, 1.21 (1.12-1.32, 81%) for prostate cancer, 1.37 (1.03-1.82, 56%) for testicular cancer, 1.19 (1.07-1.32, 37%) for colon cancer, 1.36 (1.15-1.62, 83%) for melanoma, 1.12 (1.01-1.25, 0%) for non-Hodgkin lymphoma, 1.28 (1.02-1.61, 40%) for thyroid cancer, and 1.09 (0.92-1.29, 55%) for kidney cancer. Ever-employment as a firefighter was not positively associated with lung, nervous system, or stomach cancer. Results for mesothelioma and bladder cancer exhibited low heterogeneity and were largely robust across sensitivity analyses. Conclusions: There is epidemiological evidence to support a causal relationship between occupational exposure as a firefighter and certain cancers. Challenges persist in the body of evidence related to the quality of exposure assessment, confounding, and medical surveillance bias.

Peritoneal Protein Loss in Nephrotic Syndrome on Peritoneal Dialysis (복막 투석 중인 신증후군 환자의 복막을 통한 단백 소실)

  • Ahn, Yo-Han;Jung, Eui-Seok;Lee, Se-Eun;Lee, Hyun-Gyung;Lee, So-Hee;Kang, Hee-Gyung;Ha, Il-Soo;Jung, Hae-Il;Choi, Yong
    • Childhood Kidney Diseases
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    • v.13 no.2
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    • pp.189-196
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    • 2009
  • Purpose : The pathophysiologic mechanism of nephrotic syndrome is not yet known clearly. At least in some cases, certain 'circulating factors' are thought to increase the glomerular protein permeability. Considering the systemic effect of the circulating factor on peritoneal membrane, we evaluated the loss of protein through peritoneal membrane in patients on peritoneal dialysis due to the end stage renal disease (ESRD) caused by steroid resistant nephrotic syndrome (SRNS). Methods : We retrospectively reviewed the medical records of 26 pediatric patients on peritoneal dialysis ensued during the period from 2001 to 2007 at our clinic. Twelve patients had SRNS, while 14 patients had ESRD caused by the congenital anomalies of urinary system. Results : While the other parameters including nPNA indicating the adequacy of protein intake were similar between the two groups, serum albumin was lower in SRNS patients than the non-SRNS patients ($3.7{\pm}0.3$ g/dL vs. $4.0{\pm}0.4$ g/dL, P=0.021). Peritoneal protein loss was higher in SRNS patients than in non-SRNS patients ($3,044.4{\pm}837.6\;mg/m^2$/day vs. $1,791.6{\pm}1,244.0\;mg/m^2$/day, P=0.007). The protein permeability of the peritoneal membrane measured by the ratio of total protein concentration in dialysate to plasma was twice as high in SRNS patients as the non-SRNS ($1.06{\pm}0.46%$ vs. $0.58{\pm}0.43%$, P=0.010). After 1 year, peritoneal protein loss increased in both patient groups, but to a significantly greater degree in non-SRNS patient (P=0.023). Conclusion : The results of our study support the notion that in nephrotic syndrome there are some 'circulating factors' with the systemic effect. Since the greater protein loss through peritoneal membrane in SRNS was confirmed in this study, more meticulous nutritional support and close monitoring on the nutrition are required in these patients.

Role of Ascorbic Acid in the Depolymerization of Hyaluronic Acid by $Fe^{++}$ and $H_2O_2$ ($Fe^{++}$$H_2O_2$에 의한 hyaluronic acid 분해에 있어서 ascorbic acid의 역할)

  • Lee, Jung-Soo;Chung, Myung-Hee;Lim, Jung-Kyoo;Park, Chan-Woong;Cha, In-Joon
    • The Korean Journal of Pharmacology
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    • v.21 no.1
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    • pp.62-77
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    • 1985
  • In tile Iron-catalyzed Haber-Weiss reaction to produce OH., the requirement for $O^{-}_{2}{\cdot}$ is only to reduce $Fe^{+++}$. Possibly, the role of $O^{-}_{2}{\cdot}$ can be replaced by other reducing agents. Ascorbate is one of them in biological system. In the present study, the ability of ascorbate to produce $OH{\cdot}$ in the presence of $Fe^{++}$ and $H_2O_2$ was investigated by observing the degradation of hyaluronic acid and ethylene production from methional. Ascorbate stimulated the degradation of hyaluronic by $Fe^{++}$ and $H_2O_2$. That was confirmed by both viscosity change and gel-permeation chromatographic analysis. The observed degradation was almost completely prevented by catalase and $OH{\cdot}$ scavengers. In support of the above results, ascorbate enhanced the prouction of ethylene from methional in the presence of $Fe^{++}$ and $H_2O_2$. Other reducing agents (cysteine, glutathione, NADH and NADPH) showed similar activities to ascorbate in the degradation of hyaluronic acid and ethylene production. But no stimulatory effects were observed with their oxidized forms such as NAD and NADP. Thus, it appears that reduction of the metal ion was needed for $OH{\cdot}$ production. Among the metal ions tested, $Fe^{++}$ showed most potent catalytic action in the production of $OH{\cdot}$ The results obtained support that ascorbate can substitute $O^{-}_{2}{\cdot}$ in the metal-catalyzed reactions, particularly with $Fe^{++}$ by which $OH{\cdot}$ is produced with $H_2O_2$. The significance of the ascorbate-dependent production of $OH{\cdot}$ was considered with respect to possible role of ascorbate in the damage of inflamed joints.

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Research on the Measures and Driving Force behind the Three Major Works of Daesoon Jinrihoe in North Korea in Case of the Respective Types of Unification on the Korean Peninsula (한반도 통일 유형별 북한지역의 대순진리회 3대 중요사업 추진 여건과 방안 연구)

  • Park, Young-taek
    • Journal of the Daesoon Academy of Sciences
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    • v.39
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    • pp.137-174
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    • 2021
  • The main theme of this paper centers on how to promote Three Major Works of Daesoon Jinrihoe, charity aid, social welfare, and education projects, during the unification period. Determining the best methods of promotion is crucial because the Three Major Works must be carried out after unification, and the works must remain based on the practice of the philosophy of Haewon-sangsaeng (the Resolution of Grievances for Mutual Beneficence). The idea of Haewon-sangsaeng is in line with the preface of the U.N. Charter and the aim of world peace. North Korean residents are suffering from starvation under their devastated economy, which is certain to face a crisis of materialistic deficiency during reunification. In this study, the peaceful unification of Germany, unification under a period of sudden changes in Yemen, and the militarized unification of Vietnam were taken as case studies to diagnose and analyze the conditions which would affect the implementation of the Three Major Works. These three styles of unification commonly required a considerable budget and other forms of support to carry out the Three Major Works. Especially if unification were to occur after a period of sudden changes, this would require solutions to issues of food, shelter, and medical support due to the loss of numerous lives and the destruction of infrastructure. On the other hand, the UNHCR model was analyzed to determine the implications of expanding mental well prepared and sufficiently qualified professionals, reorganizing standard organizations within complex situations, task direction, preparing sufficient relief goods, budgeting, securing bases in border areas with North Korea, and establishing networks for sponsorship. Based on this, eight detailed tasks in the field of system construction could be used by the operators of the Three Major Works to prepare for unification. Additionally, nine tasks for review were presented in consideration of the timing of unification and the current situation between South and North Korea. In conclusion, in the event of unification, the Three Major Works should not be neglected during the transition period. The manual "Three Major Works during the Unification Period" should include strategic points on organizational formation and mission implementation, forward base and base operation, security and logistics preparation, public relations and external cooperation, safety measures, and transportation and contact systems.

A Study on Perception and Attitudes of Health Workers Towards the Organization and Activities of Urban Health Centers (도시보건소 직원의 보건소 업무에 대한 인식 및 견해)

  • Lee, Jae-Mu;Kang, Pock-Soo;Lee, Kyeong-Soo;Kim, Cheon-Tae
    • Journal of Yeungnam Medical Science
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    • v.12 no.2
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    • pp.347-365
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    • 1995
  • A survey was conducted to study perception and attitudes of health workers towards health center's activities and organization of health services, from August 15 to September 30, 1994. The study population was 310 health workers engaged in seven urban health centers in Taegu City area. A questionnaire method was used to collect data and response rate was 81.3 percent or 252 respondents. The following are summaries of findings: Profiles of study population: Health workers were predominantly female(62.3%); had college education(60.3%); and held medical and nursing positions(39.6%), technicians(30.6%) and public health/administrative positions(29.8%). Perceptions on health center's resources: Slightly more than a half(51.1%) of respondents expressed that physical facilities of the centers are inadequate; equipments needed are short(39.0%); human resource is inadequate(44.8%); and health budget allocated is insufficient(38.5%) to support the performance of health center's activities. Decentralization and health services: The majority revealed that the decentralization of government system would affect the future activities of health centers(51.9%) which may have to change. However, only one quarter of respondents(25.4%) seemed to view the decentralization positively as they expect that it would help perform health activities more effectively. The majority of the respondents(78.6%) insisted that the function and organization of the urban health centers should be changed. Target workload and job satisfaction: A large proportion (43.3%) of respondents felt that present target setting systems for various health activities are unrealistic in terms of community needs and health center's situation while only 11.1 percent responded it positively; the majority(57.5%) revealed that they need further training in professional fields to perform their job more effectively; more than one third(35.7%) expressed that they enjoy their professional autonomy in their job performance; and a considerable proportion (39.3%) said they are satisfied with their present work. Regarding the personnel management, more worker(47.3%) perceived it negatively than positive(11.5%) as most of workers seemed to think the personnel management practiced at the health centers is not fair or justly done. Health services rendered: Among health services rendered, health workers perceived the following services are most successfully delivered; they are, in order of importance, Tb control, curative services, and maternal and child health care. Such areas as health education, oral health, environmental sanitation, and integrated health services are needed to be strengthening. Regarding the community attitudes towards health workers, 41.3 percent of respondents think they are trusted by the community they serve. New areas of concern identified which must be included in future activities of health centers are, in order of priority, health care of elderly population, home health care, rehabilitation services, and such chronic diseases control programs as diabetes, hypertension, school health and mental health care. In conclusion, the study revealed that health workers seemed to have more negative perceptions and attitudes than positive ones towards organization and management of health services and activities performed by the urban health centers where they are engaged. More specifically, the majority of health workers studied revealed to have the following areas of health center's organization and management inadequate or insufficient to support effective performance of their health activities: Namely, physical facilities and equipments required are inadequate; human and financial resources are insufficient; personnel management is unsatisfactory; setting of service target system is unrealistic in terms of the community needs. However, respondents displayed a number of positive perceptions, particularly to those areas as further training needs and implementation of decentralization of government system which will bring more autonomy of local government as they perceived these change would bring the necessary changes to future activities of the health center. They also displayed positive perceptions in their job autonomy and have job satisfactions.

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