• Journal of Trauma and Injury
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• v.27 no.4
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• pp.170-177
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• 2014

Purpose: The first regional trauma center selected in Korea was the Gachon University Gil hospital regional trauma center; expectation on its role has been high because of its location in the Seoul metropolitan region. To determine if those expectations are being met, we analyzed the patients visiting the center and their treatment experiences for the past 3 years in order to propose a standard for the operation of a trauma center. Methods: The visiting route, visiting methods, performance of emergency surgery, the ward and the length of stay, the injury mechanism, the injury severity score (ISS), the department that managed the surgery, and the cause of death were analyzed for 367 patients visiting the center from its establishment in June 2011 through December 2013. Results: The mean age of the patients was 47 years (285 male and 82 female patients). A total of 187 patients directly visited the center whereas 180 were transferred to the center. Traffic accidents comprised the majority of injury mechanisms, and 178 patients underwent emergency surgery. The mean length of stay per patient was 11 days for those in the ICU and 27 days for those in a general ward. These patients occupied 4 beds in the ICU and 10 beds in the general ward per day. A total of 1.21 surgeries were performed per patient, and the mean number of surgeries performed per day was 0.49. The mean ISS was 15.91, and 183 patients (50%) had an ISS of ${\geq}16$. Thirty-one patients died; they had a mean ISS of 28.42. The most frequent cause of death was multi-organ failure. The mean number of treatment consultations during a patient's stay was 6.32. Forty-five patients (13%) were discharged from the center, and 291 (79%) were transferred to another hospital. Conclusion: A systematic approach to establishing a treatment model for trauma patients, including injury mechanism, multidisciplinary treatment, and trauma surgeon intervention, is required for treating trauma patients.

• Journal of Wetlands Research
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• v.20 no.2
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• pp.190-200
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• 2018

This study estimated the marginal production value based on the production function approach to confirm the economic value of industrial water supply projects. For this, we analyzed 4 data sets classified by 11 industry types according to Cobb-Douglas Function, Translog Function, and Translog function with sector dummy variables. As a result, the average industrial marginal product value of the entire industry was 3,217~5,357 won/ton, 2,994~4,569 won/ton and 3,620~5,342 won/ton, respectively. The results by industry type were the largest in furniture and other manufacturing industries and showed the lowest marginal production value in the textile and leather industries. Overall, the results from the Cobb-Douglas function were highly evaluated. And the volatility according to data sets was also analyzed in the Cobb-Douglas function. There have been few studies on the economic value of industrial water compared to domestic water. It is considered that multidisciplinary consensus will be needed through active research in the future.

• Tuberculosis and Respiratory Diseases
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• v.59 no.5
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• pp.480-486
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• 2005

Since the year 2000, lung cancer has become the leading cause of cancer death in South Korea as in many other parts of the world. The current multidisciplinary approach for lung cancer includes a wide range of modalities, not only surgery, radiotherapy, medical drug therapy but also pain control, as well as social and psychological support. Therefore, thoracic surgeons, radiologists, nuclear medicine specialists, anesthetists, psychologist, nurses and social workers as well as medical doctors care for lung cancer patients. Sharing a common treatment protocol and optimal communication are vital aspects of shared care both from a medical and cost-effectiveness point of view. We developed a shared electronic medical record (SEMR) for treating patients with lung cancer in a university hospital to facilitate the sharing protocols and communications between doctors involved in a lung cancer clinic. A SEMR system was developed within a order communication system(OCS) for a lung cancer clinic. The records of radiological, laboratory and pathological studies as well as the records of surgery, chemotherapy, and radiotherapy were stored and presented to all doctors who treat the same patient. Every doctor was allowed to change his/her own records. They could review other doctor s records but could not alter them. With the SEMR, it was expected that the time to complete the medical records for one patient could be reduced because it was easy to review all the data from the other doctors who share the same patient. In addition, the confidence of the doctors who share a common treatment protocol would be higher. Therefore, a shared electronic medical record is expected to improve the quality of patient care.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.5 no.1
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• pp.23-26
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• 2009

Mental retardation is defined by the American Psychiatric Association as" subnormal general intellectual functioning which originates during the developmental period and is associated with impairment of either learning and social adjustment or maturation, or both." A patient with mild to moderate mental retardation can be managed adequately using restraints and medications. However, in case of severe or profound mental disability, dental treatment cannot be accomplished even with the use of behavior modification, physical restraints and sedation techniques. When treatment in the dental office has much difficulty, hospitalization for dental treatment under general anesthesia can and should be considered. This case presents the treatment of a patient with mental retardation who was referred to our department for comprehensive dental care. Dental examination revealed widespread dental caries and a severe anterior open bite with crowding problems. Under general anesthesia, generalized caries treatment was performed by our department, and the anterior dental esthetics was achieved in collaboration with the department of prosthodontic dentistry.

• Tuberculosis and Respiratory Diseases
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• v.43 no.6
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• pp.1008-1018
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• 1996

Primary mediastinal nonseminomatous germ cell tumor is extremely rare. Apart from rarity and large size, mediastinal germ cell tumors show striking similarity to testicular tumors in age, incidence, and tumor type. The symptoms associated with these tumors are related mainly to size, invasion of neighboring structures, and distant metastases. Tissue diagnosis is obtained by biopsy of the primary lesion or by biopsy of metastatic sites. Tumors often present with advanced bulky disease, which are unresectable. So these tumors require an aggressive multidisciplinary approach to management. Optimal management includes aggressive surgical debulking and early use of cisplatin-bleomycin-based combination chemotherapy. Serial biomarker measurements permit early recognition of recwrence and improved timing of surgical intervention. The prognosis for mediastinal germ cell tumors is poor, not only because they are far advanced at the time of diagnosis but also because some of the tumors-such as embryonal carcinomas, choriocarcinomas, and endodermal sinus tumors-are very aggressive. In these cases, we present three young male patients with large mass on anterior mediastinum. Tissue diagnosis was obtained by primary lesion biopsy. All patients received surgical debulking and combination chemotherapy and experienced a brief response and eventually had relapses. We report these cases with a review of literatures.

• Archives of design research
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• v.17 no.3
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• pp.81-90
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• 2004

The reason of the appearance of Internet is regarded as a milestone since we have shared information globally in a mutual way. The important thing on this point is what contents we choose for ourselves. The Internet could be meaningless unless we use it in a certain way, which ultimately means that the Internet has to deliver something valuable to us humans. Therefore, we have looked at how we can deliver and share humanity and emotion through the Internet, also how we can instill vital power into our real life, through the Internet. Fortunately, the current study must essentially be ongoing due to its nature with perhaps a multidisciplinary team brainstorming ideas. The reason for that is that not only could we find new business models for companies, but also find out new ways to appease the human mind in the modern age. In addition, as consumers needs become more specialized and diversified, companies are expected to face up to fierce competition with the help of innovative ideas. The ever-intensifying competition requires companies to cultivate new strategic tools in order to have new, powerful and sustainable comparative advantages. The goal of this research will be to explore ways of finding a new approach. Specifically, this research is about how to use the EVC(empathetic virtual character), which, this researcher believes, can deliver emotional benefits so as to make e-branding successful. According to reports, it has been proven that this new concept including the EVC can result in tremendous success. So the goal of this research is to explore the current situation and to anticipate the future concerning virtual characters.

• Journal of Chest Surgery
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• v.42 no.6
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• pp.719-724
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• 2009

Background: As the patients who undergo heart transplantation have achieved better survival in recent years, growing number of recipients are at a risk for experiencing surgical complications in addition to rejection and infection. In this paper, we report on our experience with the surgical complications that occurred in heart transplant recipients. Material and Method: From April 1994 to September 2003, 37 heart transplantations were performed at our center by a single surgeon. The indications for transplantation were dilated cardiomyopathy, ischemic cardiomyopathy, valvular cardiomyopathy and familial hypertrophic cardiomyopathy. Result: Twenty postoperative complications required surgeries in 15 patients (41%). The types of operations required were; redo-sternotomy for bleeding (5), pericardiostomy for effusion (4), implantation of a permanent pacemaker (1), right lower lobe lobectomy for aspergilloma (1), removal of urinary stone (1), cholecystectomy for gall bladder stone (1), drainage of a perianal abscess (1), paranasal sinus drainage (1), total hip replacement (1), partial gingivectomy due to gingival hypertrophy (1), urethrostomy (1), herniated intervertebral disc operation (1) and total hysterectomy for myoma uteri (1). The locations of the complications were mediastinal in 10 (27%) cases and extramediastihalin 10 (27%) cases. Conclusion: The relatively high incidence of extrathoracic complications associated with heart transplantation emphasizes the importance of a multidisciplinary approach to the improve long-term survival when managing those complex patients.

• Journal of the Korea Convergence Society
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• v.12 no.12
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• pp.443-451
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• 2021

This study is a qualitative research using focus group interviews with disabled people and their families to understand the unmet healthcare needs perceived themselves and to analyze the experiences of 'The 2^nd pilot project for primary care for people with disabilities', from 9 to 17 February 2021. The subjects of the study was the disabled who can express their opinions (group 1) or the guardians of the subjects who can not express their opinions (group 2). The participants were interviewed for about 100 minutes for each group once or twice. As a result of this study, the factors regarding unmet healthcare needs were extracted in subject, provider, institutional, and socio-cultural aspects. Further, the factors resolved and unresolved by the pilot project were extracted. Based on the results, we can recommend that the expanded application to the visiting service, inclusion of doctors from various departments, multidisciplinary approach including physical or occupational therapists, minimizing disconnection among the hospitals and healthcare centers, improvement of service quality by collecting opinions from people with disabilities, and more publicity activities should be applied.

• 한국노년학
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• v.36 no.4
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• pp.1177-1189
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• 2016

The dependency is a problem in the aged. The purpose of this study was to investigate depression, urinary incontinence, sleep patterns, and dependence, and to identify affecting factors of dependence on elderly patients in medical and care hospital. The subjects consisted of 209 elderly inpatients in the J city. The variables of dependency, depression, urinary incontinence, sleep were measured using questionnaires. Data analysis was performed using the SPSS 23.0 program, using descriptive statistic, t-test, ANOVA, Pearson correlation coefficient, and multiple regression analysis. Major findings of this study are as follows. The mean score of depression is $6.83{\pm}4.14$(out of 15), urinary incontinence is $6.44{\pm}9.63$(out of 60), sleep hour is $8.09{\pm}1.55$, quality of sleep is $39.37{\pm}6.55$(out of 60), and dependence is $42.68{\pm}8.78$(out of 85). The economic dependence among the subdomain of dependence is the highest dependence score. Dependence was positively correlated with depression(r=.26, p<.001), urinary incontinence(r=.35, p<.001). Factors Influencing dependence were depression (${\beta}.227$, p=.001), urinary incontinence (${\beta}=.259$, p<.001), and explanation of dependence is 11.5%. These results suggest that it is necessary for multidisciplinary approach and nursing intervention for decreasing dependence.

• Archives of Plastic Surgery
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• v.46 no.5
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• pp.462-469
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• 2019

Background Incisional hernia is a common complication following visceral organ transplantation. Transplant patients are at increased risk of primary and recurrent hernias due to chronic immune suppression and large incisions. We conducted a retrospective review of patients with a history of liver or kidney transplantation who underwent hernia repair to analyze outcomes and hernia recurrence. Methods This is a single center, retrospective review of 19 patients who received kidney and/or liver transplantation prior to presenting with an incisional hernia from 2011 to 2017. All hernias were repaired with open component separation technique (CST) with biologic mesh underlay. Results The mean age of patients was $61.0{\pm}8.3years\;old$, with a mean body mass index of $28.4{\pm}4.8kg/m^2$, 15 males (78.9%), and four females (21.1%). There were seven kidney, 11 liver, and one combined liver and kidney transplant patients. The most common comorbidities were hypertension (16 patients, 84.2%), diabetes (9 patients, 47.4%), and tobacco use (8 patients, 42.1%). Complications occurred in six patients (31.6%) including hematoma (1/19), abscess (1/19), seroma (2/19), and hernia recurrence (3/19) at mean follow-up of $28.7{\pm}22.8months$. With the exception of two patients with incomplete follow-up, all patients healed at a median time of 27 days. Conclusions This small, retrospective series of complex open CST in transplant patients shows acceptable rates of long-term hernia recurrence and healing. By using a multidisciplinary approach for abdominal wall reconstruction, we believe that modified open CST with biologic mesh is a safe and effective technique in the transplant population with complex abdominal hernias.