• Journal of The Korean Society of Clinical Toxicology
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• v.8 no.2
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• pp.113-121
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• 2010

Purpose: Drug-induced non-cardiogenic pulmonary edema has been reported on in a drug case series. For most of the agents that cause pulmonary edema, the pathogenic mechanisms that are responsible for the pulmonary edema remain unknown. We report here on the cases of suspected drug-induced pulmonary edema and we analyze the clinical characteristics. Methods: We reviewed the medical records of 1,345 patients who had drug adverse effects and drug poisoning from January 2005 to July 2010, and 480 of these patients were admitted to the EM Department. Among them, 17 patients developed abnormal chest radiological findings and they were analyzed for any clinical characteristics, the initial symptoms, securing the airway and the clinical results. Results: Seventeen patients out of 480 (3.54%) developed drug-induced abnormal chest radiographic pulmonary edema; they displayed initial symptoms that included mental change (41.2%), dyspnea (17.6%), vomiting (11.8%), etc, and some displayed no symptoms at all (11.8%). Only 3 patients out of the 11 who died or had severe pulmonary edema were able to obtain an advanced airway prior to their arrival to the EM Department. Clinical recovery was generally rapid and this was mostly completed within 6 hours. The mortality rate was 11.8% (2 of 17 patients), and the causative drugs were found to be propofol (35.3%, 6 of 17 patients), multiple drugs (41.2% or 7 out of 17) and one patient each with ephedrine, ethylene glycol, doxylamine and an unknown drug, respectively. Conclusion: Drug-induced pulmonary edema and deaths are not uncommon, and recovery is typically rapid with few long-term sequelae when drug administration is discontinued. Oxygen therapy and securing the airway must be performed during transportation for patients with pulmonary edema.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.21 no.1
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• pp.65-68
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• 1999

Multiple facial trauma patient should be carefully treated because of severe bleeding on extraoral and intraoral wound, possibilty of airway obstruction and hypovolemic shock. Hypovolemic shock may be divided to hemorrhagic shock and non-hemorrhagic shock. Also hemorrhagic shock is divided to mild, moderate and severe shock according to the degree of blood volume depletion. Mild shock occurs in blood loss of less than 20% of blood volume and moderate shock does in blood loss of 20-40% of blood volume. And Severe shock occurs in blood loss of more than 40% of blood volume. The goal of emergency care of trauma patient is that respiration and perfusion should be recovered to satisfactory level and that normal vital sign is maintained. We reported the case of multiple facial trauma patient with severe bleeding and hopovolemic shock and metabolic acidosis who was treated with adequate supply of fluid transfusion, intubation, tracheostomy and emergency operation.

• Journal of Korean Public Health Nursing
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• v.11 no.2
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• pp.180-193
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• 1997

This study was designed to set up more developed curriculum in Nursing department of a junior college. The sample for the study were fifteen curriculums of fifteen selected junior colleges in Seoul and Kyunggi area. The credits and hours of each curriculum were analyzed into means and compared with the one of the example college. The data were categorized into seven sections; cultural subject, basic medical science, major subjects such as Nursing, Fundamental Nursing, electives, teaching and non-teaching subjects, and clinical practice. The data were analyzed by means of descriptive statistics. The results of the study were as follows; 1. Credit hours of Cultural subjects of each college ranges from $5.8\%\;to\;25.7\%$ of the total graduate credit hours; most commonaly lectured subjects are English 05 colleges), Korean (11 colleges), psychology (10 colleges), and computer (10 colleges). 2. In the case of the example college, Anatomy and Psychology were jointed as one subject, Basic Nursing Science, and some more study in depth should be made to develop more of this type of conjunction among related subjects on basic medical science. 3. As for the mendatory subjects of the example college, subjects on Adult Nursing was fourteen credits (14 hours), which was higher than the average 12.9 hours of other colleges compared. 4. Credit hours of Basic Nursing Laboratory were eight to ten credits (12-18 hours), which was higher than actual class hours. As more and more hospitals test clinical aptitude when recruiting nurses, more emphasis should be paid to the clinical practice. 5. Among fifteen sample curriculums six to twelve electives were offered with twelve to twenty-three credits. Most commonly opened subjects were Physical Examination (5), Nursing English (14). and Geriatrics Nursing (13). Nursing English are considered to be more important in the view of clinical practice. and Oriental Nursing, Nursing Information and Health Insurance Management should be considered as specialized subjects. 6. Teaching and Non-teaching subjects In case of the example school. Clinical Emergency Medicine, Introduction to Emergency Medicine were offered for these non-teaching class students so they could prepare for the qualification examination. 7. Clinical Practice The average credit hours for clinical practice of the sample college were 20.9 credit hours $(66.5\%)$ and the example school offered twenty credit hours which was slightly lower than the other forteen.

• The Korean Journal of Emergency Medical Services
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• v.16 no.1
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• pp.81-90
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• 2012

Objectives: This study is to research delay time comparison for later defibrillation after hands off according to the changes in defibrillation electrodes. Study purpose: In defibrillation treatment that is the only way for cardiac arrest by arrhythmia, it is to find defibrillator device which can minimize late defibrillation delay time after important affect of hands off. Study object and method: After hands off according to the defibrillator device, we collected total 40 people for emergency medicine doctor, internal medicine doctor, general surgeon, nurse, emergency medical technician who are working at 2 CN, CS University hospitals in Gwangju Jeollanamdo district to find out hand off shock interval(HOSI). We then researched their general properties like occupation sector, experiences in clinic, gender, completion of AHA ACLS-P training and more. Then 40 participants continued ventricular fibrillation cardiac arrest simulation training (using human-model mannequin) designed by researcher and performed their roles as defibrillation operator. Each of participant used manual paddle and performed 4 times of defibrillation (150J) during 8 minutes of CPR and in 8day, the defibrillator devices were replaced from manual paddle to self-adhesive electrodes pads and 4 times of defibrillation (150J) under same simulation condition as manual paddle were performed. Study result: In comparison for delay time of later defibrillation after hands off of manual paddle and self adhesive electrodes pad, the self adhesive electrodes pad ($7.0{\pm}0.5sec$) seemed to reduce delay time of later defibrillation significantly (p<0.05) compared to manual paddle ($10.0{\pm}0.9sec$). The self adhesive electrodes pad, according to the general properties of participants, had no particular change in delay time after later defibrillation for the statistics (p>0.05) but the manual paddle had statistically significant differences for the occupation sector, experiences in clinic and gender (p<0.05). Conclusion: In defibrillation, the self adhesive electrodes pad($7.0{\pm}0.5sec$) showed short HOSI compared to manual paddle ($10.0{\pm}0.9sec$) significantly (p<0.05) and it applied identically for both existence and non-existence of ACLS-P training completion, experiences in clinic, gender and occupation sector. The manual paddle had also significant difference in experiences in clinic and occupation sector (p<0.05). which means the effect on HOSI according to the job mastery. Therefore, if the clinic experience is short or in case for the occupations without frequent defibrillation treatment has a danger of lowering success rate for the defibrillation using manual paddle. Therefore, it is true that using self adhesive electrodes pad for defibrillation electrodes when performing manual defibrillation in pre-hospital as well as in-hospital steps can generally minimize delay time of later defibrillation after hands off.

• SUVANNABHUMI
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• v.8 no.2
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• pp.79-111
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• 2016

Malaya attained independence on August 31, 1957 from Britain. However this new nation faced a communist insurgency known today as the "Malayan Emergency" (1948-1960). Then in 1961, Tunku announced a wider federation of "Malaysia", viz. Malaya, British Crown Colonies of Singapore, Sarawak and North Borneo, and the protectorate of Brunei. Countering communism was a principal motive for "Malaysia". Sarawak's leftist elements were rejected with an armed opposition. Malaysia was formed excluding Brunei. Amidst its birth pangs, Malaysia faced hostile neighbors Indonesia and the Philippines; the former objected by way of Konfrontasi (1963-1967) while the latter laid claim to Sabah (formerly North Borneo). Malaya/ Malaysia was borne in the midst of the Cold War (1947-1991), a bipolar world between the US and the USSR. Malaya/Malaysia is utilized as a case of analysis and evaluation in the context of the twin trends of continuities and transformations in tracing the historical developments from the 1950's to the 1990's. The risks, motives, and challenges that prompted the shift in foreign relations reveal as much of the personality of the political leadership, the prevailing situations, and conditions from within and circumstances from without.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.7
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• pp.3427-3430
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• 2012

Aim: The significance of the mucinous adenocarcinoma in TNM staging and prognosis for colorectal tumor patients is still controversial. The aim was to provide a meta-analysis for TNM staging and prognostic features of colorectal tumors. Methods: 30 individual case-control studies were finally included into this meta-analysis, involving a total of 444,489 cancer cases and 45,050 mucinous adenocarcinomas, of relations with TNM staging and prognostic features. Results: Compared to non-mucinous adenocarcinoma patients, the TNM IV stage accounted for a larger percentage of mucinous adenocarcinomas (OR=1.48, 95%CI 1.28-1.71, POR<0.001) and the prognosis was significantly poor (HR=1.06, 95%CI 1.04-1.08, P<0.001). After heterogeneity testing, the results was similar to the holistic approach outcome (HR=1.48, 95%CI 1.35-1.62, P<0.001). Conclusion: Compared to patients with non-mucinous adenocarcinomas, mucinous adenocarcinoma patients with later TNM staging make up a big percentage, and mucinous adenocarcinoma is an independent risk factor for poor prognosis.

• Journal of the Korean Society of Marine Environment & Safety
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• v.27 no.2
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• pp.275-285
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• 2021

COVID-19 is threatening the safety of ships and seafarers by delaying seafarer rotation. Shipping companies and governments have a blindspot in case of the onboard environment of seafarers. An effective, alternative plan should be devised to eliminate the possibility of human accidents in an emergency that threatens the safety of seafarers. According to the survey of former and current seafarers, the most important factor in boarding life was safety, and the most necessary thing during emergencies was to secure smooth seafarer rotation rather than improve wages and welfare. By analyzing the major routes of national shipping companies by continent, ports with a large number of calls and a high Air Connectivity Index were selected as the base port. In addition, the route was designed for effective, domestic seafarer rotation during international shipping. Other countries must be consulted to establish a travel route linking ships, ports, and airports for the safe return of sailors to their home countries during an emergency. In addition, it is necessary to work together for the seafarers who are in trouble of seafarer rotation through cooperation with the International Maritime Organization(IMO). Starting with this, the government should have a monitoring system for the return and non-return routes as well as the number of seafarers on board. If such a system is established, it will be able to determine the response direction of our country's policy in case of an emergency. Along with the shipping company's ef orts to improve the treatment of seafarers, national and social attention will be needed to review domestic laws and improve awareness about seafarers.

• Journal of Chest Surgery
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• v.26 no.8
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• pp.654-660
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• 1993

The incidence of pulmonary leiomyosarcoma is very rare as a primary lung tumor. Usually, pulmonary leiomyosarcoma arise from the smooth muscle present in the bronchi or blood vessles. We had experienced two cases of primary pulmonary leiomyosarcoma. The first case was 28-year old male patient who had been in good health until admission, when he experienced an episode of dyspnea and sudden hemoptysis. The chest X-ray film revealed a large round tumor mass in left lower lobe measuring 6.5x9.5x5.3cm in dimension. On physical examination,the patient was friction rub and rales on the left lower chest and postoperative course was smooth and non-eventful. Emergency left lower lobectomy was performed due to repeated hemoptysis. Chemotheraphy was done postoperatively as an adjuvant therapy.The second case was 52-year-old man who had been well prior to admission, when recently he noticed a abrupt growing tendency of old pulmonary coin lesion in right lower lobe on routine physical examination. Since 1968, small round mass was gradually enlarged very slowly, during recent one year interval, the tumor mass was enlarged abruptly as twice in size on chest X-ray. Bronchoscopic examination revealed no specipic findings. Right lower lobectomy was performed and pathologic examination was answered as primary leiomyosarcoma without lymph node metastasis. Postoperative course was smooth, except local wound infection.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.22 no.6
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• pp.619-623
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• 2019

We report the case of a seven-year-old boy with an ingested foreign body, which was retained within the appendix for a known duration of ten months, ultimately requiring appendectomy. The ingested foreign body was incidentally discovered by abdominal x-ray at an emergency room visit for constipation. Despite four bowel cleanouts, subsequent x-rays showed persistence of the foreign body in the right lower quadrant. While the patient did not have signs or symptoms of acute appendicitis, laparoscopic appendectomy was performed due to the risk of this foreign body causing appendicitis in the future. A small metallic object was found within the appendix upon removal. This case highlights the unique challenge presented by foreign body ingestions in non-verbal or developmentally challenged children and the importance of further diagnostic workup when concerns arise for potential retained foreign bodies.

• Safety and Health at Work
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• v.13 no.4
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• pp.507-511
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• 2022

Law enforcement officers (LEOs) often encounter rapidly changing and uncontrolled situations that expose them to various hazards. A law enforcement agency requested an evaluation by the National Institute for Occupational Safety and Health (NIOSH) when multiple LEOs reported illness after executing a search warrant and taking a suspect into custody. NIOSH investigators interviewed LEOs and reviewed medical records, forensic laboratory results for collected evidence, and environmental testing results of samples taken after the operation. Two-thirds (25 of 38) of LEOs who participated in the operation reported ≥1 symptom. Eleven LEOs met a case definition for influenza-like illness (ILI). Members of one unit were more likely to have ILI than non-members (prevalence ratio (PR), 4.1; 95% confidence interval (CI): 1.3-13.0; p = 0.01). Influenza vaccination was associated with a lower prevalence of ILI (PR, 0.2; 95% CI, 0.1-0.9; p = 0.02). Preventing employees from working while ill and annual influenza vaccination might prevent similar occurrences.