• Journal of Chest Surgery
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• v.56 no.2
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• pp.108-116
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• 2023

Background: Resuscitative endovascular balloon occlusion of the aorta (REBOA) has recently gained popularity as an adjunct to resuscitation of patients with traumatic shock. However, the effectiveness of REBOA is still debated because of inconsistent indications across centers and the lack of medical records. The purpose of this study was to investigate the effectiveness and feasibility of REBOA by analyzing clinical results from a single center. Methods: This study included 96 patients who underwent REBOA between August 2016 and September 2021 at a regional trauma center according to the center's treatment algorithm for traumatic shock. Medical records, including the time of the decision to conduct the REBOA procedure, time of operation, type of aortic occlusion, and clinical outcomes, were collected prospectively and analyzed retrospectively. Patients were classified by REBOA protocol (group 1, 2, or 3) and survival status (survivor or non-survivor) for analysis. Results: The overall success rate of the procedure was 97.9%, and the survival rate was 32.6%. In survivors, blood pressure was higher than in non-survivors both before the REBOA procedure (p=0.002) and after aortic occlusion (p=0.03). The total aortic occlusion time was significantly shorter (p=0.001) and the proportion of partial aortic occlusion was significantly higher (p=0.014) among the survivors. The non-survivors had more acidosis (p<0.001) and higher lactate concentrations (p<0.001) than the survivors. Conclusion: REBOA may be a feasible bridge therapy for resuscitation of patients with traumatic shock. Prompt and accurate decision-making to perform REBOA followed by damage control surgery could improve survival rates and clinical outcomes.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.27 no.1
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• pp.43-52
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• 2024

Purpose: In this study, we investigated the clinical profile, survival at discharge, and proportion of children with acute liver failure (ALF) meeting the criteria for, yet surviving without, liver transplantation (LT). Methods: Medical case records of children aged >28 days to ≤15 years over a period of 7 years, identified from pediatric admission and discharge registers, were screened. Children satisfying the criteria for ALF were included in this study. Results: A total of 71 records meeting the pediatric ALF (PALF) criteria were included. The survival rate at discharge was 61% (n=44). A considerable proportion of children satisfied the King's College Criteria (KCC) (56.3%) and the European Association for the Study of the Liver (EASL) criteria (7%) for LT at admission. Nonetheless, the survival rate in the absence of LT was 42.5% in children who satisfied the KCC and 20% in those who met the EASL criteria. Infection (29.5%) and paracetamol overdose (19.7%) were the major identifiable causes of PALF. Hepatitis A was the most common infection identified. No significant predictors of poor outcomes were identified in multivariable analysis. Conclusion: Our study highlights the changing survival rates and the clinical and etiological profiles of patients with PALF. In areas with poor access to LT services, survival in these children could be improved through early referral to centers with adequate intensive care facilities. Preventing ALF and referring patients to LT services are paramount to reducing mortality.

• Journal of Korean Society of Archives and Records Management
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• v.3 no.1
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• pp.1-21
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• 2003

In this paper the characteristics of the script centers golden and/or silver letter center in Koryo Dynasty and a set of seven rolls of the script written in silver letter on blue paper prayed by Yearn Seong-Ik were studied with focusing on the referred records and an epilog of the script. This script was discovered from Namgewon's stone stupa, when it was transported from original site of Daekam Dong, Kaiseong city to Kyungbok Palace in 1919. This script prayed by Yeom Seong-Ik which was written in silver paste on blue papers is a set of seven rolls, the size is 31.1 cm (length) ${\times}$ 27.2 cm (width). The cover painting and Beonsangwha(Buddha's preaching picture) were painted out and in the roll cover. This script was written with 14 letters on a line whose characteristic with the style of cover painting and Beonsangwha is similar to the golden and silver scripts prayed by kings of Koryo Dynasty. The person who prayed this script was a powerful vassal of the king Chungyeol period, Yeom Seong-Ik. According to Koryosa(Koryo History) and Koryosa jeolyo(summarized Koryo History), it is described that Yeom Seong-Ik offered his own house which was built by a group of strangers as a 'Writing Place for the complete collection of Buddhist Sutras and the place of the script of the complete collection of Buddhist Sutras. Therefore, it is possible to consider that this script a set of seven rolls of the script of Saddharma Pundarika-Sutra was written to pray for himself as well as his families' fortune at the place of golden script of the complete collection of Buddhist Sutras, and enshrined it in the Namgaewon stone stupa when the stupa was repaired in 9th year of king ChungYeol. Above all the most important point should be centered on that he offered his house as a writing place for golden script of the complete collection of Buddhist Sutras as recorded in Koryosa Jeolyo. The writing place for golden script of the complete collection of Buddhist Sutras should be emphasized on the meaning of its site. It is an important key point to clear that Kumjawon(Golden letter center) would be different from Kumjadejangso(the writing place of golden script for complete collection of Budihist Sutras) with Kumkyungsa(Goldm script place). As considereing the point that this script showed the characteristics of golden and/or silver scripts which prayed by king Chungyeol in Koryo Dynasty as they were, even though this script was manufactured by individual praying, this script follwed in the style of Kumjawon(golden letter center) and/or Unjawon(siIver letter center) as they were, because this script was written in the place of the golden script for the complete collection of Buddhist Sutras. In this paper all of the points described above with focusing on the referred records and an epilog of this script were collectively considered to make clear the characteristics of the script centers, golden and/or silver letter.

• Korean Journal of Community Nutrition
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• v.4 no.2
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• pp.207-218
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• 1999

The increased number of elderly in Korea presents great challenges for community nutrition programs. Strategies to enhance elderly nutrition are needed, as well as dietary advice that are reality-based and tailored to the need of the elderly. The purpose of this study was to evaluate the overall effectiveness of an elderly nutrition improvement program(ENIP), by assessing changes in nutrition knowledge, attitudes, and behavior after program completion. ENIP was conducted in Suwon for 4 months in 1998 at 5 centers for the elderly. The program provided individual nutrition counseling and brief biweekly group education sessions. To stimulate participation and motivation, the elderly in two centers were served free milk packs(200ml) three time a week during the program(milk＋education group), and the elderly in 3 other centers were served yoghurt on the program day(education group). Altogether, 102 subjects finished the program(milk＋education group 67 ; education group 35). Data about nutrition knowledge, dietary attitudes, diet records(24 hour recall) and dietary habit was collected before(baseline) and after the program(follow-up). The Drop-out rate for the milk＋education group(2.9%) was significantly lower than that for the education group(30.0%)(p<.001). The Nutrition Knowledge fo females milk＋education group increased significantly after the program, but no significant differences were observed in other groups. Over 60% of all the elderly showed positive responses to the healthy eating attitudes. Energy, protein, vitamin A, riboflavin, Calcium and Potassium intakes improved in the male milk＋education group. The Vitamin C intake improved in the male education group. Energy and vitamin A intakes improved in the female milk＋education group and energy, vitamin A, thiamin, riboflavin, niacin, Ca nad P in the female education group. A stepwise multiple regression analysis was performed to examine the effects of food intake changes on overall nutrient quality. For all elderly, the fish intake explained 12.6% of the variance, followed by candy intake and vegetable intake(model $R^2$=19.6%). Dietary habits such as meal time regularity and salty food reduction were markedly improved in both groups. Sixty-one percent of the milk＋education subjects stated their participation was voluntary and active, while 51% of education subjects did. Sixty four percent of the subjects stated their interest on diet increased remarkably through program participation. Considering the results, it is conjectured that ENIP had a great impact on nutrient intake, dietary attitudes and habits. Milk supplement showed no direct effects on elderly nutrition improvement, but it encouraged the program by reducing drop-out rates and inducing voluntary participation. Therefore milk supplement could enhance the community nutrition education program. Moreover it is strongly suggested that the ENIP be expanded to other communities.

• Health Policy and Management
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• v.13 no.2
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• pp.67-84
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• 2003

Immunization has been one of the most effective measures preventing from infectious diseases. However, children routine vaccination rate of Korea was 68.2% and it was not higher than expected. Korean government revised the School Health Law for every primary school children to submit the vaccination certificate record from 2005. It is quite important national Infectious disease prevention policy to keep the immunizations rate high and monitor the immunizations rate continuously. To do this, National Institute of Health introduced the National Immunization Registry(NIR) Program at 2000. Objective : The aims of this study was to evaluate the Immunization Registry program which has been implementing since 2000 at the Public Health Centers(PHC). Methods : The mail survey was done from November 2001 to January 2002. 169 (69%) Public Health Centers among 244 PHC were responded. Results : The respondents of PHC sud the Immunization Registry(IR) program had reduced the workload (18.5%). 69.2% said they inputted the immunization data into the IR program after the shots were given. 86.5% said they hadn´t checked or retrieved the children lists who had missed the scheduled immunization. Only 17.2% said the speed of internet for the R program was good. It showed that 20% of respondents hadn´t written down documents, records on immunization any more. Even there were a lot of negative results, the respondents of PHC thought that the IR program was effective. They especially agreed that the IR program could make the job accurate (81.5%), convenient (71.3%), and reduced the chances of making mistakes (71.3%), increase the service quality (78.5%). And they were well adapting the job process of the IR (79.63%). Bivariate analysis showed that the software program was the important determinants of IR success. The only Bit Computer software program has been evaluated to be less satisfactory than the Integrated (Posdata operating system + Bit software) program. Other variables, such as age, duration of present job, and location of PHC (metropolitan, small city, rural area) were not significantly related. Conclusion : It seemed that the success of NIR might depend on the software program. Because Integrated program, which has been developed from 1994, include not only the general operating and management program for PHC but also IR program. It was natural to prefer Integrated program to Bit software program. So we can suggest that it is essential for the NIR to be successful that not only the immunization software program but also hardware equipments and public health information system should be further improved.

• Research in Community and Public Health Nursing
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• v.13 no.2
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• pp.280-291
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• 2002

Objectives: This study was conducted to evaluate the maternal child health services provided by public health centers in Pyungtaek city. Methods: Data were collected based on multiple sources of official records. A questionnaire survey was obtained from 50 mothers with premature babies, and 89 mothers with full- term babies, in order to compare their demographic factors, and physical, obstetrical, and emotional status. In addition, the investigators collected data on pre and post follow-up care for the remature group to evaluate the effects of home visiting services on them. Moreover, additional data were collected from 135 pregnant women and 315 mothers with infants, to assess their degree of satisfaction for prenatal education course and breast feeding practices. Results: 1) The pregnant women's satisfaction for the prenatal education course, knowledge, and practices on self care were considered to be high. 2) Of the mothers with infants, 62.9% experienced breast feeding, but only 35.9% of them did it for six months. 3) Premature birth rate in the region was 5.6%, and 75.6% of all premature babies received follow-up care. 4) The mothers with premature babies experienced premature rupture of membrane. placenta previa, preeclampsia, and cesarean section more frequently than the mothers with full-term babies. 5) At the pre-intervention data collection point. mothers with premature babies experienced significantly less social support than mothers with full-term babies. In addition, mothers with premature babies reported higher levels of stress and care-giving burdens, and lower level of self esteem, than mothers with full-term babies, although the differences were not statistically significant. 6) In the premature group, stress, care giving burdens, and postpartum depression decreased after the intervention, whereas maternal self esteem, and the husband's support were increased after the intervention. Social support from significant others were somewhat decreased. 7) Satisfaction for the home visiting service in the mothers with premature babies was very high. Conclusion: These results showed a possibility that the recently started maternal child health services provided by the public health centers may be efficient. Although statistically significant differences were not found, the investigators found a potential for changes in a positive direction. Long-term effects of the health services on maternal child health needs should be addressed in future studies.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.11 no.6
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• pp.2078-2087
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• 2010

This study conducted a chi-square test and a logistic regression analysis by not only using a investigation data of discharged patients with damages from 2004 to 2006, but also using a census and a research data on the actual condition from health care system. The result follows; First, the centralization of medical utilization of operation patients is becoming apparent, centrally the capital area. To improve this, a policy that can not only provide medical centers and sickbed, but also improve the quality of local medical treatments for the localization of medical treatments. Second, propelling localization policy of certain diseases for the localization of medical utilization is needed as the rate of non-residential of operation patients that have diseases of the eye and adnexa, or cancers is high. Third, a localization policy for patients with damages is needed as the rate of treatments in other regions of operation patients with industrial accidents is increasing day by day.

• Journal of Trauma and Injury
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• v.25 no.4
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• pp.188-195
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• 2012

Purpose: An increase in the demand for specialized Trauma Centers led to a government-driven campaign, that began in 2009. Our hospital was selected as one of the Trauma Centers, and we reviewed data on trauma patients in order to correlate the mortality at a regional Trauma Center with its contributing factors, such as the severity of the injury, the means of arrival, and the time duration before arrival at our center. Methods: Data on the patients who visited our Trauma Center from January 2010 to November 2011 were retrospectively reviewed using electronic medical records. The patients who had revised trauma scores (RTSs) less than 7 or injury severity scores (ISSs) greater than 15 were included. The patients were categorized as survivors and non-survivors, and the means of arrival as transferred or visited directly. Time durations before arrival of less than one hour were also taken intoconsideration. Results: Two hundred(200) patients were enrolled, and the mortality rate was 36.5%. The most common cause of the accident was an automobile accident, and the most common cause of death was brain injury. The RTSs and the ISSs were significantly different in the non-survivor and the survivor groups. The mortality rate of the patients who were transferred was not statistically different from that of patients who visited directly. However, a time duration before arrival of less than one hour was statistically meaningful. Conclusion: The prognosis of the trauma patients were correlated with the severity of the trauma as can be expected, but the time between the incidence of accident and the arrival at hospital and whether the presence of transfer to trauma center were not statistically significant to the prognosis.

• Journal of Hospice and Palliative Care
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• v.18 no.4
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• pp.329-334
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• 2015

Purpose: This study was aimed at analyzing the characteristics and symptoms in home-based hospice-palliative care (HBHPC) patients registered at local public health centers. Methods: A retrospective study was performed; Data of 144 HBHPC patients registered at six public health centers in Pusan City were analyzed, including their initial visit records (registration cards, initial pain evaluation and symptom evaluation). Results: The average age of the patients was 67.7 years old. Among all, 46.2% of the patient lived alone, and 65% had middle school education or lower. The most popular (36.3%) religion was Buddhism, and 47.5% received medical assistance from the government. The most frequent diagnosis was lung cancer followed by stomach cancer and liver cancer in that order. Of all, 48.9% were functionally too weak to lead a daily life, 39.6% were under cancer treatment when registered at the public health center, and 84.5% were aware of the fact that they have reached the terminal phase. Moreover, 83.6% complained about pain, and the pain level was moderate or severe in 36.5% of them. Besides pain, fatigue was the most complained symptom (84.7%), and 49.3% of them rated their fatigue as moderate or severe. Conclusion: Most of the HBHPC patients were socio-economically underprivileged and complained about moderate or worse pain and symptoms. Therefore, it appears necessary to develop an integrated strategy that is tailored for each patient reflecting their characteristics.

• Korean Journal of Social Welfare Studies
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• v.47 no.4
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• pp.255-280
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• 2016

This study examined sexual violence characteristics among the individuals who utilized victim support services provided by National Rape Crisis Intervention Centers in Korea. The study is the part of a Korean longitudinal study on sexual assault characteristics and its implications for post-abuse adjustments, which is supported by Korean Mental Health Technology R&D Project. Eleven national rape crisis centers nationwide and 29 NGO's participated in the study. The participating centers provided the data on sexual abuse characteristics from their standardized case management system. The cases were randomly selected from the system. Total of 1077 cases were gleaned from the system and utilized for this analysis. Results indicated that the abuse characteristics differed by victims' age (children, adolescent vs. adults) as well as relationship with perpetrator. We could identify six different profile groups based on the detailed violence characteristics. The results assured us of the importance to understand the detailed characteristics of sexual violence and the old notion that 'one size may not fit all'. The results from the profile analyses may have important implication for developing victim support programs and appropriately allocating agency resources according to the different profiles of the service users.