• Journal of Trauma and Injury
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• v.25 no.2
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• pp.49-56
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• 2012

Purpose: For determining the prognosis of critically injured patients, transporting patients to medical facilities capable of providing proper assessment and management, running rapid assessment and making rapid decisions, and providing aggressive resuscitation is vital. Considering the high mortality and morbidity rates in critically injured patients, various studies have been conducted in efforts to reduce those rates. However, studies related to diagnostic factors for predicting severity in critically injured patients are still lacking. Furthermore, patients showing stable vital signs and alert mental status, who are injured via a severe trauma mechanism, may be at a risk of not receiving rapid assessment and management. Thus, this study investigates diagnostic factors, including physical examination and laboratory results, that may help predict severity in trauma patients injured via a severe trauma mechanism, but showing stable vital signs. Methods: From March 2010 to December 2011, all trauma patients who fit into a diagnostic category that activated a major trauma team in CHA Bundang Medical Center were analyzed retrospectively. The retrospective analysis was based on prospective medical records completed at the time of arrival in the emergency department and on sequential laboratory test results. PASW statistics 18(SPSS Inc., Chicago, IL, USA) was used for the statistical analysis. Patients with relatively stable vital signs and alert mental status were selected based on a revised trauma score of more than 7 points. The final diagnosis of major trauma was made based on an injury severity score of greater than 16 points. Diagnostic variables include systolic blood pressure and respiratory rate, glasgow coma scale, initial result from focused abdominal sonography for trauma, and laboratory results from blood tests and urine analyses. To confirm the true significance of the measured values, we applied the Kolmogorov-Smirnov one sample test and the Shapiro-Wilk test. When significance was confirmed, the Student's t-test was used for comparison; when significance was not confirmed, the Mann-Whitney u-test was used. The results of focused abdominal sonography for trauma (FAST) and factors of urine analysis were analyzed using the Chi-square test or Fisher's exact test. Variables with statistical significance were selected as prognostics factors, and they were analyzed using a multivariate logistics regression model. Results: A total of 269 patients activated the major trauma team. Excluding 91 patients who scored a revised trauma score of less than 7 points, 178 patients were subdivided by injury severity score to determine the final major trauma patients. Twenty-one(21) patients from 106 major trauma patients and 9 patients from 72 minor trauma patients were also excluded due to missing medical records or untested blood and urine analysis. The investigated variables with p-values less than 0.05 include the glasgow coma scale, respiratory rate, white blood cell count (WBC), serum AST and ALT, serum creatinine, blood in spot urine, and protein in spot urine. These variables could, thus, be prognostic factors in major trauma patients. A multivariate logistics regression analysis on those 8 variables showed the respiratory rate (p=0.034), WBC (p=0.005) and blood in spot urine (p=0.041) to be independent prognostic factors for predicting the clinical course of major trauma patients. Conclusion: In trauma patients injured via a severe trauma mechanism, but showing stable vital signs and alert mental status, the respiratory rate, WBC count and blood in the urine can be used as predictable factors for severity. Using those laboratory results, rapid assessment of major trauma patients may shorten the time to diagnosis and the time for management.

• Quality Improvement in Health Care
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• v.9 no.1
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• pp.34-51
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• 2002

Background : The purpose for this study is to develop a critical pathway of bullectomy for spontaneous pneumothorax patients. Methods : For this study a conceptual framework of critical pathway was developed through a review of the literature including five critical pathways which are currently being used in USA, and opinions of the critical pathway development team members at Y university hospital. In order to identify the service contents required by these patients and to draw up a preliminary critical pathway, 33 cases of medical records of patients who had received bullectomy for spontaneous pneumothorax between September, 2000 to August, 2001 at the Respiratory Center of Y university hospital in Seoul was analyzed. Results : In order to test the clinical validity of the preliminary critical pathway, it was applied to ten patients who had received bullectomy for spontaneous pneumothorax from October, 2001 to December, 2001. The average discharge day was 4.89th post operation day, six patients discharged on the fourth post operation day which was the expected day, one patients discharged one day earlier than the expected day, one patient discharged three days later than the expected day, and one patient discharged six days later than the expected day. There were variances between the critical pathway and the actual practice. The variances came from tests, medications, and treatments. One item that showed variance in clinical applications was complemented, and three items were decided not to be corrected for the final determination of the critical pathway. Conclusion : This critical pathway is applicable to the care of patients with bullectomy for spontaneous pneumothorax, but it needs more clinical applications to grasp varied variances.

• Journal of Fisheries and Marine Sciences Education
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• v.25 no.5
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• pp.1055-1067
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• 2013

We attempted to apply the HACCP system adopted in the food industry to a olive flounder (Paralichthys olivaceus) aquaculture farm to ensure the hygiene safety of farmed fish. In this study, HACCP system procedures, including HACCP team organization, critical point determination, establishment of standard limits etc., were established using Codex 12 procedures. To determine whether hazards were critical elements, we evaluated the likelihood and seriousness of each hazard element. The likelihood of residual medicine exceeding the acceptable limit in shipped fish products was demonstrated to be a critical hazard element. Management of the shipment stage was determined to be a critical control point (CCP). Checking the records for stock and release and maintaining a history of medicine use before shipping the fish were suggested as monitoring methods. The standards for acceptable residual medicine were set based on relevant laws and regulations, and then the limits were adapted and established for the CCP. An HACCP plan applicable to olive flounder farms was established.

• Journal of The Korean Society of Clinical Toxicology
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• v.11 no.2
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• pp.81-88
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• 2013

Purpose: The aim of this study is to investigate current status, indications, and complications of hyperbaric oxygen therapy. Methods: A retrospective investigation of patients who underwent hyperbaric oxygen therapy at a university medical center from September 2004 to August 2013 was conducted based on patients' medical records and results of an email survey for 99 emergency centers. Results: During the study period, a total of 233 patients underwent hyperbaric oxygen therapy. Indications for hyperbaric oxygen treatment of illness or injury were as follows: 1) 151 cases of acute carbon monoxide poisoning(65.4%), 2) flap wound management, including 42 cases(18.2%), 3) skin care transplanted, including 23 cases(10.4%), 4) Burger's disease, including 5 five cases(2.1%), respectively. Total application time$^*$ frequency was 1,088 and total time was 1,239 hours. Among 233 patients who underwent hyperbaric oxygen therapy, 32 patients(13.7%) had complications: 1) otalgia in 21 cases(9.0%), 2) mastoiditis?in six cases(2.6%), 3) hemotympanum in five cases(2.1%), respectively. There were only 8 emergency centers that currently had an operational hyperbaric oxygen chamber in 77 emergency centers(10.4%). Conclusion: Indications identified through this study showed difference from current indications worldwide. It seems necessary that physicians' perception regarding application of hyperbaric oxygen therapy for more indications be changed and improved. A hyperbaric chamber capable of providing respiratory assistance and intensive care is also needed. A good network for sharing treatment experiences and a specialized team for administration of hyperbaric oxygen therapy is also required.

• Journal of Convergence for Information Technology
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• v.7 no.6
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• pp.135-141
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• 2017

Recently, as elderly people suffering from chronic diseases have increased and disasters such as traffic accidents have increased, urgent rescue workers and doctors need to respond effectively to such emergencies. For elderly people, the difficulty in communicating their condition especially the health condition during disaster is one of the problems in which delay on immediate handling by rescue team can cause death. Providing a solution for this problem is one of the main issues in our research. In this paper, we use the QR code to communicate the minimum personal information and medical history needed for emergency medical treatment to emergency medical personnel, and to transmit the medical history and treatment data to the doctors of the hospital through QR code and fingerprint recognition, respectively. Especially, by using both QR code of smart phone and fingerprint of individual, we can protects personal information and strengthens privacy and security of medical information by allowing only authorized physicians to check medical records of the old patient.

• Clinics in Shoulder and Elbow
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• v.26 no.2
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• pp.140-147
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• 2023

Background: The management of acromioclavicular (AC) joint dislocation remains controversial. Recently, anatomic coracoclavicular (CC) fixation with a double clavicular tunnel and three flip-buttons has shown promising results. This study aimed to evaluate functional and radiological outcomes in patients with high-grade AC joint dislocation treated with anatomic CC fixation using double clavicular tunnels and three flip-buttons. Methods: A retrospective, unicentric study was performed. The study included patients with high-grade AC joint dislocation who underwent surgery with anatomic CC fixation using double clavicular tunnels and three flip-buttons. Demographic data were obtained from medical records. A functional evaluation using subjective shoulder value (SSV), visual analog scale (VAS), and disabilities of the arm, shoulder, and hand (DASH) questionnaires was performed, and an evaluation of preoperative and postoperative comparative Zanca view images was performed. Factors associated with functional outcomes and radiological AC reduction were analyzed. Results: A total of 83 patients completed follow-up and were included in the analysis. The mean SSV, VAS, and DASH scores were 92.8, 0.8, and 6.4, respectively. Patients who had complications experienced significantly worse functional outcomes (DASH: P=0.037). Suboptimal final AC reduction was observed in nine patients (11.1%), and significantly more frequently in patients older than 40 years (P=0.031) and in surgeries performed more than 7 days after injury (P=0.034). There were two reoperations (2.4%). Conclusions: Anatomic CC fixation with a double clavicular tunnel and three flip-buttons leads to good functional outcomes, low complication rates, and high rates of optimal AC reduction.

• Journal of Korean Clinical Nursing Research
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• v.15 no.1
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• pp.5-17
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• 2009

Purpose: This study was to develop a factor-type patient classification system for general nursing unit based on nursing needs (KPCS; Korean patient classification system for nurses). Method: We reviewed workload management system for nurses(WMSN) of Walter Reed Medical Center, Korean patient classification system for ICU, and nursing activities in nursing records and developed the first version of KPCS. The final version KPCS was evaluated via validity and reliability verifications based on panel discussions and data from 800 patient classifications. Content validity was performed by Delphi method and concurrent validity was verified by the correlation of two tools (r=.71). Construct validity was also tested by medical department (p<.001), patient type (p<.001), and nurse intuition (p<.001). These verifications were performed from April to October, 2008. Results: The KPCS has 75 items in classifying 50 nursing activities, and categorized into 12 different nursing area (measuring vital sign, monitoring, respiratory treatment, hygiene, diet, excretion, movement, examination, medication, treatment, special treatment, and education/emotional support). Conclusion: The findings of the study showed sound reliability and validity of KPCS based on nursing needs. Further study is mandated to refine the system and to develop index score to estimate the necessary number of nurses for adequate care.

• Journal of Animal Science and Technology
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• v.65 no.3
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• pp.588-595
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• 2023

The aim of this study was to investigate the effects of heat stress on milk traits in South Korea using comprehensive data (dairy production and climate). The dataset for this study comprised 1,498,232 test-day records for milk yield, fat- and protein-corrected milk, fat yield, protein yield, milk urea nitrogen (MUN), and somatic cell score (SCS) from 215,276 Holstein cows (primiparous: n = 122,087; multiparous: n = 93,189) in 2,419 South Korean dairy herds. Data were collected from July 2017 to April 2020 through the Dairy Cattle Improvement Program, and merged with meteorological data from 600 automatic weather stations through the Korea Meteorological Administration. The segmented regression model was used to estimate the effects of the temperature-humidity index (THI) on milk traits and elucidate the break point (BP) of the THI. To acquire the least-squares mean of milk traits, the generalized linear model was applied using fixed effects (region, calving year, calving month, parity, days in milk, and THI). For all parameters, the BP of THI was observed; in particular, milk production parameters dramatically decreased after a specific BP of THI (p < 0.05). In contrast, MUN and SCS drastically increased when THI exceeded BP in all cows (p < 0.05) and primiparous cows (p < 0.05), respectively. Dairy cows in South Korea exhibited negative effects on milk traits (decrease in milk performance, increase in MUN, and SCS) when the THI exceeded 70; therefore, detailed feeding management is required to prevent heat stress in dairy cows.

• Journal of Digital Convergence
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• v.19 no.5
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• pp.461-468
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• 2021

The purpose of this study is to collect official records of the 2019 Men's and Women's Handball World Championships to identify important shooting variables that determine the team's record of winning or losing. After collecting 192 games of men's and women's national teams from 24 countries and verifying the difference in competition records according to the winning and losing groups, the decision tree method, one of the data mining techniques, is analyzed. According to the analysis, the 9m shooting success rate and Near shooting success rate were the most important factors for both men and women. Men win 83.3% if the 9m shooting success rate is 32.5% or higher and the Near shooting success rate is 67.5%, and women win 75% if the 9m shooting success rate is 75% or more and the Near shooting success rate is 51%. Also, the women's yellow cards are considered important variables that determine victory or defeat. In conclusion, both men and women were able to identify the factors of winning and losing decision shooting, but follow-up studies are needed considering the relativity of various record variables and performance in future handball.

• Fire Science and Engineering
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• v.20 no.3 s.63
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• pp.42-47
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• 2006

Direct medical control by medical doctors is an essential part of emergency medical services system (EMSS). However, the indications are not specifically defined, even in 119 system with their own medical control team. The Seoul Metropolitan Fire and Disaster Management Department has operated internal medical consultation services on its own since January 2004. Based on the experiences from these services, we reviewed the cases of the direct medical consultation and establish the indications for direct medical control. And we presumed the demand of direct medical control with the established indications. The crews of 119 in Seoul made 793 calls to Medical Control Team during November 2004. We reviewed all of the calls according to the level of consciousness (AVPU), the kinds of emergency care done by crews during transport (10 categories), and the mechanisms of injuries (9 categories). The need for direct medical control was judged by authors with reviewing the records reported by the crews and control teams. Among 23 items, 14 items assigned as the indications, which were abnormal level of consciousness (VPU), 6 kinds of emergency care, and 5 mechanisms of injures. The sum of the three of them, 7,782 cases (45.9%), was in need of direct medical control. In conclusion, about half of the patients transported by 119 crews in Seoul require direct medical control. The need for the direct medical control in Seoul was estimated as many as 260 calls per day. To fulfill the need for direct medical control and to provide a effective medical control, the direct medical control should be accomplished through the communications between the crews and the medical staffs in the local hospitals.