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Clinical Study of Vascular Injuries (혈관 손상의 임상적 고찰)

  • Chung, Sung-Woon;Kim, Young-Kyu
    • Journal of Chest Surgery
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    • v.40 no.7 s.276
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    • pp.480-484
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    • 2007
  • Background: Major vascular injuries can jeopardize a patient's life or imperil limb survival. We performed this study to establish an optimal management plan for vascular injuries. Material and Method: We retrospectively reviewed 26 cases of vascular injury that were treated at Pusan National University Hospital from May, 1999 to September, 2004. The age and sex distribution, the locations and causes of vascular injury, the diagnostic tools, the degree of injuries, clinical manifestations, the treatment modality and complications were reviewed. Result: The mean age was 39.5 years (range: $12{\sim}86$) and the male to female ratio was 22 : 4. The injuries were in 6 descending thoracic aortas, 4 femoral arteries, 4 popliteal veins and so on. The causes of injury were iatrogenic in 8 cases, traffic accident in 7, stab injury in 6 and industrial accident in 5. The most commonly used diagnostic tools were CT and angiography. The degrees of arterial injury were pseudoaneurysm in 10 cases, partial severance in 5, complete severance in 3 and thrombosis in 3. The degrees of venous injury were partial severance in 6 cases, complete severance in 2 and arteriovenous fistula in 2. The clinical manifestations were absence of pulse in 8 cases, coldness in 7, chest pain in 6, swelling in 5, bleeding in 5 and so on. The most frequently used type of revascularization was graft interposition in 11 cases. Two arteriovenous fistulae were repaired by endovascular procedure. There was one case of mortality due to multi-organ failure after hemorrhagic shock, There were three major amputations, and two of them were due to delayed diagnosis and treatment. Conclusion: A system for the early diagnosis and treatment is essential for improving limb salvage and patient mortality. As a consequence of the widespread application of endovascular procedures, the incidence of iatrogenic injuries has recently increased. Educating physicians is important for the prevention of iatrogenic injury. Easy communication and cooperation for earlier involvement of a vascular surgeon is also an important factor.

A basic research for evaluation of a Home Care Nursing Delivery System (가정간호 서비스 질 평가를 위한 도구개발연구)

  • Kim, Mo-Im;Cho, Won-Jung;Kim, Eui-Sook;Kim, Sung-Kyu;Chang, Soon-Bok;Ryu, Ho-Sihn
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.6
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    • pp.33-45
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    • 1999
  • The purpose of this study was to develop a basic framework and criteria for evaluation of quality care provided to patients with the attributes of disease in the home care nursing field, and to provide measurement tools for home health care in the future. The study design was a developmental study for evaluation of hospital-based HCN(home care nursing) in Korea. The study process was as follows: a home care nursing study team of College of Nursing. Yonsei University reviewed the nursing records of 47 patients who were enrolled at Yonsei University Medical Center Home Care Center in March, 1995. Twenty-five patients were insured at that time, were selected from 47 patients receiving home care service for study feasibility with six disease groups; Caesarean Section (C/S), simple nephrectomy, Liver cirrhosis(LC), chronic obstructive pulmonary disease(COPD), Lung cancer or cerebrovascular accident(CVA). In this study, the following items were selected : First step : Preliminary study 1. Criteria and items were selected on the basis of related literature on each disease area. 2. Items were identified by home care nurses. 3. A physician in charge reviewed the criteria and content of selected items. 4. Items were revised through preliminary study offered to both HCN patients and discharged patients from the home care center. Second step : Pretest 1. To verify the content of the items, a pretest was conducted with 18 patients of which there were three patients in each of the six selected disease groups. Third step : Test of reliability and validity of tools 1. Using the collected data from 25 patients with either cis, Simple nephrectomy, LC, COPD, Lung cancer, or CVA. the final items were revised through a panel discussion among experts in medical care who were researchers, doctors, or nurses. 2. Reliability and validity of the completed tool were verified with both inpatients and HCN patients in each of field for researches. The study results are as follows: 1. Standard for discharge with HCN referral The referral standard for home care, which included criteria for discharge with HCN referral and criteria leaving the hospital were established. These were developed through content analysis from the results of an open-ended questionnaire to related doctors concerning characteristic for discharge with HCN referral for each of the disease groups. The final criteria was decided by discussion among the researchers. 2. Instrument for measurement of health statusPatient health status was measured pre and post home care by direct observation and interview with an open-ended questionnaire which consisted of 61 items based on Gorden's nursing diagnosis classification. These included seven items on health knowledge and health management, eight items on nutrition and metabolism, three items on elimination, five items on activity and exercise, seven items on perception and cognition, three items on sleep and rest, three items on self-perception, three items on role and interpersonal relations, five items on sexuality and reproduction, five items on coping and stress, four items on value and religion, three items on family. and three items on facilities and environment. 3. Instrument for measurement of self-care The instrument for self-care measurement was classified with scales according to the attributes of the disease. Each scale measured understanding level and practice level by a Yes or No scale. Understanding level was measured by interview but practice level was measured by both observation and interview. Items for self-care measurement included 14 for patients with a CVA, five for women who had a cis, ten for patients with lung cancer, 12 for patients with COPD, five for patients with a simple nephrectomy, and 11 for patients with LC. 4. Record for follow-up management This included (1) OPD visit sheet, (2) ER visit form, (3) complications problem form, (4) readmission sheet. and (5) visit note for others medical centers which included visit date, reason for visit, patient name, caregivers, sex, age, time and cost required for visit, and traffic expenses, that is, there were open-end items that investigated OPD visits, emergency room visits, the problem and solution of complications, readmissions and visits to other medical institution to measure health problems and expenditures during the follow up period. 5. Instrument to measure patients satisfaction The satisfaction measurement instrument by Reisseer(1975) was referred to for the development of a tool to measure patient home care satisfaction. The instrument was an open-ended questionnaire which consisted of 11 domains; treatment, nursing care, information, time consumption, accessibility, rapidity, treatment skill, service relevance, attitude, satisfaction factors, dissatisfaction factors, overall satisfaction about nursing care, and others. In conclusion, Five evaluation instruments were developed for home care nursing. These were (1)standard for discharge with HCN referral. (2)instrument for measurement of health status, (3)instrument for measurement of self-care. (4)record for follow-up management, and (5)instrument to measure patient satisfaction. Also, the five instruments can be used to evaluate the effectiveness of the service to assure quality. Further research is needed to increase the reliability and validity of instrument through a community-based HCN evaluation.

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A Study on the Consciousness of the Environment Pollution Problem in Pohang City (환경문제에 관한 시민의식 조사 - 통합후 포항시민을 대상으로 -)

  • Ha, Yeong-Gil;Park, Kyung-Min;Kwon, Young-Sook
    • Journal of agricultural medicine and community health
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    • v.21 no.1
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    • pp.61-73
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    • 1996
  • This study conducted to determine the attitude on environment pollution by Pohang city citizens. 1,059 Pohang city citizens in the age group 20 and over were chosen and surveyed by officials's interview at Up, Myun and Dong during the period 6 September to 20 September 1995. The issue problems to be solved in Pohang city were traffic control 47.3%, environment pollution 22.7%, cultural institutions 11.6%, water service 9.9%, education system 5.1% and community security 2.1%. The 55.1% of subjects responded that responsibility for environment pollution is every citizens duty. The trash from houses were 'garbage'(48.1%), 'waste of life'(21.8%), 'reuse trash'(15.6%) and 'one use thing'(14.5%) in order. The 66.9% of subjects responded that the trash's standard envelopes can be easily tear and its texture is not good. The respondents sometimes or often had experienced foreign bodies, sediment in the water service supply. The 45.9% of the respondents use natural water as drinking water, and the water service supply(26.7%), underground water(17.0%) and buying water(9.3%) were followed. Pertaining to the air pollution(by percent) was pollution of the steel industry complex 78.0%, combustive gas 16.6% and construction dust 1.7%. The respondents at southern district complained of respiratory tract by air pollution and the respondents at northern district complained of the visual disturbance and the offensive odor(P<0.05). Water pollution problem is factory's wastewater 56.2%, home wastewater 36.4% and livestock's wastewater 5.6% in order. The respondents at southern district complained of the noise pollution by airplanes and factories at the afternoon and the respondents at northern district complained of the noise pollution by vehicles(P<0.05).

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A Study on the Analysis and Efficiency of Police Budget (경찰의 예산분석 및 효율화 방안에 관한 연구)

  • Park, Jong-Seung;Kim, Chang-Yun
    • Korean Security Journal
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    • no.38
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    • pp.7-32
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    • 2014
  • This study is aimed to analyze problems of police budgetary execution and to suggest better ways for establishing effective budget implementation as well as legitimacy of securing budget in the field of police work. For this purpose, this paper analyzed the annual reports on police budgetary execution, from 2009 to 2012, conducted by National Assembly Budget Office. In result, most parts of the police budgetary execution were not satisfied with the audit standard, and especially in terms of management of budgetary execution, it showed 40% in inappropriateness. In addition, excessive and underestimate appropriation in the police budgetary execution, which happened frequently in other offices, was recorded on the second place. 10% of the amount of budget was executed for ordinance violence. Given results analyzed from each division, Transportation Division occupied 40% of the amount of related problems and all of types in the field did not meet the audit standard, thus it is required to manage budgetary execution effectively. In terms of Public Safety Division, the problem was related to budgetary allocation prior to execution, such as overlap in other works, excessive and underestimate appropriation, and inappropriate business plans. Director General for Planning and Coordination did not meet the standard of law system maintenance, Given the light of the result of analyzing programs, traffic safety and securing communication was the most problematic and support for police administration, crime prevention and protecting the disadvantaged, educating professional police officers, and establishment of policing infrastructure were required to be reformed in sequence. In order to resolve these problems, it is demanded to check budgetary execution and the process in business plans on a regular basis. Additionally, in case of using budget in inappropriate parts, tough penality including reduction of budget in related to the local police should be implemented to increase the importance of budgetary execution. Moreover, because of the fact that a part of problem of budgetary execution was originally caused by the budgetary allocation, it is advised to allocate police budget using the budget proposal of National Finance Act and Ministry of Strategy and Finance.

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Current Situation and Cooperation on the Metropolitan Airport between Korea and Japan (한국 및 일본의 수도권 공항의 현황과 협력)

  • Kim, Doo-Hwan
    • The Korean Journal of Air & Space Law and Policy
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    • no.spc
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    • pp.137-163
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    • 2007
  • The air market in Asia has already entered upon the age of limitless competition. It means a very important moment in Asia air market. Each Asian country thus has put a lot of effort into a development plan and support to their hub airport. In order to achieve such a plan, first of all we should build closer cooperation system between the two countries Japan and Korea. The Korea and Japan are very fast growing in the northeast countries within the global air transport market. Air passenger and cargo traffic volumes between Korea and Japan have increased dramatically, since the 1990s. In response to such a trend, both countries have opened new airports and expanded existing facilities in the hopes of laying claims to the main international hub airport in Asia. Apart from the trend, air transportation between Korea and Japan's metropolitan areas is the only transportation in substance, even if they are located very closely in geographical position. The air transportation between the two countries shows that it is necessary to get fast and more convenient because of the economic and cultural interchange and exchange concentrated on the metropolitan areas, and that will promote the economic growth of Korea and Japan. However, within the air transportation industry field, there have no sufficient seats/slots to supply the air demand from the capital cities of each country, as well as no counterplan for some problems regarding capacityand sustain ability of metropolitan airports. Thus, it is necessary for us to consider in all aspects and solve them to improve air transportation between Korea and Japan. This paper is to try to demonstrate this matter and from all angles, that is, in legal and political aspects, facilities and given environmental conditions and cooperation between Korea and Japan. I think that it is indeed a great necessary and convenient for many Korean and Japanese tourists to conclude a new 'Open Sky Agreement' between Japan and Korea in order to the prepare the increase of the shuttle flight between Haneda-Gimpo and opening of air route newly for shuttle flight between Haneda and Cheongju as well as opening of air route for shuttle flight between Haneda-Shanghai Hongqiao International Airport and Beijing International Airport for the 2008 Beijing Olympic Games. Furthermore it is a great desirable thing for us to conclude a new 'Open Sky Agreement' in cooperation reciprocally among the Japan, China and Korea for opening the new air route by the shuttle flight.

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Analysis of Consciousness and Model on Land for the Another use After Quarrying (채석장의 부지 활용에 대한 의식 및 모델 분석)

  • Park, Jae Hyeon
    • Journal of Korean Society of Forest Science
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    • v.101 no.3
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    • pp.387-394
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    • 2012
  • The study was conducted to develop an effective forest resources use models for an alternate use of abandoned quarry by an attitude survey. According to the result of survey, a pessimistic view due to dust, noise pollution, and forest damage was 5% higher than an affirmative view by economic benefits from the development of quarry. The 42% of the respondents preferred the alternate use of abandoned quarry and the 25% of the respondents wanted an art and cultural space. The optimum size of alternate use was 5-10 ha (43%) with the requirement of nearby residents (32%). According to the SWOT analysis for abandoned quarry, the strength factors were an effective use of land, the content development of modern industrial inheritance + cultural and art fusion, attraction for nearby city and visitors, a harmony of beauty landscape and clean environment, and a sustainable increase of domestic and foreign visitors with the 5-day-work week. The opportunity factors were the improvement of traffic networks through KTX and local highway, the creation of the new growth engines with the establishment of artistic creation belts, the providing of unique cultural and art space through grafting of tour and education, the creation of local income through stone processed goods, and the vitalization of local development through eco-city. The weakness factors were a psychological remoteness and backwardness, and the weakness of staying tour infra. The threat factors were a poor financial support for sustainable development in nearby quarry and a modify of legal and institutional system for the alternated use of abandoned quarry. The developed restoration models for the alternate use in abandoned quarry are classified to a sculpture park, a waterfall and lake park, a rock-climbing, a sports park + forest park, a native botanical garden, a culture and art park, a complex park, a water storage site, a water storage site to extinguish forest fire, a geriatric hospital, an agricultural facility, and a school site types etc. The results suggest that the alternate use in the abandoned soil and stone quarry is needed to establish facility use models with consideration of user's preference.

A Study on Estimating Optimal Tonnage of Coastal Cargo Vessels in Korea (우리나라 연안화물선의 적정선복량 추정에 관한 연구)

  • 이청환;이철영
    • Journal of the Korean Institute of Navigation
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    • v.13 no.1
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    • pp.21-53
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    • 1989
  • In the past twenty years, there has been a rapid increase in the volume of traffic in Korea due to the Korean great growth of the Korean economy. Since transformation provides an infrastructure vital to economic growth, it becomes more and more an integral part of the Korea economy. The importance of coastal shipping stands out in particular, not only because of the expansion limit on the road network, but also because of saturation in the capacity of rail transportation. In spite of this increase and its importance, coastal shipping is falling behind partly because it is givenless emphasis than ocean-going shipping and other inland transportation systems and partly because of overcompetition due to excessive ship tonnage. Therefore, estimating and planning optimum ship tonnage is the first take to develop Korean coastal shipping. This paper aims to estimate the optimum coastal ship tonnage by computer simulation and finally to draw up plans for the ship tonnage balance according to supply and demand. The estimation of the optimum ship tonnage is peformed by the method of Origin -Destimation and time series analysis. The result are as follows : (1) The optimum ship tonnage in 1987 was 358, 680 DWT, which is 54% of the current ship tonnage (481 ships, 662, 664DWT) that is equal to the optimum ship tonnage in 1998. this overcapacity result is in excessive competition and financial difficulties in Korea coastal shipping. (2) The excessive ship tonnage can be broken down into ship types as follows : oil carrier 250, 926 DWT(350%), cement carrier 9, 977 DWT(119%), iron material/machinery carrier 25, 665 DWT(117%), general cargo carrier 17, 416DWT(112%). (3) the current total ship crew of 5, 079 is more than the verified optimally efficient figure of 3, 808 by 1271. (4) From the viewpoint of management strategy, it is necessary that excessive ship tonnage be reduced and uneconomic outdated vessels be broken up. And its found that the diversion into economically efficient fleets is urgently required in order to meet increasing annual rate in the amounts of cargo(23, 877DWT). (5) The plans for the ship tonnage balance according to supply and demand are as follows 1) The establishment of a legislative system for the arrangement of ship tonnage. This would involve; (a) The announcement of an optimum tonnage which guides the licensing of cargo vessels and ship tonnage supply. (b) The establishment of an organization that substantially arrangement tonnage in Korea coastal shipping. 2) The announcement of an optimum ship tonnage both per year and short-term that guides current tonnage supply plans. 3) The settlement of elastic tariffs resulting in the protect6ion of coastal shipping's share from other tonnage supply plans. 4) The settlement of elastic tariffs resulting in the protection of coastal shipping's share from other transportation systems. 4) Restriction of ocean-going vessels from participating in coastal shipping routes. 5) Business rationalization of coastal shipping company which reduces uneconomic outdated vessels and boosts the national economy. If we are to achieve these ends, the followings are prerequisites; I) Because many non-licensed vessels are actually operating and threatening the safe voyage of the others in Korea coastal routes, it is necessary that those ind of vessels be controlled and punished by the authorities. II) The supply of ship tonnage in Korean coastal routes should be predently monitored because most of the coastal vessels are to small to be diverted into ocean-going routes in case of excessive supply. III) Every ship type which is engaged in coastal shipping should be specialized according to the characteristics of its routes as soon possible.

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Limited Open Reduction and Internal Fixation of the Tibial Pilon Fractures (제한 절개를 통한 관혈적 정복 및 내고정술을 이용한 경골 Pilon 골절의 치료)

  • Kang, Chung-Nam;Kim, Jong-Oh;Kim, Dong-Wook;Koh, Young-Do;Ko, Sang-Hun;Yoo, Jae-Doo;Hwang, Jun-Ho
    • Journal of Korean Foot and Ankle Society
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    • v.1 no.2
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    • pp.102-111
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    • 1997
  • The tibial Pilon fracture, which is defined as a comminuted intraarticular fracture of the distal tibia, is difficult to manage because high axial compression and rotational forces to the ankle joint result in impaction, severe comminution, metaphyseal disruption and soft tissue damage. There are variable methods of treatment such as manipulation and cast, calcaneal traction and cast, external fixation, pin and plaster, limited open reduction and external fixation, and open reduction and rigid internal fixation. Though most of authors reported better result after a surgical treatment. than that of conservative treatment, many complications such as posttraumatic arthritis and soft tissue problem still remain troublesome. We have reviewed 19 cases of the tibial Pilon fractures in 18 patients which were treated with limited open reduction and internal fixation from September 1993 to May 1996. The results were as follows: 1. The fractures were classified into five types according to the system of Ovadia and Beals, and the most frequent type was type 3 (53%). The most common cause of injury was traffic accident (47%). 2. All of the cases of type 1 and 2, in which the injury of the ankle joint was less severe, revealed good or excellent clinical results. But in type 4 and 5, because the injury is much severe and accurate reduction is difficult, the clinical results were unsatisfaetory. 3. The most frequent complication was posttraumatic osteoarthritis, and which developed in second frequent complication, was developed m the three cases of type 3 in which the radiographic results were less than fair, but there were no correlation with the clinical results. 4. We could markedly reduce the complications related to the soft tissue problem of Pilon fracture by treatment with limited open reduction and internal fixation, and consider that this is a good method of treatment of Pilon fracture when the injury is less severe and accurate reduction is possible.

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A Study on the Representations of an Bell Chamber in Namhansansung (남한산성 종(鐘)과 종각(鐘閣) 복원을 위한 연구)

  • Lee, Jin-Hyang;Kim, Dae-Ho;Lee, Jae-Keun
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.28 no.4
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    • pp.120-126
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    • 2010
  • As the importance of an historical area is getting increased in these days, the reconstruction of an bell chamber in Namhansansung has significant historial, educational and cultural meaning. The purpose of this study, as a study on an bell chamber in Namhansansung, is to assume an original location of the bell chamber and identify the size and shape of the original bell chamber through literature study, site inspection, and analysis on old maps. In addition, this study could provide useful information when new bell chamber is constructed. According to the literature study, site inspections(5 times) and analysis on old maps, the original bell chamber is assumed to locate near current Oroji tea house at the rotary, where was in the area of Hanggung. With regard to the traffic system, it is assume that there was an old road along with the current local road No.342 connecting the South Gate with North Gate and a Y or T shape intersection connecting the site of old bell chamber with the north. In addition, there was a government office street from the old bell chamber to Hanggung. The shape of old bell chamber is assumed to have Paljak or Woojingak roof. Samo roof was not found in all the five maps. Regarding the direction of bell chamber, three maps indicate that it faces the East and two maps show that it faces the South. Therefore, it is assumed that the length and width of the roof have similar size. However, a new bell chamber should face the East, which is the same direction with Hanggung. As there is a record which states that a bell in the Cheonheoungsa, Seonggeosan, Cheonan was used as a Namhansansung's bell when the Cheonheoungsa was closed, this study suggests that new Namansansung's bell should be built, considering histroical value and artistry of Cheonheoungsa's bell. This study is a basic research for the reconstruction of Namhansansung in 2009. However, as reconstruction of historical assets should be based on thorough historical evidences. Therefore, more detail researches by a indicator analysis are left for the topic of future studies.

The Risk Assessment of the Fire Occurrence According to Urban Facilities in Jinju-si (진주시 도시시설물별 화재발생 위험도 평가)

  • Bae, Gyu Han;Won, Tae Hong;Yoo, Hwan Hee
    • Journal of Korean Society for Geospatial Information Science
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    • v.24 no.1
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    • pp.43-50
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    • 2016
  • Urbanization in Korea has increased significantly and subsequently, various facilities have been concentrated in urban areas at high speed in accordance with a growing urban population. Accordingly, damages have occurred due to a variety of disasters. In particular, fire damage among the social disasters caused the most severe damage in urban areas along with traffic accidents. 44,432 cases of fire occurred in 2015 in Korea. Due to these accidents, 253 were killed and property damage of 4,50 billion won was generated. However, despite the efforts to reduce a variety of damage, fire danger still remains high. In this regard, this study collected fire data, generated from 2007 to 2014 through the Jinju Fire Department and the National Fire Data System(NFDS) and calculated fire risk by analyzing the clustering of fire cases and facilities in Jinju-si based on the current DB of facilities, offered by the Ministry of Government Administration and Home Affairs. As a result, the risk ratings of fire occurrence were classified as four stages under the standards of the US Society of Fire Protection Engineers(SEPE). Business facilities, entertainment facilities, and automobile facilities were classified as the highest A grade, detached houses, Apartment houses, education facilities, sales facilities, accommodation, set of facilities, medical facilities, industrial facilities, and life service facilities were classified as U grade, and other facilities were classified as EU grade. Finally, hazardous production facilities were classified as BEU grade, the lowest grade. In addition, in the case of setting the standard with loss of life, the highest risk facility was the hazardous production facilities, while in the case of setting the standard with property damage, a set of facilities and industrial facilities showed the highest risk. In this regard, this study is expected to be effectively utilized to establish the fire reduction measures against facilities, distributed in urban space by calculating risk grades regarding the generation frequency, casualties, and property damage, through the classification of fire, occurred in the city, according to the facilities.