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김신우,이경수,김건엽,Jung Jeung Lee,Jong-yeon Kim,Daegu Medical Association 대한의학회 2020 Journal of Korean medical science Vol.35 No.15
With the epidemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2, the number of infected patients was rapidly increasing in Daegu, Korea. With a maximum of 741 new patients per day in the city as of February 29, 2020, hospital-bed shortage was a great challenge to the local healthcare system. We developed and applied a remote brief severity scoring system, administered by telephone for assigning priority for hospitalization and arranging for facility isolation (“therapeutic living centers”) for the patients starting on February 29, 2020. Fifteen centers were operated for the 3,033 admissions to the COVID-19 therapeutic living centers. Only 81 cases (2.67%) were transferred to hospitals after facility isolation. We think that this brief severity scoring system for COVID-19 worked safely to solve the hospital-bed shortage. Telephone scoring of the severity of disease and therapeutic living centers could be very useful in overcoming the shortage of hospital-beds that occurs during outbreaks of infectious diseases.
Park Bo Eun,Lee Jang Hoon,Park Hyuk Kyoon,Kim Hong Nyun,Jang Se Yong,Bae Myung Hwan,Yang Dong Heon,Park Hun Sik,Cho Yongkeun,Lee Bong Yul,Nam Chang Wook,Lee Jin Bae,Kim Ung,Chae Shung Chull,Daegu COVI 대한의학회 2021 Journal of Korean medical science Vol.36 No.2
Background: Data regarding the association between preexisting cardiovascular risk factors (CVRFs) and cardiovascular diseases (CVDs) and the outcomes of patients requiring hospitalization for coronavirus disease 2019 (COVID-19) are limited. Therefore, the aim of this study was to investigate the impact of preexisting CVRFs or CVDs on the outcomes of patients with COVID-19 hospitalized in a Korean healthcare system. Methods: Patients with COVID-19 admitted to 10 hospitals in Daegu Metropolitan City, Korea, were examined. All sequentially hospitalized patients between February 15, 2020, and April 24, 2020, were enrolled in this study. All patients were confirmed to have COVID-19 based on the positive results on the polymerase chain reaction testing of nasopharyngeal samples. Clinical outcomes during hospitalization, such as requiring intensive care and invasive mechanical ventilation (MV) and death, were evaluated. Moreover, data on baseline comorbidities such as a history of diabetes, hypertension, dyslipidemia, current smoking, heart failure, coronary artery disease, cerebrovascular accidents, and other chronic cardiac diseases were obtained. Results: Of all the patients enrolled, 954 (42.0%) had preexisting CVRFs or CVDs. Among the CVRFs, the most common were hypertension (28.8%) and diabetes mellitus (17.0%). The prevalence rates of preexisting CVRFs or CVDs increased with age (P < 0.001). The number of patients requiring intensive care (P < 0.001) and invasive MV (P < 0.001) increased with age. The in-hospital death rate increased with age (P < 0.001). Patients requiring intensive care (5.3% vs. 1.6%; P < 0.001) and invasive MV (4.3% vs. 1.7%; P < 0.001) were significantly greater in patients with preexisting CVRFs or CVDs. In-hospital mortality (12.9% vs. 3.1%; P < 0.001) was significantly higher in patients with preexisting CVRFs or CVDs. Among the CVRFs, diabetes mellitus and hypertension were associated with increased requirement of intensive care and invasive MV and in-hospital death. Among the known CVDs, coronary artery disease and congestive heart failure were associated with invasive MV and in-hospital death. In multivariate analysis, preexisting CVRFs or CVDs (odds ratio [OR], 1.79; 95% confidence interval [CI], 1.07–3.01; P = 0.027) were independent predictors of in-hospital death after adjusting for confounding variables. Among individual preexisting CVRF or CVD components, diabetes mellitus (OR, 2.43; 95% CI, 1.51–3.90; P < 0.001) and congestive heart failure (OR, 2.43; 95% CI, 1.06–5.87; P = 0.049) were independent predictors of in-hospital death. Conclusion: Based on the findings of this study, the patients with confirmed COVID-19 with preexisting CVRFs or CVDs had worse clinical outcomes. Caution is required in dealing with these patients at triage.
Correction of hand deformities after burns
Daegu Son 대한수부외과학회 2022 대한수부외과학회지 Vol.27 No.1
Hand burns can lead to deformities even after successful primary healing. They are the most common cause of skin contracture involving the hand. This review article discusses ways to correct claw deformity, flexion contracture in the palm and finger, and web space contracture, which are post-burn hand deformities commonly encountered in clinical practice. Loss of skin is the end result in many cases of hand deformities after burns. Therefore, reinforcing the lost skin is the principle of corrective surgery. Even if the skin is thicker than the full-thickness skin, it will engraft if damage to the tissue and blood vessels of the recipient is minimized. The thicker the skin, the less re-contraction and growth occur. The foot is an ideal donor site for skin grafts on the hand. In particular, the instep or the area below the malleolar is a very good donor site. The first web space of the hand is very important for hand function, and it must be reconstructed with Z-plasty, a skin graft, and a free flap step by step according to the degree of contraction.
Cho, Daegu,Cho, Hunhee,Kim, Daewon Vilnius Gediminas Technical University 2014 Journal of Civil Engineering and Management Vol.20 No.1
<P>A type-based system is widely used for cost and schedule control in the NATM (New Austrian Tunnelling Method) tunnel. This study raises several limitations of the type-based system: a broad level of control, a distributed approach to cost and schedule data, ad hoc management, and difficulty in deriving meaningful data. Integrated cost and schedule control promises a myriad of benefits on both information flow and construction management. Nevertheless, the integrated approach still seems to be a long way from common use in the construction industry because it requires considerable overhead effort to acquire, track, and analyze the integrated data. The objective of this study is to propose a new method to automate the required processes for implementing cost and schedule integration. We propose an operational-level automatic data processing system for cost and schedule integration. The proposed system consists of a real-time location system for detecting equipment locations, a wireless mesh network for transmitting the location signals to a field office, and a prototype model for transforming the signals to cost and schedule data. Technical feasibility is analyzed through a pilot project. The study offers a new approach to facilitating sensor technologies for cost and schedule integration.</P>
Large Auricular Chondrocutaneous Composite Graft for Nasal Alar and Columellar Reconstruction
Son, Daegu,Kwak, Minho,Yun, Sangho,Yeo, Hyeonjung,Kim, Junhyung,Han, Kihwan Korean Society of Plastic and Reconstructive Surge 2012 Archives of Plastic Surgery Vol.39 No.4
Background Among the various methods for correcting nasal deformity, the composite graft is suitable for the inner and outer reconstruction of the nose in a single stage. In this article, we present our technique for reconstructing the ala and columella using the auricular chondrocutaneous composite graft. Methods From 2004 to 2011, 15 cases of alar and 2 cases of columellar reconstruction employing the chondrocutaneous composite graft were studied, all followed up for 3 to 24 months (average, 13.5 months). All of the patients were reviewed retrospectively for the demographics, graft size, selection of the donor site and outcomes including morbidity and complications. Results The reasons for the deformity were burn scar (n=7), traumatic scar (n=4), smallpox scar (n=4), basal cell carcinoma defect (n=1), and scar contracture (n=1) from implant induced infection. In 5 cases of nostril stricture and 6 cases of alar defect and notching, composite grafts from the helix were used ($8.9{\times}12.5$ mm). In 4 cases of retracted ala, grafts from the posterior surface of the concha were matched ($5{\times}15$ mm). For the reconstruction of the columella, we harvested the graft from the posterior scapha ($9{\times}13.5$ mm). Except one case with partial necrosis and delayed healing due to smoking, the grafts were successful in all of the cases and there was no deformity of the donor site. Conclusions An alar and columellar defect can be reconstructed successfully with a relatively large composite graft without donor site morbidity. The selection of the donor site should be individualized according to the 3-dimensional configuration of the defect.