Posterior Reversible Encephalopathy Syndrome in a Critically Ill Postoperative Patient

Min Ae Keum,Hyo Keun No,Choong Wook Lee,전상범,홍석경 대한중환자의학회 2015 Acute and Critical Care Vol.30 No.1

Posterior reversible encephalopathy syndrome (PRES) is a transient condition characterized by altered mental status, seizure, headache,and visual disturbance with typical neuro-imaging findings in the bilateral parieto-occipital regions. Clinicians should be aware of this syndrome because delayed diagnosis and treatment result in irreversible neurologic deficits. We present the case of a 77-year-old male diagnosed with PRES in the setting of postoperative critical illness caused by small-bowel strangulation.

건삭 파열에 의한 외상성 삼천판 역류: 증례보고

금민애 ( Min Ae Keum ),노효근 ( Hyo Keun No ),선병주 ( Byung Joo Sun ),홍석경 ( Suk Kyung Hong ) 대한외상학회 2015 大韓外傷學會誌 Vol.28 No.2

Traumatic tricuspid regurgitation is a rare complication of blunt chest trauma caused by chordal rupture, anterior papillary muscle rupture and anterior leaflet tear. Since clinical symptoms are vague, early diagnosis is difficult and some patient exhibit symptoms of right heart failure. Right heart failure has been the traditional indication for surgical treatment, such as tricuspid valve replacement. Recently, early detection using transthoracic echocardiography and surgical treatment, like valve repair, prior to overt right heart failure have been shown to better prognosis. We report a case of traumatic tricuspid regurgitation with chordal rupture in patient due to traffic accident. [ J Trauma Inj 2015; 28: 67-70 ]

Rapidly growing pediatric trampoline-related injuries in Korea: a 10-year single center retrospective study

Min-Jeng Cho,Ji Hoon Kim,Sung Jeep Kim,Kyu Hyouck Kyoung,Min Ae Keum,Sung Kyun Park 대한소아청소년과학회 2019 Clinical and Experimental Pediatrics (CEP) Vol.62 No.3

Purpose: Several published policy statements have warned against the risks associated with trampoline use and recommended safety guidelines. However, few studies have focused on trampoline-related injuries in Korea. This study aimed to assess the incidence and characteristics of pediatric trampoline-related injuries presented to Ulsan University Hospital. Methods: We retrospectively reviewed the medical records of children aged <16 years with trampoline-related injuries who visited our Emergency Department between 2008 and 2017. Results: Over the 10-year period, 178 trampoline-related injuries were reported, which represented a significant increase (P=0.016). Most (87.6%) of the injuries occurred during the last 5 study years, and a rapid increase in injuries was observed in children aged <6 years. Lower extremity injuries (62.4%) were the most common, followed by injuries of the upper extremities, head and face, and trunk, including injuries to the neck and spine. Sixty-seven children (37.6%) had fractures, and proximal tibia fractures were the most common. Fractures were significantly more common in younger children (<6 years old) than in older children (P=0.026). Conclusion: In Korea, the mechanism of trampoline injury is similar to that of injuries incurred in indoor trampoline parks but is characterized by smaller spaces and multiple users. Trampoline use and the incidence of trampoline-related injuries in children aged <6 years are increasing rapidly. Prohibiting the use of trampolines for children aged <6 years, restricting simultaneous use by multiple children, and ensuring adult supervision should be strictly emphasized. Public awareness and policy guidelines are needed to reduce the incidence of trampoline-related injuries

Rapidly growing pediatric trampoline-related injuries in Korea: a 10-year single center retrospective study

Cho, Min Jeng,Kim, Jihoon,Kim, Sung Jeep,Kyoung, Kyu Hyouck,Keum, Min Ae,Park, Sung Kyun The Korean Pediatric Society 2019 Clinical and Experimental Pediatrics (CEP) Vol.62 No.3

Purpose: Several published policy statements have warned against the risks associated with trampoline use and recommended safety guidelines. However, few studies have focused on trampoline-related injuries in Korea. This study aimed to assess the incidence and characteristics of pediatric trampoline-related injuries presented to Ulsan University Hospital. Methods: We retrospectively reviewed the medical records of children aged <16 years with trampoline-related injuries who visited our Emergency Department between 2008 and 2017. Results: Over the 10-year period, 178 trampoline-related injuries were reported, which represented a significant increase (P=0.016). Most (87.6%) of the injuries occurred during the last 5 study years, and a rapid increase in injuries was observed in children aged <6 years. Lower extremity injuries (62.4%) were the most common, followed by injuries of the upper extremities, head and face, and trunk, including injuries to the neck and spine. Sixty-seven children (37.6%) had fractures, and proximal tibia fractures were the most common. Fractures were significantly more common in younger children (<6 years old) than in older children (P=0.026). Conclusion: In Korea, the mechanism of trampoline injury is similar to that of injuries incurred in indoor trampoline parks but is characterized by smaller spaces and multiple users. Trampoline use and the incidence of trampoline-related injuries in children aged <6 years are increasing rapidly. Prohibiting the use of trampolines for children aged <6 years, restricting simultaneous use by multiple children, and ensuring adult supervision should be strictly emphasized. Public awareness and policy guidelines are needed to reduce the incidence of trampoline-related injuries.

국소진행성 직장암에서 수술 전 방사선 및 항암화학 동시요법의 효과

조재호(J ae Ho Cho),성진실(Jinsil Seong),금기창(Ki Chang Keum),김귀언(Gwi Eon Kim),서창옥(Chang Ok Suh),노재경(Jae Kyung Roh),정현철(Hyun Cheol Chung),민진식(Jin Sik Min),김남규(Nam Kyu Kim) 대한방사선종양학회 2000 Radiation Oncology Journal Vol.18 No.4

목 적 : 직장암에서 완치를 기대할 수 있는 치료는 수술요법이다. 진행성 병변으로서 근치절제가 불가능한 경우에 있어서는 수술 전 보조요법을 통해 절제연이 음성인 근치절제율을 높이고자 하는 노력이 시도되고 있다. 이에 저자들은 수술 전 방사선 및 항암화학 동시요법으로 근치 절제율을 높여 치료성적을 향상시키기 위하여 전향적 임상 연구를 시행하였다. 대상 및 방법 : 1995년 1월부터 1998년 6월까지 국소적으로 진행된 직장암으로 내원하여 수술전 병기결정 검사를 통하여 근치적 절제가 불가능하다고 판단된 37명의 환자가 본 연구에 포함되었다. 수술전 병기결정은 직장수지검사, 경직장초음파, 컴퓨터단층촬영, 자기공명영상 등을 이용하였다. 방사선 치료는 3 문 내지 4 문 조사식으로 총 45∼50.4 Gy를 시행하였으며, 방사선 치료 첫째 주와 다섯째 주에 항암 화학요법(5- Fluorouracil, 370∼450 mg/m2 , IV bolus, 5 days; Leucovorin 20 mg/m2 , IV bolus, 5 days)이 동시에 투여되었다. 방사선 치료 후 4∼6주 후에 근치적절제술을 시행하였다. 전체 37명의 환자 중 31명에서 계획된 방사선 및 항암화학 동시요법 후 근치적 수술이 시행되었고, 나머지 6명은 환자 이해부족으로 치료가 중단 된 경우 4예, 치료중 진행성 병변(Perforation)으로 응급수술을 시행한 후 방사선 단독치료를 한 경우 1예, 그리고 1예에서는 방사선 및 항암화학 동시요법을 시행 후 수술하기 전에 폐전이가 발견되어 전신항암화학 요법만을 시행하였다. 결 과 : 계획된 치료가 시행된 환자 중 94% (29/31)에서 절제연 음성인 완전근치절제가 가능하였으며, 병리적 완전관해율은 6% (2/31), 임상적 완전관해율은 23% (7/31)이었다. 수술 전 병기 감소율은 68%에서 관찰되었다. 수술은 2예에서 국소 절제술, 14예에서 저위전방절제술, 8예에서 복회음부 절제술, 4예에서 하트만씨 절제술, 3예에서 부분 내용제거술을 시행되었다. 치료와 연관된 급성 독성으로는 Grade III & IV의 백혈구 감소증 각각 4예(13%), 2예(6%)를 제외하고는 대부분 경미하였다. 결 론 : 국소적으로 진행되어 근치적 절제가 어려운 직장암에서 계획된 수술 전 방사선 및 항암화학 동시요법을 통해서 수술 후 병기 감소(68%)와 높은 완전근치절제율(94%)을 얻을 수 있었다. 치료에 따른 독성도 대부분 경미하여 좋은 순응도를 보였다. 나아가 이러한 치료를 통해 얻어지는 국소 제어율과 전체 생존율에 대해서는 향후 추적 관찰을 통해 분석해 나갈 예정이다. Purpose :We conducted a prospective non- randomized clinical study to evaluate the efficacy and toxicity of the preoperative concurrent chemoradiotherapy for locally advanced unresectable rectal cancer. Materials and Methods : Between January 1995 and June 1998, 37 consecutive patients with locally unresectable advanced rectal cancer were entered into the study. With 3- or 4- fields techniuqe, a total of 45 Gy radiation was delivered on whole pelvis, followed by 5.4 Gy boost to the primary tumor in some cases. Chemotherapy was done at the first and fifth week of radiation with bolus i.v. 5- Fluorouracil (FU) 370∼450 mg/m2 , days 1∼5, plus Leucovorin 20 mg/m2 , days 1∼5. Of 37 patients, 6 patients did not receive all planned treatment course (refusal in 4, disease progression in 1, metastasis to lung in 1). Surgical resection was undergone 4∼6 weeks after preoperative concurrent chemoradiotherapy. Results :Complete resection rate with negative margins was 94% (29/31). Complete response was seen in 7 patients (23%) clinically and 2 patients (6%) pathologically. Down staging of tumor occured in 21 patients (68%). Treatment related toxicity was minimal except grade III & IV leukopenia in 2 patients, respectively. Conclusion : Preoperative concurrent chemoradiotherapy in locally advanced rectal cancer was effective in inducing down staging and complete resection rate. Treatment related toxicity was minimal. Further follow up is on- going to determine long term survival following this treatment.

Rapidly Growing Pediatric Trampoline-Related Injuries in Korea

Jihoon Kim,Min Jeng Cho,Sung Jeep Kim,Kyu Hyouck Kyoung,Min Ae Keum,Sung Kyun Park 대한외과학회 2018 대한외과학회 학술대회 초록집 Vol.2018 No.11

The Relationship of Hemoglobin Level and Organ Function in Brain-dead Donors

KyuHyouck Kyoung,Min Ae Keum,Sungjeep Kim,Kyunghak Choi 대한외과학회 2022 대한외과학회 학술대회 초록집 Vol.2022 No.11

국내 남성 하이 캐주얼 의류의 디자인에 관한 연구

강경영,김금순,오경애,왕향,이민옥,이지현,정진아,조귀선 연세대학교 생활과학대학 1989 婦學 Vol.22 No.-

The purposes of this study were to investigate historial background of men's hight casual wear in Korea and to make a suggestion for '89 s/s design based on the market research. The results of the market research show men's hight casual wear market divided into formal brand and informal brand, there is no great difference between their target markets which is based on age, taste, and price. On the basis of this results and the international fashion trend for '89 s/s, we suggested four trends for men's hight casual wear design in consideration of Time, Place, and Occasion.

Antibiotic use in patients with abdominal injuries: guideline by the Korean Society of Acute Care Surgery

장지영,Wu Seong Kang,Min-Ae Keum,Young Hoon Sul,Dae-Sang Lee,Hangjoo Cho,Gil Jae Lee,이재길,Suk-Kyung Hong 대한외과학회 2019 Annals of Surgical Treatment and Research(ASRT) Vol.96 No.1

Purpose: A task force appointed by the Korean Society of Acute Care Surgery reviewed previously published guidelines on antibiotic use in patients with abdominal injuries and adapted guidelines for Korea. Methods: Four guidelines were assessed using the Appraisal of Guidelines for Research and Evaluation II instrument. Five topics were considered: indication for antibiotics, time until first antibiotic use, antibiotic therapy duration, appropriate antibiotics, and antibiotic use in abdominal trauma patients with hemorrhagic shock. Results: Patients requiring surgery need preoperative prophylactic antibiotics. Patients who do not require surgery do not need antibiotics. Antibiotics should be administered as soon as possible after injury. In the absence of hollow viscus injury, no additional antibiotic doses are needed. If hollow viscus injury is repaired within 12 hours, antibiotics should be continued for ≤ 24 hours. If hollow viscus injury is repaired after 12 hours, antibiotics should be limited to 7 days. Antibiotics can be administered for ≥7 days if hollow viscus injury is incompletely repaired or clinical signs persist. Broad-spectrum aerobic and anaerobic coverage antibiotics are preferred as the initial antibiotics. Second-generation cephalosporins are the recommended initial antibiotics. Third-generation cephalosporins are alternative choices. For hemorrhagic shock, the antibiotic dose may be increased twofold or threefold and repeated after transfusion of every 10 units of blood until there is no further blood loss. Conclusion: Although this guideline was drafted through adaptation of other guidelines, it may be meaningful in that it provides a consensus on the use of antibiotics in abdominal trauma patients in Korea.

근거기반 구강간호 실무지침 개정

조용애 ( Cho Yong Ae ),이선희 ( Lee Seon Heui ),김경숙 ( Kim Kyeong Sug ),임효민 ( Im Hyo Min ),김태희 ( Kim Tae Hee ),최미영 ( Choi Mi Young ),서현주 ( Seo Hyun Ju ),박효선 ( Park Hyo Sun ),왕금현 ( Wang Keum Hyun ),김찬희 ( Kim 병원간호사회 2020 임상간호연구 Vol.26 No.2

Purpose: This study aimed to update the previously published nursing practice guideline for oral care. Methods: The guideline were updated according to the manuals developed by National Institute for Health and Care Excellence (NICE) and Scottish Intercollegiate Guidelines Network (SIGN), and a Handbook for Clinical Practice Guideline Developer Version 1.0. Results: Updated nursing practice guideline for oral care was consisted of 10 domains and 79 recommendations. The number of recommendations in each domain were: 5 general issues, 2 oral care indications, 9 oral assessment, 16 general oral care, 12 oral care for critically ill patients, 16 oral care for cancer patients, 12 oral care for cancer patients with oral complications, 5 oral care education, 1 oral care referral, and 1 documentation and report. In terms of grades for recommendations, 11.4% was grade A, 17.0% was grade B, and 68.2% was grade C. Twelve new recommendations were developed and 7 previous recommendations were deleted. Conclusion: Updated nursing practice guideline for oral care is expected to serve as an evidence-based practice guideline for oral care in South Korea. It is recommended that this guideline be spread to clinical nursing settings nationwide to improve the effectiveness of oral care practice.