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Purpose: Ocular injury is a significant problem in pediatric patients. The aim of this investigation was to evaluate clinical characteristics of pediatric eye injury for the purpose of offering preventive strategies. Methods: This retrospective study was carried out by evaluating the records of patients under the age of 15 years who were treated for ocular injury at the Kyungpook National University Hospital emergency medical center, from January 2003 to December 2008. A total of 477 patients were included in the study. Age, sex, date of injury, location where injury occurred, cause of injury, diagnosis, any effects on visual acuity, and any complications, were analyzed. Results: Ocular injury occurred more frequently in boys (72.3%) than in girls, and the highest incidence was seen in ages 11 to 15 years (37.3%). Ocular injury frequently occurred in the home or at school. The most common cause of injury was due to instruments (51.6%). Surgery was necessary in 71 patients (14.9%), complication developed in 48 patients (10.1%), and 40 patients (8.4%) suffered from decreased visual acuity. Conclusion: It`s important to monitor boys, in particular, who are engaged in physical activities in the home and at school. Appropriate education and application of personal protective equipment are important methods to aid in prevention of pediatric ocular trauma, especially with children in the home and with adolescents engaged in sporting activities.
안재윤 ( Jae Yun Ahn ), 서강석 ( Kang Suk Seo ), 박정배 ( Jung Bae Park ), 정제명 ( Jae Myung Chung ), 류현욱 ( Hyun Wook Ryoo ), 강성원 ( Sung Won Kang ), 최규일 ( Kyu Il Choi ), 김윤정 ( Yun Jeong Kim ) 대한응급의학회 2009 大韓應急醫學會誌 Vol.20 No.5
Purpose: The following study was performed to compare basic life support (BLS) skills and knowledge over a 6 months interval in preclinical medical students. Methods: Upon initial instruction, 112 first-year medical students at a teaching hospital were given instructions in BLS, their knowledge performance was evaluated by written test and skills test via checklist designed by instructors and PC SkillReporting System(R) (Laerdal, Norway). Their performance was re-evaluated 6 months after initial BLS training in an identical fashion. Evaluation was performed on 103 out of 112 students who had taken initial BLS training. Results: The results of written test showed that the students evaluated right after taking initial BLS training have better knowledge of BLS compared to students evaluated 6 months after taking initial BLS training (p<0.001). Results of skills test evaluated by checklist showed decrease in adequate performance of students evaluated 6 months after BLS education in 12 out of 18 items compared to students who have just received initial BLS training. The decreases were statistically significant in 6 items. Total scores after 6 months were also lower compared with initial scores (p<.0.001). The results of the skills test using PC Skill Reporting System(R) demonstrated that the percentage of adequate ventilation volume, compression rate, hands-off time, and hand position were each 18.4%, 46.6%, 47.6%, 84.2% initially and 5.8%, 32.0%, 32.0%, 76.1% at 6 months after initial training. Students performed significantly worse 6 months post training in 4 out of 7 items (p<0.05). Conclusion: Knowledge and skills of preclinical medical students decreased significantly after a 6 month period compared to knowledge and skills after initial training. Therefore, retraining of BLS is required within 6 months, but more study is required to determine appropriate intervals and methods of retraining.
Objective: Sixteen cases of blunt diaphragmatic injury were clinically reviewed during 10 years from Oct.1987 to Jun.1996 at the Kangdong sacred heart hospital. The age and sex distribution were ranged from 3 to 67-old-years. The most common age range was between third decades to fifth decades in 10 cases(62.50%) and occurred predominantly in male, the sex ratio was 4.3: 1.(M:F 4.3:1) The modes of blunt diaphragmatic injury were due to motor vehicle accidents(MVA), motor cycle accidents(MCA),fall down(FD) and others. Most common injuries were responsible for MVA. MVA were pedestrian traffic accidents 5 cases (41.7%), driver 4 cases(33.3%) passenger 3 cases(25,0%). In the blunt diaphragmatic injury sites, the left-sided diaphragmatic injury had predominant[left-sided cases 10(62. 50%), right-sided cases 6(37.50%)]. Cost common symptoms and signs were chest pain or chest discomfort(81.25%) and dyspnea(68.75%), abdominal tenderness(50.00%), decreased bowel sound and breath sound(50.00%) and others. All of 16 cases in blunt diaphrahmatic injury were associated with other injuries. The associated injuries were hemopneumothorax 14(87.50% ), hemoperitoneum 7(43.75%), liver injury 7(43.75%), orthopedics fracture 14(87.50%), head injury 5(31.25%) and others. The diagnostic methods were used with simple x-ray, ultrasonogram and computed tomogram. The preoperative diagnosis of blunt diaphragmatic injury were suggested in 10 cases(62.50%) and others were confirmed during operation. The thirteen cases of all of sixteen cases were performed emergency operation within eight hours. The herniated intraabdominal organs through ruptured diaphragm were presented in 10cases(62.5%) [stomach 7 cases(43.75%), spleen 6 cases(37.50%), colon 3 cases(18.75%), liver 3 cases(18.75%), small bowel and omentum 2 cases(12.50%), respectively]. The mean size of blunt diaphragmatic injury were 7.7cm, right-sided mean size were 9cm, left-sided mean size were 6.9cm. The most common site of blunt diaphragm- atic injury were presented in anteromedial site 7 cases(43.75%). Simple chest x-ray revealed abnormal finding [hemothorax 10 cases(62.50%), pneumothorax 4 cases(25.00%), herniated organ into thorax 8 cases(50.00%), diaphragm elevation 3 cases(18.75%) and others]. The postoperative complication were associated in 10 cases(62.50%) out of 16 cases. Common complications were pleural effusion 6 cases(37.50%) and atelectasis 3 cases( 18.75%). Injury severity score(ISS) value of ] 6 cases in the blunt trauma ranged from 10 to 59. It was presented with mean value of ISS(35.5),mean value of ISS survivors(35) and nonsurvivors(55.5). Reised trauma score(RTS) value ranged also 'rom 4 to 12. There were revealed with mean value of RTS(9.7),mean value of RTS survivors(10) and nonsurvivors(6.5). All of the blunt traumatic injury, mortality rate was related to the values of ISS and RTS.
최규일 ( Kyu Ill Choi ), 서강석 ( Kang Suk Seo ), 류현욱 ( Hyun Wook Ryoo ), 박정배 ( Jung Bae Park ), 정제명 ( Jae Myung Chung ), 안재윤 ( Jae Yoon Ahn ), 강성원 ( Seong Won Kang ), 이재혁 ( Jae Hyuck Yi ) 대한외상학회 2009 大韓外傷學會誌 Vol.22 No.2
Purpose: Early diagnosis and management of therapeutic interventions are very important in chest trauma. Conventional chest X-rays (CXR) and computed tomography (CT) are the diagnostic tools that can be quickly implemented for chest trauma patients in the emergency department. In this study, the usefulness of the CT as a diagnostic measurement was examined by analyzing the ability to detect thoracic injuries in trauma patients who had visited the emergency department and undergone CXR and CT. Methods: This study involved 84 patients who had visited the emergency department due to chest trauma and who had undergone both CXR and CT during their diagnostic process. The patients` characteristics and early vital signs were examined through a retrospective analysis of their medical records, and the CXR and the CT saved in the Picture Archiving Communication System (PACS) were examined by a radiologist and an emergency physician to verify whether or not a lesion was present. Results: Pneumothoraxes, hemothoraxes, pneumomediastina, pulmonary lacerations, rib fractures, vertebral fractures, chest wall contusions, and subcutaneous emphysema were prevalently found in a statistically meaningful way (p<0.05) on the CT. Even though their statistical significance couldn`t be verified, other disorders, including aortic injury, were more prevalently found by CT than by CXR. Conclusion: CT implemented for chest trauma patients visiting the emergency department allowed disorders that couldn`t be found on CXR to be verified, which helped us to could accurately evaluate patients. (J Korean Soc Traumatol 2009;22:142-7)
이유철(Yoo Chul Lee), 여상희(Sang Hee Yeo), 이원기(Won Kee Lee), 강덕식(Duk Sik Kang), 강이철(Echeol Kang), 곽연식(Yun Sik Kwak), 김보완(Bo Wan Kim), 이종명(Jong Myung Lee), 장봉현(Bong Hyun Chang), 정제명(Jae Myung Chung), 조희중(Hee Jung Cho) 한국의학교육학회 2003 Korean journal of medical education Vol.15 No.1
'스콜라' 이용 시 소속기관이 구독 중이 아닌 경우, 오후 4시부터 익일 오전 7시까지 원문보기가 가능합니다.
Purpose: Kyungpook National University School of Medicine initiated a pilot project to admit small number of qualified students who received BS degree or above in the field of sciences in 1996. This study was conducted to evaluate effectiveness of the pilot project. Methods: Students academic grades, outcome of their opinion surveys on adaptability to the school life, difficulties and problems from the classes of 1996 to 2001 were analyzed. Results: A total of 57 students were admitted to this program over the past 7-year period, 54.8% of them from natural science major and 36.8% from engineering. Students admitted with BS degree were performing above average in the class by % rank. There was no significant difference in academic performance between the natural science and the engineering major. Of 20 graduated, only one took career in basic medical science (physiology). The students thought undergraduate education was helpful in maturing personal characters than in knowledge or skill attainment. Conclusion: The achievement of medical students admitted after baccalaureate level was comparable to that of students with two years of premedical education.
Purpose: The purpose of this study is to supply basic data for medical supports of the international games held in Korea and to design adequate plans for medical support systems in the international games. Methods: We analyzed patients who visited the medical facilities during Summer Universiade Daegu 2003. A total of 3,363 individuals used the Athlete`s Village Polyclinic during the Game, but a total of 1,079 cases were treated with traditional oriental medicine and were excluded. Standard charts were available for the 2,248 cases. Data were collected regarding patients` sex, age, participation role, chief complaint, diagnosis, visits of medical departments, management, and disposition. We classified patients according to acuity scoring criteria (a four-tier triage system), economies, and the data compared. Significant athlete injuries were triaged immediately by physicians stationed at the event scene. Results: In the analysing, we used 2,248 cases, including some repeat visits. There were 987 visits by athletes, 937 visits by officials, 236 visits by staffs, and 88 visits by others. Musculoskeletal diseases were the primary chief complaint. Curiously, the lower income group visited the Polyclinic more often than the high income group. Conclusion: Most Polyclinic staffs were volunteers, providing encouragement and enthusiasm to patients. In this study, patient were contacted with emergency physicianbased medical service. For the future plans of the medical supports for similar events, effective medical plans should be finalized by considering multiple factors.
이현희 ( Hyun Hee Lee ), 서강석 ( Kang Suk Seo ), 정제명 ( Jae Myung Chung ), 박정배 ( Jeong Bae Park ), 류현욱 ( Hyun Wook Ryoo ), 김종근 ( Jong Kun Kim ), 서준석 ( Jun Seok Seo ), 이삼범 ( Sam Beom Lee ), 최우익 ( Woo Ik Choi ), 이경원 () 대한응급의학회 2008 大韓應急醫學會誌 Vol.19 No.3
Purpose: To report characteristics of out-of-hospital cardiac arrest (OHCA) patients in whom 119 rescuers used an automated external defibrillator (AED) in the metropolitan area Methods: 1,689 OHCA patients were transferred to hospitals by 119 rescuers between 1 January and 31 December, 2006. Among them, 106 OHCA patients for whom 119 rescuers used an AED were enrolled retrospectively. Results: Shockable rhythm with AED use was 70.8%, witnessed arrest was 46.2%, and bystander cardiopulmonary resuscitation (CPR) was 6.6%. The most common location of cardiac arrest was in the home, at 74.5%. Response time was 7.1(±3.9) minutes. Chest compression during transport was done by 119 rescuers in 87.7% of cases, and assisted ventilations such as advanced airway management and bag valve mask ventilation were performed by 119 rescuers in 17.0%. Initial ECG findings at ED were asystole(59.4%), PEA(25.5%), VF/pulseless VT(8.5%), sinus rhythm(4.7%), and others(1.9%). The most common etiology of cardiac arrest was presumed cardiac origin in 68.9% of cases. Sustained return of spontaneous circulation (ROSC) was 26.4%. The proportion of patients discharged alive was 11.3%. Conclusion: The performance of bystander CPR and usage of AED, and appropriate CPR done by 119 rescuers were unsatisfactory in metropolitan Daegu. There is a marked need to establish basic life support education in the areas of bystander CPR, and a quantitative and qualitative development of 119 rescue capability.
Purpose: The rate of volunteering by emergency residents is currently low in Korea because of the relatively high job stress. We aimed to investigate the job stress and job satisfaction of emergency residents and we wanted to identify the related factors. Methods: Data was collected by conducting a cross-sectional mail survey. This mail was sent to 397 emergency residents in Korea. Among them, 226 persons answered the questionnaire and 220 responses were analyzed, with excluding 6 incomplete answers. Results: Age, gender, the marriage status and the type of training hospital showed no statistically significant differences in relation to job stress and job satisfaction. XXXXBut the grade of the residents, satisfaction as emergency residents, thoughts of changing their job, thoughts of leaving the emergency department, their social and economic positions and the type of work-shift showed significant differences for job stress and job satisfaction. XXX Among the job stresses, the mean scores of the job factor, the environmental factor and the reward factor were 3.45±0.90, 3.63±0.67 and 3.55±0, respectively. Among job satisfaction, the mean scores of the job factor, the relationship factor and the reward factor were 3.59±0.67, 2.46±0.74 and 2.53±0.80, respectively Conclusion: The job stress of emergency residents is excessive, and especially for the environmental and reward factors, and the degree of job satisfaction is low. Management of crowding, improving the environment by changing the type of work-shift type, eradicating violence in the emergency department and adequate rewards are needed to reduce this job stress. Efforts to increase the treatment capability and positively improve the relationship of residents with other medical specialists should be made to enhance emergency residents` job satisfaction.