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윤여규,윤효영,정연권 대한외상학회 1994 大韓外傷學會誌 Vol.7 No.1
To solve the problem of tertiary medical center emergency room, overcrowding and long hospital stay, it is very important to analyze the emergency patients who visited tertiary medical center and to accumulate data bases of various hospitals. For this purpose, we have reviewed 14,521 cases of pateints who visited the emergency room of Seoul National University Hospital, tertiary medical center, from,January 1 to December 31, 1992. The results were as follow: 1. Male to female ratio was l.4:1 and the most common age group was 6th decade. 2. The peak time of patient's enterance in emergency room was between 12:00 PM and 4:00 PM (26.7%), and second peak was between 08:00 AM and midday. 3. In a week, Monday was the most crowding day (mean 44 patients). 4. The most predominant monthly distribution of visit was March and September. 5. Of the patients, 71.7% were known to live in Seoul, 6. About half of the patients who visited emergency room needed internal medical care and 42% of them had gastrointestinal disease. 7. The admission rate was 29.5% and transfer rate was 3.9%. The number of the patients who could admit the ward was largest in Monday (mean 15.2 patients) and smallest in Sunday (mean 6.8 patient,s). The average duration from visit to admission was 51 hours. 8. About 1% (144 patients) of patients expired during the treatment in the emergency room and most of them(81.3%) were internal medical patients.
간암 수술 환자의 감염에 있어 Cefotetan의 임상적 치험
윤여규,왕순주 대한외상학회 1994 大韓外傷學會誌 Vol.7 No.2
Cefotetan is a newly developed third generation cephalosporin which is widely used to the surgical patients and reveal resistance to B-lactamase, but reports of side effects such as hypoprothrombinemia or immune hemolytic anemia exist. Total 390 patients were selected who underwent surgery due to hepatic malignancy. Among them 40 patients were proved to have infection of specific species microbiologically. 191 patients were treated with cefotetan, the rest of 199 patients were not treated with cefortetan. 1. The duration of fever is 5.4 day in average in cefotetan group, 5.9 day in non-cefotetan group. 2. Number of fever is l. 4 in average in cefotetan group, 1. 5 in non-cefotetan group. 3. 58 patients (30.4%) developed clinical infection in cefotetan group, 75 patients (35. 7%) in non-cefotetan group. 4. Clinical effects of treatment were divided as exellent, good, poor. The numbers of patients in series are 19(32. 7%), 32(55. 2%), 7(12. 1%) in cefotetan group, 21(29. 6%), 36(50. 7%), 14(19. 7%) in non-cefotetan group. 5. Microbiological effects of treatment were divided as negative conversion, decrease, miscellaneous. Th.e number of patients in series are 6(33.3%), 8(44.5%), 4(22.2%) in cefotetan group, 5(22.7%), 10(45.5%), 7(31.8%) in non-cefotetan group. 6. Number of clinical bleeding is 14(7.3%) in cefotetan group, 17(8.5%) in non- cefotetan group. 7. Laboratory tests of bleeding tendency were no so different between two groups. In conclusion, antibiotic treatment with cefotetan is effective antimicrobial therapy to the surgical patients with hepatic malignacy and there would be less side effects as reported in our study.
윤여규 대한의사협회 2012 대한의사협회지 Vol.55 No.7
A regionalization strategy is a model for improving the performance of the emergency medical service (EMS) system. The regionalization strategy has goals to provide appropriate, timely,effective, and efficient EMS in a region. However, the current EMS regionalization model in Korea is insufficient to achieve these goals due to a shortage of resources in rural regions, crowded emergency departments in metropolitan regions, and non-customized and mismatched levels of emergency departments. Recently, the concept of the regionalization model has been changed from a general regionalized model to a specialty care regionalization one. For example, the trauma care system, cardiac arrest care system, stroke care system, and ST elevation myocardial infarction care system are modern regionalization strategies to improve the performance of EMS. This is a new method of customizing and matching between region-based needs and the supply of EMS. If we can implement this strategy, we can expect improved performance of regional EMS systems.