• Journal of Korean Neurosurgical Society
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• v.53 no.1
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• pp.39-42
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• 2013

Objective : Obtaining real-time image is essential for neurosurgeons to minimize invasion of normal brain tissue and to prompt diagnosis of intracranial event. The aim of this study was to report our three-year experience with a mobile computed tomography (mCT) for intraoperative and bedside scanning. Methods : A total of 357 mCT (297 patients) scans from January 2009 to December 2011 in single institution were reviewed. After excluding postoperative routine follow-up, 202 mCT were included for analysis. Their medical records such as diagnosis, clinical application, impact on decision making, times, image quality and radiologic findings were assessed. Results : Two-hundred-two mCT scans were performed in the operation room (n=192, 95%) or intensive care unit (ICU) (n=10, 5%). Regarding intraoperative images, extent of resection of tumor (n=55, 27.2%), degree of hematoma removal (n=42, 20.8%), confirmation of catheter placement (n=91, 45.0%) and monitoring unexpected complications (n=4, 2.0%) were evaluated. A total of 14 additional procedures were introduced after confirmation of residual tumor (n=7, 50%), hematoma (n=2, 14.3%), malpositioned catheter (n=3, 21.4%) and newly developed intracranial events (n=2, 14.3%). Every image was obtained within 15 minutes and image quality was sufficient for interpretation. Conclusion : mCT is feasible for prompt intraoperative and ICU monitoring with enhanced diagnostic certainty, safety and efficiency.

• Journal of Korean Academy of Nursing
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• v.48 no.3
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• pp.362-374
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• 2018

Purpose: This study aimed to develop a triage competency scale (TCS) for emergency nurses, and to evaluate its validity and reliability. Methods: Preliminary items were derived based on the attributes and indicators elicited from a concept analysis study on triage competency. Ten experts assessed whether the preliminary items belonged to the construct factor and determined the appropriateness of each item. A revised questionnaire was administered to 250 nurses in 18 emergency departments to evaluate the reliability and validity of the scale. Data analysis comprised item analysis, confirmatory factor analysis, contrasted group validity, and criterion-related validity, including criterion-related validity of the problem solving method using video scenarios. Results: The item analysis and confirmatory factor analysis yielded 5 factors with 30 items; the fit index of the derived model was good (${\chi}^2/df=2.46$, Root Mean squared Residual=.04, Root Mean Squared Error of Approximation=.08). Additionally, contrasted group validity was assessed. Participants were classified as novice, advanced beginner, competent, and proficient, and significant differences were observed in the mean score for each group (F=6.02, p=.001). With reference to criterion-related validity, there was a positive correlation between scores on the TCS and the Clinical Decision Making in Nursing Scale (r=.48, p<.001). Further, the total score on the problem solving method using video scenarios was positively correlated with the TCS score (r=.13, p=.04). The Cronbach's ${\alpha}$ of the final model was .91. Conclusion: Our TCS is useful for the objective assessment of triage competency among emergency nurses and the evaluation of triage education programs.

• Journal of Korean Academy of Nursing
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• v.34 no.8
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• pp.1434-1442
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• 2004

Purpose. Professional nursing ethics is a living, dynamic set of standards for nurses' professional moral behavior. Furthermore, in daily clinical nursing training, nursing students are constantly confronted with decision-making that is moral in nature. The aim of this study was to identify the perceived ethical attitudes in the clinical training process of senior nursing students using Q-methodology to offer basic strategies for nursing ethics education and thereby improve patients' care. Methods. Q-methodology provides a scientific method for identifying perception structures that exist within certain individuals or groups. Thirty-seven participants in a university rated 38 selected Q-statements on a scale of 1-9. The collected data were analyzed using pc-QUNAL software. Results. Principal component analysis identified 3 types of ethical attitudes in nursing students in Korea. The categories were labeled Sacred-life, Science-realistic and Humane-life. Sacred-life individuals think that a life belongs to an absolute power (God), not a man, and a human life is a high and noble thing. Science-realistic individuals disagreed that allowing an induced abortion or embryo (human) duplication is unethical behavior that provokes a trend, which takes the value of a life lightly; most of them took a utilitarian position with respect to ethical decisions. Humane-life individuals exhibit a tendency toward human-centered thought with respect to ethical attitudes. Conclusion. This study will be of interest to educators of students of nursing and hospital nursing administrators. Also, the findings may provide the basis for the development of more appropriate strategies to improve nursing ethics education programs.

• THE JOURNAL OF KOREAN ORIENTAL ONCOLOGY
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• v.9 no.1
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• pp.89-97
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• 2003

Recently, the occurrence and death rates of cancer have increased rapidly. In oriental medicine, the tongue gives some kind of special physiological information on human body. Oriental medical doctors have used information about the color, degree of wetness and shape of the patient's tongue to determine patient's disease and body condition. This fact leads us that the tongue image is one of the most important clinical data for helping doctor's decision making. It also has significant meaning to cancer patients related with traditional theory of oriental medicine. In diagnosis and treatment of cancer, tongue diagnosis can give some prognosis and change o cancer. It also detect the sign of early stage cancer, but it cannot diagnose the kind of cancer and/or benign or malignant. Nowadays BioTechnology(BT) has developed rapidly, but there are a lot of limits(economy, accuracy, clinical significance, etc). Tongue diagnosis is very economic and practical way of diagnose and has a lot of possibility of development. The need for doctors and it also helps the development of tongue diagnosis related with cancer.

• Journal of the Korea Society of Computer and Information
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• v.25 no.2
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• pp.93-103
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• 2020

The telecare medical information system (TMIS) supports convenient and rapid health-care services. A secure and efficient authentication and key agreement scheme for TMIS provides safeguarding electronic patient records (EPRs) and helps health care workers and medical personnel to rapidly making correct clinical decisions. Giri et al. proposed an RSA-based remote user authentication scheme using smart cards for TMIS and claimed that their scheme could resist various malicious attacks. In this paper, we point out that their scheme is still vulnerable to lost smart card attacks and replay attacks and propose an improved scheme to prevent the shortcomings. As compared with the previous authentication schemes for TMIS, the proposed scheme is more secure and practical.

• Korean Journal of Clinical Laboratory Science
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• v.38 no.2
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• pp.111-116
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• 2006

One of the cardinal findings of the renal diseases is proteinuria, which appears in the early phase of kidney diseases and is very important in diagnosis, prognosis and decision making in the treatment process and results of the treatment. The study subjects were 126 patients who visited the nephrology department of Kangbuk Samsung Hospital. Serum was requested for urine protein electrophoresis. Total protein was measured with Bayer Advia 1650 (Biuret). Quantitation of each fraction was done by multiplying the percentage of each fraction by the total protein. Serum creatinine and BUN were also measured with Bayer Advia 1650 (Jaffe and Urease). Serum protein EP was done with REP(rapid electrophoresis) using Helena Kit reagents (REP Ultra SPE Kit, Ponceau S stain, Acetic acid, Methanol, EP Control). Concentrated urine was used for urine protein EP. The SPSS package was used for statistics analysis. Percentage and quantitation of the level of albumin in renal diseases were significantly lower than those in healthy controls. Total protein was correlated with albumin. In terms of proportion, ${\alpha}1$-globulin, ${\alpha}2$-globulin, ${\beta}$-globulin, and ${\gamma}$-globulin fractions were increased in the disease group. But, in the quantified level, ${\alpha}2$-globulin was increased and ${\beta}$-globulin and ${\gamma}$-globulin were decreased. ESRD patients showed an increased secretion of high molecular proteins in urine protein EP. A decreased level in serum total protein correlated with the decreased level of serum albumin and the total amount of urine total protein. This study revealed the variety in the level of serum and urine proteins and their subgroups by EP.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.15 no.1
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• pp.7-13
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• 2019

The aim of this study was to clarify the barriers of dental treatment for special needs patients felt by dentists and to determine the dentist-related factors contributing to the obstacles in treatment planning and decision making. Questionnaires were distributed and responded by dentists working at five public-based special care clinics in South Korea. Factors divided into three parts (dentist demographics, clinical factors, and educational and administrational factors) were assessed and analyzed for correlations between dentist-related factors and dentist-felt burdens for special care treatment. Fisher's exact test and Chi-square test were used at the level of 0.05. A total of 34 dentists responded to the questionnaires. Almost all dentists had obstacles in the treatment of special needs patients in terms of the patients' lack of cooperation (94.1%), proxy communication with caregivers (94.1%), payment reward system (63.6%), deficient workforce (67.7%), and others. The longer dentists had been practicing for special needs patients, the more they were dissatisfied with the reward system and a longer time was spent for communication with patients and their caregivers (p<0.05). For specialists, more obstacles were experienced in treatment planning due to a deficiency in the clinical information obtained from their patients compared to general practitioners (p<0.05). A total of 82.4% of the respondents approved of mandatory educational programs for special care dentists. There were practitioner-based factors related to the amount of obstacles felt by special care dentists. To overcome the treatment barrier of special needs patients, in-depth education and training are required in special care dentistry.

• The Journal of the Convergence on Culture Technology
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• v.5 no.1
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• pp.59-66
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• 2019

This study was to investigate the effect of deontology and utilitarianism on the ethical values of nursing students and to provide basic data. Data collection was conducted from May 14 to June 1, 2018 in 180 students of a university nursing student in Daegu who explained their research and agreed to the study. The collected data were analyzed using the SPSS 21.0 program. In order to confirm the difference between the subjects' demographic characteristics and nursing-related characteristics, the independent t-test and ANOVA were used, and the post-test was conducted using the $Sch{\acute{e}}ffe$ post-test. The ethical values of the nursing students were $97.51{\pm}8.96$ out of 150, indicating that they were inclined toward the position of deontology. The first grade students were more dominant, and the higher the grade, the more inclined toward utilitarianism. It is necessary to develop education to establish ethical values so that ethical decision making can be done through philosophical thinking when various nursing dilemma situations in the clinical field are based on the results.

• Korean Journal of Clinical Pharmacy
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• v.31 no.2
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• pp.145-152
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• 2021

Background: The Life-Sustaining Treatment Decision-Making Act has allowed anyone aged 19 or older to sign an Advance Directive not to receive life-sustaining treatment when they are in the 'death process'. Recently, the Korean Pharmaceutical Association announced to raise awareness of the Advance Directive to the general public through community pharmacies across the country. This study aimed to investigate the public's willingness to accept pharmacist's consultation regarding the Advance Directive and to present future directions to pharmacists Methods: This cross-sectional questionnaire study using 16-items was conducted in adults, Study subjects were recruited by convenience sampling method during August 5-15, 2020. Results: Of 460 respondents, 51.7% were younger than 30-year-old and 58.7% were not in the healthcare field in terms of job or major. 60.2% knew about the Advance Directive and 81.7% agreed the necessity to sign when healthy. 50.0% had the willingness to consult with pharmacists on the Advance Directive for well-dying and 80.4% preferred verbal explanation together with written information. Simple linear regression analysis results showed a significant relationship between trust in pharmacists or satisfaction with pharmacist's communication and willingness to use pharmacist' consultation on the Advance Directive (1-point increases in values measured on a five-point scale are associated with 0.464 and 0.486 increases, respectively.) Conclusion: This study suggests that pharmacists need to improve the public's trust and communication capability to satisfy with public's demands on well-dying service.

• Clinical and Experimental Reproductive Medicine
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• v.48 no.2
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• pp.163-173
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• 2021

Objective: This study aimed to characterize a validated model for predicting oocyte retrieval in controlled ovarian stimulation (COS) and to construct model-based nomograms for assistance in clinical decision-making regarding the gonadotropin protocol and dose. Methods: This observational, retrospective, cohort study included 636 women with primary unexplained infertility and a normal menstrual cycle who were attempting assisted reproductive therapy for the first time. The enrolled women were split into an index group (n=497) for model building and a validation group (n=139). The primary outcome was absolute oocyte count. The dose-response relationship was tested using modified Poisson, negative binomial, hybrid Poisson-E_max, and linear models. The validation group was similarly analyzed, and its results were compared to that of the index group. Results: The Poisson model with the log-link function demonstrated superior predictive performance and precision (Akaike information criterion, 2,704; λ=8.27; relative standard error (λ)=2.02%). The covariate analysis included women's age (p<0.001), antral follicle count (p<0.001), basal follicle-stimulating hormone level (p<0.001), gonadotropin dose (p=0.042), and protocol type (p=0.002 and p<0.001 for short and antagonist protocols, respectively). The estimates from 500 bootstrap samples were close to those of the original model. The validation group showed model assessment metrics comparable to the index model. Based on the fitted model, a static nomogram was built to improve visualization. In addition, a dynamic electronic tool was created for convenience of use. Conclusion: Based on our validated model, nomograms were constructed to help clinicians individualize the stimulation protocol and gonadotropin doses in COS cycles.