• Journal of Medicine and Life Science
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• 제21권2호
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• pp.31-39
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• 2024

This study was conducted to determine whether level-1 emergency medical technicians (EMTs) can adequately recognize ST-segment elevation myocardial infarction (STEMI) in the emergency department (ED) and whether their ability to do so differs from that of emergency medicine physicians (EMP). From December 2022 to November 2023, patients aged 20 years or older visiting the ED with chief complaints suggesting acute coronary syndrome (ACS) were enrolled. As soon as the patient arrived at the ED, a level-1 EMT conducted a 12-lead electrocardiogram (ECG) to assess STEMI; an EMP subsequently assessed whether to activate the percutaneous coronary intervention team. Demographic characteristics, test results, and final diagnoses were collected from the medical records. Among the 723 patients with case report forms, 720 were included in the analysis. These were categorized as follows: 117 (16.3%) with STEMI, 159 (22.1%) with non-ST-segment elevation ACS, and 444 (61.7%) with other conditions. STEMI was correctly recognized in 100 patients (91.7%) by level-1 EMTs and in 104 patients (95.4%) by EMPs (kappa=0.646). EMTs with less than 1 year of ED work experience correctly recognized 60 out of 67 STEMI patients (89.6%), which was comparable with the EMPs who recognized 65 out of 67 STEMI patients (97.0%, kappa=0.614). EMTs with more than 1 year of ED work correctly recognized 40 out of 42 STEMI patients (95.2%), and therefore performed better than EMPs, who recognized 39 out of 42 STEMI patients (92.9%, kappa=0.727). The level-1 EMTs adequately recognized STEMI using a 12-lead ECG and were in substantial agreement with the evaluations of the EMPs.

• 한국학교보건학회지
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• 제10권2호
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• pp.271-283
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• 1997

This study is designed for the school health education, contributing experience of life from middle school students from broken homes by describing specifically what they go through. And on this basis this study works out a grounded theory on the experience of life for middle school students from broken homes. The data was collected through a series of interviews with nine subjects singled out at each stage of research. With the permission of the subjects, the interviews were recorded and transcribed. The interviews lasted from 30 minutes up to one hour and 20 minutes. The in-depth interviewing methods and observations was used for data collection. The data was analyzed in the framework of grounded theory as mapped out by Strauss & Corbin (1990). By analyzing the materials eighty-three concepts were extracted, and they were united into 21 subordinate categories through the course of analysis. These were classified into nine precedence categories. The core category was found to be the adaptation of 'Wichookdem" or "Shrinkage". "Shrinkage" widows experienced was showed as the results "Self-reliance" and "Overcoming" through the course of generation and reaction, confrontation, and adaptation. According to the analysis findings of materials, the central phenomenon was showed as "shrinkage", the causal condition as "surprise", "Darkness", "Grudge", "Desolate", "Empty". The veins as presence of those around people and existence of support, and the meditate situation as self-support. For the strategy in solving "shrinkage", preparations of countermeasure and self-reinforcement were showed. And self-reliance and overcoming were the results. Through the contrast to the cases of ground materials, relation statements as follows were induced; (1) The weaker the suffering is, the weaker the "shrinkage" tends to be. (2) The stronger the suffering is, the stronger the "shrinkage" tends to be. (3) The more frequent and serious the suffering, the stronger the "shrinkage" tend to be. (4) The more infrequent and not serious the suffering is, the weaker the "shrinkage" tends to be. (5) The weaker the "shrinkage" is, the more self-control1ed the responses tends to be. (6) The stronger the "shrinkage" is, the more impulsive the responses tends to be. (7) The more satisfying the support is, the more self-controlled the responses to the "shrinkage" tends to be. (8) The more dissatisfying the support is, the more impulsive the responses to the "shrinkage" tends to be. (9) The more concrete the type of support is, the more self-controlled the responses to the "shrinkage" tends to be. (10) The more superficial the type of support is, the more impulsive the responses to the "shrinkage" tends to be. (11) The more self-controlled the responses are, the more self-reliant the subjects tends to be. (12) The more impulsive the responses are, the more conflict and wandering the subjects tends to be. (13) Whether the responses to the "shrinkage" express themselves in self-control or an impulse, it will be resulted in the form of either tension or pain. The following two were confirmed on the basis of repetitive relations; (1) If a subject's suffering is weak, infrequent and not serious, the "shrinkage" is weak. Also the subject's support is highly satisfying, and the support type is concrete. The responses to the "shrinkage" result in self-control which consequence is self-reliance with part. of it resulting in tension and pain. (2) If a subject's suffering is strong, frequent and serious, the "shrinkage" is strong. Also the subject's support is dissatisfying, and the support type is superficial. The responses to the "shrinkage" result in an impulsion whose consequence is wandering with part of it resulting in tension and pain. Through the results in this study, the following is to be suggested; O This research is basically aimed at analyzing the experience of the middle school students living in broken homes, for the more inclusive approach, the study for them is made systematically according to the type of their problems.

• 한국산학기술학회논문지
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• 제22권4호
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• pp.263-272
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• 2021

본 연구는 성인의 생애주기별 구강건강 지식과 교육 요구도를 조사하여 웰에이징을 위한 구강건강 교육안을 개발하는데 기초자료를 제공하고자 한다. 2021년 2월 한 달 동안 한국갤럽의 온라인・모바일 조사를 통해 만 19세 이상 성인 319명을 조사하였다. 연구내용은 일반적 특성, 구강건강관련 삶의 질, 구강보건 지식, 웰에이징 교육 요구도를 조사하였다. 조사 자료는 PASW Statistics ver 18.0 (IBM Co., Armonk, NY, USA) 통계 프로그램을 이용하였다. 구강보건 지식과 교육 요구도 조사결과 전 연령층에서 예방법이 가장 높게 나타났다. 그 다음으로 청년층은 원인, 중년층은 치료법, 장년층과 노인층은 구강질환과 전신질환 관련성이 높게 나타나 연령층별 교육 요구도에 차이가 있었다. 관심 있는 구강질환은 시린이, 구취, 치주질환, 치아변색 순서이었다. 구강보건 교육 희망기관은 인터넷 치과・의료기관, 보건소 순서이었다. 교육방법은 강의+체험, 동영상, 전문가강의 순서로 나타났다. 본 연구는 웰에이징을 위한 생애주기별 교육 시행시 대상자의 요구도를 반영한 교육안 개발을 위한 기초자료로 활용할 수 있을 것으로 사료된다.

• 대한통합의학회지
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• 제1권4호
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• pp.37-47
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• 2013

PURPOSE : Club dance is one of the most popular cultures worldwide and is getting popular in Korea over time. However, club still has negative awareness in the country due to the media spreading only harmful aspects of club culture. At any rate, nowadays many young aged people can easily have chances to experience clubs so we tried to find out the bad effects caused by clubs. METHOD : We conducted a survey and the number of participants who agreed to participate in this survey was 500, including both men and women. There are a total of 50 questions in the questionnaire form used by this study and the questions were divided into three categories: general(18), psychologic-related(7), social-cultural(9), and physical-related(16) questions. Data collected for this study was analyzed via frequency analysis using SPSS. RESULT : In our survey, most students who had already experienced the club culture tend to go to club once or twice a month, and they answered that they would feel bored if they were nor able to do so. In terms of social life, most respondents said that they had lower efficiency in working and studying the next day after going to clubs because of fatigue. In physical aspect, club users use then pelvis and lower back a lot while dancing. The respondents answered that they experienced muscle soreness, a loss in weight, and changes in their body as a consequence of intense dancing. They complaint pain mostly in lower limbs, so we could find out the fact that legs were primarily used for the club dance. CONCLUSION : To sum up, the club culture in undergraduate students affects on their daily living and body, and also has good effects as well as bad ones. Therefore, we need to look at the club culture positively and to improve bad effects of club culture.

• Tuberculosis and Respiratory Diseases
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• 제84권2호
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• pp.96-104
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• 2021

Background: Many chronic obstructive pulmonary disease (COPD) patients receiving monotherapy continue to experience symptoms, exacerbations and poor quality of life. This study aimed to assess the efficacy and safety of direct switch from once-daily tiotropium (TIO) 18 ㎍ to indacaterol/glycopyrronium (IND/GLY) 110/50 ㎍ once daily in COPD patients in Korea. Methods: This was a randomized, open-label, parallel group, 12-week trial in mild-to-moderate COPD patients who received TIO 18 ㎍ once daily for ≥12 weeks prior to study initiation. Patients aged ≥40 years, with predicted post-bronchodilator forced expiratory volume in 1 second (FEV₁) ≥50%, post-bronchodilator FEV₁/forced vital capacity <0.7 and smoking history of ≥10 pack-years were included. Eligible patients were randomized in a 1:1 ratio to either IND/GLY or TIO. The primary objective was to demonstrate superiority of IND/GLY over TIO in pre-dose trough FEV₁ at week 12. Secondary endpoints included transition dyspnea index (TDI) focal score, COPD assessment test (CAT) total score, and rescue medication use following the 12-week treatment, and safety assessment. Results: Of the 442 patients screened, 379 were randomized and 347 completed the study. IND/GLY demonstrated superiority in pre-dose trough FEV₁ versus TIO at week 12 (least squares mean treatment difference [Δ], 50 mL; p=0.013). Also, numerical improvements were observed with IND/GLY in the TDI focal score (Δ, 0.31), CAT total score (Δ, -0.81), and rescue medication use (Δ, -0.09 puffs/day). Both treatments were well tolerated by patients. Conclusion: A direct switch from TIO to IND/GLY provided improvements in lung function and other patient-reported outcomes with an acceptable safety profile in patients with mild-to-moderate airflow limitation.

• Journal of Hospice and Palliative Care
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• 제10권3호
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• pp.145-153
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• 2007

목적: 본 연구는 약 15년간의 우리나라 호스피스 연구의 총체적인 주제와 경향을 확인함으로써 추후 호스피스 연구의 방향을 제시하고자 실시되었다. 방법: 1991년 1월부터 2004년 7월까지의 우리나라 박사학위논문 7편, 석사학위논문 44편과 호스피스와 관련된 논문이 주로 수록되는 분야별 간호학회지, 의학회지, 호스피스 학회지, 호스피스 협회 학술지, 호스피스 연구소 논문집의 논문에서 호스피스와 관련된 개념이 제시된 논문 59편으로 총 110편을 목록화하여 분석하였다. 분석은 연구 발표년도, 연구설계, 연구대상, 상관관계 연구, 조사연구, 실험연구, 질적 연구, 측정도구 별로 분류하여 분석하였다. 결과: 2000년 이후의 논문이 52편으로 2000년 이후부터 본격적으로 호스피스 논문이 증가하였음을 알 수 있다. 학회지에 발표한 논문으로는 한국 호스피스 완화 의료학회지가 16편으로 가장 많았고, 질적 연구는 13편으로 다소 적은 편수였다. 연구대상별로 살펴보면, 사람을 대상으로 한 연구가 98편으로 가장 많았고, 이 중 말기환자를 대상으로 한 연구가 44편으로 나타났다. 결론: 분석 결과 향후에는 호스피스 간호이론의 기초 정립을 위한 양적방법론에 근거한 서술적 연구와 질적 연구가 더욱 많이 행해져야 할 것이며, 호스피스 간호 중재의 효과를 확인하는 실험연구를 통하여 간호중재의 효율성을 입증하는 연구도 필요한 것으로 생각된다.

• Advances in pediatric surgery
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• 제17권2호
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• pp.154-161
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• 2011

Tracheoesophageal fistula without esophageal atresia (H-type TEF) is a congenital anomaly that is characterized by a fistula between the posterior wall of the trachea and the anterior wall of the esophagus, not accompanied by esophageal atresia. The purpose of this study is to investigate the clinical characteristics, diagnostic time, the side of cervical approach and short term result after surgery by searching medical records of patients treated for H-type TEF. The search was done at University of Ulsan, Department of Pediatric Surgery of Asan Medical Center, and the total number of patients from May 1989 to December 2010 was 9 with M:F ratio of 1:2. The median gestational age was $39^{+6}$ ($32^{+6}{\sim}41^{+0}$) wks. Seven out of nine patients were born at term and the other two were born premature. The clinical presentation was aspiration pneumonia, difficulty in feeding, chronic cough, vomiting, abdominal distension and growth retardation. The symptoms presented right after birth. The diagnosis was made with esophagography and the median time of diagnosis was 52 days of life. The majority of surgical corrections were performed within two weeks of diagnosis (median; 15d, range; 1d - 6m). Six patients had associated anomalies, and cardiac anomalies were most common. The cervical approach was utilized in all cases (right 2, left 7). Transient vocal cord palsy and minor esophageal leakage complicated two cases. Although the diagnosis of H-type TEF was difficult and often delayed, we had a good short term result. The left cervical approach was preferred.

• Journal of Preventive Medicine and Public Health
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• 제36권3호
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• pp.279-288
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• 2003

Objectives : Evidence for an effect of rerroductive factors on colorectal carcinogenesis is not yet consistent. Little research has been conducted to investigate whether reproductive factors were associated with colorectal adenomas that are the precursors of colorecta1 cancer, We evaluated the relationships between reproductive factors and the degree of dysplasia of the colorectal adenoma and cancer as colorectal adenoma-carcinoma sequence. Methods : For this study, 241 adenoma cases with histopathologically confirmed incident colorectal adenoma, 76 cancer cases with colorectal cancer and 1677 controls were collected from Our Lady of Mercy Hospital, The Catholic University of Korea, during 1994-1999. Before colonoscopy, information on demographic characteristics, reproductive factors, life style habits and dietary intake were obtained by interviewed questionnaire. Adjusted OR and 95% CI were estimated by using polytomous logistic regression model, Potential confounders that were selected based on the goodness of fit Statistics and interaction between risk factors were considered in this adjustment. The Wald statistic was calculated to test the heterogeneity of the odds ratios for each case. Results .: Postmenopausal women with natural menopause were found to be positively associated with the risk of mild dysplasia adenoma (multivariate-adjusted OR : 2.59, 95% CI=1.1-0.2). Parity was found to be negatively associated with the risk of colorectal lancer (age-adjusted OR : 0.40, 95% CI=0.2-0.9), but did not significantly decrease the risk of colorectal cancer (multivariate-adjusted OR : 0.95, 95% CI=0.3-2.9). Me associations were seen between a9e at menarche, breast feeding, induced abortion, oral contraceptive use, menopausal types, menopausal age or hormone replacement therapy (HRT and the degree of dysplasia of the colorectal adenoma and cancer. However, none of these associations differed' significantly between the degree of dysplasia of the colorectal adenoma and cancer. Conclusions : These findings suggest that postmenopausal women with natural menopause may experience increased risk of mild dysplasia adenorna among colorectal adenoma-carcinoma sequence.

• 대한임상독성학회지
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• 제11권1호
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• pp.9-18
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• 2013

Purpose: Antidotes for toxicological emergencies can be life-saving. However, there is no nationwide stocking and delivery system for emergency antidotes in Korea. We report on a two-year experience of a nationwide stocking and delivery trial for emergency antidotes at emergency departments in Korea. Methods: An expert panel of clinical toxicologists reviewed and made a list of 15 stocked antidote. These antidotes were purchased or imported from other countries and delivered from 14 antidote stocking hospitals nationwide 24 hours per day, seven days per week. Results: From August 1, 2011 to April 30, 2013, 177 patients with acute poisoning, with a median age of 48.5 years, were administered emergency antidotes. The causes of poisoning were intentional in 52.0% and 88.0% were intentional as a suicide attempt. Regarding clinical severity, using the poisoning severity score, 40.7% of patients had severe to fatal poisoning and 39.0% had moderate poisoning according to clinical severity. The most frequent presenting symptom was neurologic deficit, such as altered mentality (62.7%). alerted mentality (62.7%). Emergency antidotes were administered as follows: methylene blue (49 cases), flumazenil (31), N-acetylcysteine (25), glucagon (17), 100% ethanol (15), cyanide antidote kit (12), anti-venin immunoglobulin (5), pyridoxine (4), hydroxocobalamine (2), and deferoxamine (1). The median time interval from antidote request to delivery at the patient's bedside was 95 minutes (interquartile range 58.8-125.8). Conclusion: Findings of this study demonstrated the possibility of successful operation of the nationwide system of emergency antidotes stocking and delivery in Korea.

• 동의신경정신과학회지
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• 제30권3호
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• pp.209-220
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• 2019

Objectives: As a general emotion, everyone can temporarily experience depression, but depressive disorder is a disease that excessively affects daily life. Among the various causes of depression, the deficiency of monoamine-based neurotransmitters such as serotonin and epinephrine are considered significant. Thus, antidepressants that target monoamines are used frequently. However, side effects such as nausea, vomiting, insomnia, anxiety, and sexual dysfunction are observed. Thus, it is necessary to develop a new therapeutic agent with fewer side effects. In this study, we investigated the antidepressant effect of JG02, used to treat depression by normalizing the flow of qi (氣) in Korean medicine. Methods: C57BL/6 mice were selected and randomly divided into six groups: normal, control, amitriptyline, and JG02 (50, 125, 250 mg/kg), respectively. Except for normal, depression was induced by applying restraint stress at the same time for six hours daily for 14 consecutive days. Saline, amitriptyline or JG02 samples were orally administered two hours before applying the stress. After that, a forced swimming test and an open field test were performed. Additionally, serum corticosterone, serotonin mRNA, BDNF mRNA, and protein in the hippocampal region were measured and compared. Results: JG02 decreased immobility time rate in the FST and increased the zone transition number and travel distance in the OFT. Also, JG02 inhibited the release of serum corticosterone, and increased serotonin, BDNF gene expression, and BDNF protein in the hippocampus. Conclusions: In this study, JG02 showed significant antidepressant effects on the chronic restraint stress mice model. When further research is performed based on JG02, the development of a new antidepressant is considered highly possible.