• 대한간호학회지
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• 제19권1호
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• pp.40-62
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• 1989

This study was conducted to measure the effects of clinical application of a Nursing Diagnosis Protocol. The dependent variables were the degree of patient's satisfaction and the degree of nurse's satisfaction with the nursing activity. Analysis of the effect of the use of the nursing diagnosis protocol was based on the nursing record. The subjects for this study were 61 nurses(experimental group 31, control group 30) and 155 patients (experimental group 55, control group 100) on four internal medicine wards in K University Hospital in Seoul. Data collection was done from August to October 12,1988. The results obtained in this study can be summarized as follows, 1, Effect of the clinical application of the nursing diagnosis protocol. 1) The first hypothesis ; “nurses who use the nursing diagnosis protocol will have higher degrees of satisfaction than those who use traditional methods” was rejected (t＝.54, df＝58, p＝.59). 2) The second hypothesis ; “patients nursed by nurses using the nursing diagnosis protocol will have higher degrees of satisfaction than those nursed with traditional methods” was supported(t＝1.93, df＝154, p＝.05). 3) The third hypothisis : Major hypothesis ; “the nursing records of the experimental group, who used the nursing diagnosis protocol, will be more detailed than those of the control group” was supported (t＝6.40, df＝79.90, p＝.000). (1) The first subhypothesis ; “The recorded data collection of the experimental group will be more detailed than that of the control group” was rejected (t＝1.79, df＝118, p＝.07). (2) The second subhypothesis ; “The recorded patient's problem statement of the experimental group will be more detailed than that of the control group”, was supported. (3) The third subhypothesis ; “The nursing record of the experimental group will be more convenient for implementation than that of the control group” was supported. 2. Factors related to the nurse's degree of satisfaction with protocol. 1) No general characteristics(age, religion, education level, duty career, present duty career) were related to the nurse's degree of satisfaction. 2) Variables related to the nurse's degree of satisfaction were “satisfaction as a nurse” and “consider nursing as lifelong job” (t＝-2.6, df＝13.22, p＝.02, t＝2.41, df＝23.85, p＝.02). 3. Factors related to the patient's degree of satisfaction. 1) General characteristics related to the patient's degree of satisfaction with nurses using the protocol were age, educational level, and being married.(F＝5.17, df＝3/153, p＝.00, t＝ -2.39, df＝154, p＝,01, f＝5.91, df＝2/153, p＝.00) 2) The variables previous hospitalization, duration of hospitalization, the hospital unit presence of a relative, medical insurance, or medical diagnosis were not related to the patient's degree of satisfaction. 1. The experimental group's nursing record was more detailed than the control group's record with regard to the physical and psychological state of the patients. As noted above, the experimental group nurses, who use a nursing diagnosis had protocol were less satisfied than the control group who used traditional methods of the recording, but experimental group patients had a higher degree of satisfaction than the control group patients. The nursing records of experimental group, using the nursing, diagnosis protocol was more detailed than that of the control group. If the nursing diagnosis protocol is used in clinical nursing practice, the quality of nursing care may be improved.

• 보건행정학회지
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• 제31권2호
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• pp.180-187
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• 2021

Background: This study analyzed the effect of applying the diagnosis-related group (DRG)-based payment system, which was implemented in July 2012 for hospitals and clinics nationwide, on the cesarean section rate. Methods: The subjects of the study were divided into new groups that participated in the payment system after July 2012 and maintenance groups that participated in the payment system before July 2012. As an analysis method, a difference-in-difference analysis, which is a quasi-experimental design, was used. The risk-adjusted cesarean section rate was used as a dependent variable. Results: Seven risk factors (malpresentation of fetus, eclampsia, multiple pregnancies, problems in the placenta, previous Cesarean section, cephalopelvic disproportion, problems in amniotic fluid) were included in the final risk-adjustment model, and found to have a statistically significant relationship with the cesarean section rate. Results showed that the risk-adjusted cesarean section rate increased significantly in new groups after the application of the DRG-based payment system. Conclusion: Study results provided policy implications for the reorganization of the DRG-based system should that reflects the demands of obstetricians, such as organizing a consultative body with obstetricians and establishing a reasonable fee.

• 한방재활의학과학회지
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• 제23권3호
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• pp.149-157
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• 2013

Objectives This study was designed to: (1) investigate the clinical feature of tongue diagnosis, (2) make an observation of significant changes in tongue diagnosis according to the patient's physical condition and laboratory result and (3) identify clinical efficacy of tongue diagnosis. Methods 300 patients' tongue diagnosis results were analyzed and the patients were divided to each group according to the physical condition and laboratory result. Then, chi-square test was performed to assess statistical significance between tongue diagnosis results of each group. Results As a result of analyzing the spread of tongue diagnosis according to the patient's physical condition and laboratory result, 18 groups had statistical significance related to specific tongue color and tongue coating. Conclusions Even if there would be possible misinterpretations in one-to-one match between the tongue diagnosis and certain diseases, we identified that tongue diagnosis results were changed somewhat related to patient's physical condition with some tendency and tongue diagnosis could be used for meaningful clinical diagnostic tool.

• Journal of Oral Medicine and Pain
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• 제18권2호
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• pp.29-41
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• 1993

A prevalence study was carried out on 847 CMD patients who had visited the Department of Oral Medicine in Pusan National University from 1990 to 1993. To obtain the same type of information, all subjects were interviewed and examined clinically using a standardized examination form, The ratio of women to men was about 3:1 and all subjects were divided into acute and chronic groups on the basis of 6 months of duration. Diagnostic groups consisted of muscle disorder, joint disorder and muscle-joint disorder. As related to gender, duration and diagnosis subjective and objective symptoms in CMD were studied. The obtained results were as follows : 1. Muscle-joint disorder had the highest percent, followed by muscle disorder and joint disorder. 2. The most common reasons for CMD treatment were pain, joint noise and limited opening, while headache and neckache were relatively often reported as associated symptoms and dizziness, ringing in the ears also reported as secondary CNS excitatory effects. 3. Pain was more ofter seen in women, acute group and muscle-related disorder groups (p<0.05, p<0.01). Noise was significantly frequent in chronic group and joint-related groups (p<0.01). 4. Analysis of contributing factors presented that macrotrauma was found frequently in men (p<0.05), and that muscle-related groups were more related to stress than joint disorder grop (p<0.05). 5. Hard end feel was seen significantly often in joint-related disorder group (p<0.05). On the other hand, soft end feel was frequent in muscle disorder. 6. Reciprocal clicks and crepitation increased with chronicity. Subjects with joint-related disorder groups significantly often reported all kinds of noises (p<0.01). 7. Tender muscles and joints were more often reported in women and chronic group. Whereas muscle-related disorder groups revealed significantly more tender muscles (p<0.01). joint-related disorder groups presented significantly more tender joints (p<0.01).

• Clinical Psychopharmacology and Neuroscience
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• 제16권4호
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• pp.505-507
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• 2018

Clozapine may be associated with cardiovascular adverse effects including QTc prolongation and, more rarely, with myocarditis and pericarditis. Although rare, these latter cardiovascular adverse effects may be life-threatening and must be immediately recognized and treated. Several cases of clozapine related-pericarditis have been described and often it has a subtle and insidious onset with symptoms that may be often misdiagnosed with psychiatric manifestations (e.g. anxiety, panic or somatization) leading to a delayed correct diagnosis with potential fatal consequences. In the present report we describe the case of a 27-year-old girl with schizoaffective disorder taking long acting aripiprazole and valproate who developed a sudden onset clozapine-related pericarditis during titration phase that resolved with immediate clozapine discontinuation and indomethacin administration. We underline the importance of an early diagnosis of clozapine-related pericarditis and the need to have monitoring protocols to prevent this potentially fatal adverse effect especially when polypharmacy is administered to patients taking clozapine.

• 한국산학기술학회논문지
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• 제16권4호
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• pp.2656-2664
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• 2015

본 연구는 위암 진단 당시 진단 경로에 따라 병기 및 관련요인의 차이가 있는지 비교하기 위해 시행되었다. 조사대상은 충남대학교 병원에서 위암에 대해 진단 받은 뒤 수술하기 위해 내원한 환자 375명으로 하였으며, 자료 수집은 2010년 8월 1일부터 2013년 3월 31일까지 표준화된 자기기입식 설문지를 사용하여 수집하였다. 증상군과 검진군간에 영향을 미치는 요인의 위험도를 측정하기 위해 로지스틱회귀분석을 사용 하였다. 연구결과, 검진군에서의 조기위암의 비율이 증상군에서 보다 유의하게 높아(p=0.001) 조기검진의 중요성을 시사해 주었다. 또한 증상군은 검진군에 비해 병기가 상대적으로 높았다.(p=0.001). 앞으로 위암 선별검사가 널리 시행되고 대규모의 전향적인 연구가 뒷받침 되면 우리나라에 가장 적절한 검사 및 간격에 대한 추정까지도 가능할 것이다.

• 대한간호학회지
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• 제19권1호
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• pp.24-39
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• 1989

This study was conducted to investigate the present situation and problems related to the use of nursing diagnosis in practice. The data were obtained from 332 subjects (27 director of nursing service, 302 staff nurses) who worked in university hospitals in Korea from July through August 1988 using a mailed questionnaire. Data were analyzed by frequency, X$^2$ test and t-test. The findings were as follows ; 1, Clinical use of nursing diagnosis by directors of nursing service and staff nurses. 1) The majority of the nursing departments (88.9%) conducted group education on nursing diagnosis during the last 5 years and 81.5% of them kept a record format for nursing diagnosis : 88.9% of them had had prior experience with the nursing diagnosis. 2) Most of nurses (97.0%) had received education on nursing diagnosis. 2. Factors related to the clinical use of nursing diagnosis in nursing service departments and by staff nurses. 1) The one factor related to the use of nursing diagnosis in the nursing service department was the existence of a record. 2) Factors related to the use of nursing diagnosis by the staff nurses were the organization style of the nursing service department, group education during the last 5 years, existence of a record, the attitude of the director of nursing service, and prior experience of the use of the nursing diagnosis as characteristics of nursing service department and educational experience of nursing diagnosis as a character of nurse. 3. Problems with the use of nursing diagnosis. 1) The primary problem was the lack of time and personnel (mean : 3.757) ; the second problem was the lack of knowledge and will to use nursing diagnosis in practice by the staff nurses(mean : 3.546). 2) There was no significant difference in problems expressed by the director of nursing services and the nurses. The majority of nurses who worked in the university hospitals expressed interest in and concern about the use of nursing diagnosis. Most of the nurses had had education about on nursing diagnosis but use in practice was limited. The primary problem was lack of time and manpower. Strategies for improving use of the nursing diagnosis in practice : 1) Strengthening the education about nursing diagnosis and a holistic approach to understanding human beings. 2) Develop protocols for the use of nursing diagnosis. 3) Eliminate the language barrier regarding nursing diagnosis by translation into in Korean. 4) Decentralization of the nursing service to promote accountability by individual nurses for use of nursing diagnosis.

• Asian Pacific Journal of Cancer Prevention
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• 제14권2호
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• pp.685-689
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• 2013

Objective: To study the effects of down-regulation of HDAC6 expression on proliferation, cell cycling and migration of esophageal squamous cell carcinoma (ESCC) cells and related molecular mechanisms. Methods: ESCC cell line EC9706 cells were randomly divided into untreated (with no transfection), control siRNA (transfected with control siRNA) and HDAC6 siRNA (transfected with HDAC6 small interfering RNA) groups. Effects of HDAC6 siRNA interference on expression of HDAC6 mRNA and protein in EC9706 cells were investigated by semi-quantitative RT-PCR, Western blotting and immunocytochemistry methods. Effects of down-regulation of HDAC6 expression on cell proliferation, cell cycle, and cell migration were studied using a CCK-8 kit, flow cytometry and Boyden chambers, respectively. Changes of mRNA and protein expression levels of cell cycle related factor (p21) and cell migration related factor (E-cadherin) were investigated by semi-quantitative RT-PCR and Western blotting methods. Results: After transfection of HDAC6 siRNA, the expression of HDAC6 mRNA and protein in EC9706 cells was significantly downregulated. In the HDAC6 siRNA group, cell proliferation was markedly inhibited, the percentage of cells in G0/G1 phase evidently increased and the percentage of cells in S phase decreased, and the number of migrating cells significantly and obviously decreased. The mRNA and protein expression levels of p21 and E-cadherin in the HDAC6 siRNA group were significantly higher than those in the untreated group and the control siRNA group, respectively. Conclusions: HDAC6 siRNA can effectively downregulate the expression of HDAC6 mRNA and protein in EC9706 cells. Down-regulation of HDAC6 expression can obviously inhibit cell proliferation, arrest cell cycling in the G0/G1 phase and reduce cell migration. The latter two functions may be closely related with the elevation of mRNA and protein expression of p21 and E-cadherin.

• Journal of Preventive Medicine and Public Health
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• 제34권4호
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• pp.347-353
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• 2001

Objectives : To determine the impacts of Diagnosis-Related Groups/Prospective Payment System (DRG/PPS) on the quality of care in cases of Cesarean section and to describe the policy implications for the early stabilization of DRG/PPS in Korea. Methods : Data was collected from the medical records of 380 patients who had undergone Cesarean sections in 40 hospitals participating in the DRG/PPS Demonstration Program since 1999. Cesarean sections were peformed in 122 patients of the FFS(Fee-For-Service) group and 258 patients of the DRG/PPS group. Measurements of quality used included essential tests of pre- and post-operation, and the PPI(Physician Performance Index) score. The PPI was developed by two obstetricians. Results : Univariate analysis demonstrated significant differences in PPI scores according to the payment systems. With respect to the mean of PPI scores, a higher score was found in the DRG/PPS group than in the FFS group. However, the adjusted effect did not show significant differences between the FFS group and the DRG/PPS group. Conclusion : This study suggested that the problem of poor quality may not be related to the implementation of DRG/PPS in Cesarean section. However, this study did not consider the validity and reliability of the process measurement, and it did not exclude the possibility of data emission in medical records.

• 대한치과의사협회지
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• 제53권4호
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• pp.238-248
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• 2015

Sleep related breathing disorders(SRBDs) are a group of diseases accompanied by difficulties in respiration and ventilation during sleep. Central sleep apnea, obstructive sleep apnea(OSA), sleep-related hypoventilation, and hypoxemia disorder are included in this disease entity. OSA is known to be the most common SRBDs and studies show its significant correlation with general health problems including hypertension, arrhythmia, diabetes, and metabolic syndrome. The diagnostic process of OSA is composed of physical examinations of the head and neck area and also the oral cavity. Radiologic studies including cephalography, CT, MRI, and fluoroscopy assist in identifying the site of obstruction. However, polysomnography(PSG) is still considered the gold standard for the diagnosis of OSA since it offers both qualitative and quantitative recording of the events during a whole night's sleep. The dentist who is trained in sleep medicine can easily identify patients with the risk of OSA starting from simple questions and screening questionnaires. Diagnosis is the first step to treatment and considering the high rate of under-diagnosis for OSA the dentist may play a substantial role in the diagnosis and treatment of OSA which will eventually lead to the well-being of the patient as a whole person. So the objective of this article is to assist dental professionals in gaining knowledge and insight of the diagnostic measures for OSA including PSG.