• Korean Journal of Radiology
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• 제23권9호
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• pp.921-930
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• 2022

Objective: To identify epidermal growth factor receptor (EGFR) mutations in lung adenocarcinoma based on ¹⁸F-fluorodeoxyglucose (FDG) PET/CT radiomics and clinical features and to distinguish EGFR exon 19 deletion (19 del) and exon 21 L858R missense (21 L858R) mutations using FDG PET/CT radiomics. Materials and Methods: We retrospectively analyzed 179 patients with lung adenocarcinoma. They were randomly assigned to training (n = 125) and testing (n = 54) cohorts in a 7:3 ratio. A total of 2632 radiomics features were extracted from the tumor region of interest from the PET (1316) and CT (1316) images. Six PET/CT radiomics features that remained after the feature selection step were used to calculate the radiomics model score (rad-score). Subsequently, a combined clinical and radiomics model was constructed based on sex, smoking history, tumor diameter, and rad-score. The performance of the combined model in identifying EGFR mutations was assessed using a receiver operating characteristic (ROC) curve. Furthermore, in a subsample of 99 patients, a PET/CT radiomics model for distinguishing 19 del and 21 L858R EGFR mutational subtypes was established, and its performance was evaluated. Results: The area under the ROC curve (AUROC) and accuracy of the combined clinical and PET/CT radiomics models were 0.882 and 81.6%, respectively, in the training cohort and 0.837 and 74.1%, respectively, in the testing cohort. The AUROC and accuracy of the radiomics model for distinguishing between 19 del and 21 L858R EGFR mutational subtypes were 0.708 and 66.7%, respectively, in the training cohort and 0.652 and 56.7%, respectively, in the testing cohort. Conclusion: The combined clinical and PET/CT radiomics model could identify the EGFR mutational status in lung adenocarcinoma with moderate accuracy. However, distinguishing between EGFR 19 del and 21 L858R mutational subtypes was more challenging using PET/CT radiomics.

• 임상간호연구
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• 제19권2호
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• pp.255-264
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• 2013

Purpose: This study was done to examine the effects of assertiveness training on Intensive Care Unit (ICU) nurses' assertive behavior, job stress, communication conflict, and self-esteem toward improving their communication skills and coping. Methods: The assertiveness training program was developed to a 10-hour program consisting of 3 sessions. The goals were to understand assertive behavior and learn how to practice assertive communication in general conflict situations and/or a difficult conflict situation in the ICU. Participants were 65 nurses recruited from a tertiary teaching hospital and of these, 27 nurses completed the program. Data were collected from Jan. 30th to Mar. 28th, 2009 using a questionnaire which included demographic characteristics, assertive behaviour scale, job stress scale, communication conflict inventory-specific, and self-esteem scale. Data were analyzed using SPSS v. 14.0 for $x^2$ test and t-test. Results: ICU nurses in the experimental group had a significant increase in aspects of assertive behavior and a decrease in job stress. Conclusion: The results of the study indicate that assertiveness training is effective in increasing ICU nurses' assertive behavior and decreasing job stress through reinforcement of assertiveness behavior.

• Clinical and Experimental Vaccine Research
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• 제12권2호
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• pp.134-142
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• 2023

Purpose: The aim of this study was to determine the scope of knowledge, attitudes, and behaviors of pregnant women about the coronavirus disease 2019 (COVID-19) vaccine. Materials and Methods: A total of 886 pregnant women were recruited for the study. A cross-sectional questionnaire was conducted on these selected participants. Data about past infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), SARS-CoV-2 infection of closely related people, and deaths due to COVID-19 among their relatives were questioned. Results: The rate of vaccination was higher (64.1%) in pregnant women with higher education levels. Informing about the vaccine, especially by health professionals, showed that the rates of vaccination (25%) increased (p<0.001). In addition, a significant increase was observed in vaccination rates with increasing age and financial income (p<0.001). Conclusion: The main limitation of our study is that the vaccine, which was approved for "emergency use", was just started to be administered to pregnant women during the study. Our findings show that our target audience, low-income, low-education, younger pregnant women should be given more attention than those who apply to the doctor for routine follow-up.

• 한국학교보건학회지
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• 제13권1호
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• pp.147-160
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• 2000

The purpose of this study was to serve as a basis for better student practice in dental hygiene and for determining educational direction for dental hygiene clinical education by examining what students and clinical-practice instructors thought on clinical practice and what factors gave an impact to clinical education. For attaining the purpose, an investigation was made of 449 third-grade students in the department of dental hygiene at seven educational institutes in Seoul and Kyoung-gi province. 246 instructors in charge of the clinical practice of the students at dental hospital or clinics were also examined. The findings of this study were as follows: 1. The instructors and students had different opinions on the number of trainees, training time, beginning of training, and assessment(p<0.05). The instructors thought that a trainee was appropriate for an instructor(59.8%), and that training time was not sufficient(30.8%). They considered it proper for students to start practice during the summer vacation of second year(21.5%), and responded that assessment should be done by the dentist, dental hygienist or professor in charge(44.7%). However, the students had an idea that an instructor should take charge of 2 or 3 trainees(47.4%), and that there was a lot of training time(55.7%). They considered it appropriate to start practice in the first term of second grade(l9A%), and thought the assessment should be made by the dentist and dental hygienist in charge(44.8%). 2. The students' satisfaction was clinical practice was affected(p<0.05) by their own selection of training institutes(28.1%), the absence of trainee from other colleges(29.4%), ample practice time(28.3%), implementation of student assessment once a day(45.3%), diverse practice opportunities (45.5%), and easy traffic to the training institute(32.9%). 3. The achivement of clinical practice was influenced by practice opportunities, the degree of faithful treatment performance, the frequency of student assessment, the number of trainees, traffic to training institutes, assistance in understanding theoretical knowledge of clinical practice, and assessment methods(p<0.05).

• 대한간호학회지
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• 제53권4호
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• pp.412-425
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• 2023

Purpose: Nurses play an important role in ensuring patient rehabilitation and are involved in all aspects of multidimensional rehabilitation. Therefore, strengthening rehabilitation nursing education is vital to ascertain high-quality rehabilitation and optimum outcomes. This study examined the effectiveness of a new teaching reform-a modified Six-Sigma-based training program-against a conventional educational program on rehabilitation specialist nurses' core competencies, post-training performance, and satisfaction. Methods: A quasi-randomized controlled trial was conducted to assess the effectiveness of the modified training program. We recruited 56 learners from the 2020 training course at the Hunan Rehabilitation Specialist Nurse Training Base as the control group. Sixty learners from the base's 2021 training course were recruited as the intervention group. Data were collected in a consistent manner from both groups after the training program was implemented. Results: Those who underwent the modified training program showed better improvement in all core competencies than those who underwent the conventional training program (p < .05); the scores for theoretical knowledge, clinical nursing lectures, reviews, and nursing case management improved significantly following the teaching reform (p < 0.05). Further, overall satisfaction as well as base management and theoretical teaching satisfaction improved significantly (p < .05). Conclusion: The modified training program strengthens rehabilitation nurses' base management abilities; enhances their core competencies; expands their interest in and breadth, depth, and practicability of theoretical courses; and updates the teaching methods.

• 임상간호연구
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• 제18권3호
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• pp.381-390
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• 2012

Purpose: This study was conducted to examine the effects of simulation-based infection control training on the ICU nurses' perception, clinical performance, and self-efficacy of infection control. Methods: Thirty-eight nurses were assigned into two groups using a career stratified randomization. In the experimental group, the subjects received a simulation-based infection control training, whereas the control group participated in a conventional lecture-based training. Two weeks after the completion of the training sessions, the participants were evaluated for perception, clinical performance, and self-efficacy regarding the infection control. Results: The experimental group that received simulation-based infection control training showed an improvement in perceiving the infection control compared to that of the control group, but the difference was not statistically significant. In terms of the clinical performance, the experimental group and the control group scored $26.05{\pm}3.22$ and $18.53{\pm}3.37$ points respectively, demonstrating a statistical significance (p<.001). There was no significant difference between the two groups in regards to the self-efficacy. Conclusion: The developed simulation-based infection control training showed positive effects in improving clinical performance of infection control over conventional lecture-based training, confirming that a simulation-based training is an effective method in advancing the practical performance of ICU nurses.

• 디지털융복합연구
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• 제15권11호
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• pp.307-315
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• 2017

본 연구는 임상실습을 경험한 치위생학과 학생들을 대상으로 임상실습지에서 치과감염관리에 대한 인식과 수행정도를 조사하여 병원내 감염을 최소화 시키고 교육과정개발과 교육프로그램을 마련할 때 감염관리 지침과 행동지침에 필요한 기초자료를 제공하기 위해 시행하였다. 경북에 소재하는 4년제 대학에서 임상실습을 실제 경험한 치위생학과 학생을 대상으로 설문조사하였으며 치과의원, 치과병원, 대학병원이나 종합병원에 실습한 학생을 구분하여 각 실습지에 따른 치과감염관리에 대한 인식과 수행정도를 비교하였다. 연구결과 학생들은 감염방지에 대한 교육 경험자가 많았으나 실습지에 따라 감염방지관리의 수행정도는 대학병원이나 종합병원에서 높았으며 실습지에 따라 차이가 나타났다. 따라서 학생들이 임상실습시 감염관리에 대한 인식과 수행정도를 높이기 위해서는 감염관리 지침서를 제작하여 임상실습기관에 배부하고 담당자를 통해 관리하며 학교 측에서는 임상실습과 연계성 있는 감염관리 교육프로그램을 운영하여 체계적인 제도를 마련해야 할 것으로 생각된다.

• Clinical and Experimental Pediatrics
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• 제65권1호
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• pp.53-55
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• 2022

• Asian Pacific Journal of Cancer Prevention
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• 제15권4호
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• pp.1581-1584
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• 2014

Background: The overall prognosis for cancers of unknown primary (CUP) is poor, median overall survival (OS) being 6-12 months. We evaluated our multicentric retrospective experience for CUP administered docetaxel and cisplatin combination therapy. Materials and Methods: A total of 29 patients that were pathologically confirmed subtypes of CUP were included in the study. The combination of docetaxel ($75mg/m^2$, day 1) and cisplatin ($75mg/m^2$, day 1) was performed as a first line regimen every 21 days. Results: The median age was 51 (range: 27-68). Some 17 patients had multimetastatic disease on the inital diagnosis. Histopathological diagnoses were well-moderate differentiated adenocarcinoma (51.7%), undifferentiated carcinoma (27.6%), squamous cell cancer (13.8%), mucoepidermoid carcinoma (3.4%) and neuroendocrine differentiated carcinoma (3.4%). Median number of cycles was 3 (range: 1-6). Objective response rate was 37.9% and clinical benefit was 58.6%. Median progression free survival (PFS) and overall survival (OS) were 6 months (range: 4.3-7.7 months) and 16 months (range: 8.1-30.9 months), respectively. Fourteen patients (60.8%) were treated in a second line setting. There was no treatment related death. Most common toxicities were nausia-vomiting (44.6%) and fatigue (34.7%), serious cases (grade 3/4) suffering nausia-vomiting (10.3%), neutropenia (13.8%) and febrile neutropenia (n=1). Conclusion: The combination of cisplatin and docetaxel is an effective regimen for selected patients with CUP.

• Asian Pacific Journal of Cancer Prevention
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• 제16권13호
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• pp.5159-5162
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• 2015

Background: Chronic myeloproliferative diseases are clonal stem cell diseases which occur as a result of uncontrollable growth and reproduction of hematopoietic stem cells, which are the myeloid series source in bone marrow. Recent studies have suggested that chronic inflammation can be a triggering factor in the clonal change in chronic myeloproliferative neoplasia (CMPN). In our study, we evaluated the existence of a chronic inflammation process in our Philadelphia negative (Ph-)CMPN patients using inflammation parameters in combination with demographic, laboratory and clinical characteristics of the patients. Materials and Methods: Demographic characteristics, clinical and laboratorial data, and thrombosis histories of 99 Ph-CMPN patients, who were diagnosed at our outpatient clinic of hematology in accordance with WHO 2008 criteria, were analyzed retrospectively,with 80 healthy individuals of matching gender and age included as controls. Complete blood counts, sedimentation, C reactive protein (CRP), JAK V617F gene mutations, abdomen ultrasound images and previous thrombosis histories of these patients were retrospectively analyzed. Results: Ph-CMPN and healthy control groups included 99 and 80 cases, respectively. PV, ET and MF diagnoses of patients were 43 (%43.4), 44 (44.4%) and 12 (12.1%), respectively. JAK V617F gene mutation was found to be positive in 64 (71.1%) of all cases and in 27(65.8%), 32 (82%), 5 (50%) of the cases in PV, ET and PMF groups, respectively. Thrombosis was determined as 12 (12%) in the entire group, 12.5% in the JAK V617F negative and 15.3% in the positive patients, with no statistical significance (p=0.758). No significant difference was observed between patients with and without previous thrombosis history in respect to hemogram parameters, sedimentation and CRP (p>0.05), neutrophil to lymphocyte ratio (NLR), erythrocyte distribution width (RDW), mean platelet volume (MPV) and sedimentation levels of the patient.