• Asian Pacific Journal of Cancer Prevention
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• 제15권16호
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• pp.6905-6910
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• 2014

Background: The relation ofsurvivin gene expression to survival and surgical prognostic factors in the patients with endometrial carcinoma is unclear. Materials and Methods: In this study, 62 cases who were operated due to endometrial carcinoma were investigated between 2003 and 2011 in the the gynecological oncology clinic of Female Disease Training and Investigation Hospital of Etlik Zubeyde, Hanim, Turkey. Clinical and surgical prognostic factors were investigated by screening the records of these cases. With the standard streptavidin-biotin immune peroxidase method, cytoplasmic and nuclear expression of survivin was investigated in sections with specific antibodies (1:100, diagnostic Bio Systems, USA) primer. The aim was to elucidate any relation between survivin expression and defined prognostic factors and survival. Results: There was no statistically significant relationship between cytoplasmic and nuclear indexes identified for survivin and age, body mass index, the levels of preoperative hemoglobin, platelet and Ca 125, stage, grade, lymph node meastasis, the number of meta statical lymph nodes (total, paraaortic and pelvic), myometrial invasion, serosal invasion, adnexal involvement, the presence of acid in the first diagnosis, the involvement of omentum, the adjuvant treatment application of the cases, the presence of recurrence and rate of mortality (p>0.05). Statistical significance was noted for the presence of advanced stage lymph node metastasis (pelvic, paraaortic, pelvic and paraaortic), serosal involvement, positive cytology, lymph vascular space invasion, intra abdominal metastasis, and omentum involvement. When investigated the relation between cytoplasmic and nuclear survivin indexes and total survival, the result was not statistically significant (p>0.05). Conclusions: In our study, there was no statistically significant relationship between the rates of cytoplasmic and nuclear survivin expression with identified prognostic factors and total or non-disease survival.

• Clinical and Experimental Pediatrics
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• 제59권sup1호
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• pp.161-164
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• 2016

Guillain-$Barr{\acute{e}}$ syndrome and acute transverse myelitis manifest as demyelinating diseases of the peripheral and central nervous system. Concurrency of these two disorders is rarely documented in literature. A 4-year-old girl presenting with cough, fever, and an impaired walking ability was admitted to hospital. She had no previous complaints in her medical history. A physical examination revealed lack of muscle strength of the lower extremities and deep tendon reflexes. MRI could not be carried out due to technical problems; therefore, both Guillain-$Barr{\acute{e}}$ syndrome and acute transverse myelitis were considered for the diagnosis. Intravenous immunoglobulin treatment was started as first line therapy. Because this treatment did not relieve the patient's symptoms, spinal MRI was carried out on the fourth day of admission and demyelinating areas were identified. Based on the new findings, the patient was diagnosed with acute transverse myelitis, and high dose intravenous methylprednisolone therapy was started. Electromyography findings were consistent with acute polyneuropathy affecting both motor and sensory fibers. Therefore, the patient was diagnosed with concurrency of Guillain-$Barr{\acute{e}}$ syndrome and acute transverse myelitis. Interestingly, while concurrency of these 2 disorders is rare, this association has been demonstrated in various recent publications. Progress in diagnostic tests (magnetic resonance imaging and electrophysiological examination studies) has enabled clinicians to establish the right diagnosis. The possibility of concurrent Guillain-$Barr{\acute{e}}$ syndrome and acute transverse myelitis should be considered if recovery takes longer than anticipated.

• 대한통합의학회지
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• 제1권3호
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• pp.19-28
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• 2013

Purpose : The purpose of this study was to find out the impact of action-observation training and task-oriented training on activities of daily living performance of stroke patients. Method : 30 stroke patients hospitalized in D hospital located in Busan and treated were randomly allocated to Action-Observation Training Group and Task-Oriented Training Group in fifteens. To compare activities of daily living performance before and after therapy intervention, Korea-modified Barthel index (K-MBI) was carried out. Result : In both groups, activities of daily living performance of stroke patients before and after therapy intervention showed statistically significant differences (p<.05) and activities of daily living performance between two groups after therapy intervention showed statistically significant differences. Conclusion : It was found that action-observation training and task-oriented training improved activities of daily living performance of stroke patients. It is considered that the application of action-observation training and task-oriented training to clinical occupational therapy will show a positive effect on the improvement of activities of daily living performance.

• 대한방사선기술학회지:방사선기술과학
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• 제33권3호
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• pp.193-201
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• 2010

본 연구는 환자 중심의 의료서비스를 강화하고 있는 현 병원 이미지에 부합하는 개방형 임상실습 프로그램을 개발하여 방사선(학)과 졸업생의 임상 적응력과 전문성을 높이는데 목적을 두고 있다. 개방형 임상실습 프로그램은 학습모형 개발과정과 유사하여 ADDIE학습모형을 근간으로 각 단계별 요소를 구성하여 개발하였다. 문헌고찰과 임상의 요구사항을 수렴하여 일부 학생을 대상으로 1차 시안을 통해 예비수업을 시행하였으며, 관련 전문가의 자문과 수정을 거쳐 프로그램을 개발하였다. 개발된 프로그램은 전문가 그룹을 통해 내용 타당도의 검증을 받고자 하였다. 분석, 설계, 개발, 실행, 평가의 다섯 단계가 순환적으로 구성되어 있는 프로그램은 임상의 변화와 요구사항에 적절한 학습과제에 대해 적용할 수 있는 단계별 과정으로 구현되었다. 프로그램의 유용성과 단계별 내용 타당도는 유의 수준에서 만족한 결과를 도출하였다. 개방형 임상실습 프로그램은 의료계의 요구사항과 효과적인 학습 프로그램 적용을 통해 임상에 있는 방사선사가 환자 중심의 의료서비스에 좀 더 적극적으로 임상에 적응하고 이를 통해 전문적인 전공기술을 활용하는데 도움을 주고자 제안되었다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제18권1호
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• pp.26-30
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• 2007

This practice parameter for non-pharmacological treatment for attention-deficit hyperactivity disorder (ADHD) review the domestic and international literature on the psychosocial treatment of children and adolescents with ADHD. This parameter include the parental training & education, cognitive behavior therapy(group or individual), social skill training, family therapy, play therapy (individual psychotherapy) and non-traditional therapy (art therapy, herbal therapy et al). Among them, there is some proven evidence only in parental training & education and cognitive behavior therapy. So, this parameter describes some details only in the field of parental training & education and cognitive behavior therapy. The efficacy or effectiveness, especially, cost-effectiveness of specific psychosocial treatment method for ADHD cannot be fairly assessed due to the scarcity of controlled clinical data. Based on the clinical expert consensus and limited evidence, we cautiously suggest the practice recommendations about the non-pharmacological psychosocial treatment fur children and adolescents with ADHD.

• 한국병원경영학회지
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• 제10권3호
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• pp.1-24
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• 2005

This study purports to investigate the determinants of individual personnel rating of the employees at a university hospital in Seoul, Korea. The sample used in this study consisted of 63 nurses, 41 para-medical staff (Clinical Pathologist, and Radiologist), and 67 administrative staff. Independent variables of the study included the achievement level of the selection test (English, major subject, and interview), post-entrance development factors (education and training, career development, supervisory support, co-worker support, and organizational support), and demographic characteristics. Data for the achievement level of the entrance exam and years for the first promotion were collected from the administrative records of the study hospital, while data for the post-entrance development factors were collected from the survey with self-administered questionnaires using 5-point Likert Scale during June 10-25, 2003. Collected data were analyzed using hierarchical multiple regression. The results of the study showed that achievement level of the interview and English exam at the selection test, education and training, organizational support, and supervisory support while working at the hospital, and length of duration (below 8 years) and educational background (4-year college graduates) among demographic variables had significant positive effects on the personnel rating. The results of the study imply that hospital administrators should make an effort to improve the validity of the selection test, and to motivate the employees to receive more education and training.

• Archives of Plastic Surgery
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• 제40권2호
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• pp.104-108
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• 2013

Background Microsurgical techniques are considered standard procedures in reconstructive surgery. Although microsurgery by itself is defined as surgery aided by optical magnification, there are no guidelines for determining in which clinical situations a microscope or loupe should be used. Therefore, we conducted standardized experiments to objectively assess the impact of optical magnification in microsurgery. Methods Sixteen participants of microsurgical training courses had to complete 2 sets of experiments. Each set had to be performed with an unaided eye, surgical loupes, and a regular operating microscope. The first set of experiments included coaptation of a chicken femoral nerve, and the second set consisted of anastomosing porcine coronary arteries. Evaluation of the sutured nerves and vessels were performed by 2 experienced microsurgeons using an operating microscope. Results The 16 participants of the study completed all of the experiments. The nerve coaptation and vascular anastomoses exercises showed a direct relationship of error frequency and lower optical magnification, meaning that the highest number of microsurgical errors occurred with the unaided eye. For nerve coaptation, there was a strong relationship (P<0.05) between the number of mistakes and magnification, and this relationship was very strong (P<0.01) for vascular anastomoses. Conclusions We were able to prove that microsurgical success is directly related to optical magnification. The human eye's ability to discriminate potentially important anatomical structures is limited, which might be detrimental for clinical results. Although not legally mandatory, surgeries such as reparative surgery after hand trauma should be conducted with magnifying devices for achieving optimal patient outcomes.

• 보건행정학회지
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• 제26권4호
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• pp.373-381
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• 2016

Background: The purpose of this study is to evaluate the outcomes of clinical education program for nurses in regional public hospital, utilizing the Kirkpatrick's model. Methods: Kirkpatrik's 4-level model was applied to this study. Trainees were asked to fill out questionnaires in the middle and at the end of the program. Also administrators of excellent trainees were asked to fill out the questionnaires regarding nursing management performance after 1-2 months from the end of the training course. Results: All trainees had positive reactions to the clinical education program. Not only the results of individual level (satisfaction and achievement scores, academic achievement scores, practical application rate, and educational transition factors) but also the scores of organization level (nursing management performance scores) are improved. Conclusion: By showing a correlation between the effectiveness factors we need to verify the relationship between these factors in a future study. In addition, development of quantitative and qualitative performance indicators are needed. To establish a long-term education system, it is required to applying the excellent trainee's successful experiences.

• 한국보건간호학회지
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• 제28권3호
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• pp.644-657
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• 2014

Purpose: The purpose of this study was to try to understand the essence of the experience early turnover of the new nurse by applying the phenomenological method and to provide basic data for a community-based management program. Method: Phenomenological approach was used to identify subjects experience. Subjects were five new nurses, with less than one year of clinical experience in clinical practice. This study used in-depth interview. Results: there were 104 meaningful sentences or phrases, with 41 generally comprehensive thema. Finally, thema were classified into 12 thema clusters. Conclusion: Finally, based on the results, some suggestions regarding management of early turnover of new nurses are needed. First, we proposed a new characterized of hospital selection method for each hospital. Second, practical training in clinical practice in the school and the community is necessary in order to reduce the real impact of new nurses. New nurses require various support elements in order to mitigate the real shock the first time they encounter clinical practice. Third, addition of work-related training and promotion of a self-esteem program will be needed. Fourth, interview opportunities with seniors who adapted successfully in clinical should be provided for new nurses. In addition, continuous communication should be provided for new nurses.

• 약학회지
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• 제54권6호
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• pp.507-521
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• 2010

Training for asthma patients by professionals has been highly emphasized for patients' self-management. In the present study, three standardized training sessions targeting hospital pharmacists were performed. On the basis of the number of training sessions taken, a non-educated group (CG), an once-educated group (NG), and a twice more-educated group (IG) were allocated. The most frequent errors of using an inhalant were shaking before the use in MDI while taking breathe out before inhaling in the case of DPI, and the total average number of errors were the biggest for CG and the smallest in IG. On comparison in the number of the four symptoms of asthma according to the level of seriousness, it was revealed that the total average number was the biggest in CG and the smallest in IG. In the level of awareness regarding the contents of training for patients, patients over 50 tended to answer that they were aware of education contents, and particularly in mouth rinsing and the use before/after a meal, significant similarity was examined. Regular asthma patient training performed by hospital pharmacists appeared to reduce errors in the inhaler usage, increase the quality of life of an patient, and help a patient remember the contents of the training. Especially among patients over 50, it was found to be more effective and retraining of more than two sessions was requisite.