• The Journal of the Korean bone and joint tumor society
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• v.15 no.1
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• pp.1-6
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• 2009

The usefulness and accuracy of computer-assisted surgery have been evaluated clinically in many orthopedic fields, such as, joint replacement arthroplasty, cruciate ligament reconstruction, and pedicle screw placemen. Recently several preliminary reports have been issued on the application of navigation to bone tumor surgery. The main advantage of navigation-assisted bone tumor surgery is that it provides highly accurate three-dimensional radiological information for intraoperative guidance. In particular, distances from tumors to resection margins can be precisely determined using intraoperative three-dimensional images. Accordingly, the technique allows preservation of function to be maximized by minimizing unnecessary resection. However, surgeons should recognize that the accuracies of navigation systems in bone tumor surgery have some hidden pitfalls. Here, based on our clinical results, we describe the surgical techniques used and include some cautionary notes.

• Journal of Korean Clinical Nursing Research
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• v.17 no.2
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• pp.262-274
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• 2011

Purpose: To identify the effects of clinical practicum reinforcement program on nursing student's clinical competency and satisfaction in the ICU. Methods: The study utilized a quasi-experimental pretest-posttest research design. The participant was 76 senior nursing students, who were engaged in two week-long clinical practicum in ICU at the C university hospital in a G city, Korea. The clinical practicum reinforcement program was applied to the experimental group (n=39), while the control group (n=37) was involved in the conventional practicum program. The collected data were analyzed using descriptive analysis, $x^2$/Fisher's exact test, and t-test, ANCOVA with SPSS/WIN 18.0 program. Results: After 2 weeks' clinical practicum, the experimental group showed a statistically significant increase in the clinical performance abilities by self evaluation, when compared to the control group. Clinical instructor's evaluation on the student's clinical performance revealed that the experimental group showed higher level in nursing activity than that of the control group (p<.001). However, there was no significant difference between the two groups in terms of the satisfaction on the clinical practicum program except the learning guidance and the evaluation. Conclusion: The clinical practicum reinforcement program is an effective one for improving the student's clinical competency.

• Archives of Craniofacial Surgery
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• v.22 no.5
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• pp.254-259
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• 2021

Background: Prophylactic antibiotics are commonly used in craniofacial surgeries. Despite the low risk of surgical site infection after nasal surgery, a lack of consensus regarding the use of antibiotic prophylaxis in the closed reduction of nasal bone fractures has led to inappropriate prescribing patterns. Through this study, we aimed to investigate the status of prophylactic antibiotic use in closed reductions of nasal bone fractures in Korea. Methods: This retrospective cohort study was conducted using data from the National Health Insurance Service-National Sample Cohort of Korea from 2005 to 2015. We analyzed the medical records of patients who underwent closed reduction of nasal bone fractures. The sex, age, region of residence, comorbidities, and socioeconomic variables of the patients were collected from the database. Factors that affect the prescription of perioperative antibiotics were evaluated using multivariate logistic regression analysis. Results: A total of 3,678 patients (mean±standard deviation of age, 28.7±14.9 years; 2,850 men [77.5%]; 828 women [22.5%]) were included in this study. The rate of antibiotic prescription during the perioperative period was 51.4%. Approximately 68.8% of prescriptions were written for patients who had received general anesthesia. The odds of perioperative prophylactic antibiotic use were significantly higher in patients who received general anesthesia than who received local anesthesia (odds ratio, 1.59). No difference was found in terms of patient age and physician specialty. Second-generation cephalosporins were the most commonly prescribed antibiotic (45.3%), followed by third- and first-generation cephalosporins (20.3% and 18.8%, respectively). In contrast, lincomycin derivatives and aminoglycosides were not prescribed. Conclusion: The findings of this study showed that there was a wide variety of perioperative antibiotic prescription patterns used in nasal bone surgeries. Evidence-based guidance regarding the prescribing of antimicrobial agents for the closed reduction of nasal bone fractures should be considered in future research.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.42
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• pp.11.1-11.8
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• 2020

Background: The purpose of this study is to compare the skeletal stability of two-jaw surgery via surgery-first approach with conventional two-jaw surgery in facial asymmetry patients by measuring the skeletal changes after surgery from a three-dimensional analysis. From January 2010 to January 2014, 40 patients with facial asymmetry who underwent two-jaw surgery in Pusan National University Hospital were included in this study. They were classified into experimental group (n = 20) who underwent two-jaw surgery via surgery-first approach and control group (n = 20) who underwent conventional two-jaw surgery. After selection of 24 landmarks and the construction of horizontal and sagittal, coronal reference planes, changes in 10 linear measurements and 2 angular measurements were compared between the surgery-first approach and conventional groups in the preoperative, immediate postoperative, and postoperative periods. The paired t test and Student t test were used for statistical analysis. The mean and standard deviation of the measurement were calculated for the experimental and control groups. Results: The statistical analysis showed that changes in skeletal measurements were similar between the surgery-first approach and conventional groups, according to each period. However, U1-SRP measurement showed statistically significant changes in surgery-first approach groups at postsurgical change (T1 to T2). Also, the mean treatment duration in the treatment group was 15.9 ± 5.48 months whereas that in the control group was 32.9 ± 14.05 months. Conclusion: In facial asymmetry patients, similar results were observed in the postoperative skeletal stability when 2-jaw surgery via surgery-first approach was compared with conventional 2-jaw surgery. However, significant lateral deviation of upper incisor midline was observed. In addition, a shorter average treatment duration was observed. To stabilize the unstable occlusion after surgery, increased wearing of the stent and proactive rubber guidance will be needed.

• Clinical Pain
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• v.20 no.2
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• pp.141-144
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• 2021

There are some cases of myofascial pain syndrome (MPS) with chronic upper back pain that does not respond to dry needling or trigger point injection, well-known treatments for MPS. A 67-year-old female developed a stabbing upper back pain with trigger point at left T7~8 levels 10 years ago. She complained of the pain with Numeral Rating Scale (NRS) 8 points. Myofascial release technique and trigger point injection had no effect. Under ultrasound guidance 20 ml of 1% lidocaine was injected into thoracic paravertebral space. Immediately, the pain was reduced to NRS 4 points. One week later, the second block was performed in the same way as the first, and the pain was reduced to NRS 2 points. The stabbing pain disappeared, and oral opioids were discontinued. Ultrasound guided thoracic paravertebral space block is an effective and safe treatment for refractory MPS with chronic upper back pain.

• Clinical Pain
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• v.18 no.2
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• pp.59-64
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• 2019

Objective: This study evaluated the feasibility of ultrasound-guided lumbar nerve root block (LNRB) and S1 nerve root block by identifying spread patterns via fluoroscopy in cadavers. Method: A total of 48 ultrasound-guided injections were performed in 4 fresh cadavers from L1 to S1 roots. The target point of LNRB was the midpoint between the lower border of the transverse process and the facet joint at each level. The target point of S1 nerve root block was the S1 foramen, which can be visualized between the median sacral crest and the posterior superior iliac spine, below the L5-S1 facet joint. The injection was performed via an in-plane approach under real-time axial view ultrasound guidance. Fluoroscopic validation was performed after the injection of 2 cc of contrast agent. Results: The needle placements were correct in all injections. Fluoroscopy confirmed an intra-foraminal contrast spreading pattern following 41 of the 48 injections (85.4%). The other 7 injections (14.6%) yielded typical neurograms, but also resulted in extra-foraminal patterns that occurred evenly in each nerve root, including S1. Conclusion: Ultrasound-guided injection may be an option for the delivery of injectate into the S1 nerve root, as well as lumbar nerve root area.

• Pediatric Infection and Vaccine
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• v.28 no.3
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• pp.133-143
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• 2021

Purpose: This study aimed to determine the incidence of central line-associated bloodstream infection (CLABSI) in the neonatal intensive care unit (NICU), evaluate the patients' clinical characteristics, and identify the etiologic agents for guidance in prevention and treatment. Methods: A retrospective chart review study of infants classified as having CLABSI was conducted at the NICU of Seoul National University Bundang Hospital from January 2016 to December 2020. Results: Of the 45 infants, 53 had CLABSIs within a follow-up period of 18,622 catheter days. The incidence of CLABSIs was 2.85 per 1,000 catheter days. The most common catheter type was a peripherally inserted central catheter (n=47, 81%). A total of 57 pathogens were isolated, of which 57.9% (n=33) were Gram-positive bacteria, 36.8% (n=21) were Gram-negative bacteria, and 5.3% (n=3) were Candida spp. The most common pathogens were Staphylococcus aureus (n=12, 21%) and coagulase-negative staphylococci (n=12, 21%), followed by Klebsiella aerogenes (n=8, 14%). The median duration of bacteremia was 2 days, and 19 episodes showed bacteremia for 3 days or more. The mortality rate of infants within 14 days of CLABSI was 13.3% (n=6). Conclusions: This study analyzed the incidence of CLABSI and the distribution of pathogens in the NICU. Continuous monitoring of CLABSI based on active surveillance serves as guidance for empiric antibiotic use and also serves as a tool to assess the necessity for implementation of prevention strategies and their impact.

• The Journal of the Korea Contents Association
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• v.10 no.3
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• pp.241-249
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• 2010

The purpose of this study is to provide basic information for marketing strategy for hospitals in Busan Metropolitan area by investigating of the web-site management and effect on hospital management about the web-sites managers. Survey of 53 web-site managers was taken between May 1st and May 25th 2008. The survey was carried out to gather information about characteristics of web-site managers and creating, managing and operating process of web-sites and web-sites' effect and information sharing abilities. The results of survey are as follows. First, most of hospitals' web-sites were launched between 2001 to 2005 via outsourcing. Most of hospitals spent about one to three million won for their web-sites and renew web-sites every year. Most of these web-sites have hospital PR, Q&A, and on-line support functions. Second, most of whom participated in survey have agreed that a hospital web-site has influence in hospital management in various categories such as introducing hospital to medical examination, making doctor's appointment, providing patient guidance, providing medical information, and patient counselling. This study shows that effects of web-sites are closely related to web-site satisfaction level. Therefore, to raise the hospital satisfaction level, it is necessary for hospitals to put more efforts in creating web-site that provides more medical information and improved on-line services.

• Journal of Korean Public Health Nursing
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• v.10 no.2
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• pp.74-89
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• 1996

It hasbeen individual and social problems that mattoids, alcohols and old people alienated from their families have wandered about the streets for rapid urbanzation, industrialization and nuclear families. In our country, measures for proper guidance for the tramps under the supports of government in 1982 have been carried out. But it has been difficult that we protected without Welfare Acts for them. According to those the study has aimed to provide for the fundamental data to advance public utilities as needs of an administrative organ with focus on contents of nursing records charts, furthermore general traits of subjects perceived details related to diseases. Medical record service has been a 'D' municipal hospital. All the subjects were a total of 4,855 persons, 2.436 in 1992, 2.419 in 1994. 1. Social Traits They mainly have attended a hospital, especially Thursday and Friday from a week and winter from the seasons. They equally have attended a hospital in the beginning, middle and end of the month. They equally have attended a hospital in the months. Government and public offices such as police stations and district offices have trusted them to a hospital. After they left a hospital. their residence has been their home confirmed in the ratio of $59.2\%$. 2. Controling Characteristics of a Medical Institution The proportion of males to females was 7 to 1. In the ages, the adults at the first of adulthood from 25 years to 44 years were $52.6\%$ mostly entered a hospital. In the observations the percentage of patients should be entered total was $8.8\%$. In general. the proportion of changes by fee was about $4\%$. Then the number of patients were on an average from 30. 76 to 32, 55 persons in 1992. It was from 25. 63 to 26. 87 in 1994. But the numbers were 5 to 6. It showed that the number was decreased. 3. Medical Traits The number of days by measured and the number of days which have been entered to a hospital have not made differences. The kinds of diseases were 1.11 in 1992. but were 1. 16 in 1994. In terms of 17 kinds of international diseases divided. the diseases recorded probably have been accidents. poisoning and violence( XVII). digestive trouble(IX). endoctrin disoders. metabolism and dystrophy(III) in orders, then they have been measured $51.0\%,\; 12.7\%,\; 6.8\%$. All patients who have been entered to a hospital severly have been drinking. As the seriousness of drinking and the kinds of diseases have indicated positively correlated. It have indicated that the more serious drinking have been. the more the number of diseases have been. As we have known according to abover results. the Acts for Homeless People related to special medical problems been have revised. furthemore they need to support the basic medical adds in order to maintaim their lives.

• Quality Improvement in Health Care
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• v.5 no.1
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• pp.28-40
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• 1998

Background : Many patients have been frequently complaining that they have to spend couples of hours in hospital on visiting outpatient clinic. Among several steps, two major time consuming steps were waiting to see a doctor and/or waiting at pharmacy to get medicine. Therefore not only to provide the proper guidance for medication or counseling on health affairs but also to make waiting time short is very important for the better hospital services. The aim of this study is to validate several time-saving processes to reduce waiting time at outpatient pharmacy and its efficacy. Methods : We surveyed the time interval actually taken to receive medicine after issuing prescription by doctors, and analyzed the data on the bases of relevant or possible causative factors. Then following processes were given to reduce waiting time and resurveyed and compared both data to validate efficacy of those processes : 1. No work-off on Monday and Tuesday 2. Work hour shift to start 30 minutes earlier 3. Changeable work shift between outpatient pharmacy and ward pharmacy according to work load 4. Use of pre-made medicines prescribed more frequently by certain doctors at certain time 5. Cooperation with doctors to use set prescriptions. Results : Before the process, mean waiting time at pharmacy was 29.2 minutes and most time consuming period was from noon to 1 PM, 3 to 4 PM, 1 to 2 PM in order of frequency. Only 37.7 % of patients could get the medicine within 20 minutes. Three times of surveys after process showed mean waiting time at pharmacy were 18.1 minutes, 19.0 minutes, and 17.6 minutes, respectively. And 72.7 %, 81.3%, and 82.2% of patients could get the medicine within 20 minutes. Conclusion : The mean waiting time was markedly reduced with above mentioned processes which applied intradepartmently event hough with little cooperation from other department. Consequently, the complaints of patients were decreased with increasing the satisfaction degree. In conclusion, those suggestions were recommanded to improve the degree of satisfaction of patients.