• Tuberculosis and Respiratory Diseases
• /
• v.84 no.2
• /
• pp.125-133
• /
• 2021

Background: The coronavirus disease (COVID-19) can manifest in a range of symptoms, including both asymptomatic systems which appear nearly non-existent to the patient, all the way to the development of acute respiratory distress syndrome (ARDS). Specifically, COVID-19-associated pneumonia develops into ARDS due to the rapid progression of hypoxia, and although arterial blood gas analysis can assist in halting this deterioration, the current environment provided by the COVID-19 pandemic, which has led to an overall lack of medical resources or equipment, has made it difficult to administer such tests in a widespread manner. As a result, this study was conducted in order to determine whether the levels of oxygen saturation (SpO₂) and the fraction of inhaled oxygen (FiO₂) (SF ratio) can also serve as predictors of ARDS and the patient's risk of mortality. Methods: This was a retrospective cohort study conducted from February 2020 to Mary 2020, with the study's subjects consisting of COVID-19 pneumonia patients who had reached a state of deterioration that required the use of oxygen therapy. Of the 100 COVID-19 pneumonia cases, we compared 59 pneumonia patients who required oxygen therapy, divided into ARDS and non-ARDS pneumonia patients who required oxygen, and then investigated the different factors which affected their mortality. Results: At the time of admission, the ratios of SpO₂, FiO₂, and SF for the ARDS group differed significantly from those of the non-ARDS pneumonia support group who required oxygen (p<0.001). With respect to the predicting of the occurrence of ARDS, the SF ratio on admission and the SF ratio at exacerbation had an area under the curve which measured to be around 85.7% and 88.8% (p<0.001). Multivariate Cox regression analysis identified that the SF ratio at exacerbation (hazard ratio [HR], 0.916; 95% confidence interval [CI], 0.846-0.991; p=0.029) and National Early Warning Score (NEWS) (HR, 1.277; 95% CI, 1.010-1.615; p=0.041) were significant predictors of mortality. Conclusion: The SF ratio on admission and the SF ratio at exacerbation were strong predictors of the occurrence of ARDS, and the SF ratio at exacerbation and NEWS held a significant effect on mortality.

• Journal of Korean Academy of Dental Administration
• /
• v.7 no.1
• /
• pp.39-43
• /
• 2019

Smartphone usage has become so common that it has reached 2 billion people in the last year. As a result of this, hospitals have started making use of smartphones at various medical sites and research services for patients. This study aimed to establish support for developing a long distance program for patients with implants who have difficulty visiting clinics or with busy modern lives, by using smartphones for oral hygiene management instruction. The data were collected for 12 weeks, from July 24 to October 21, 2015, for patients who agreed to participate in the study. Although the subjects found the process of transferring photos via smartphone to be cumbersome (75%), the satisfaction level of the oral hygiene management program was excellent for all participating patients, and they all wanted to continue with further management using this process. The results from the phone satisfaction survey showed that oral hygiene self-management after oral hygiene control training by smartphones was mostly equal to previous habits (87.5%) or had partially increased but had not decreased. The need for data on more varied age groups and the issues of protecting the security of personal information on smartphones require further study. However, our study confirmed the efficacy of using electronic media (smartphones) for oral hygiene management in patients with a dental implant due to their improvement of oral hygiene performance as evidenced by less bleeding from probing on post-program visit.

• Journal of Oriental Neuropsychiatry
• /
• v.32 no.1
• /
• pp.1-11
• /
• 2021

Objectives: To investigate the prevalence of acute stress disorder (ASD) and post-traumatic stress disorder (PTSD) in patients with traffic injuries. In addition, PTSD patients was classified using 'pattern identification for jing ji and zheng chong'. Methods: Questionnaires such as the primary care PTSD screen for DSM-5(PC-PTSD-5), Korean version of PTSD checklist-5 (PCL-5-K), and the instrument of pattern identification for jing ji and zheng chong were conducted on 195 patients within 3 days to 1 year after traffic accidents. Patients were recruited from six medical institutions. Collected data were used to determine the prevalence of acute stress disorder and post-traumatic stress disorder. Results: On PC-PTSD-5, the prevalence was 39.1% for ASD and 50% for PTSD. On PCL-5-K, the prevalence was 20.4% for ASD and 29.3% for PTSD. Satisfying both PC-PTSD-5 and PCL-5-K, the prevalence was 18.2% for ASD and 25.8% for PTSD. As a result of pattern identification for jing ji and zheng chong, 'weakness of heart and gall bladder type' accounted for the highest proportions in both ASD and PTSD groups. Conclusions: In this study, the prevalence was 39.1% for ASD and 50% for PTSD by PC-PTSD-5. Satisfying both PC-PTSD-5 and PCL-5-K, the prevalence was 18.2% for ASD and 25.8% for PTSD. Further large-scale prospective studies are needed to analyze the prevalence of ASD and PTSD, the rate of progression from ASD to PTSD, and the type of pattern identification.

• Journal of Korean Academy of Dental Administration
• /
• v.8 no.1
• /
• pp.1-7
• /
• 2020

Dental settings have unique characteristics that warrant specific infection control considerations, including (1) prioritizing the most critical dental services and provide care in a way that minimizes harm to patients due to delayed care, or harm to personnel from potential exposure to persons infected with the COVID-19 disease, and (2) proactively communicate to both personnel and patients the need for them to stay at home if sick. For health care, an interim infection prevention and control recommendation (COVID-19) is recommended for patients suspected of having coronavirus or those whose status has been confirmed. SARS-CoV-2, which is the virus that causes COVID-19, is thought to be spread primarily between people who are in close contact with one another (within 6 feet) through respiratory droplets that are produced when an infected person coughs, sneezes, or talks. Airborne transmission from person-to-person over long distances is unlikely. However, COVID-19 is a new disease, and there remain uncertainties about its mode of spreads and the severity of illness it causes. The virus has been shown to persist in aerosols for several hours, and on some surfaces for days under laboratory conditions. COVID-19 may also be spread by people who are asymptomatic. The practice of dentistry involves the use of rotary dental and surgical instruments, such as handpieces or ultrasonic scalers, and air-water syringes. These instruments create a visible spray that can contain particle droplets of water, saliva, blood, microorganisms, and other debris. While KF 94 masks protect the mucous membranes of the mouth and nose from droplet spatter, they do not provide complete protection against the inhalation of airborne infectious agents. If the patient is afebrile (temperature <100.4°F)* and otherwise without symptoms consistent with COVID-19, then dental care may be provided using appropriate engineering and administrative controls, work practices, and infection control considerations. It is necessary to provide supplies for respiratory hygiene and cough etiquette, including alcohol-based hand rub (ABHR) with 60%~95% alcohol, tissues, and no-touch receptacles for disposal, at healthcare facility entrances, waiting rooms, and patient check-ins. There is also the need to install physical barriers (e.g., glass or plastic windows) in reception areas to limit close contact between triage personnel and potentially infectious patients. Ideally, dental treatment should be provided in individual rooms whenever possible, with a spacing of at least 6 feet between the patient chairs. Further, the use of easy-to-clean floor-to-ceiling barriers will enhance the effectiveness of portable HEPA air filtration systems. Before and after all patient contact, contact with potentially infectious material, and before putting on and after removing personal protective equipment, including gloves, hand hygiene after removal is particularly important to remove any pathogens that may have been transferred to the bare hands during the removal process. ABHR with 60~95% alcohol is to be used, or hands should be washed with soap and water for at least 20 s.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.21 no.12
• /
• pp.660-671
• /
• 2020

This study is a descriptive survey study that attempted to confirm clinical nurses' consciousness of biomedical ethics, moral sensitivity, critical thinking deposition, and nursing ethics code of clinical nurses, as well as to identify the factors influencing the recognition of the nursing code of ethics. The general and ethical characteristics of the subject were calculated by frequency, percentage, mean, and standard deviation, and the difference for each variable according to the general and ethical characteristics was analyzed using SAS 9.4, independent t-test, and one-way ANOVA, and Scheffé test. The average, standard deviation, and the minimum and maximum values were used for the scores of each variable, and the correlation was determined using the Pearson correlation coefficient. Multiple regression was used to identify the factors that influence the recognition of the nurse's code of ethics. All variables showed significant correlations. Critical thinking deposition (p<.05) was the most influential variable in recognizing the code of ethics for nurses. Critical thinking deposition (p<.001), consciousness in biomedical ethics (p<.001), and moral sensitivity (p<.001) were shown to be affected in order, with 27.4% explaining power. Therefore, it is necessary to develop and apply educational programs to clinical nurses that can improve critical thinking, life and bioethics, and moral sensitivity.

• Korean Journal of Clinical Laboratory Science
• /
• v.53 no.1
• /
• pp.122-130
• /
• 2021

The types of artifacts that are observed in intraoperative neurophysiological monitoring (INM) is truly diverse. The removal of artifacts that interfere with the examination is essential. In addition, improving the quality of the examination by removing artifacts is a reflection of the competency of the examiner and is also the best way to ensure patient safety. However, if knowledge of the equipment or anesthesia in the operating room is insufficient due to lack of experience, artifacts cannot be removed even with a method appropriate to the situation. If artifacts are not separated and removed, the reading of the examination results in confusion in the operation process. This can be a fatal problem in neurosurgery that requires rapid and sophisticated procedures. In this paper, the causes of artifacts that occur during surgery are classified into electrical factors, non-electrical factors, and other factors, and a method and examination method for removing artifacts according to the specific situation is mentioned. Although the operating room environment is a very critical place to simultaneously consider various scenarios, we hope that a stable and optimal INM will play a role by knowing the types and causes of various artifacts and how to tackle them.

• Journal of Korean Academy of Dental Administration
• /
• v.9 no.1
• /
• pp.14-24
• /
• 2021

Dentists and dental hygienists are major collaborators, as expressed by the concept of "Four-handed dentistry." Dentists are guaranteed their legal duties and rights in accordance with the Medical Act, whereas dental hygienists are currently stipulated in the scope of their legal duties under the Act on Medical Technicians. However, there is a difference between the actual work and the legal work performed by dental hygienists; therefore, the work is dependent on many legal controversies and authoritative interpretations. The purpose of this study is, first, to develop a reliable questionnaire tool regarding the actual work performed by dental hygienists in dental hospitals and clinics, and second, to examine the awareness of the appropriateness of legal work based on the developed questionnaire. The target subjects of the survey were dental hygienists and dentists, and the dental hygienists were those who worked in dental hospitals and clinics as license reporters of the Korean Dental Hygienists Association. A total of 1,294 dental hygienists and 39 dentists were included in the final analysis. In the dental hygienist group, 19 items received the response "appropriate for legal work" in over 90% of cases, accounting for 25% of the total 76 items. In addition, in a total of 31 items, more than 80% of the responses were appropriate for legal work. Among them, the highest was 'Scailing' (97.7%), followed by "Extraoral-Panorama" (97.1%). In the dentist group, 10 out of 76 items showed over 90% adequacy for legal work, and among them, "instrument cleaning and sterilization" was the highest at 100%. It was followed by "Intraoral radiography," "Scailing," and "Toothpick method, TPM" with 97.4%. In the case of dentists, 28 out of a total of 76 items showed an appropriateness of more than 80% for legal work. This study comprehensively investigated the actual work of dental hygienists in line with timely and appropriate social issues and provided reliable statistics in evidence-based dentistry.

• Journal of Korean Foot and Ankle Society
• /
• v.26 no.2
• /
• pp.95-102
• /
• 2022

Purpose: This study was based on the Korean Foot and Ankle Society (KFAS) member survey and aimed to report the current trends in the management of syndesmotic injuries over the last few decades. Materials and Methods: A web-based questionnaire containing 36 questions was sent to all KFAS members in September 2021. The questions were mainly related to the preferred techniques and clinical experiences in the treatment of patients with syndesmotic injuries. Answers with a prevalence ≥50% of respondents were considered a tendency. Results: Seventy-six (13.8%) of the 550 members responded to the survey. The results showed that the most preferred method to diagnose a syndesmotic injury was magnetic resonance imaging (MRI). Intraoperatively, the external rotation stress test and the Cotton test were most frequently used to confirm syndesmotic diastasis. The reduction was usually done by a reduction clamp. One 3.5-mm screw was used most frequently over three cortices at 2~4 cm above the ankle joint. The preferred ankle position during fixation was 0° dorsiflexion. Removal of the syndesmotic screw was routinely done by most surgeons, mainly because of the limitation of movement and risk of screw breakage. Factors that affect suture button selection included non-rigid fixation which enables adequate fixation, early weight-bearing, and an infrequent need to remove the hardware. Inadequate reduction was considered the main factor that affects poor prognosis. Conclusion: This study proposes updated information about the current trends in the management of syndesmotic injuries in Korea. Consensuses in both the diagnostic and therapeutic approach to patients with syndesmotic injury were identified in this survey study. This study may raise the awareness of the various possible approaches toward the injury and should be used to further establish a standard protocol for the management of syndesmotic injuries.

• Journal of the Korean Society of Radiology
• /
• v.16 no.3
• /
• pp.357-363
• /
• 2022

This study aims to improve the safety inspection awareness of occupational exposure and help radiation safety management by analyzing radiation exposure doses by occupational type of radiation related-workers and radiation workers. Radiation-related workers and radiation workers were classified into three occupations (radiological technologist, doctors, and nurses). A nominal risk coefficient based on ICRP 103 was used to calculate the probability of causing side effects of the lungs due to exposure doses. As a result of analyzing the exposure dose of all workers for one year, the exposure dose of radiological technologist among radiation-related workers was 1.63 ± 2.84 mSv, doctors 0.12 ± 0.22 mSv, and nurses 0.59 ± 1.08 mSv. The one-year deep dose for radiation workers was 2.44 ± 3.30 mSv for radiological technologists, 0.19 ± 0.26 mSv for doctors, and 0.12 ± 0.00 mSv for nurses. Due to this dose, the probability of causing side effects in the lungs was 1.2 per 100,000 radiological technologist, 0.096 doctors, and 0.06 nurses. In this study, it is believed that the probability of side effects on lungs by occupation of radiation exposure dose will be studied and used as useful data for radiation safety management in relation to probabilistic effects in the future.

• Journal of Biomedical Engineering Research
• /
• v.43 no.5
• /
• pp.341-352
• /
• 2022

Medical image segmentation is the most important task in radiation therapy. Especially, when segmenting medical images, the liver is one of the most difficult organs to segment because it has various shapes and is close to other organs. Therefore, automatic segmentation of the liver in computed tomography (CT) images is a difficult task. Since tumors also have low contrast in surrounding tissues, and the shape, location, size, and number of tumors vary from patient to patient, accurate tumor segmentation takes a long time. In this study, we propose a method algorithm for automatically segmenting the liver and tumor for this purpose. As an advantage of setting the boundaries of the tumor, the liver and tumor were automatically segmented from the CT image using the 2D CoordConv DeepLab V3+ model using the CoordConv layer. For tumors, only cropped liver images were used to improve accuracy. Additionally, to increase the segmentation accuracy, augmentation, preprocess, loss function, and hyperparameter were used to find optimal values. We compared the CoordConv DeepLab v3+ model using the CoordConv layer and the DeepLab V3+ model without the CoordConv layer to determine whether they affected the segmentation accuracy. The data sets used included 131 hepatic tumor segmentation (LiTS) challenge data sets (100 train sets, 16 validation sets, and 15 test sets). Additional learned data were tested using 15 clinical data from Seoul St. Mary's Hospital. The evaluation was compared with the study results learned with a two-dimensional deep learning-based model. Dice values without the CoordConv layer achieved 0.965 ± 0.01 for liver segmentation and 0.925 ± 0.04 for tumor segmentation using the LiTS data set. Results from the clinical data set achieved 0.927 ± 0.02 for liver division and 0.903 ± 0.05 for tumor division. The dice values using the CoordConv layer achieved 0.989 ± 0.02 for liver segmentation and 0.937 ± 0.07 for tumor segmentation using the LiTS data set. Results from the clinical data set achieved 0.944 ± 0.02 for liver division and 0.916 ± 0.18 for tumor division. The use of CoordConv layers improves the segmentation accuracy. The highest of the most recently published values were 0.960 and 0.749 for liver and tumor division, respectively. However, better performance was achieved with 0.989 and 0.937 results for liver and tumor, which would have been used with the algorithm proposed in this study. The algorithm proposed in this study can play a useful role in treatment planning by improving contouring accuracy and reducing time when segmentation evaluation of liver and tumor is performed. And accurate identification of liver anatomy in medical imaging applications, such as surgical planning, as well as radiotherapy, which can leverage the findings of this study, can help clinical evaluation of the risks and benefits of liver intervention.