• Journal of Korean Academy of Nursing
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• v.30 no.1
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• pp.60-71
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• 2000

This research is a field investigation to collect basic information about the safe and efficient use of physical restraint in hospitals and for the ultimate minimization of restraint use. The objects of this study were sixty-four patients. They were restrained physically. Add their 32 family members, 24 nurses of two university hospitals in Seoul were also involved in the study. From April 16, to May 27, 1999. Research data were collected throughout the observation and interview process. Also, the data was analyzed using frequencies and field study notes that were invented by researchers. Results of this study were as follows: 1. According to the sex and age distinction; male's restraint use was 75%, female's was 25% and pre-schoolage children 39.1%, middle age 26.5%, and senior citizens 20.3%. According to the disease distinction; neuro-system was 35.9%, respiratory system was 21.9%. In the Ward, 40.6% of ICU patients were restrained and 39.0% of pediatric ward children were also to restraint. 70.3% of patients were restrained under 5days, while 10.9% were restrained 10days. 2. Types of physical restraints were wrist restraint (45.21%), arm board (35.62%), leg restraint (8.22%), chest restraint (6.85%), elbow restraint (2.74%) and mitten restraint (1.37%). 3. The percentage was 3.5%, which was in 64 restrained out of 1828 hospitalized people. At 1st investigation, the ratio was 3.5%, the 2nd was 3.0% and the 3rd was 3.9%. 4. The reasons of using the physical restraint were 'to protect implements' (72.84%), 'to protect patients' (18.52%), 'to protect an operative site' (8.64%). 5. The result of the patients; family and nurses' response analysis was: 'It seems to be safe', 'It uses properly', 'It is convenient for relatives and nurses', 'It is helpful to treatment', 'Objective think it is not restraint' were 79.9%. 'It is discomfort and stuffy', 'The implement is ineffective' were 21.1%. However in interview of the patients who can do verbally communication, 6 of 7 was responded that 'It is stuffy and uncomfortable'. 6. When restraint is used, the main decision is usually made by the nurses 42.2% of the time. The statistics read as thus: nurses and the physician in charge 31.3%, nurses and family 12.5%, physician's order 7.8%, only family 6.2%. Although the record of restraint was only 15.6% so that only 10 cases out of all the 26 ICU patients restrained. This study shows that physical restraints which of infringe independent-right of patients, are used without using criterion, explaining the agreement. Also, subjective decision of physician, nurses, and family make the decision of using restraint. So development of practice manuals and rules for restraint implementation is urgent.

• Journal of Korean Neurosurgical Society
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• v.38 no.3
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• pp.215-220
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• 2005

Objective : Many researchers believe that the hypothermia shows neuro-protective effect on brain injury. To understand the molecular mechanism of the hypothermic treatment, this study investigated its effects on the expression of cell death or survival related proteins such as p53, Bcl-2 and Bax in the rat traumatic brain injury[TBI] model. Methods : Twenty rats [Spraque Dawley, $200{\sim}250g$] were subjected to the brain injury of moderate severity [$2.4{\sim}2.6atm$] using the fluid percussion injury device and five rats were received only same surgery as controls. During 30minutes after the brain injury, the hypothermia group was maintained the body temperature around $34^{\circ}C$ while the control group were maintained that of $36^{\circ}C$. Five rats in each group were sacrificed 12h or 24h after brain injury and their brain sections was analyzed for physical damages by H-E stains and the extent of apoptosis by TUNEL assay and immunohistochemical stains. The tissue damage after TBI was mainly observed in the ipsilateral cortex and partly in the hippocampus. Results : Apoptosis was observed by TUNEL assay and the Bax protein was detected in both sample which harvested 12h and 24h after TBI. In the hypothermia treatment group, tissue damage and apoptosis were reduced in HE stains and TUNEL assay. In hypothermia treatment group rat shows more expression of the Bcl-2 protein and shows less expression of the Bax protein, at both 12h and 24h after TBI. Conclusion : These results show that the hypothermia treatment is an effective treatment after TBI, by reducing the apoptotic process. Therefore, it could be suggested that hypothermia has a high therapeutic value for treating tissue damages after TBI.

• Journal of Oriental Neuropsychiatry
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• v.24 no.4
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• pp.419-434
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• 2013

Objectives: The object of this study is to observe the cognition and motor function recovery effects of Joojakwhan (JJW), a traditional Korean poly-herbal formula for treating various neuropsychiatric diseases such as dementia, for the mildly stroke rats, with 60 minutes of reperfusion transient middle cerebral artery occlusion (tMCAO). Methods: In the present study, 125, 250 and 500 mg/kg of JJW were orally administered, once per day for 10 continuous days 2 hours after the tMCAO. The body weight changes, infarct sizes under 2% 2, 3, 5-triphenyl tetrazolium chloride (TTC) stain, sensorimotor functions and cognitive motor behavior tests were serially monitored with cerebral caspase-3 and cleaved poly (ADP-ribose) polymerase (PARP)-immunoreactivities and histopathological changes. The effects of tMCAO on sensorimotor functions were evaluated by using of limb placing and body-swing tests, and the cognitive motor behaviors were also observed with water maze tests. Results: From the results of tMCAO, with marked decreases of body weights, disorders of sensorimotor functions increases the limb placing test scores, and decrease the numbers and percentages of body swings to the ipsilateral sides. The cognitive motor behaviors increases the distances and time to reach the escape platform which included the inhibitions of the decreases with repeated trials that were observed with focal cerebral cortex infarct volumes. In addition, the marked increases of the atrophy, numbers of degeneration, caspase-3- and PARP-immunoreactive cells around peri-infarct ipsilateral cerebral cortex were also observed in tMCAO controls when compared with the sham control rats, respectively. Conclusions: The results obtained from this study suggest that oral administrations of JJW indicate obvious cognitions and motor function recoveries of the rats with tMCAO, mild strokes, which are mediated by neuro-protective effects through known antioxidant effects of components.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.11 no.9
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• pp.3318-3324
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• 2010

This study was to examine the effectiveness of neurofeedback training by observing the pre and post brainwave measurement results of about 16(Primary Student 6, middle school student10) student who have shown resistance stress and body stress, mental stress. The study was examined at S city M dong A hearing impairments student, from Mar. 2008 and to Feb. 2009. The methodology used in the study is the Coloring Analysis Program of the Brain Quotient Test. As the brain waves are adjusted by timeseries linear analysis, the brain function quotients can reflect the functional states of the brain. The training took place two times a week, for about 40 minutes per session. The result confirmed the differences of both resistance stress quotient and body stress, mental stress. The results of the analysis show that neurofeedback training plays positive role in changing the brain function. Therefore, the result of the study shows that there is possibility that Neuro Feedback technique might be positively affecting resistance stress of the hearing impairments student, relationship between neurofeedback training and stress among several categories.

• The Korean Nurse
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• v.35 no.3
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• pp.61-76
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• 1996

The purpose of this study was to develop a nursing care delivery system which can provide patient focused care and increase satisfaction for both patients and nurses. This study was a quasi-experimental study to test the effectiveness of direct / indirect nursing care hours, patient satisfaction, nurse's job satisfaction, and the difference of the length of stay between model and control group. Control group data were collected from 100 patients who had lumbar disease in the neuro-surgical unit and model group data were from 66 patients who didn't have family residents from August 21, 1995 to February 29, 1996. Model unit was operated by modified PPM(Professional Practical Model) system for 3 months from December 1, 1995 to February 29, 1996. Working committee empowered nurses to make a decision to provide increased opportunities for autonomy, accountability, and control over the environment in which they deliver care. Satisfaction survey was done twice and analyzed by the SPSS program. The results of the study were as follows; 1. Mean direct nursing care hours of the model group was 90.47 minutes as it was 28.04 in the control group which shows significant statistical difference (t=-18.0, P=0.000). 2. Patient satisfaction to nursing care of in the model group was significantly higher than the control group (t=-6. 77, P=0.000) and it apples to the all subcategories, too. 3. Nurse's job satisfaction shows the significant increase in the model group than the control group(Z=-3.0405, p=0.0024). 4. There was no statistical difference between 2 groups in average length of stay except for the post-op patient which shows 5.4 days less in the model group. This study shows that patient satisfaction and nurse's job satisfaction were increased and length of stay was decreased in the model group. Even though this new developed Patient - Nurse Oriented Model can provide nursing with the opportunity to improve patient care to increase productivity and highly valued, it is very difficult to practice due to the limited nursing resources, higher acuity levels and nursing care cost. It is strongly recommended that the government needs to look at the unreasonable reimbursement system and recognize the nursing care costs to the high acuity level patients. Otherwise, make the patient responsible for the nursing care cost so that we can provide more efficient and patient focused care.

• Journal of the Korean Society of Radiology
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• v.82 no.6
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• pp.1545-1555
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• 2021

Purpose The purpose of this study was to evaluate the rates of unacceptable diagnosis and clinically significant diagnostic discrepancy in radiology sections and imaging modalities through a peer review of teleradiology. Materials and Methods Teleradiology peer reviews in a Korean teleradiology clinic in 2018 and 2019 were included. The peer review scores were classified as acceptable and unacceptable diagnoses and clinically insignificant and significant diagnostic discrepancy. The diagnostic discrepancy rates and clinical significance were compared among radiology sections and imaging modalities using the chi-square test. Results Of 1312 peer reviews, 117 (8.9%) cases had unacceptable diagnoses. Of 462 diagnostic discrepancies, the clinically significant discrepancy was observed in 104 (21.6%) cases. In radiology sections, the unacceptable diagnosis was highest in the musculoskeletal section (21.4%) (p < 0.05), followed by the abdominal section (7.3%) and neuro section (1.3%) (p < 0.05). The proportion of significant discrepancy was higher in the chest section (32.7%) than in the musculoskeletal (19.5%) and abdominal sections (17.1%) (p < 0.05). Regarding modalities, the number of unacceptable diagnoses was higher with MRI (16.2%) than plain radiology (7.8%) (p < 0.05). There was no significant difference in significant discrepancy. Conclusion Peer review provides the rates of unacceptable diagnosis and clinically significant discrepancy in teleradiology. These rates also differ with subspecialty and modality.

• Journal of Oral Medicine and Pain
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• v.33 no.4
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• pp.353-374
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• 2008

The descriptive epidemiology of specific neuropathic pain disorders has not been well-des-cribed, although the burden of neuropathic pain is well recognized. The true incidence of neuro-pathic pain disorder is unknown, but it is believed to be under diagnosed and treated inade-quately, despite the development of various diagnostic system. The purpose of this study was to report the epidemiology of specific neuropathic pain as managed by all kinds of hospital in Korea. A descriptive analysis of the epidemiology of prevalent trigeminal neuralgia(TN)(n-=77,053 27,6%), atypical facial pain(AFP)(n=12,382 4.4%), glossopharyngeal neuralgia(GN)-(n=1,319 0.5%), post-herpetic neuralgia(PHN)-(n=84,598 30.3%), diabetic neuropathy(DN)-(n=85,989 30.8%), atypical odontalgia(AO)-(n=16,001 5.7%) and glossodynia(GD)(n=2,133 0.8%) and treatment departments and treatment durations from computerized Health Insurance Review and Assessment Service(HIRA) of Korea: January 2003 to December 2005, are reported with rates increasing over time for PHN and DN and decreasing for the other neuropathic pain disorders. Most patients were treated at private clinic record for 57.6-72.8% of patients except OA for 10.3%. The percentage of Dept of dentistry for outpatients was 3.2% for TN, 34.7% for AO and 15.4% for GD. Other neuropathic pain patients visited nearly medical clinic.

• Journal of Korean Neurosurgical Society
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• v.64 no.4
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• pp.592-607
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• 2021

Objective : Few studies exist on primary spinal cord tumors (PSCTs) in pediatric patients. The purpose of this study was to perform descriptive analysis and detailed survival analysis for PSCTs. Methods : Between 1985 and 2017, 126 pediatric patients (male : female, 56 : 70) with PSCTs underwent surgery in a single institution. We retrospectively analyzed data regarding demographics, tumor characteristics, outcomes, and survival statistics. Subgroup analysis was performed for the intramedullary (IM) tumors and extradural (ED) tumors separately. Results : The mean age of the participants was 6.4±5.04 years, and the mean follow-up time was 69.5±46.30 months. The most common compartment was the ED compartment (n=57, 45.2%), followed by the IM (n=43, 34.1%) and intradural extramedullary (IDEM; n=16, 12.7%) compartments. Approximately half of PSCTs were malignant (n=69, 54.8%). The most common pathologies were schwannomas (n=14) and neuroblastomas (n=14). Twenty-two patients (17.5%) died from the disease, with a mean disease duration of 15.8±15.85 months. Thirty-six patients (28.6%) suffered from progression, with a mean period of 22.6±30.81 months. The 10-year overall survival (OS) rates and progression-free survival (PFS) rates were 81% and 66%, respectively. Regarding IM tumors, the 10-year OS rates and PFS rates were 79% and 57%, respectively. In ED tumors, the 10-year OS rates and PFS rates were 80% and 81%, respectively. Pathology and the extent of resection showed beneficial effects on OS for total PSCTs, IM tumors, and ED tumors. PFS was affected by both the extent of removal and pathology in total PSCTs and ED tumors; however, pathology was a main determinant of PFS rather than the extent of removal in IM tumors. The degree of improvement in the modified McCormick scale showed a trend towards improvement in patients with IM tumors who achieved gross total removal (p=0.447). Conclusion : Approximately half of PSCTs were malignant, and ED tumors were most common. The most common pathologies were schwannomas and neuroblastomas. Both the pathology and extent of resection had a decisive effect on OS. For IM tumors, pathology was a main determinant of PFS rather than the extent of removal. Radical excision of IM tumors could be a viable option for better survival without an increased risk of worse functional outcomes.

• Proceedings of the Korea Water Resources Association Conference
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• 2007.05a
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• pp.532-536
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• 2007

급속한 도시화 및 지구온난화로 인한 집중호우로 홍수피해가 해마다 증가하고 있다. 홍수피해를 최소화하기 위하여 4대강 중심의 홍수예경보시스템이 구축되는 등 다양한 제도적 장치가 마련되고 있으나 중소하천이 분포되어 있는 도시유역에서의 홍수예측기능은 부족한 실정이다. 본 연구에서는 중소 도시하천에 적용 가능한 실시간 도시홍수예측서비스 시스템(Realtime Urban Flood Forecasting Service, U-FFS)을 개발하였다. 경기도 성남에 위치한 탄천을 대상유역으로 선정하고 실시간 강우 및 수위관측소를 설치하여 수문데이타를 수집하였으며 이를 바탕으로 수위예측모형을 구축하였다. 모형구축에는 이미 국내외 학계에서 그 정확도가 입증된 바 있는 Data-driven 모델의 일종인 ANFIS(Adaptive Neuro-Fuzzy Inference System)를 이용하였다. 개발된 수위예측모형은 지정된 시간에 자동으로 작동 가능한 실행파일로 프로그래밍되어 최종적으로 홍수예측 웹서비스와 연동된다. U-FFS는 집중호우 발생 시 최종 유출구의 30분, 1시간, 2시간 후의 수위 예측값을 웹 상을 통해 제공함으로써 언제 어디서나 홍수예측 정보를 누구나 손쉽게 획득할 수 있는 장점이 있다. 시범운영 결과, 30분 및 1시간 후의 수위 예측은 정확도가 매우 뛰어났으며 2시간 후의 수위 예측의 정확성은 다소 떨어지는 것으로 확인되었으나 전반적인 홍수예측 판단에는 무리가 없을 것으로 예상된다. 본 시스템의 홍수예측모형은 생성 및 수정이 간편하여 그 활용성이 매우 높을 것으로 기대된다. 특히 안전함을 지향하는 각종 U-City나 홍수피해가 빈번한 도시유역에 적용하면 기존 시스템과 차별화된 실시간 홍수예측 서비스가 가능해져 홍수피해를 최소화할 수 있을 것이다. 취수구 직경 D의 3.3배를 벗어나지 않는다는 결과를 도출할 수 있었다.링 목적으로 사용될 수 있다. 본 연구에서 개발한 영상수위계는 한강홍수통제소 관할의 전류, 청담대교 등 4개소 낙동강 홍수통제소 2개소, 지자체 등에 적용되었으며, 적용 결과 비교적 안정적이면서 정확하게 수위를 측정하는 것으로 나타났다. 한편 기존 CCD 카메라 이외에 CCTV를 이용한 영상수위계를 개발하여 영상의 화질 개선뿐 아니라 하천화상 감시 기능을 강화하였다.소류의 섭취율은 높았다. 집단간의 상관도를 보면 교육별로 김치, 장아찌, 콩이 각각 p>0.5 수준에서 유의한 차가 없었고, 나머지는 유의한 차가 있었다. 연령별로는 멸치가 유의한 차가 없었고(p>0.5), 수입별로는 콩이 유의한 차가 없었다(p>0.5). 4. 영양지식(營養知識) 검토 가정생활(家庭生活)에 필요(必要)한 일반적(一般的)인 영양지식(營養知識)은 대체적으로 낮은 편이었다. 어린이 영양, 편식의 해로움, 비만증의 해로움, 임신부 그리고 수유부 영양에 대하여는 일반적으로 알고 있다고 하였으며, 그다음으로 이유기 영양, 어린이 발육에 필요한 식품, 식품과 영양소와의 관계, 우유의 성분, 노인영양에 대하여 잘 알고 있는 비율이 낮았으며, 인체의 영양소, 식단작성여부, 간식의 이론, 식품감별법에 대하여는 가장 낮은 비율을 나타냈다. 각 영양지식은 교육정도가 높을수록 영양지식이 높았고, 교육별 집단간의 유의한 차가 나타났다. (0.001

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.22 no.4
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• pp.253-261
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• 2011

Objectives : This study aimed to investigate the efficacy and safety of Metadate CD (MCD) when given to Korean children and adolescents with attention-deficit hyperactivity disorder (ADHD). We also explored the effects of the drug on diverse neuro-cognitive functions. Methods : Ninety-one subjects with ADHD (mean age 8.6${\pm}$2.2 years) were recruited at 6 outpatient clinics in Seoul, Korea. We used the ADHD Rating Scale (ARS), Clinical Global Impression (CGI), and comprehensive attention test (CAT) to measure the drug's effects. Results : After 0.92${\pm}$0.32mg/kg/day of MCD were administered for 57.4${\pm}$7.6 days, there was a 48.5% reduction in the mean total ARS scores (p<.001). Fifty-seven subjects (64.8%) showed either much improved or very much improved outcomes on the CGI-Improvement scale. The CGI-Severity scale also decreased from an average of 4.7 to an average of 2.9 (p<.001). Errors and response time standard deviations of the CAT, sustained attention test-to-response tasks, the flanker test, and divided attention test scores decreased after treatment (p<.05). The forward memory span of the spatial working memory test scores increased (p<.05). Thirty-five patients (39.8%) experienced side effects, of which the most common were headache (14.8%), nausea (12.5%), and anorexia (9.1%). Conclusion : This open-label study suggests that MCD is effective and safe in improving the symptoms and neurocognitive functions of Korean children and adolescents with ADHD.