• Journal of Chest Surgery
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• v.49 no.5
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• pp.350-355
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• 2016

Background: Mitral stenosis (MS) remains one of the important heart diseases. There are many factors that influence the clinical outcomes, and little is known about how left ventricular (LV) dysfunction clinically affects the prognosis of the patient with MS after mitral valve replacement (MVR). We reviewed our clinical experiences of MVR in patients with MS who had LV dysfunction. Methods: Between January 1991 and January 2013, 110 patients with MS who underwent MVR were analyzed and divided into two groups according to ejection fraction (EF). Group 1 ($EF{\leq}45%$) included 13 patients and group 2 (EF>45%) included 97 patients. Results: Thromboembolism occurred in 8 patients after MVR (group 1: n=3, 23.1%; group 2: n=5, 5.2%) and its incidence was significantly higher in group 1 than in group 2 (p=0.014). There were 3 deaths each in groups 1 and 2 during follow-up. The overall rate of cardiac-related death in group 1 was significantly higher than in group 2 (group 1: n=3, 23.1%; group 2: n=3, 3.1%; p=0.007). The cumulative survival rate at 1 and 15 years was 83.9% and 69.9% in group 1 and 97.9% and 96.3% in group 2 (p=0.004). The Cox regression analysis revealed that survival was significantly associated with postoperative stroke (p=0.011, odds ratio=10.304). Conclusion: This study identified postoperative stroke as an adverse prognostic factor in patients with MS after MVR, and a s more prevalent in patients with LV dysfunction. Postoperative stroke should be reduced to improve clinical outcomes for patients. Preventive care should be made in multiple ways, such as management of LV dysfunction, atrial fibrillation, and anticoagulation.

• Fire Science and Engineering
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• v.20 no.4 s.64
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• pp.77-90
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• 2006

This is for Criminal Law problem that can be happened during the rescue working of 119 rescue member. There are mainly 3sections can be Criminal Law Problem. At first, denying a rescue request. Second, thing that do not transfer patient or people need someone's help by their refusal. Third, emergency medical management. It can be criminal act if somebody do the 3sections thing under Law about emergency medical treatment. It also can be homicide under Criminal Law or accidental homicide, a charge of injuring a person if people need rescue die or become worse through the work. Rescuers are responsible for a criminal case by their carelessness and fault. A plan has to remain to protect them when they do violence to the life and health of a people inevitably. This paper examines the plan can protect them through the analysis and application of related Law about rescuer's work which can be Criminal Law Problem, presents rational establish plan of Rescuer Protect Law to make them their job well as a rescuer.

• Journal of Korean Clinical Nursing Research
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• v.24 no.2
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• pp.178-187
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• 2018

Purpose: The purpose of this study was to explore the relationships among workplace bullying, organizational commitment, and turnover intention of nurses. Methods: A cross-sectional study was conducted. Data were collected using a structured questionnaire from nurses at five public hospitals (N=190). Results: The experience of bullying was 31.29 points (range 16-64) on average: Work-related bullying was the highest, followed by verbal/non verbal bullying and external threats. The consequences of bullying were 30.54 points (range 13-52) on average: The physical/psychological withdrawal was the highest, followed by increasing distrust and the poor quality of patient care. The experiences of bullying had positive correlations with the consequences of bullying (r=.55, p<.001) and the turnover intention (r=.27, p<.001), and had a negative correlation with organizational commitment (r=-.28, p<.001). The consequences of bullying had a positive correlation with the turnover intention (r=.52, p<.001), and had a negative correlation with organizational commitment (r=-.49, p<.001). Organizational commitment showed a negative correlation with the turnover intention (r=.63, p<.001). Conclusion: The findings of this study suggests the needs of a regular monitoring system and organizational management for workplace bullying, which helps nurses to commit to their organization and to be retained in a workplace.

• Journal of Korean Clinical Nursing Research
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• v.25 no.3
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• pp.237-250
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• 2019

Purpose: The aim of this study was to investigate the satisfaction of newly graduated nurses with educational programs and their experiences in role transition. Methods: Data were collected from November 1 to December 15, 2018 and 483 new graduate nurses working at 15 tertiary hospitals and 10 general hospitals participated. For data collection, self-report questionnaires including the Casey-Fink Graduate Nurse Experience Survey tool and satisfaction with education were used. Data were analyzed using descriptive statistics, t-test, and one-way analysis of variance. Results: Satisfaction with education ranged from 3.09 to 3.27, and satisfaction with preceptors was 3.45(maximum 4). The skill that new nurses ranked as most difficult during the first 3 months was charting/documentation, and throughout a whole year, the top 4 difficult skills were cardiopulmonary resuscitation/emergency response, ventilator care, end-of-life care, and prioritization/time management. In comfort/confidence, new graduates felt most comfortable with support and least comfortable with patient safety. More than 50 percent of new graduates experienced stress during role transition, and the most frequently experienced stressors were related to job performance and personal life. Levels of satisfaction with education and comfort/confidence differed according to the hospital type and number of preceptors for new nurses. Conclusion: In order to facilitate the transition of new graduate nurses to professional nurse, an extended period of education, systematic and standardized transition programs, and continuous support during the first year of practice are required.

• Archives of Hand and Microsurgery
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• v.23 no.4
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• pp.296-300
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• 2018

Penile shaft reconstruction requires adequate soft tissue characteristics as well as constant vascular pedicles when considering a perforator flap. The free flap technique using various donor sites and regional conventional and perforator flaps have been utilized for penile shaft reconstruction. Still, the free flap techniques include challenging surgical procedures in addition to postoperative management. The regional flap can be applied to limited defects due to the size and shape. We performed the bilateral superficial external pudendal artery (SEPA) perforator flaps in order to reconstruct a circumferential penile shaft defect. The circumferential wound has noted necrotic tissue involving superficial (Dartos) fascia. We underwent debridement, preserving deep (Buck's) fascia and corpus spongiosum. Thereafter, the soft tissue defect was covered with bilateral SEPA perforator flaps. The patient has been observed for 27 months, showing penile resilience without deformity or wound-related problems.

• Acute and Critical Care
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• v.33 no.4
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• pp.252-259
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• 2018

Background: The aim of this study was to investigate the effects of using a systematic approach to tracheostomy care by a clinical nurse specialist and surgical intensivists for patients with a tracheostomy who were transferred from the surgical intensive care unit (SICU) to the general ward. Methods: In this retrospective study, subjects were limited to SICU patients with a tracheostomy who were transferred to the general ward. The study period was divided into a preintervention period (January 1, 2007 to December 31, 2010) and a postintervention period (January 1, 2011 to December 31, 2014), and electronic medical records were used to analyze and compare patient characteristics, clinical outcomes, and readmission to the SICU. Results: The analysis included 44 patients in the preintervention group and 96 patients in the postintervention group. Decannulation time ($26.7{\pm}25.1$ vs. $12.1{\pm}16.0days$, P=0.003), length of stay in the general ward ($70.6{\pm}89.1$ vs. $40.5{\pm}42.2days$, P=0.008), length of total hospital stay ($107.5{\pm}95.6$ vs. $74.7{\pm}51.2days$, P=0.009), and readmission rate of SICU decreased due to T-cannula occlusion (58.8% vs. 5.9%, P=0.010). Conclusions: Using a systematic approach to tracheostomy care in the general ward led to reduction in decannulation time through professional management, which resulted in a shorter hospital stay. It also lowered SICU readmission by solving problems related to direct T-cannula.

• International Journal of Clinical Preventive Dentistry
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• v.14 no.4
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• pp.264-270
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• 2018

Objective: This study performed a quantitative analysis using the real-time polymerase chain reaction technique to examine the oral microbial prevalence in adults and intended to examine the correlations between risk factors of periodontal disease and oral bacteria and correlation between oral test scores and oral microorganisms. Methods: We examined papillary marginal attached (PMA) index, modified patient hygiene performance (M-PHP) index, probing depth (PD), modified gingival index, and oral bacteria counts and surveyed 117, 20 years or older adult males and females who visited dental clinics in the Daejeon region to analyze the prevalence and oral health. Results: The prevalence was 100% for Fusobacterium nucleatum, meaning it was observed in all examined subject, 85.5% for Parvimonas micra, 76.1% for Prevotella intermedia, and 72.6% for Tannerella forsythia. The averages of P. gingivalis and T. forsythia increased as the examined subjects were older, and there was a statistically significant difference between T. forsythia and E. nodatum in relation to medical history, between P. intermedia and P. micra in relation to gender, and between P. intermedia and E. corrodens in relation to smoking (p<0.05). For a correlation between the oral test scores and oral microorganisms, P. gingivalis and F. nucleatum was highly correlated with PD (correlation coefficient of 0.51 and 0.41) (p<0.01) while P. gingivalis, P. micra, C. rectus, and E. nodatum were significantly correlated with M-PHP index, gingival index, PD, and PMA index (p<0.01, p<0.05). Conclusion: For oral health management of adults, the age, systemic disease, and smoking are closely related to oral bacteria, and P. gingivalis, T. forsythia, F. nucleatum, P. intermedia, P. micra, C. rectus, E. corrodens, and E. nodatum are considered to be the oral microorganisms that indicate periodontal health.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.24 no.1
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• pp.100-108
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• 2021

Purpose: Percutaneous endoscopic gastrostomy (PEG) tube placements are commonly performed pediatric endoscopic procedures. Because of underlying disease, these patients are at increased risk for airway-related complications. This study compares patient characteristics and complications following initial PEG insertion with general endotracheal anesthesia (GETA) vs. anesthesia-directed deep sedation with a natural airway (ADDS). Methods: All patients 6 months to 18 years undergoing initial PEG insertion within the endoscopy suite were considered for inclusion in this retrospective cohort study. Selection of GETA vs. ADDS was made by the anesthesia attending after discussion with the gastroenterologist. Results: This study included 168 patients (GETA n=38, ADDS n=130). Cohorts had similar characteristics with respect to sex, race, and weight. Compared to ADDS, GETA patients were younger (1.5 years vs. 2.9 years, p=0.04), had higher rates of severe American Society of Anesthesiologists (ASA) disease severity scores (ASA 4-5) (21% vs. 3%, p<0.001), and higher rates of cardiac comorbidities (39.5% vs. 18.5%, p=0.02). Significant associations were not observed between GETA/ADDS status and airway support, 30-day readmission, fever, or pain medication in unadjusted or adjusted models. GETA patients had significantly increased length of stay (eβ=1.55, 95% confidence interval [CI]=1.11-2.18) after adjusting for ASA class, room time, anesthesia time, fever, and cardiac diagnosis. GETA patients also had increased room time (eβ=1.20, 95% CI=1.08-1.33) and anesthesia time (eβ=1.50, 95% CI=1.30-1.74) in adjusted models. Conclusion: Study results indicate that younger and higher risk patients are more likely to undergo GETA. Children selected for GETA experienced longer room times, anesthesia times, and hospital length of stay.

• Journal of dental hygiene science
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• v.20 no.4
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• pp.187-199
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• 2020

Background: Korean dental hygienists perform various tasks under the supervision of dentists in addition to the tasks listed in the law. Many meaningful studies have been conducted to determine the actual tasks of dental hygienists, but these studies did not show common results due to the differences in research methods or designs. Hence, this study aimed to review the reported data on the tasks of dental hygienists in Korea and to clarify them based on a systematic literature review. Methods: For the literature search, the COre, Standard, and Ideal model presented by the National Library of Medicine was referenced. Seven databases were searched for literatures published in Korea, including PubMed, and Google Scholar. Of the 352 studies found using key words, titles, and abstracts, 46 were finally extracted based on the first and second exclusion criteria. After confirming the tasks of Korean dental hygienists in 46 literatures, 136 tasks were listed and calculated as appearance rate in the literature. Results: The most common tasks in 46 studies were fluoride application (67.2%), radiography (65.4%), scaling (65.4%), sealant (60.7%), patient management and counseling (56.7%), tooth-brushing education (52.2%), impression taking with alginate (50.1%), and making temporary crowns (47.9%). The most mentioned tasks of dental hygienists in public health centers were fluoride application (100%), sealant (100%), oral health education (71.4%), public oral health program evaluation (71.4%), school fluoride mouth-rinsing program (71.4%), water fluoridation (57.1%), tooth-brushing education (57.1%), school oral health programs (57.1%), and public elderly oral health programs (57.1%). Conclusion: This study showed that Korean dental hygienists had 136 tasks by reviewing 46 related studies and that the main job of Korean dental hygienists was oral disease prevention including scaling, sealant, and fluoride application.

• Journal of dental hygiene science
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• v.21 no.1
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• pp.1-7
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• 2021

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is transmitted primarily through droplets, and dental practitioners are at risk of occupational exposure to SARS-CoV-2 infection owing to direct contact with the patient's mouth, aerosols from dental procedures, and saliva. Wearing a mask is believed to be the best method of protection against infection, and a systematic literature review was conducted on whether the dental masks used in dentistry are effective in preventing Coronavirus Infectious Disease-19 (COVID-19). Methods: We used PubMed, Google Scholar, DBpia, NDSL, and KISS databases for this study. Of the 917 documents narrowed down by the search terms "Coronavirus, COVID-19, and dental," 83 documents were collected and studied. Ultimately, 42 of these papers were selected for analysis after considering duplication from the flow chart of the literature selection process. Results: While dental masks are often used when treating patients with unknown COVID-19 status, the Ministry of Food and Drug Safety stated that the use of dental masks is insufficient in preventing cross-transmission of COVID-19; instead, it was recommended that N95 masks, which correspond to KF94 masks, should be worn daily. On the other hand, wearing a dental mask and following precautions such as hand hygiene may not pose a significantly higher risk of infection than wearing an N95 mask when treating COVID-19 patients. Conclusion: There is an ongoing discussion regarding the use of dental masks when treating dental patients, and many argue that different types of masks should be selected according to the degree of infection and the individual's respiratory condition. By considering the safety and efficacy of dental masks in preventing infection, improvements can be made in the management of COVID-19 and dental-related infections.