• Korean Journal of Head & Neck Oncology
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• v.34 no.1
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• pp.1-7
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• 2018

Papillary thyroid carcinoma has a good prognosis, but the frequency of locoregional lymph node metastasis is high and is known to occur stepwise fashion. Prophylactic central node dissection in papillary thyroid carcinoma is widely performed from the past. But, the pros and cons of the prophylactic central node dissection has been ongoing for a long time. In the American Thyroid Association management guideline for thyroid nodules and differentiated thyroid cancer, which is the most widely used, recommendations about prophylactic central node dissection has been changed in past ten years. In recent systematic review and meta-analysis, prophylactic central node dissection increases the rate of transient hypocalcemia and recurrent laryngeal nerve injury, but there is no difference in the frequency of permanent hypocalcemia or recurrent laryngeal nerve injury. Prophylactic central node dissection has not been shown to improve patient survival, but recurrence has been reported to decrease. According to a questionnaire survey of the members of Korean Scociety of Thyroid-Head and Neck Surgery, Korean doctors tend to perform the prophylactic central node dissection more aggressively than other countries. The reason for this is that Korea has a large number of thyroid surgeries and therefore surgeons are more experienced than other countries.

• The Korean Journal of Pain
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• v.27 no.3
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• pp.200-209
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• 2014

Background: Spinal opioid administration is an excellent option to separate the desirable analgesic effects of opioids from their expected dose-limiting side effects to improve postoperative analgesia. Therefore, physicians must better identify either specific opioids or adequate doses and routes of administration that result in a mainly spinal site of action rather than a cerebral analgesic one. Methods: The purpose of this topical review is to describe current available clinical evidence to determine what opioids reach high enough concentrations to produce spinally selective analgesia when given by epidural or intrathecal routes and also to make recommendations regarding their rational and safety use for the best management of postoperative pain. To this end, a search of Medline/Embase was conducted to identify all articles published up to December 2013 on this topic. Results: Recent advances in spinal opioid bioavailability, based on both animals and humans trials support the theory that spinal opioid bioavailability is inversely proportional to the drug lipid solubility, which is higher in hydrophilic opioids like morphine, diamorphine and hydromorphone than lipophilic ones like alfentanil, fentanyl and sufentanil. Conclusions: Results obtained from meta-analyses of RTCs is considered to be the 'highest' level and support their use. However, it's a fact that meta-analyses based on studies about treatment of postoperative pain should explore clinical surgery heterogeneity to improve patient's outcome. This observation forces physicians to use of a specific procedure surgical-based practical guideline. A vigilance protocol is also needed to achieve a good postoperative analgesia in terms of efficacy and security.

• Journal of Community Nutrition
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• v.1 no.2
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• pp.133-139
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• 1999

The purpose of this survey was to investigate eating habits, life styles and nutritional care of diabetic outpatients and to provide basic data for developing individualized nutritional care and diabetic education programs. This survey was carried out by nutritional counseling with a questionnaire and checking medical record. Information about the general characteristics of the subjects, eating habits, health-related life styles and attitude and perception of subjects to diet therapy was gathered from 200 randomly-sampled diabetic outpatients at a University Hospital located in Inchon. All data were analyzed by Statistical Analysis System(SAS) software. The results are summarized as follows : Female subjects were 63.5% of total subjects and 65.5% of total subjects were 50 years or more. The average Body Mas Index(BMI) of male and female subjects were 23.06kg/㎡ and 25.02kg/㎡ respectively and 44% of all subjects wee obese. Among subjects, type II diabetic patients were 81.0% and 82.5% of subjects had suffered from diabetes for more than one year. Also 41% subjects had diabetic history in their family. More than half of the subjects had nutrition education concerning diabetes. Also 75.5% of them thought that nutrition education was effective. The most important guideline in diet therapy was to eat cooked rice with dietary fiber-rich grains. Therefore, it might be necessary to develop nutrition education program adjusted according to diabetic patient's needs and life styles, which may increase feasibility of self-care and implementation of management guidelines.

• Journal of Korean Academy of Nursing Administration
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• v.22 no.4
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• pp.384-395
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• 2016

Purpose: The purpose of this study was to investigate perceptions of adequacy and job performance of the nurse assistants' nursing job as evaluated by registered nurses and nurse assistants in geriatric hospitals, and by caregivers from the same hospitals. Methods: Participants included 62 registered nurses, 57 nurse assistants, and 64 patient caregivers who completed a measurement scale on the job of nurse assistants. Data collection was conducted from October to December, 2015. Data were analyzed using descriptive statistics and one-way ANOVA by IBM SPSS/WIN program version 21.0. Results: There were significant differences by items in perception of adequacy of nurse assistants' nursing job of among the three groups. There was also a significant difference in perception of the nurse assistants' job performance among the three groups. Conclusion: For nurse assistants in geriatric hospitals, the Ministry of Health and Welfare needs to develop an appropriate job practice guideline. In addition, there should be periodic courses of retraining and continuing education for nurse assistants.

• Journal of Korean Academy of Nursing
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• v.40 no.6
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• pp.892-902
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• 2010

Purpose: This study was done to identify participation by home healthcare nurses in clinical decision making and factors influencing clinical decision making. Methods: A descriptive survey was used to collect data from 68 home healthcare nurses in 22 hospital-based home healthcare services in Korea. To investigate participation, the researcher developed 3 scenarios through interviews with 5 home healthcare nurses. A self-report questionnaire composed of tools for characteristics, factors of clinical decision making, and participation was used. Results: Participation was relatively high, but significantly lower in the design phase (F=3.51, p=.032). Competency in clinical decision making (r=.45, p<.001), perception of the decision maker role (r=.47, p<.001), and perception of the utility of clinical practice guidelines (r=.25, p=.043) were significantly correlated with participation. Competency in clinical decision making (Odds ratio [OR]=41.79, p=.007) and perception of the decision maker role (OR=15.09, p=.007) were significant factors predicting participation in clinical decision making by home healthcare nurses. Conclusion: In order to encourage participation in clinical decision making, education programs should be provided to home healthcare nurses. Official clinical practice guidelines should be used to support home healthcare nurses’ participation in clinical decision making in cases where they can identify and solve the patient health problems.

• Korean Journal of Occupational Health Nursing
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• v.14 no.1
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• pp.44-55
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• 2005

Purpose: The purpose of this study was to describe the current status of work-related back pain among nurses in the U.S. Method: Literature review and website searching were conducted. Key words as 'nurse and back pain (or back injury)' were used in searching the Medline, NIOSHTIC-2and reference list of selected studies. Total studies were selected of which subjects were nurses working in the U.S., and published since 1970. Results: Though there was variation in the measurement among studies, the prevalence rate of back pain among nurses in the U.S. could be estimated about 50%. Risk factors were confirmed as the frequency of patient lifting, ward, nursing shortage, overtime, work shift, stress on physical demand, but age and work experiences showed the inconsistent relation. It has been well known that educational approach is not enough to prevent back pain. Intervention studies to apply the ergonomic approach using mechanical devices reported the effects, but the devices were less diverse than European countries or Canada. The study for lifting team was rare. Federal government developed only the guideline for nursing home that had no legal obligation. As a professional nursing organization, ANA has been trying to educate and advocate for "No lift policy" since 2003. Meanwhile, two trade unions of nurses made efforts to establish the law strengthening the responsibility of health care facilities. Conclusion: The research and policy development will be needed to prepare to rapid increase of back pain among Korean nurses.

• Annals of Clinical Neurophysiology
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• v.9 no.2
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• pp.59-62
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• 2007

Electroencephalogram (EEG) is an indispensable tool for diagnosis of epilepsy and is the only assisting barometer of complete remission of epilepsy, which means prolonged, persistent suppression of cortical excitement in epileptic focus in addition to the clinical control of epileptic seizure. The specific morphologies or distribution of epileptic form discharges give us good information for the classification of seizure or epilepsy and epileptic syndromes, which consists of "Pros." in terms of diagnostic approach. In contrast, the EEG as a tool for long-term follow up might be limited due to the various clinical situation of each patient, which consists of "Cons." in terms of the usefulness of EEG for clinical decision. "Cons." aspect of EEG, which clinicians are more frequently coped with than those of "Pros", is an obstacle of utilization of follow up EEG in clinical practice. This is an overview about controversies in usefulness of EEG and the detailed aspects of "Pros." and "Cons." of EEG for clinical decision will be discussed following two articles. We tried to make consensus for the usefulness of EEG especially in the situation of "Cons." with plausible guideline.

• The Journal of Korean Obstetrics and Gynecology
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• v.20 no.3
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• pp.238-245
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• 2007

Purpose: In postpartum period, women are very weak and liable to various diseases. So postpartum care is very important. But excessive heating and sweating cause postpartum diseases. Methods: The patient in this case, 37 years-old female was in Kyunghee University East-West neo medical center for 8days(27th/Oct/2006 - 3rd/Nov/2006). Her chief complains when she was admitted in the hospital were sweating, chilling, and mild dizziness. These symptoms were caused by excessive heating and sweating. We thought that her condition was deficiency of Qi. After giving her the therapies with herb medicine, acupuncture and moxibustion, her symptoms got almost disappeared and her condition got better. Results: After the oriental medical treatment, the clinical symptom of postpartum disease was improved. Conclusion: This case study shows that excessive heating and sweating cause postpartum diseases and the oriental medical therapy is effective in treating postpartum disease. And the guideline of postpartum care is needed.

• Journal of Acupuncture Research
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• v.36 no.4
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• pp.197-203
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• 2019

The purpose of this study was to investigate useful manual therapy techniques for peripheral facial nerve palsy and to propose guidelines to be applied for current manual therapy techniques. Several databases were searched to find manual therapies for facial palsy. These therapies included cervical, and temporomandibular joint chuna manual therapy, proprioceptive neuromuscular facilitation, neuromuscular re-education, facial exercise, and mime therapy. Both cervical, and temporomandibular joint chuna manual therapy release nerve compression, helping blood circulation and nerve conduction. Proprioceptive neuromuscular facilitation uses irradiation, bilateral activation, and eccentric facilitation to improve muscle power and symmetry. Neuromuscular re-education, as a retraining tool for facial movement patterns, enhances neuromuscular feedback. Facial exercise helps the patient continuously move and massage facial muscle themselves. Mime therapy aims to develop a conscious connection between the use of certain muscles and facial expressions. The use of facial chuna manual therapy for peripheral facial nerve palsy can stimulate the proprioceptive neuromuscular receptors in the face. Peripheral facial nerve palsy has 4 phases; progress phase, plateau phase, recovery phase, and sequelae phase. Each phase needs different treatments which include relaxation, assistance, resistance, origin-insertion extension, and nerve pathway expansion.

• Journal of East-West Nursing Research
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• v.28 no.2
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• pp.132-141
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• 2022

Purpose: This study aimed to investigate intensive care unit (ICU) nurses' actual and perceived glove uses for preventing healthcare associated infection. Methods: We observed nurses' donning glove by occasions and adherence to guideline for glove uses in four ICU in a single hospital. Total of 378 cases were observed from August 16 through October 6, 2020. Sixty one nurses of 66 nurses observed responded to a self-reported questionnaire about perceived glove use and knowledge of glove use. Data analysis was performed using descriptive statistics. Results: The number of observed episodes for glove use was 277. Although the highest numbers of occasions of wearing gloves was contact precaution, the compliance rate was 72.1%. The rates of donning gloves were low in the insertion and removal of peripheral venous catheters, blood glucose testing and blood sampling, which were at risk for exposure to blood. We observed misuse of wearing gloves even when they were not required. Results showed that the majority of non-compliance with glove use were a failure of performing hand hygiene before and after glove use and a failure of changing gloves between procedures on the same patient. The participant's knowledge of glove use was high. Conclusion: Based on the results, it is necessary to provide ICU nurses with education and reinforcement of proper glove uses for infection control.