• Archives of Craniofacial Surgery
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• v.23 no.6
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• pp.256-261
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• 2022

Background: Treating panfacial fractures (PFFs) can be extremely difficult even for experienced surgeons. Although several authors have attempted to systemize the surgical approach, performing surgery by applying a unidirectional sequence is much more difficult in practice. The purpose of this study was to review the literature on PFF surgery sequence and to understand how different surgical specialists-plastic reconstructive surgery (PRS) and oral maxillofacial surgery (OMS)-chose sequence and review PFFs fixation sequence in clinical cases. Methods: The PubMed and Google Scholar databases were scoured for publications published up until May 2020. Data extracted from the studies using standard templates included fracture part, fixation sequence, originating specialist, and the countries. Bibliographic details like author and year of publication were also extracted. Also, we reviewed the data for PFFs patients in the Trauma Registry System of Dankook University Hospital from 2011 to 2021. Results: In total, 240 articles were identified. This study comprised 22 studies after screening and full-text analysis. Sixteen studies (12 OMS specialists and 4 PRS specialists) used a "bottom-top" approach, whereas three studies (1 OMS specialist and 2 PRS specialists) used a "top-bottom" method. However, three studies (only OMS specialists) reported on both sequences. In our hospital, there were a total of 124 patients with PFF who were treated during 2011 to 2021; 64 (51.6%) were in upper-middle parts, 52 (41.9%) were in mid-lower parts, and eight (6.5%) were in three parts. Conclusion: Bottom-top sequencing was mainly used in OMS specialists, and top-bottom sequencing was used at a similar rate by two specialists in literature review. In our experience, however, it was hard to consistently implement unidirectional sequence suggested by a literature review. We realigned the reliable and stable buttresses first with tailoring individually for each patient, rather than proceeding in the unidirectional sequence like bottom-top or top-bottom.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.48 no.6
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• pp.331-341
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• 2022

This systematic review evaluates current evidence regarding the feasibility of using needleless jet injection instead of a conventional local anesthetic needle. EBSCO, ProQuest, PubMed, and Scopus databases were used to identify relevant literature published in English from 2005 to 2020. Ten studies were selected. Five of them were randomized clinical trials, 3 case-control studies, and 2 equivalence trials. Using the Critical Appraisal Skills Program checklist, 6 studies scored between 67% and 100%, and 4 studies scored between 34% and 66%. According to Jadad's scale, 2 studies were considered strong, and 8 studies were considered moderate in quality. The results of the 10 studies showed differences in patient preference for needleless jet injection. Needleless injection technique has been found to be particularly useful in uncooperative patients with anxiety and needle phobia. Needleless jet injection is not technique sensitive. However, with needleless jet anesthesia, most treatments require additional anesthesia. Conventional needle anesthesia is less costly, has a longer duration of action, and has better pain control during dental extraction. Needleless jet anesthesia has been shown to be moderately accepted by patients with a fear of needles, has a faster onset of action, and is an efficient alternative to conventional infiltration anesthesia technique.

• Journal of Korean Foot and Ankle Society
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• v.26 no.1
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• pp.16-21
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• 2022

When an ankle lateral malleolar fracture is accompanied by a deltoid ligament rupture without a medial malleolar fracture, such an injury is called a bimalleolar equivalent fracture. This means that even if there is no bony injury on the medial side, there may be functional instability of the ankle joint due to damage to the deltoid ligament. Manual or gravity external rotational stress radiography is used to differentiate an ankle bimalleolar equivalent fracture from an isolated lateral malleolar fracture. If the medial joint gap is widened on the stress radiography, the deltoid ligament injury can be diagnosed, and surgical treatment for fibula fractures is recommended. After open reduction of the fibula fracture (with syndesmotic fixation if needed), a decision on the repair of the deltoid ligament is taken depending on the surgeons' preference and intraoperative findings. The deltoid ligament repair is performed by inserting a suture anchor (or anchors) in the medial malleolus and fixing the deep and superficial deltoid ligaments to the medial malleolus. The only randomized study to evaluate the utility of deltoid ligament sutures in ankle fractures did not support the deltoid ligament suture, but the study itself had many limitations. An appropriately powered, randomized, controlled trial of the deltoid ligament repair with both patient-reported outcome and radiographic outcome evaluation is needed in the future.

• Journal of the Korean Burn Society
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• v.16 no.2
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• pp.99-103
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• 2013

Purpose: The biggest problem of wound healing is a possible occurrence of lesion. Especially, in the case of patients who have a skin injury around exposed body parts, if their treatment period drag on for long time, they can suffer from aftereffects and the costs can be passed on to a society. Therefore, in this research, we investigated the need to develop the effective medicine and appliances for the patients by examining which therapy methods are being applying to the skin damage and what is the advantage and limit by evaluating the patient's satisfaction level. Methods: We carried out an online and offline survey targeting medical teams in order to analyze device for wound care. A total of 125 medical teams applied to the research, and investigate the level of customer satisfaction. Results: The moist dressings are the most used method for wound healing. When it comes to the level of customer satisfaction, biological dressing product also has a high satisfaction level. However its high cost tends to limit the use. Conclusion: This research reached a conclusion that it is need to develop a low cost and high efficiency wound care product considering the fact that its high cost and low efficiency induced economic problems. Generally, it is needed to develop a product for skin regeneration based on biological technologies, not a product just for damage cure.

• The Journal of the Convergence on Culture Technology
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• v.9 no.5
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• pp.237-244
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• 2023

The aim of this study was to explore the satisfaction and needs of 119 paramedics with regard to continuing education and to develop and implement a continuing education program that can enhance their competence in accordance with the purpose of continuing education. The differences in satisfaction with continuing education according to general characteristics were significantly different depending on age, qualification, and clinical experience, and in terms of continuing education topic needs, 'Advanced Trauma Life Support' was the highest need among all groups, and additional desired continuing education topics were the management of mentally ill patients and various field case-based education, indicating a high preference for practical topics that are helpful in emergency patient care work. Therefore, it is believed that efforts should be made to improve the operation of continuing education from various angles, taking into account the general characteristics of continuing education recipients, and improving the quality of continuing education by reflecting the needs of continuing education recipients and selecting practical topics for continuing education.

• Journal of agricultural medicine and community health
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• v.49 no.3
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• pp.216-234
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• 2024

Background: Hapcheon-gun, Gyeongsangnam-do, is designated as an emergency medical vulnerable area, facing significant challenges in transporting and treating emergency patients. A detailed analysis of the regional emergency medical system is required to identify effective solutions. Methods: This study employed a mixed-methods approach, combining quantitative data from the National Emergency Medical Information System and emergency activity logs with qualitative data from focus group interviews involving 24 stakeholders, including medical staff, paramedics, civil servants, and local residents. Results: Quantitative findings indicated an aging population in Hapcheon-gun, with a growing number of elderly emergency room users. Despite the utilization of local emergency medical institutions, a lack of trust and preference for urban hospitals led even patients with mild conditions to seek care at higher-level facilities. Following the COVID-19 pandemic, transport distances and times for patients using 119 emergency services increased. Qualitative analysis identified several issues: limited capacity of local institutions, challenges in patient transport due to misaligned emergency medical zones, an increase in severely ill patients, and the absence of a coordinated emergency medical consultative body. Recommendations include strengthening local institutions through government support, realignment of emergency zones, legal reforms, the establishment of a continuous consultative body, and enhancing the capacity of medical staff, paramedics, and residents. Conclusion: Improving the emergency medical system in Hapcheon-gun will require targeted efforts in institutional strengthening, legal and administrative support, and capacity-building initiatives.

• Journal of Yeungnam Medical Science
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• v.13 no.2
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• pp.324-346
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• 1996

A survey was conducted to study attitudes of physician, nurse and patient towards physician's and nurse's uniform, from March 1 to March 31, 1996. The study population was 130 physicians and 147 nurses engaged in Yeungnam University Medical Center and 211 inpatients of Yeungnam University Medical Center. A questionnaire method was used to collect data. The following are summaries of findings: In the respect of physician's uniform, both physicians and nurses preferred other type of gown to the traditional coat-typed one and especially, nurses preferred more than physicians. Patients showed no difference in the preference of the traditional one and other form of gown as a whole but those who had higher educational level preferred other form of gown(p<0.01). Regarding the color of physician's gown, 73.6% of physicians and nurses liked white color, and 86.3% of the patients also liked the white color. Male physicians preferred the white color more than female physicians and nurses(p<0.01). Patients showed no meaningful difference for the color. The opinion of insisting on wearing a necktie when physician see patients was given by male physicians, physicians of fifty or more, physicians working in the field of medicine and professors, which showed significantly higher percentage than other groups(p<0.01). In the group of patiens， the same opinion was given by female, the group of sixty or more, the group of elementary school graduates or less and people residing in other cities and counties more than male, the group of other ages, the group of having higher educational level and people of Taegu city(p<0.01). It tended to agree wearing casual wear of physician during the working time of weekend and holiday as a whole. Younger physicians showed significantly higher preference for it(p<0.05). Regarding the nurse's uniform, both physicians and nurses preferred trousers, and 96% of the nurses did. Especially, nurses who were forty years old or more and who served at outpatient department and administrative and aid parts expressed 100 percent partiality to trousers. For the patients, those who had lower educational level preferred skirt and those who had higher educational level preferred trousers. As to the color of nurse's gown, 46.7% of the physicians and nurses liked white color. The physicians preferred white and nurses preferred other color(p<0.01). Of the patients, 79.1% liked white color. Regarding the wearing cap, 95.9% of the nurses replied it didn't have to wear the cap. The nurses who were fifty or more and who served at outpatient department and special parts gave whole answers of not having to wear the cap. On the other hand, 77.7% of the patients answered nurse had to wear the cap. From the above findings, it would be advisable to give a change to the forms and colors of the gowns to match with the trend and sense of the time instead of insisting on the traditional typical ones.

• Journal of Nutrition and Health
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• v.40 no.4
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• pp.334-346
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• 2007

The present study examined the reproductive factors and food intake pattern which influence on the breast cancer risk in Daegu${\cdot}$Gyungbuk area. The case subjects were 103 patients newly diagnosed as breast cancer at Kyungpook National University Hospital. The control subjects were 159 healthy women selected by frequency matching of age and menopausal status in the same community. The survey was conducted by individual interviews using questionnaires which include general and reproductive characteristics, dietary habits, and food frequency. The odds ratios were calculated by using unconditional logistic regression after adjusting for confounding variables. The mean age of the subjects was 50 yrs, and mean body mass index was significantly high in the patient group than in the control. The patient group had a significantly higher familial history of breast cancer and a significantly shorter breast-feeding period compared to the control group. It has been found no significant relationship between extrinsic hormone use such as oral contraceptives or estrogen replacement therapy and breast cancer risk. In regard of food habits, a high preference for the cooking method of steaming rather than frying, panbroiling or roasting was significantly associated with lower relative risk of breast cancer. The higher intake frequencies of fruits for all subjects, and seaweeds only for postmenopausal subjects were related with a significantly lower relative risk of breast cancer. The results of the study suggest that the possible risk factors for the breast cancer occurrence include high BMI, family history, less breast feeding experience, preference for the cooking method of frying, and less consumption of fruits and seaweeds. This study provides an useful data for nutrition education to prevent breast cancer for the residents in Daegu${\cdot}$Gyungbuk area.

• Journal of Chest Surgery
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• v.32 no.9
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• pp.806-812
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• 1999

Background: Selection of reconstruction route in esophageal cancer surgery is based on the patient's status, characteristics of tumor, surgeon's preference and experience. Of the various routes, it has been documented that subcutaneous or substernal route may prolong operation time and may be vulnerable to postoperative respiratory complications. This study was designed to evaluate whether the selection of reconstruction route affects the surgical outcomes. Material and Method: Of 131 patients who have undergone resection and reconstruction for esophageal cancer, posterior mediastinal route(Group I, n=34), substernal route (Group II, n=31), and subcutaneous route(Group III, n=21) were retrospectively reviewed in 86 patients. Results of early operations and morbidities were compared between the groups. Result: There was a male prevalence(79 of males vs. 7 of females). There were 81 squamous cell cancers and 5 adenocarcinomas. There were no differences between groups in weight, height, age, cancer staging and location, and in the preoperative anesthetic risk evaluation and pulmonary function test(p=NS). Postoperative mechanical ventilation time was longer in Group I(20.6 hours) than in Group II(7.8 hours) or III(3.4 hours)(p=0.005). Duration of stay in the intensive care unit was prolonged in Group III(6.4 days) compared to Group I (3.9 days) or II(3.1 days)(p=0.043). No differences were noted in the duration of hospital stay between the groups(p=NS). Blood transfusion was needed in 30 out of 34 patients in Group I compared to 14/31 in Group II or 15/21 in Group III(p=0.001). The mean amount of transfusion for each patient was also higher in Group I(3,833 mL) than in Group II(1535 mL) or Group III(1419 mL)(p=0.04), but there was no difference in the inreoperation due to bleeding. Ea ly mortality rate was substantially higher in Group I(17.6%) but the differences between the groups were insignificant(p=NS). Although sepsis was a more prevalent cause of death in Group I, it was not related to anastomotic leak. Other morbidities did not differ between the groups(p=NS). Conclusion: In above results show that the reconstruction route does not affect the outcome of esophageal cancer surgery. We believe that the selection of reconstruction route can be based on the surgeon's preference and experience.

• Journal of Intelligence and Information Systems
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• v.16 no.2
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• pp.73-94
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• 2010

The attending system is a medical system that allows doctors in clinics to use the extra equipment in hospitals-beds, laboratory, operating room, etc-for their patient's care under a contract between the doctors and hospitals. Therefore, the system is very beneficial in terms of the efficiency of the usage of medical resources. However, it is necessary to develop a strong support system to strengthen its weaknesses and supplement its merits. If doctors use hospital beds under the attending system of hospitals, they would be able to check a patient's condition often and provide them with nursing care services. However, the current attending system lacks delivery and assistance support. Thus, for the successful performance of the attending system, a networking system should be developed to facilitate communication between the doctors and nurses. In particular, the nursing records in the attending system could help doctors monitor the patient's condition and provision of nursing care services. A nursing record is the formal documentation associated with nursing care. It is merely a data repository that helps nurses to track their activities; nursing records thus represent a resource of primary information that can be reused. In order to maximize their usefulness, nursing records have been introduced as part of computerized patient records. However, nursing records are internal data that are not disclosed by hospitals. Moreover, the lack of standardization of the record list makes it difficult to share nursing records. Under the attending system, nurses would want to minimize the amount of effort they have to put in for the maintenance of additional records. Hence, they would try to maintain the current level of nursing records in the form of record lists and record attributes, while doctors would require more detailed and real-time information about their patients in order to monitor their condition. Therefore, this study developed a system for assisting in the maintenance and sharing of the nursing records under the attending system. In contrast to previous research on the functionality of computer-based nursing records, we have emphasized the practical usefulness of nursing records from the viewpoint of the actual implementation of the attending system. We suggested that nurses could design a nursing record dictionary for their convenience, and that doctors and nurses could confirm the definitions that they looked up in the dictionary through negotiations with intelligent agents. Such an agent-based system could facilitate networking among medical institutes. Multi-agent systems are a widely accepted paradigm for the distribution and sharing of computation workloads in the scientific community. Agent-based systems have been developed with differences in functional cooperation, coordination, and negotiation. To increase such communication, a framework for a multi-agent based system is proposed in this study. The agent-based approach is useful for developing a system that promotes trade-offs between transactions involving multiple attributes. A brief summary of our contributions follows. First, we propose an efficient and accurate utility representation and acquisition mechanism based on a preference scale while minimizing user interactions with the agent. Trade-offs between various transaction attributes can also be easily computed. Second, by providing a multi-attribute negotiation framework based on the attribute utility evaluation mechanism, we allow both the doctors in charge and nurses to negotiate over various transaction attributes in the nursing record lists that are defined by the latter. Third, we have designed the architecture of the nursing record management server and a system of agents that provides support to the doctors and nurses with regard to the framework and mechanisms proposed above. A formal protocol has also been developed to create and control the communication required for negotiations. We verified the realization of the system by developing a web-based prototype. The system was implemented using ASP and IIS5.1.