• Archives of Plastic Surgery
• /
• 제45권3호
• /
• pp.271-274
• /
• 2018

The decision of which surgical approach to use for the treatment of a multifocal craniofacial abscess is still a controversial matter. A failure to control disease progress in the craniofacial region can potentially put the patient's life at risk. Therefore, understanding the various ways to approach the craniofacial region helps surgeons to obtain satisfactory results in such cases. In this report, we describe a patient who visited the emergency department with a large swelling in his right cheek. A blood test and computed tomography revealed odontogenic maxillary sinusitis. The patient developed sepsis due to a progressive multifocal abscess. An abscess was seen in the temporal muscle, infratemporal fossa, and interorbital region. To control this multifocal abscess, we used the facial dismasking flap (FDF) approach. After debridement using the FDF approach, we succeeded in obtaining sufficient drainage of the abscess, and the patient recovered from sepsis. The advantages of the FDF approach are that it provides a wide surgical field, extending from the parietal region to the mid-facial region, and that it leaves no aesthetically displeasing scars on the face. The FDF approach may be one of the best options to approach multifocal abscesses in the craniofacial region.

• Asian Pacific Journal of Cancer Prevention
• /
• 제14권11호
• /
• pp.6315-6319
• /
• 2013

To study the differentiated expression of the proto-oncogene Pokemon in nasopharyngeal carcinoma (NPC) cell lines and tissues, mRNA and protein expression levels of CNE1, CNE2, CNE3 and C666-1 were detected separately by reverse transcription polymerase chain reaction (RT-PCR), real-time PCR and Western-blotting. The immortalized nasopharyngeal epithelial cell line NP69 was used as a control. The Pokemon protein expression level in biopsy specimens from chronic rhinitis patients and undifferentiated non keratinizing NPC patients was determined by Western-blotting and arranged from high to low: C666-1>CNE1>CNE2> CNE3>NP69. The Pokemon mRNA expression level was also arranged from high to low: CNE1>CNE2>NP69>C666-1>CNE3. Pokemon expression of NP69 and C666-1 obviously varied from mRNA to protein. The Pokemon protein level of NPC biopsy specimens was obviously higher than in chronic rhinitis. The data suggest that high Pokemon protein expression is closely associated with undifferentiated non-keratinizing NPC and may provide useful information for NPC molecular target therapy.

• 간호행정학회지
• /
• 제16권2호
• /
• pp.143-151
• /
• 2010

Purpose: This study was conducted to define nurses' level of self-leadership, self-esteem, and organizational effectiveness, and to examine relationships among above variables. Methods: The subjects of this study were 313 nurses from two general hospitals located in Seoul Metropolitan area in Korea. The data was collected by self-reported instruments: Self-leadership scale, Self-esteem scale, Job satisfaction scale, Organizational commitment scale, and Turnover intention scale, Data was analyzed by descriptive statistics, Pearson correlation coefficient, and stepwise multiple reg res don u dng SPSS-PC program, Results: The average scores of variables were; self-leadership, 3,72/5,00 self-esteem, 3,76/5,00 Job satisfaction, 3,36/5.00 organizational commitment, 3.29/5.00 and turnover intentioncri 2.94/5,00, Self-leadership was dgnificantly correlated to self-esteem, job satisfaction, organizational commitment, and turnover intention. Self-leadership, job satisfaction, and turnover intention explained 52.3% of organizational commitment. Self-leadership and organizational commitment explained 43% of turnover intention. Conclusions: It is recommended to develop standardized self-leadership curriculum in the nursing school to build a foundation of self-leadership from undergraduate nursing students, Educational programs are needed that promote nurses' self-leadership as regular continuing education. Organizational effectiveness would be improved by providing programs to enhance nurses' self-esteem, educational motivation, and organizational commitment, which boost self-leadership.

• 임상간호연구
• /
• 제23권2호
• /
• pp.222-235
• /
• 2017

Purpose: The purpose of this study was to investigate the reality, status of clinical nurses' emotional labor and the relationship with physical discomfort, burnout, depression and social support. Methods: A thousand three hundred sixteen clinical nurses from 42 hospitals nationwide participated in this study. Questionnaires were developed for evaluating the reality and status of emotional labor of clinical nurses after interviewing focus groups and reviewing literatures. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficient. Results: Ninety eight percent of nurses had answered having emotional labor and they experienced 82 times per year, 9.6 times during last a month which means they experience it every other day. The one who provoke emotional labor were patients, guardians, physicians, supervisor, and colleagues in sequence. Eighty percent of nurses had intention to leave their jobs after experiencing emotional labor. They were doing more surface acting than deep acting of emotional labor. Conclusion: Clinical nurses in Korea experienced excessively high level of emotional labor and delayed responding to clients' requests due to lack of time for caring each patient was revealed as one of the main causes of emotional labor.

• 대한골대사학회지
• /
• 제25권4호
• /
• pp.267-274
• /
• 2018

Background: This prospective cohort study used nationwide claims data to investigate the incidence of fall and fragility fractures in association with urinary incontinence (UI) in the elderly, and to compare mortality after fragility fractures in elderly patients with or without incontinence. Methods: A total of 39,854 Korean adults (age, 66-80 years) who participated in health examinations between 2007 and 2012 and were followed up until 2015 were analyzed. Patient and comparison groups were classified according to the presence or absence of UI. The cumulative incidence of osteoporotic fragility fractures and falls in the 2 groups was assessed and compared. Hazard ratios for fragility fractures were calculated for the risk of UI in association with falls using a Cox proportional hazards model. Results: Of 39,854 elderly participants, 5,703 were classified in the UI group, while 34,151 were placed in the comparison group. Fall rates were significantly higher (20.8%) in the incontinence group than in the comparison group (4.7%) (P<0.001). Women in the incontinence group (13.9%) showed a significantly higher incidence of all types of fragility fractures than those in the comparison group (11.8%) (P=0.005). After adjustment for confounders, UI was not a significant risk factor for fragility fractures in men (P=0.878) or women (P=0.324). Conclusions: This study demonstrated that elderly women with UI have a significantly higher incidence of osteoporotic fragility fractures. In addition, elderly women are at higher risk for falls.

• 가정∙방문간호학회지
• /
• 제26권1호
• /
• pp.5-18
• /
• 2019

Purpose: Frailty is associated with an increased risk of adverse health outcomes. We aimed to review the relationships between frailty and health outcomes in community-dwelling Korean elderly individuals. Methods: Whittemore and Knafls' framework for conducting integrative reviews was used. PubMed, Cumulative Index to Nursing and Allied Health Literature, and six Korean databases were searched. For analysis, the study included articles written in English and Korean published between January 1960 and June 2018. Of the total 1,488 studies found in the databases, we analyzed 15 studies that met the quality of the evaluation criteria. Results: The prevalence of frailty in Korean elderly individuals ranged from 6.5% to 11.7% when divided into three levels of frailty. The health outcomes assessed in relation to frailty were divided into five domains: quality of life, physical health, psychosocial health, health behavior, and health care quality. Frailty was negatively associated with all five domains. Conclusions: Our study suggested that nurses should be aware of the limitations in the physical and cognitive functions of frail elderly individuals and provide tailored interventions for Korean elderly individuals. Furthermore, a large-scale study is needed to develop the Korean model of the frailty assessment tool and to verify the conceptual model of this study.

• 임상간호연구
• /
• 제15권2호
• /
• pp.91-102
• /
• 2009

Purpose: This study was done to examine the effect of a urinary incontinence management program on physical symptoms, daily life problems, and sexual life problems for women with mixed urinary incontinence. Methods: This study was conducted using a one group pre-test and post-test design. For the survey, 28 women having mixed urinary incontinence were chosen by convenience sampling and agreed to participate in this study. Their physical symptoms (urinary symptoms, maximum vaginal contraction pressure, and duration of vaginal contraction), daily life problems, and sexual life problems were measured. For descriptive statistics and Wilcoxon signed-rank test were used with SPSS Win 14.0. Results: There were statistically significant differences in the mean scores of physical symptoms (urinary symptoms and maximum vaginal contraction pressure), daily life problems, and sexual life problems. Conclusion: This urinary incontinence management program showed improvements in physical symptoms, daily life, and sexual life of women in the sample. The study results indicate that for effective urinary incontinence management programs nurses should recognize the importance of continual treatment and also develop coping strategies that have sensitivity and are appropriate for patients' daily and sexual problems.

• 한국산학기술학회논문지
• /
• 제18권9호
• /
• pp.334-346
• /
• 2017

본 연구는 병원에서 근무하고 있는 간호사의 업무 스트레스를 극복하고 직무를 지속할 수 있게 하는 내면적 특성을 파악하여 병원 간호사의 조기 이직을 감소시키고 근무 지속력을 향상시키기 위한 방법을 모색하는데 기여하고자 수행되었다. 서울과 경기 지역 내 위치한 상급종합병원 2곳과 종합병원 3곳에서 근무하고 있는 경력 5년 이상의 간호사 12명을 추천 받아 포커스 그룹 면담을 3차례에 걸쳐 수행하였다. 자료 수집 기간은 2016년 1월 27일부터 4월 20일까지였다. 면담 내용을 내용분석 방법으로 분석한 결과, 병원에서 직무를 지속하고 있는 경력 간호사의 내면적 특성 및 강점이 4개의 범주와 13개의 하위범주로 나타났다. 연구에서 도출된 4개의 범주는 '자기극복을 위한 노력', '긍정적인 자세', '주변 관계와의 소통과 지지', 그리고 '간호전문직으로서의 성장 도모'였다. 연구에서 드러난 이러한 간호사의 강점을 강화시킬 수 있는 중재의 적용이 필요하며, 그를 위해서 자기 극복력을 강화하고 긍정적 자세와 소통 능력을 신장시키며 직업 정체성을 확립시키게 하는 자기성찰 훈련 및 교육이 필요함을 제언한다.

• 한국산학기술학회논문지
• /
• 제18권5호
• /
• pp.445-455
• /
• 2017

본 연구는 모자동실 유형에 따른 산모의 피로도와 모유수유율에 차이가 있는지를 확인하기 위해 시도되었다. 서울소재 일 종합병원의 모자동실제 정책이 전일모자동실제에서 부분모자동실제로 전환된 후 두 제도 간에 산모의 피로도와 모유수유율에 차이가 있는지 비교하기 위해 수행되었으며, 평가내용은 출산 후 산모의 피로도와 모유수유율을 비교분석하여 관련성을 파악하는 것이다. 전일모자동실제의 산모 64명을 대상으로 자체 평가한 2012년 10월의 분석결과와 부분모자동실제로 전환운영한 2014년 6- 7월까지의 산모 43명을 대상으로 수집한 자료를 비교분석하였다. 자료처리 및 분석방법은 SPSS 22.0을 이용하여 빈도, 백분율, $x^2-test$, t-test, 피어슨상관관계분석을 통해 4개의 가설을 검정하였다. 그 결과 '전일모자동실군이 부분모자동실군보다 하루 수유횟수가 많은 것'으로 나타났으며, '전일모자동실군과 부분모자동실군 간에 모유수유율은 차이가 없었다'. '전일모자동실군이 부분모자동실군보다 피로도가 높았으며', '산모의 피로도와 입원기간동안의 모유수유율은 관련이 없게' 나타났다. 따라서 본 연구 결과를 토대로 모자동실제 유형에 따라 모유수유율에는 차이가 없으므로 산모의 피로도가 높은 전일모자동실제로 운영하는 것 보다 산모와 신생아의 상태를 고려하여 개별화된 부분모자동실제로 운영하는 방안을 고려해 볼 수 있다.

• Archives of Plastic Surgery
• /
• 제41권3호
• /
• pp.253-257
• /
• 2014

Background Although the utility of flaps for the treatment of sternal wound infections following median sternotomy has been reported for 30 years, there have been few reports on the risk factors for complications after reconstruction. The objective of this investigation was to identify factors related to complications after the reconstruction of sternal wound infections. Methods A retrospective analysis of 74 patients with reconstructive surgery after sternal wound infection over a 5-year period was performed. Clinical data including age, sex, body mass index (BMI), comorbidities, bacterial culture, previous cardiac surgery, wound depth, mortality rate, type of reconstructive procedure, and complication rate were collected. Results The patients' BMI ranged from 15.2 to $33.6kg/m^2$ (mean, $23.1{\pm}3.74kg/m^2$). Wound closure complications after reconstructive surgery were observed in 36.5% of the cases. The mortality rate was 2.7%. Diabetes mellitus significantly affected the rate of wound closure complications (P=0.041). A significant difference in the number of complications was seen between Staphylococcus aureus (S. aureus) and coagulase-negative Staphylococci (P=0.011). There was a correlation between harvesting of the internal thoracic artery and postoperative complications (P=0.048). The complication rates of the pectoralis major flap, rectus abdominis flap, omentum flap, a combination of pectoralis major flap and rectus abdominis flap, and direct closure were 23.3%, 33.3%, 100%, 37.5%, and 35.7%, respectively. Conclusions Diabetes mellitus, S. aureus, harvesting of the internal thoracic artery, and omentum flap were significant factors for complications after reconstruction. The omentum flap volume may be related to the complications associated with the omentum flap transfer in the present study.