• Asian Pacific Journal of Cancer Prevention
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• 제16권16호
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• pp.7237-7242
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• 2015

Background: Epithelial ovarian cancer (EOC) is the commonest malignancy involving the ovaries. Maximum surgical cytoreduction (MCR) followed by adjuvant taxane-platinum chemotherapy are the standard of care treatments. Aims: To study treatment outcomes of EOC patients that were maximally cyto-reduced and received adjuvant paclitaxel-carboplatin (PC) chemotherapy. Materials and Methods: This retrospective cohort study included 174 patients with EOC treated at the Egyptian National Cancer Institute between 2006 and 2010. For inclusion, they should have had undergone MCR with no-gross residual followed by adjuvant PC chemotherapy. MCR was total abdominal hysterectomy/bilateral salpingo-oophorectomy [TAH/BSO] or unilateral salpingo-oophorectomy [USO] plus comprehensive staging. Results: The median age was 50 years. Most patients were married (97.1%), had offspring (92.5%), were postmenopausal (53.4%), presented with abdominal/pelvic pain and swelling (93.7%), had tumors involving both ovaries (45.4%) without extra-ovarian extension i.e. stage I (55.2%) of serous histology (79.9%) and grade II (87.4%). TAH/BSO was performed in 97.7% of cases. A total of 1,014 PC chemotherapy cycles were administered and were generally tolerable with 93.7% completing 6 cycles. Alopecia and numbness were the commonest adverse events. The median follow up period was 42 months. The 2-year rates for disease free survival (DFS) and overall survival (OS) were 70.7% and 94.8%, respectively. The respective 5-year rates were 52.6% and 81.3%. Advanced stage and high-grade were significantly associated with poor DFS and OS (p<0.001). Age >65 years was associated with poor OS (p =0.008). Using Cox-regression, stage was independent predictor of poor DFS and OS. Age was an independent predictor of poor OS.

• 한국임상약학회지
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• 제22권2호
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• pp.181-186
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• 2012

Objective: To report a fatal case of Multidrug-resistant Acinetobacter baumannii (MDR-AB) in a patient with interstitial lung disease (ILD) on high-dose glucocorticoids. Case Summary: A 66-year-old man with a history of coniosis was transferred to the hospital with progressive cough and sputum production. This patient has been diagnosed with pneumonia and ILD on admission, requires antimicrobial therapy and systemic immunosuppressants. He received high dose of methylprednisolone and cyclophosphamide for ILD as well as ceftriaxone and azithromycin for pneumonia. On day 7 in the intensive care units (ICUs), patient had fever and leukocytosis, thus antimicrobials were switched to piperacillin. After 13 days in the ICU, Acinetobacter baumannii and methicillin-resistant Staphylococcus aureus (MRSA) were isolated on transtracheal aspirate (TTA) and meropenem was initiated. However, it was revealed a multidrug-resistant Acinetobacter baumannii (MDR-AB) species, resistant to carbapenem. Patient was administered colistin but expired due to septic shock on day 84. Discussion: Systemic immunosuppressive therapy can result in infections that may compromise patient's survival. MDR-AB has emerged as a serious cause of nosocomial infections in immunocompromised patients. MDR-AB is resistant to most standard antimicrobials and therapeutic options are limited. Conclusion: We report our recent experience with a fatal MDR-AB pneumonia in a patient with ILD, who had to be treated with high dose glucocorticoids and immunosuppressnts.

• 지역사회간호학회지
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• 제13권4호
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• pp.710-718
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• 2002

Purpose: The purpose of this study was to identify the relationship between fatigue, and self-efficacy in patients with lung cancer. Method: The data was collected from January 21th to April 8th 2001. The study subjects were recruited from K hospital in Pusan, Korea. Their fatigue was measured using the 22-item Revised Piper Fatigue Scale developed by Piper et al. (1998) and translated by the investigators, and self-efficacy was measured using the 10-item General Self-efficacy Questionnaire developed by Lee, Schwarzer & Jerusalem. The data were analyzed by SPSS 10.0 program using frequency, percentage, mean and standard deviation, t-test, ANOVA, Post-hoc test (Scheffe's test), and Pearson Correlation Coefficients. Result: 1) The mean fatigue score was $118.48{\pm}33.02$ (range: 22-220). The scores for sub-dimension were $35.40{\pm}10.06$ in behavior/severity, $25.98{\pm}9.06$ in affective score, $27.88{\pm}10.06$ in sensory score, and $29.22{\pm}8.27$ in cognitive/mood. The mean self-efficacy score was $28.80{\pm}5.85$. 2). There were significant differences in the fatigue of patients with lung cancer on income per month (F=4.651, p= .014), 'present pain' (F=2.601, p= .012), 'change of weight' (F=5.911, p= .005), by general characteristics. 3) There were significant differences in the self-efficacy of patients with lung cancer on 'religion' (F=3.732, p= .031), 'employment status' (F=5.525, p= .003), 'past therapy' (F=2.869, p= .034), by general characteristics 4) There was a significant negative correlation between fatigue and self-efficacy (r=- .528, p= .000). Conclusion: Patients with lung cancer experience fatigue. Increased fatigue is associated with decreased self-efficacy. Nurses must provide patients with nursing care for the less occurrence of fatigue and interventions to manage self-efficacy for them.

• 가족자원경영과 정책
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• 제14권4호
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• pp.213-237
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• 2010

This study aimed at figuring out the current state of 26 family-health support centers in Gyeonggi-do, in order to prepare an activation plan for the centers. These centers are the main mediators of the family health operation. This study also aimed to understand the center users' satisfaction and demands. The results were as follows. First, a total of 65,794 participants from 9,960 businesses were processed. The majority had attended various integrated family services, followed by family counseling and/or family-friendly culture-establishing businesses. Second, the main users' profiles were as follows: average age, 41; average number of persons in the family, 3.78; education above foundation-level degree; diverse jobs that included special occupations; average monthly incomes of 3,390,000 won; and a middle-class living standard (as self-described by participants). Third, the users' main concern for their families was "financial difficulties," and they had an interest in education and counseling. Although they thought education and counseling were suitable solutions, they hesitated because they did not think their problems were serious enough to merit them. Fourth, the satisfaction level of their participation in their center's program was generally high, at 3.9-4.2 points. The majority of them said they would attend again in the future.

• 한국보육지원학회지
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• 제8권5호
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• pp.253-274
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• 2012

본 연구는 한국 전래동요 중에서 유아에게 적합한 것을 선정하기 위한 기준을 마련하여 유아교육 현장에서 전래동요가 효율적으로 적용되기 위한 가능성의 구안에 그 목적을 두었다. 이를 위해 설정한 연구문제는 첫째, 유아에게 적합한 한국 전래동요의 선정 기준은 어떠한가, 둘째, 선정기준에 따른 유아를 위한 한국 전래동요는 어떠한가이다. 먼저, 유아에게 적합한 한국 전래동요의 기준을 선정하기위해 유아교육 및 유아교육 관련 전문가 30명을 대상으로 델파이 조사를 통해 문항을 선정하였다. 수집된 응답들은 spss 12.0의 프로그램을 이용하여 평균과 표준편차를 계산하였다. 연구 결과 유아에게 적합한 한국 전래동요의 선정 기준은 '전통적 놀이공간과 놀이언어의 즐거움이 살아있는가, 옛 아이들의 생활 모습과 정서를 담고 있는가, 유아가 쉽게 이해할만한 내용인가, 유아가 흥미를 느낄만한 내용인가, 유아의 발달에 도움을 주는가, 유아가 쉽게 부를 수 있는 선율인가, 장단이 단순하고 반복적인가'로 나타났다. 또한 선정기준이 확정됨에 따라 이 기준을 바탕으로 유아에게 적합한 전래동요 112곡이 선정되었다. 112곡의 노랫말은 주로 '놀이의 즐거움'을 표현한 곡들로 전래동요의 전승을 위해서는 놀이가 함께 연행되어야 함을 시사한다.

• Clinical and Experimental Pediatrics
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• 제62권11호
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• pp.416-421
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• 2019

Background: The seropositivity rate of hepatitis B surface antigen (anti-HBs) antibodies is known to be ≥95% after hepatitis B virus vaccination during infancy. However, a low level or absence of anti-HBs in healthy children is discovered in many cases. Recent studies in adults reported that a reduced anti-HBs production rate is related to obesity. Purpose: To investigate whether body mass index (BMI) affects anti-HBs levels in healthy children following 3 serial dose vaccinations in infancy. Methods: We recruited 1,200 healthy volunteers aged 3, 5, 7, or 10 years from 4-day care centers and 4 elementary schools. All subjects completed a questionnaire including body weight, height, and vaccine type received. Levels of serum hepatitis B surface antigen (HBsAg) and anti-HBs in all subjects were analyzed using electrochemiluminescence immunoassay. The standardized scores (z score) for each sex and age were obtained using the lambda-mu-sigma method in the 2017 Korean National Growth Charts for children and adolescents. Results: Our subjects (n=1,200) comprised 750 males (62.5%) and 450 females (37.5%). The overall anti-HBs seropositivity rate was 57.9% (695 of 1,200). We identified significant differences in mean BMI values between seronegative and seropositive groups (17.45 vs. 16.62, respectively; P<0.001). The anti-HBs titer was significantly decreased as the BMI z score increased adjusting for age and sex (B=-15.725; standard error=5.494; P=0.004). The probability of anti-HBs seropositivity based on BMI z score was decreased to an OR of 0.820 after the control for confounding variables (95% confidence interval, 0.728-0.923; P=0.001). Conclusion: There was a significant association between anti-HBs titer and BMI z score after adjustment for age and sex. Our results indicate that BMI is a potential factor affecting anti-HBs titer in healthy children.

• 한국농촌간호학회지
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• 제18권1호
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• pp.57-71
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• 2023

Purpose: This study aims to provide primary data for policy alternatives by identifying the problem of the nursing workforce shortage. Methods: For quantitative data, 446 questionnaires were analyzed. The mean and standard deviation were used for content description. ANOVA analysis and Scheffe? test were used to compare the differences according to the hospital level. For qualitative data, 1:1 in-depth and group interviews were conducted for six participants. Results: The factors nurses prioritized when choosing a workplace were salary, commuting distance, and work-life balance. Clinical nurses cited low wages, heavy workloads, and burnout as the most considerable difficulties in performing their duties. Factors influencing nurse's turnover intention were low wages, unmanageable workload, and rotation to unwanted departments in that order. New nurses tend not to apply to small-medium-sized hospitals, experienced nurses in their 30s-40s leave hospitals due to childcare and shift work difficulties, and nurses in their 50s and older tend to move to nursing homes rather than acute hospital settings. Conclusion: In this study, wage and workload were mentioned as the most critical factors in nurses' workplace selection, job performance difficulties, and turnover intention, so it is necessary to pay attention to this aspect when improving treatment for nurses.

• 대한영상의학회지
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• 제81권5호
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• pp.1053-1068
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• 2020

문재인 정부의 새로운 건강보험 보장성 강화 대책에 따라 2018년부터 뇌 MRI, 뇌혈관/경부혈관 MRA, 두경부 MRI 급여가 확대되어 시행 중이다. 2018년 10월부터 2020년 4월까지 개정되어 현재 시행 중인 MRI 급여와 관련된 '요양급여의 적용기준 및 방법에 관한 세부사항'을 중심으로 정리해 보았다. 이 종설은 MRI 요양급여체계, 두통, 어지럼증 환자의 급여기준조정, 뇌 MRI, 뇌혈관/경부혈관 MRA, 두경부 MRI의 급여기준, 표준영상, 판독소견서 등을 포함하였다. 이 글을 통해 영상의학과 전문의가 보험 영역에서도 전문적인 지식을 갖추어 영상의학과 전문의의 전문성을 확보하고, 소속병원에서 주도적인 역할을 하는데 도움이 되고자 한다. MRI 급여화 확대 정책이 진행 중으로 관련 보건복지부의 세부고시가 개정될 수 있다. 따라서 MRI와 보험과 관련된 사안을 지속적으로 업데이트하는 것이 요망된다.

• Journal of Preventive Medicine and Public Health
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• 제57권3호
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• pp.260-268
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• 2024

Objectives: Regional disparities in cardiovascular care in Korea have led to uneven patient outcomes. Despite the growing need for and access to procedures, few studies have linked regional service availability to mortality rates. This study analyzed regional variation in the utilization of major cardiovascular procedures and their associations with short-term mortality to provide better evidence regarding the relationship between healthcare resource distribution and patient survival. Methods: A cross-sectional study was conducted using nationwide claims data for patients who underwent coronary artery bypass grafting (CABG), percutaneous coronary intervention (PCI), stent insertion, or aortic aneurysm resection in 2022. Regional variation was assessed by the relevance index (RI). The associations between the regional RI and 30-day mortality were analyzed. Results: The RI was lowest for aortic aneurysm resection (mean, 26.2; standard deviation, 26.1), indicating the most uneven regional distribution among the surgical procedures. Patients undergoing this procedure in regions with higher RIs showed significantly lower 30-day mortality (adjusted odds ratio [aOR], 0.73; 95% confidence interval, 0.55 to 0.96; p=0.026) versus those with lower RIs. This suggests that cardiovascular surgery regional availability, as measured by RI, has an impact on mortality rates for certain complex surgical procedures. The RI was not associated with significant mortality differences for more widely available procedures like CABG (aOR, 0.96), PCI (aOR, 1.00), or stent insertion (aOR, 0.91). Conclusions: Significant regional variation and underutilization of cardiovascular surgery were found, with reduced access linked to worse mortality for complex procedures. Disparities should be addressed through collaboration among hospitals and policy efforts to improve outcomes.

• 한국실내디자인학회논문집
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• 제27권2호
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• pp.24-36
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• 2018

Implementing a home modification to enable elderly's safe and independent living is the key plan to realize their aging in place. South Korea in which had entered an aged society is not yet vitalized in home modification for the elderly compared to that of welfare-developed countries, and South Korea provides support that is limited to the low-income elderly. Therefore, this purpose of this study was to analyze the laws related to the home modification, the present condition of home modification support, the standards and guidelines in home modification, the support in house modification cost, and supporting organization and working force in the home modification. Through the analyzing process, this study examined the current situation and problems of institutional support in the home modification for elderly and the proposed plan for institutional improvement. The suggestions based on the results are as in the following. 1) Home modification support law(act or regulation) is required to be improved 2) Home modification support system correspondent to aging process should be provided regardless of their income levels. 3) Delicate plan standard and guideline are necessary for a process of implementing the home modification for the elderly. 4) Information on life behavior is in need for the implementation of elderly-customized home modification. 5) Cost for the home modification should be considered to cover by the Act on Long-Term Care Insurance for the Aged. 6) Housing Welfare Center and Housing Welfare Professional should be actively utilized for the home modification support institution and work force.