• Journal of Korean Biological Nursing Science
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• v.16 no.4
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• pp.267-275
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• 2014

Purpose: The practice of enteral nutrition with gastric residual volumes (GRVs) as a clinical indicator is poorly standardized in intensive care units. This study aims to summarize the results from studies that evaluated the clinical outcomes related to the GRVs. Methods: This systematic review study analyzed 11 studies consisting of four randomized controlled trials, one non-randomized controlled trial, and six observational studies. Results: No consistent relationship between GRV thresholds and clinical outcomes was observed. Higher GRVs were not consistently correlated with clinical outcomes such as higher gastrointestinal complications, aspiration pneumonia, or mortality. Higher GRVs significantly generate complications more often. Findings show that a single GRV more than 200 mL or two consecutive GRVs more than 150 mL should raise concern about negative consequences. Conclusion: Critical care nurses need to monitor GRVs closely during their practice of enteral nutrition. For critically ill patients receiving enteral nutrition, a GRV threshold of 200 ml would be a desirable limit to provide safe and adequate nutrition with a conservative approach.

• Archives of Craniofacial Surgery
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• v.14 no.2
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• pp.73-80
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• 2013

It is important to distinguish deformational plagiocephaly from craniosynostosis, the two conditions are different with respect to clinical progression and treatment options. Deformational plagiocephaly is diagnosed based on the patient's medical history and physical examination. Until recently, there has been no standardized method of evaluation. Visual assessment, anthropometric assessment, digital scanning, and radiologic evaluation are mostly commonly used modalities for diagnosis and assessment. Treatment of deformational plagiocephaly requires an understanding of natural progression of the disease. Deformational plagiocephaly should be classified according to its severity before the proper method and time for treatment are determined. Treatment includes repositioning, physiotherapy and remodeling with the use of orthotic devices. In general, repositioning is preferred for patients younger than six months old while treatment with the use of orthotic devices such as helmet is preferred for patients over six months old. Moreover, treatment with the use of orthotic devices is also favored for severe plagiocephaly. There is continuing research on the relation between deformational plagiocephaly and developmental delay.

• Clinical and Experimental Reproductive Medicine
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• v.42 no.3
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• pp.126-129
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• 2015

Essure (Bayer) received approval from the U.S. Food and Drugs Administration as a permanent non-hormonal contraceptive implant in November 2002. While the use of Essure in the management of hydrosalpinx prior to in vitro fertilization (IVF) remains off-label, it has been used specifically for this purpose since at least 2007. Although most published reports on Essure placement before IVF have been reassuring, clinical experience remains limited, and no randomized studies have demonstrated the safety or efficacy of Essure in this context. In fact, no published guidelines deal with patient selection or counseling regarding the Essure procedure specifically in the context of IVF. Although Essure is an irreversible birth control option, some patients request the surgical removal of the implants for various reasons. While these patients could eventually undergo hysterectomy, at present no standardized technique exists for simple Essure removal with conservation of the uterus. This article emphasizes new aspects of the Essure procedure, as we describe the first known association between the placement of Essure implants and the subsequent development of fluid within the uterine cavity, which resolved after the surgical removal of both devices.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.46 no.2
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• pp.87-98
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• 2020

The aim of this study was to determine the efficacy of oral splints in reducing the intensity of pain in patients with temporomandibular joint dysfunction in both short and long-term treatment durations. Electronic databases, Cochrane Library, MEDLINE via PubMed, Web of Science, Egyptian Knowledge Bank, and EMBASE were searched for randomized controlled trials comparing different types of splints to non-occluding splints, behavioral therapy, pharmacotherapy, counseling, and no treatment. The risk of bias was assessed by using Cochrane risk of bias recommendations. Fixed and random effects were used to summarize the outcomes. The effect estimates were expressed as standardized mean differences (SMD) or risk ratios with a 95% confidence interval (CI). Subgroup analyses were carried out according to the treatment duration. Twenty-two studies met the inclusion criteria. A meta-analysis of short-term studies up to three months revealed no significant difference between the study groups. However, long-term studies exhibited a significant difference in pain reduction in favor of the control group. Total analysis revealed that the control group resulted in significant pain reduction (SMD 0.14, 95% CI 0.05-0.23, P=0.002, I²=0%). Oral splints are not effective in reducing pain intensity or improving function in patients with temporomandibular joint dysfunction.

• Journal of Korean Critical Care Nursing
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• v.8 no.2
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• pp.13-22
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• 2015

Purpose: This study identified the current status and perception of intensive care unit nurses' handover. Methods: A cross sectional descriptive survey was employed. The population included nurse managers and staff nurses who worked in intensive care units in hospitals with more than 500 beds and excluded nursing homes, psychiatric hospitals, and military hospitals. Results: Of the nurses, 61.7% were satisfied with the current handover method, 68.36% had no handover-related guidelines, and 83.2% of them perceived that the handover was important for patients' safety. The most frequent cause for errors related to handover was that the "nursing workload is heavy." The nurses perceived that their handover was informative ($5.62{\pm}0.79$) and efficient ($5.04{\pm}0.98$). The variables associated with their perception of the handover were the level of satisfaction with the current handover method, existence of handover guidelines, and importance of handover for patient safety. Conclusion: The development of standardized handover guidelines, especially for intensive care units, is necessary to reduce handover time and errors and to improve handover quality for patients'safety and high standards of nursing care.

• Korean Medical Education Review
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• v.20 no.3
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• pp.135-140
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• 2018

In clinical clerkships, residents function as trainees, workers, and teachers for other medical students. Although residents care for patients in harsh environments and encounter precarious patient-safety situations, they are working towards becoming competent specialists. Residency education programs are very important in cultivating specialists able to adapt to the rapidly-changing medical environment, and are also necessary to improve the quality of specialist training. Competent specialists not only need clinical competency, but also a wide range of abilities including professionalism, leadership, effective communication, cooperation, and attention to continuous professional development/continuing medical education activities. Each Korean association of specialties has its own educational goals and standardized education programs to help residents learn specific techniques and competencies related to medical care for patients, though the training environment of each residency is different within each trainee hospital. Although it is also important to evaluate residency education programs, currently there is only an examination of knowledge and assessment of skills based on mini-clinical evaluation exercises or direct observation of procedural skills. In order to develop an objective and estimable evaluation tool that can assess the overall achievement level within each training course, it is necessary to evaluate the knowledge, skills, and attitudes of residents. Residency education programs need further attention and reform.

• Korean Journal of Adult Nursing
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• v.25 no.2
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• pp.170-182
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• 2013

Purpose: This study investigated the effectiveness of simulation training with a hybrid model of student nurses' performance ability and reported self confidence. Methods: A nonequivalent control group with pre-posttest was designed. Data collection was done during the first semester in 2012 at a college of nursing in Seoul. Nursing performance ability and reported self confidence related to taking care of patients with urinary problems were evaluated. The treatment group (n=96) received simulation training of a catheterization procedure with a hybrid model involving standardized patients and a mannequin. Nursing students in the comparison group (n=84) did not receive the simulation training but would receive it prior to their next clinical practicum's. Results: The treatment group showed a significantly higher performance ability and reported self confidence than that of the comparison group. The perceived helpfulness and contentment of the simulation training in experimental group was high. Conclusion: The findings of this study demonstrated that simulation with a hybrid model was effective in teaching skills prior to the clinical experience which suggests that skill development is not dependent on the actual clinical situation. Nurse educators should consider simulation training as a tool beyond that of clinical practicum.

• Korean Journal of Clinical Pharmacy
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• v.6 no.2
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• pp.24-27
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• 1996

In order to determine whether there was a clinically sufficient amount of drug remaining in used fentanyl patches, quantitative analysis of two different types of patches, each containing 2.5 mg (n=36) and 5 mg (n=20) was performed. After being used for approximately 72 hours by patients with cancer, each patch was put in the plastic bag and stored at $4^{\circ}C$ until analysis. Fentanyl remaining in patches was extracted with 50 ml methanol, diluted with water, and counted twice in a $\gamma-Counter$ (expressed as CPM). Patches that originally contained 2.5 mg and 5 mg of fentanyl were shown to have $0.48{\sim}1.86\;mg\;(mean:\;1.03\;mg,\;41.16\%)\;and\;0.37{\sim}3.95\;mg\;(mean:\;2.37\;mg,\;47.33\%)$ after use, respectively. A wide interpatient variability was observed in the rate of fentanyl release from patches although the application period was standardized to 72 hours. Since a significant amount of drug remained in the discarded patches, it is highly recommended that patients dispose used ones under supervision to prevent abuse or misuse of the narcotic drug.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.14
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• pp.5859-5861
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• 2015

Background: Kidney cancer has shown an increasing trend in recent decades. This study aimed to determine change in the incidence rate between 2003 and 2009 in Iran. Materials and Methods: In this study, national cancer registry data were used. Crude incidence rates were calculated per 100,000 and age-standardized incidence rates (ASRs) were computed using the direct standardization method and the world standard population. Significant trend of incidence rates was examined by the Cochran-Armitage test for linear trend. Results: A total of 6,944 cases of kidney cancer were reported. The incidence cases increased from 595 patients in 2003 to 1,387 patients in 2009. Sex ratio (male to female) was 1.67. ASR also increased from 1.18 in 2003 to 2.52 in 2009 per 100,000, but the increasing trend was not significant. Conclusions: A slow increasing trend of incidence rate was observed in the study population. This may be due to an increase of risk factors. It is suggested to perform a study on risk factors for the cancer.

• Journal of muscle and joint health
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• v.21 no.1
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• pp.46-54
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• 2014

Purpose: This study was designed to explore the stage distribution of subjects according to stages of change for exercise and to identify factors that could discriminate subjects in various stages. Methods: The sample consisted of 182 subjects who had metabolic syndrome. The instruments used in this study were the stage placement instrument for exercise, the metabolic syndrome knowledge and metabolic syndrome health belief scale, and the metabolic syndrome exercise self efficacy scale. Data were analyzed using chi-square, ANOVA, and discriminant analysis by using the SPSS 19.0 program. Results: For exercise stages, exercise efficacy, occupation, and exercise benefit showed high standardized canonical discriminant function coefficients. Subjects in precontemplation/contemplation stage for exercise were more likely to have occupations, had less exercise efficacy and exercise benefit than those in other stage. Conclusion: This study implies that the level of exercise efficacy and exercise benefit of subjects in precontemplation/contemplation stage need to be enhanced in developing exercise program incorporating the stage of change for metabolic syndrome patients.