• Clinical and Experimental Pediatrics
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• 제65권1호
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• pp.21-28
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• 2022

Crohn disease (CD) is a multifactorial inflammatory disorder that can affect all segments of the gastrointestinal (GI) tract but typically involves the ileum and/or colon. To assess patient prognosis and choose appropriate treatment, it is necessary to accurately evaluate the factors influencing poor outcomes, including disease phenotype. Pediatric CD involving the upper GI (UGI) tract has become increasingly recognized with the introduction of routine upper endoscopy with biopsies for all patients and the increased availability of accurate small bowel evaluations. Most clinical manifestations are mild and nonspecific; however, UGI involvement should not be overlooked since it can cause serious complications. Although controversy persists about the definition of upper GI involvement, aphthoid ulcers, longitudinal ulcers, a bamboo joint-like appearance, stenosis, and fistula are endoscopic findings suggestive of CD. In addition, the primary histological findings, such as focally enhanced gastritis and noncaseating granulomas, are highly suggestive of CD. The association between UGI involvement and poor prognosis of CD remains controversial. However, the unstandardized definition and absence of a validated tool for evaluating disease severity complicate the objective assessment of UGI involvement in CD. Therefore, more prospective studies are needed to provide further insight into the standardized assessment of UGI involvement and long-term prognosis of CD. Our review summarizes the findings to date in the literature as well as UGI involvement in CD and its clinical implications.

• 대한족부족관절학회지
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• 제26권3호
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• pp.118-122
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• 2022

Although total ankle arthroplasty (TAA) has increased considerably in the past ten years, reflecting improvements in implant design and survivorship, the clinical outcomes have been less satisfactory than total hip or total knee arthroplasties. Several issues under debate include postoperative management and rehabilitation in TAA. Especially, there is no consensus or evidence for the most appropriate postoperative management and rehabilitation for patients undergoing TAA. This study was therefore undertaken to suggest appropriate postoperative management and rehabilitation in TAA, after reviewing published articles and focusing on the following topics: prehabilitation, hospital stay, immobilization type and duration, weight-bearing management, pharmacological treatment, and adopted rehabilitation protocols. In previous studies, the postoperative management and rehabilitation proposed depended on the surgeon's preference, the patient's characteristics, and the associated surgical procedures performed after TAA. Nonetheless, our research indicates the best approach is to include a prehabilitation program, immobilization in the early postoperative stage (2~4 weeks), range of motion exercise with partial weight-bearing ambulation, followed by full weight-bearing ambulation after six weeks. Further studies are required to develop a standardized rehabilitation protocol and improve the overall quality of care after TAA.

• Journal of Hospice and Palliative Care
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• 제26권3호
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• pp.101-111
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• 2023

Purpose: This study aimed to identify levels of perception and performance of end-oflife care among nurses and to investigate correlations between perception and performance. Methods: This cross-sectional descriptive survey included 321 nurses from a tertiary hospital in Seoul, Korea. The participants had at least 6 months of work experience and had been involved in end-of-life care at least once, in either ward or intensive care unit settings. A structured questionnaire was utilized to assess their perception and performance of endof-life care. Results: The mean score for perception of end-of-life care was 3.23±0.34, while the score for performance of end-of-life care was 3.08±0.34. There was a significant positive correlation between nurses' perception of end-of-life care and their performance in this area (r=0.78, P<0.001). Conclusion: It is necessary to change perceptions regarding end-of-life care and to develop systematic and standardized education programs including content such as assessing the hydration status of dying patients, evaluating mental aspects such as suicidal ideation, and providing spiritual care for nurses working in end-of-life departments.

• 임상간호연구
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• 제16권3호
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• pp.25-37
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• 2010

Purpose: The purpose of this study was to examine potential factors related to the management of cancer pain, that is, hospital institutional factors as well as personal aspects of nurses. Methods: This study was a descriptive research study in which 229 RNs working in 2 tertiary medical institutions in Seoul and 4 secondary medical institutions in Seoul, Incheon and Gyeonggi were surveyed. Results: It was found that nurses' knowledge about pain intervention, their working division and their knowledge about the use of analgesics had different effects on their pharmacologic interventions. These 3 variables explained 14.5% of the variance regarding pharmacologic interventions. On the other hand, nurses' knowledge about pain interventions and nursing organization were variables affecting non-pharmacologic interventions by the nurses. These two variables explained 22.1% of the variance regarding non-pharmacologic interventions by the nurses. Conclusion: The findings indicate that nursing organization, one of hospital institutional factors, had significant effects on non-pharmacologic interventions. Therefore, to increase effective pain management by nurses, an organizational system should be established such as placement of nurse practitioners, improvement of nurses' autonomy in pain management, and development and distribution of standardized guidelines.

• Physical Therapy Rehabilitation Science
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• 제12권2호
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• pp.177-184
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• 2023

Objective: Manual therapy is a commonly utilized approach in managing chronic pain, but its specific impact on pain catastrophizing remains uncertain. The objective of this systematic review and meta-analysis was to examine the effects of manual therapy on pain catastrophizing in individuals with chronic pain. Design: A systematic review and meta-analysis Methods: A comprehensive search was conducted in electronic databases to identify relevant studies published from 2014 onwards. Studies that evaluated the impact of manual therapy on pain catastrophizing in individuals with chronic pain were incorporated. The risk of bias in the selected studies was evaluated using the Cochrane tool for risk of bias in qualitative analysis. For the quantitative analysis, RevMan 5.4 software was utilized, employing a random-effects model as the analysis model. The effect measure used in the analysis was the standardized mean difference (SMD). Results: In total, 26 studies were collected, and following the screening process, three of them were incorporated into the final analysis. The included studies involved a total of 153 patients with chronic pain. The interventions comprised various manual therapy techniques targeting different areas of the body. Pain catastrophizing and pain intensity were the primary outcomes of interest. The meta-analysis revealed a significant reduction in pain catastrophizing scores following manual therapy intervention compared to control conditions (SMD = -0.91, 95% CI: -1.25 to -0.58). However, heterogeneity between the studies was observed. Conclusions: Despite the limited quantity and heterogeneity of studies, it has been demonstrated that manual therapy intervention is effective in reducing pain catastrophizing in individuals with chronic pain.

• 한국간호교육학회지
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• 제29권2호
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• pp.148-160
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• 2023

Purpose: The purpose of this study was to construct and test a structural model of nursing students' performing communication skills. Methods: The data collection was conducted from October 13 to October 20, 2020. The participants were 286 students from nursing colleges located in three cities. The data analysis method was a covariance structure analysis with using IBM SPSS statistics version 23.0 and AMOS 21.0 statistical programs. Results: The hypothetical model showed a proper fit with the data: root mean square error of approximation=.08, standardized root mean square residual=.06, adjusted goodness of fit=.85, normed fit index=.91, and comparative fit index=.94. The model fit indices were normed to fit index=2.96. Statistically significant explanatory variables for the performing communication skills of nursing students were peer support, emotional intelligence, ethical sensitivity, and communication self-efficacy. The variables accounted for 66.1% of the performing communication skills of nursing students. Conclusion: Based on the above results, it appears necessary to develop strategies for improving the performing communication skills of nursing students, and having positive effects on health outcomes of the subjects by considering the variables of peer support, emotional intelligence, ethical sensitivity, and communication self-efficacy. Such strategies could potentially have positive effects on the health outcomes of the patients.

• International Journal of Internet, Broadcasting and Communication
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• 제15권4호
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• pp.261-269
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• 2023

We propose to design a Holochain-based security and privacy protection system for resource-constrained IoT healthcare systems. Through analysis and performance evaluation, the proposed system confirmed that these characteristics operate effectively in the IoT healthcare environment. The system proposed in this paper consists of four main layers aimed at secure collection, transmission, storage, and processing of important medical data in IoT healthcare environments. The first PERCEPTION layer consists of various IoT devices, such as wearable devices, sensors, and other medical devices. These devices collect patient health data and pass it on to the network layer. The second network connectivity layer assigns an IP address to the collected data and ensures that the data is transmitted reliably over the network. Transmission takes place via standardized protocols, which ensures data reliability and availability. The third distributed cloud layer is a distributed data storage based on Holochain that stores important medical information collected from resource-limited IoT devices. This layer manages data integrity and access control, and allows users to share data securely. Finally, the fourth application layer provides useful information and services to end users, patients and healthcare professionals. The structuring and presentation of data and interaction between applications are managed at this layer. This structure aims to provide security, privacy, and resource efficiency suitable for IoT healthcare systems, in contrast to traditional centralized or blockchain-based systems. We design and propose a Holochain-based security and privacy protection system through a better IoT healthcare system.

• Korean Journal of Radiology
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• 제20권1호
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• pp.34-49
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• 2019

Conventional transcatheter arterial chemoembolization (c-TACE) is a widely used first-line palliative treatment for patients with unresectable hepatocellular carcinoma (HCC). Despite the effectiveness of c-TACE, to date, technique and procedure scheduling has not yet been standardized. Drug-eluting microspheres (DEMs) were therefore introduced to ensure more sustained and tumor-selective drug delivery for permanent embolization. These DEMs can load various drugs and release them in a sustained manner over a prolonged period. This approach ensures the delivery of high concentrations of chemotherapeutic agents to tumors, without increasing systemic concentrations, and promote tumor ischemia and necrosis. This review summarizes the recent advances in the use of DEM-TACE to treat HCC.

• 대한영상의학회지
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• 제85권3호
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• pp.549-565
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• 2024

자기공명영상은 자궁선근증의 진단과 그와 관련된 병리를 발견하는데 중요한 도구이다. 자궁선근증을 정확히 진단하기 위해서는 자궁선근증의 전형적인 자기공명영상 소견과 함께 비전형적인 특징을 인식하는 것이 필요하다. 최근에는 자궁선근증의 수술 전 정확한 진단과 적절한 치료법을 결정하기 위해 표준화된 분류 시스템이 개발되었다. 자기공명영상 기반 분류에 따라 다양한 아형을 구분하여 서로 다른 자기공명영상 표현형을 식별하는 것은 자궁선근증 환자를 특정 치료로 분류하고 치료 반응을 모니터링하는데 도움이 될 수 있다.

• 대한두개안면성형외과학회지
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• 제25권4호
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• pp.192-196
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• 2024

Angiolymphoid hyperplasia with eosinophilia (ALHE) is a rare condition characterized by nodular lesions predominantly in the head and neck region, often causing discomfort or pain. Treatment remains challenging because of its rarity and the lack of established guidelines. This report presents a case of ALHE affecting the earlobes that was successfully managed using ear lobule reduction surgery and subsequent intralesional steroid injections. A 31-year-old woman with a history of recurrent earlobe masses underwent a partial excision to avoid the loss of the earlobe. Histopathological examination confirmed Kimura disease, a variant of ALHE. Subsequent local methylprednisolone injections effectively controlled the remaining lesions, resulting in significant size reduction without notching. Various treatment modalities have been attempted for this condition; however, recurrence rates remain high. Surgical resection combined with intralesional corticosteroid injections is the preferred approach. In this case, a sub-antitragal groove technique for earlobe reduction was employed to preserve the lateral edge of the ear lobule, minimize the risk of deformity, and achieve a predictable outcome. The sub-antitragal groove technique offers an approach to reduce earlobe size without compromising aesthetics. Further research is required to elucidate the pathogenesis of ALHE and establish standardized treatment protocols for this rare condition.