• Korean Journal of Transplantation
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• v.31 no.4
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• pp.170-176
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• 2017

We need to establish an informative guideline to increase inter-institutional and inter-observer reproducibility of renal transplant diagnosis, and to improve the diagnostic ability of pathologists in Korea. A first nation-wide survey for renal transplant pathology was conducted by Renal Pathology Study Group of the Korean Society of Pathologists in 2016, to provide the continued excellence in the transplantation pathology laboratory, and to improve the diagnostic ability for the best treatment of transplant patients. This survey revealed the significant variations in scale, work load and biopsy indications for the renal transplant pathology in various institutions in Korea. The Banff classification were used by all institutions for the diagnosis of renal transplant pathology, but different formats were used: most institutions (70%) used the "2013 Banff classification" while the others were using "2007 Banff classification" (20%) or even older formats. In daily diagnostic practice of the renal allografts, difficulties that pathologists encounter were quite diverse due to different environments they work in. Most respondents agreed that standardized diagnostic practice guidelines, regular education on renal transplant pathology and convenient ways of consultation are further needed. We are currently working toward the enhancement of the expertise of renal pathologists and to increase inter-institutional and inter-observer reproducibility by 1) development of a set of virtual slides of renal allograft biopsies for the training, 2) validation and gathering expert's consensus on the core variables of rejection diagnosis by using virtual slides, and 3) continued education by the developed virtual slide atlas.

• The Journal of Korean Medicine
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• v.43 no.3
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• pp.49-64
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• 2022

Objectives: Peer role-play (PRP) has been used in health care training simulations because standardized patient training requires considerable time and expense. This study described the implementation of clinical simulation using PRP and examined the effect. Methods: Final year students from a single college of Korean medicine engaged in PRP as part of clinical skills practice. Education tools from clinical practice guidelines were used to structure the PRP. Communication competency was assessed with the Korean Version of the Self-Efficacy Questionnaire (KSE-12). Whether this training helped to achieve graduate outcomes was evaluated on a five-point scale. Results: Fifty-nine students (53.2%) participated in the survey. Among 12 items on the KSE-12, the score for "How certain are you that you are able to successfully listen attentively to the patient?" was the highest. Further, PRP was found to be helpful for self-directed learning, establishment of one's professional identity, and the ability to communicate and manage patients. Three themes ("Benefits of role-play", "The importance of positive feedback", "Limitations and problems of role-play"), 15 categories, and 16 central meanings were derived by categorizing learners' subjective opinions about PRP. Conclusions: Study findings indicate that PRP may contribute to improving communication skills and establishing a professional identity for future Korean medicine doctors. We suggest using PRP in clinical education in colleges of Korean Medicine.

• Korean Journal of Clinical Pharmacy
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• v.33 no.2
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• pp.128-134
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• 2023

Background: This systematic review and meta-analysis aimed to evaluate the efficacy and cardiovascular safety of romosozumab compared with placebo. Methods: Randomized controlled trials (RCTs) were searched from Medline, EMBASE, Cochrane Central, and Web of Science until July 2022. Primary outcomes included the change in bone mineral density (BMD) from baseline at month 6. The secondary outcomes were the change of bone turnover markers (N-terminal propeptide of type 1 procollagen (P1NP); C-terminal telopeptide of type 1 collagen (CTX)) from baseline at month 3, and the incidence of cardiovascular adverse events for the total follow-up period. Results: A total of 7 RCTs on 8,370patients were included. Romosozumab showed better effects in improving BMD in both lumbar spine and femoral neck at month 6 (standardized mean difference, SMD 2.20 [95% CI: 1.89-2.52], SMD 0.63 [95% CI: 0.41-0.86]). In contrast to placebo, romosozumab significantly increased PINP levels and reduced CTX levels at month 3 (SMD 0.93 [95% CI: 0.65-1.22], SMD -1.03 [95% CI: -1.23~ -0.82]. However, there was no significant difference in the composite incidence of cardiovascular adverse events and major adverse cardiovascular events (OR 1.16 [95% CI: 0.82-1.65], OR 1.08 [95% CI: 0.75-1.56]). Conclusion: This analysis showed that romosozumab significantly improved BMD compared to placebo and was beneficial for change in bone turnover markers. There is no significant difference in the incidence of cardiovascular adverse events compared to placebo.

• Imaging Science in Dentistry
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• v.53 no.4
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• pp.345-353
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• 2023

Purpose: The objective of this study was to propose a method for developing a clinical phantom to reproduce various diseases that are clinically prevalent in the field of dentistry. This could facilitate diverse clinical research without unnecessarily exposing patients to radiation. Materials and Methods: This study utilized a single dry skull, which was visually and radiographically examined to evaluate its condition. Existing lesions on the dry skull were preserved, and other relevant lesions were artificially created as necessary. These lesions were then documented using intraoral radiography and cone-beam computed tomography. Once all pre-existing and reproduced lesions were confirmed by the consensus of 2 oral and maxillofacial radiologists, the skull was embedded in a soft tissue substitute. To validate the process, cone-beam computed tomography scans and panoramic radiographs were obtained of the fabricated phantom. All acquired images were subsequently evaluated. Results: Most lesions could be identified on panoramic radiographs, although some sialoliths and cracked teeth were confirmed only through cone-beam computed tomographic images. A small gap was observed between the epoxy resin and the bone structures. However, 2 oral and maxillofacial radiologists agreed that this space did not meaningfully impact the interpretation process. Conclusion: The newly developed phantom has potential for use as a standardized phantom within the dental field. It may be utilized for a variety of imaging studies, not only for optimization purposes, but also for addressing other experimental issues related to both 2- and 3-dimensional diagnostic radiography.

• The Journal of Korean Academic Society of Nursing Education
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• v.30 no.1
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• pp.29-38
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• 2024

Purpose: This study aimed to investigate student nurses' satisfaction by type of clinical practicum and to determine predictors of clinical competence in pediatric nursing. Methods: A total of 189 Junior and Senior student nurses across seven colleges in the Busan Metropolitan City were enrolled in the study. The participants completed a structured questionnaire containing items about their learning satisfaction with different types of pediatric nursing practicums and their clinical competence. Data were analyzed using the mean, standard deviation, independent t-test, ANOVA, and multiple regression analysis. Results: Regarding satisfaction with each type of clinical practicum, the mean satisfaction score (out of 10) was 8.18±2.26 for on-site clinical rotations and 7.35±2.20 for alternative practicums. Among the different types of alternative practicum approaches, those with a satisfaction score of 7 or higher included fundamental nursing skills, watching videos, simulation etc., while those with a satisfaction score of less than 6 were virtual simulation and problem-based learning. The predictors of clinical competence in pediatric nursing were learning satisfaction with practice, school year, and alternative practicum, accounting for 35.0% of the variance in clinical competency. Conclusion: It would be helpful to combine on-site clinical rotations with alternative practicum approaches and to develop various alternative practice programs using simulation practice, virtual reality, immersive interactive systems, and standardized patients to enhance students' clinical competency.

• Journal of Hospice and Palliative Care
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• v.9 no.2
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• pp.86-92
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• 2006

Purpose: This study was conducted to develop a measuring tool for spiritual care performance of hospice team members. The tool may be utilized for providing hospice patients with more systematic and standardized spiritual tares. Methods: The concept and questions of the tool were developed, and then its validity and reliability were tested. For the validity and reliability tests, a self-reported questionnaire comprising 33 questions with 4 point scale ($1{\sim}4$), was developed, and the data were collected from 192 hospice team members from December 2005 to February 2006. Results: Thirty three questions, drafted through literature review and professional consultation, were reviewed by 20 professionals for their validity, were revised and supplemented resulted in the final 33 questions. The questions with a correlation coefficient grater than .30 were selected: all the 33 questions were selected based on this criterion. The reliability coefficient, Cronbarh's ${\alpha}$, was 0.95. The 33 questions were analyzed for factors, and six factors were extracted: relationship formation and communication, encouragement and promotion of spiritual growth, linking with spiritual resources, preparation of death, evaluation and quality control for spiritual intervention, Intervention, and spiritual assessment for intervention. Conclusion: The tool developed in this study includes six factors and has high level of reliability. This tool Will greatly contribute to assess and improve hospice care services, providing systematic and standardized spiritual cares for terminally ill patients and their families.

• Tuberculosis and Respiratory Diseases
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• v.56 no.5
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• pp.523-531
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• 2004

Background : Bronchoscopy in patients on mechanical ventilation is being performed much more frequently. However, there is little data on the changes in physiologic parameters and no established mechanical ventilation protocol during bronchoscopy. A decreasing or the removal of positive end-expiratory pressure (PEEP) during bronchoscopy may precipitate severe hypoxemia and/or derecruitment. Methods : Our standardized mechanical ventilation protocol, without changing the PEEP level, was used during bronchoscopy. The physiological parameters were measured during the bronchoscopic procedure. Results : During bronchoscopy, respiratory acidosis, elevation of peak pressure, elevation of heart rate and auto-PEEP were developed, but were reversible changes. Procedure-related gross barotraumas or other severe complications did not developed. Conclusion : No serious complications developed during bronchoscopy under our standardized mechanical ventilation protocol when the PEEP level remained unchanged. The procedure time should be kept to a minimum to decrease the exposure time to undesirable physiological changes.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.11
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• pp.7978-7989
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• 2015

Dyslipidemia is a major risk factor for cardio-cerebrovascular disease. Although the prevalence among Korean adults is very high, its management is known to be poor. The aim of this study was to access the prevalence, awareness, treatment, and control rates of dyslipidemia according to treatment guideline rather than diagnostic criteria. The risk factors for cardio-cerebrovascular disease were evaluated to apply the appropriate risk-based threshold of the lipid treatment targets according to risk category. Analysis was done using nationally representative data (n = 16,263) collected from adults aged 20 years and older participating the Korea National Health and Nutrition Examination Survey (KNHANS) 2010-2012. The age-standardized prevalence rate of dyslipidemia according to treatment criteria was 34.1%. Of these prevalent cases, however, only 19.2% were aware; 9.5% treated; and 8.7% controlled. The age-standardized control rate among treated persons was 47.5%. Men had a significantly higher prevalence than women (39.7% vs. 28.8%), but a significantly lower rate of awareness, treatment, and control (16.0% vs. 22.3%, 7.7% vs. 11.3%, and 6.1% vs. 11.2%, respectively). As the higher risk category, the prevalence rate was higher but the control rate was lower. The prevalence of patients with diabetes was 82.5% when applying the treatment criteria (LDL-cholesterol level of ${\geq}100mg/dL$ and triglyceride level of ${\geq}200mg/dL$). However, only 11.9 % of these were controlled, whose LDL-cholesterol and triglycerides were lower than the treatment goals. Our findings suggest that effective strategies are required to decrease the gap between the prevalence of dyslipidemia and the following treatment. It would be worthwhile to strengthen the follow-up management of patients with dyslipidemia in the National Health Screening Program, especially in the high risk group of cardio-cerebrovascular disease.

• The Korean Journal of Nuclear Medicine Technology
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• v.21 no.1
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• pp.76-82
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• 2017

Purpose Whole body bone scan is one of the most frequently performed in nuclear medicine. Basically, both the anterior and posterior views are acquired simultaneously. Occasionally, it is difficult to distinguish the lesion by only the anterior view and the posterior view. In this case, accurate location of the lesion through SPECT / CT or additional static scan images are important. Therefore, in this study, various improvement activities have been carried out in order to enhance the work capacity of technologists. In this study, we investigate the effect of technologist training and standardized work process processes on bone scan error reduction. Materials and Methods Several systems have been introduced in sequence for the application of new processes. The first is the implementation of education and testing with physicians, the second is the classification of patients who are expected to undergo further scanning, introducing a pre-filtration system that allows technologists to check in advance, and finally, The communication system called NMQA is applied. From January, 2014 to December, 2016, we examined the whole body bone scan patients who visited the Department of Nuclear Medicine, Asan Medical Center, Seoul, Korea Results We investigated errors based on the Bone Scan NMQA sent from January 2014 to December 2016. The number of tests in which NMQA was transmitted over the entire bone scan during the survey period was calculated as a percentage. The annual output is 141 cases in 2014, 88 cases in 2015, and 86 cases in 2016. The rate of NMQA has decreased to 0.88% in 2014, 0.53% in 2015 and 0.45% in 2016. Conclusion The incidence of NMQA has decreased since 2014 when the new process was applied. However, we believe that it will be necessary to accumulate data continuously in the future because of insufficient data until statistically confirming its usefulness. This study confirmed the necessity of standardized work and education to improve the quality of Bone Scan image, and it is thought that update is needed for continuous research and interest in the future.

• Journal of Society of Preventive Korean Medicine
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• v.19 no.3
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• pp.45-55
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• 2015

Objective : The aim of this study was to survey the present utilization of pattern identification(PI) in the clinical field among Korean Medicine Doctors. Method : This survey was conducted from Oct. 1 to Oct. 31, 2014 by face-to-face interview using structured questionnaire. The subjects were 400 korean medicine doctors who worked in hospitals or clinics. The questionnaire consisted of two sections - a demographics section(i.e., sex, age, clinical experience, place of work, residence and so on) and the main research section(i.e., the PI utilization rate, the utilization of PI systems, the utilization of PI in the clinical domain and in the treatment domain, the correlation between utilization PI and so on). Results : This study revealed that subjects used the PI to 66.7% of their patients on average. The utilization rate of PI in patients was significantly higher for female physicians than for male physicians, for physicians worked in clinics than for physicians who worked in hospitals and for physicians with more than 10 years clinical experience than for physicians with less than 10 years clinical experience. In the utilization of PI systems, Visceral PI was most as 92.0%. There were significant difference on the PI utilization rate according to utilization of Meridian and Collateral PI, Triple Energizer PI, Defense, Qi, Nutrient and Blood PI, Six-Meridian PI and Six Excesses PI. As a result of analysing the PI utilization rate by clinical domain and in the treatment domain, the Treatment and the Drug Treatment showed the highest values. Among utilized PI systems, the correlation coefficients between Defense, Qi, Nutrient and Blood PI and Triple Energizer PI showed the highest value, but the correlation coefficients between Sasang Constitutional Medicine with the each PI showed substantially lower value. Conclusion : The results of this study demonstrate that usage of PI was higher than usage of U code(in KCD) usage in clinical field. we suggested that additional studies on using PI and developing more appropriate standardized tool should be conducted to widen scope of PI's utilization.