• Journal of Digital Convergence
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• v.13 no.7
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• pp.269-282
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• 2015

This study is to define the hemodiafiltration treatment compliance indicators and discriminate standards for hemodiafiltration patients and development of hemodiafiltration treatment compliance measurement-convergent form. Date was collected from 300 on-line hemodiafiltration patients. To verify the hemodiafiltration treatment compliance indicators and discriminate standards, used construct validity and content validity by clinical professional group. Discriminant ability of 3 indicators-interdialysis weight gain rate(IWGR), serum phosphate level, rate of self change of total hemodiafiltration treatment time(SCR-HEFTT)- is 95.6%(wilks ramda=.256, p=.002). And hemodiafiltration treatment compliance measurement-convergent form has 91.7% discriminant accuracy. Hemodiafiltration treatment compliance is important that nurses can aware pre-stage of complication and give appropriate nursing intervention. Also this measurement can be used for foundation data of the nursing intervention development that prevent dialysis patient's complication.

• Korean Journal of Head & Neck Oncology
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• v.38 no.2
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• pp.7-13
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• 2022

Human papillomavirus (HPV) is a causative agent for a subset of oropharyngeal cancer (OPC). The current standard of care (SOC) for locally advanced OPC is 70 Gy definitive radiotherapy (RT) concurrent with cisplatin, which entails significant proportions of acute and late grade 3 or higher toxicities. Accordingly, discovery of favorable prognosis of HPV-related OPC has led to enthusiasm to attenuate subspecialties therapy in multidisciplinary treatment. Diverse deintensification strategies were investigated in multiple phase 2 trials with an assumption that attenuated treatments result in comparable oncologic outcome and less toxicities compared with SOC. Several trials on chemotherapy deintensification revealed that concomitant administration of cisplatin is not to be omitted or substituted for cetuximab without compromising progression-free survival or local control. A transoral robotic surgery (TORS) is investigated as alternative local treatment, but TORS plus SOC or mild deintensified adjuvant RT showed similar toxicities and inferior oncologic outcomes compared with SOC definitive RT or moderately deintensified RT. However, it has been reported that TORS plus deintensified 30-36 Gy adjuvant RT results in excellent outcome and less late toxicity compared with SOC adjuvant RT. Several phase 2 trials reported apparently equivalent progression-free survival and local control and similar adverse effects with moderately deintensified 60 Gy RT compared with SOC 70 Gy RT. Further dose reduction below 60 Gy has been investigated using biology-directed approaches, which use response to induction chemotherapy or metabolic images to triage HPV-positive OPC for deintensified RT. In summary, these trials provide valuable insights for future directions. Available evidence consistently showed that moderately deintensified RT is effective and safe for HPV-positive OPC in both definitive and adjuvant settings. Concurrent cisplatin remains an essential component without which progression-free survival is significantly compromised for advanced HPV-positive OPC. A simple incorporation of TORS to SOC may be detrimental for oncologic outcome without anticipated toxicity reduction. Given the lack of level 1 evidence, it is prudent to curb an unjustified deviation from the current SOC and limit any deintensified strategies to clinical trials and adhere to the current SOC.

• Journal of the Society of Disaster Information
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• v.11 no.2
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• pp.191-202
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• 2015

The purpose of this study was to examine the influence of the disaster perception and satisfaction level of volunteer fire-fighters on the continuity of their volunteering. The 163 subjects in this study were selected from male and female volunteer fire-fighters who resided in urban and rural regions in Gangwon Province. After a this survey was conducted, the collected data were analyzed by a statistical package SPSS WIN 20.0, and frequency analysis, correlation analysis and multiple regression analysis were made. The level of statistical significance was all set at p<.05. The findings of the study were as follows: First, as for the correlation of disaster perception, satisfaction and volunteering continuity, perception of disaster countermeasures, satisfaction and the level of participation were negatively correlated with one another, and there was a positive correlation among disaster training, disaster preparation, regional disaster, the period of volunteering, and will of persistent volunteering. Second, as for perception of disaster, the volunteer fire-fighters were asked a question about disaster countermeasures, and the largest group replied they were partially aware of the countermeasures. Concerning questions about disaster training/education experience and triage, the biggest group replied they underwent the training and knew about triage on the whole. Regarding questions on the emergency contact system and emergency work schedule, they knew about the two in general. As to a question on the occurrence of human disaster, the greatest group answered that they knew about it yet not well. Third, in regard to the impact of satisfaction level on volunteering continuity, the period of volunteering was affected by needs for experience, social contact and social recognition among the subfactors of satisfaction level, and will of persistent volunteering was under the influence of social contact and achievement needs. The level of persistent volunteering was affected only by needs for experience and achievement needs.

• Tuberculosis and Respiratory Diseases
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• v.54 no.3
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• pp.311-319
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• 2003

Background : Previous studies have suggested that a B-type natriuretic peptide(BNP) test can provide important information on diagnosis, as well as predicting the severity and prognosis of heart failure. Myocardial dysfunction is often observed in critically ill noncardiac patients admitted to the Intensive Care Unit, and the prognosis of the myocardial dysfunction needs to be determined. This study evaluated the predictability of BNP on the prognosis of critically ill noncardiac patients. Methods : 32 ICU patients, who were hospitalized from June to October 2002 and in whom the BNP test was evaluated, were enrolled in this study. The exclusion criteria included the conditions that could increase the BNP levels irrespective of the severity, such as congestive heart failure, atrial fibrillation, ischemic heart disease, and renal insufficiencies. A triage B-Type Natriuretic Peptide test with a RIA-kit was used for the fluorescence immunoassay of BNP test. In addition, the acute physiology and the chronic health evaluation (APACHE) II score and mortality were recorded. Results : There were 16 males and 16 females enrolled in this study. The mean age was 59 years old. The mean BNP levels between the ICU patients and control were significantly different ($186.7{\pm}274.1$ pg/mL vs. $19.9{\pm}21.3$ pg/mL, p=0.033). Among the ICU patients, there were 14(44----) patients with BNP levels above 100 pg/mL. The APACHE II score was $16.5{\pm}7.6$. In addition, there were 11 mortalities reported. The correlation between the BNP and APACHE II score, between the BNP and mortality were significant (r=0.443, p=0.011 & r=0.530, p=0.002). The mean BNP levels between the dead and alive groups were significantly different ($384.1{\pm}401.7$ pg/mL vs. $83.2{\pm}55.8$ pg/mL p=0.033). However, the $PaO_2/FiO_2$ did not significantly correlate with the BNP level. Conclusion : This study evaluated the BNP level was elevated in critically ill, noncardiac patients. The BNP level could be a useful, noninvasive tool for predicting the prognosis of the critically ill, noncardiac patients.

• Journal of the Korean Orthopaedic Association
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• v.54 no.4
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• pp.293-301
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• 2019

Soft tissue masses of the extremities and torso are a common problem encountered by orthopaedic surgeons. Although these soft tissue masses are often benign, orthopaedic surgeons need to recognize the key features differentiating benign and malignant masses. An understanding of the epidemiology and clinical presentation of soft tissue masses is needed to develop a practical approach for evaluation and surgical management. Size and depth are the two most important factors on which triage decisions should be based. In a differential diagnosis of a tumor, it is important to know the characteristics of the soft tissue mass through detailed history taking and physical examinations before the diagnostic procedures. A variety of imaging studies, such as simple radiography, ultrasound, magnetic resonance imaging, positron emission tomography, computed tomography, bone scan, and angiography can be used to diagnose tumors. Know the ledge of advantages and disadvantages of each imaging study is essential for confirming the characteristics of the tumor that can be observed in the image. In particular, ultrasonography is convenient because it can be performed easily in an outpatient clinic and its cost is lower than other image studies. On the other hand, the accuracy of the test is affected by the skill of the examiner. A biopsy should be performed to confirm the tumor and be performed after all imaging studies have been done but before the final treatment of soft tissue tumors. When a biopsy is to be performed, careful attention to detail with respect to multidisciplinary coordination beforehand, cautious execution of the procedure to minimize complications, and expedient follow-up and referral to a musculoskeletal oncologist when appropriate, are essential.

• Journal of Trauma and Injury
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• v.19 no.1
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• pp.54-58
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• 2006

Purpose: The committee on trauma of the american college of surgeons, in its manual resources for optimal care of the injured patients involved in falls from less than 20 feet need not be taken to trauma centers. Because triage criteria dictate less urgency for low-level falls, this classification scheme has demerits for early detection and treatment of serious problems in the emergency room. Methods: A prospective analysis was conducted of 182 patients treated for fall-related trauma from June 2003 to March 2004. Falls were classified as group A (<3 m), group B (${\geq}3m$, <6 m), and group C (${\geq}6m$). Collected data included the patient's age, gender, site and height of fall, surface fallen upon, body area of first impact, body regions of injuries, Glasgow Coma Scale (GCS), Revised Trauma Score (RTS), and Injury Severity Score (ISS). Results: The 182 patients were classified as group A (105) 57.7%, group B (61) 33.5%, and group C (16) 8.8%. There was a weak positive correlation between the height of fall and the patients' ISS in the three groups (p<0.001). There were significant differences in GCS (p=0.017), RTS (p=0.034), and ISS (p=0.007) between group A and B. In cases that the head was the initial impact area of the body, the GCS (p<0.001) and the RTS (p=0.002) were lower, but the ISS (p<0.001) was higher than it was for other type of injuries. Hard surfaces as an impact surface type, had an influence on the GCS (p<0.001) and the ISS (p=0.025). Conclusion: To simply categorize patients who fall over 6 meters as severely injured patients doesn't have much meaning, and though patients may have fallen less than 6 meters, they should be categorized by using the dynamics (impact surface type, initial body - impact area) of their fall.

• Journal of Korean Academy of Dental Administration
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• v.8 no.1
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• pp.1-7
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• 2020

Dental settings have unique characteristics that warrant specific infection control considerations, including (1) prioritizing the most critical dental services and provide care in a way that minimizes harm to patients due to delayed care, or harm to personnel from potential exposure to persons infected with the COVID-19 disease, and (2) proactively communicate to both personnel and patients the need for them to stay at home if sick. For health care, an interim infection prevention and control recommendation (COVID-19) is recommended for patients suspected of having coronavirus or those whose status has been confirmed. SARS-CoV-2, which is the virus that causes COVID-19, is thought to be spread primarily between people who are in close contact with one another (within 6 feet) through respiratory droplets that are produced when an infected person coughs, sneezes, or talks. Airborne transmission from person-to-person over long distances is unlikely. However, COVID-19 is a new disease, and there remain uncertainties about its mode of spreads and the severity of illness it causes. The virus has been shown to persist in aerosols for several hours, and on some surfaces for days under laboratory conditions. COVID-19 may also be spread by people who are asymptomatic. The practice of dentistry involves the use of rotary dental and surgical instruments, such as handpieces or ultrasonic scalers, and air-water syringes. These instruments create a visible spray that can contain particle droplets of water, saliva, blood, microorganisms, and other debris. While KF 94 masks protect the mucous membranes of the mouth and nose from droplet spatter, they do not provide complete protection against the inhalation of airborne infectious agents. If the patient is afebrile (temperature <100.4°F)* and otherwise without symptoms consistent with COVID-19, then dental care may be provided using appropriate engineering and administrative controls, work practices, and infection control considerations. It is necessary to provide supplies for respiratory hygiene and cough etiquette, including alcohol-based hand rub (ABHR) with 60%~95% alcohol, tissues, and no-touch receptacles for disposal, at healthcare facility entrances, waiting rooms, and patient check-ins. There is also the need to install physical barriers (e.g., glass or plastic windows) in reception areas to limit close contact between triage personnel and potentially infectious patients. Ideally, dental treatment should be provided in individual rooms whenever possible, with a spacing of at least 6 feet between the patient chairs. Further, the use of easy-to-clean floor-to-ceiling barriers will enhance the effectiveness of portable HEPA air filtration systems. Before and after all patient contact, contact with potentially infectious material, and before putting on and after removing personal protective equipment, including gloves, hand hygiene after removal is particularly important to remove any pathogens that may have been transferred to the bare hands during the removal process. ABHR with 60~95% alcohol is to be used, or hands should be washed with soap and water for at least 20 s.

• Women's Health Nursing
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• v.5 no.1
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• pp.133-145
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• 1999

The purposesof the study are to analyze the community nursing center in U.S.A and to develop the model of nursing care system based on nurse-midwifery clinic in community for women's health in Korea. 1. In America nursing center is defined as nurse-anchored system of primary care delivery or neighborhood health center. Nursing centers are identified the following four types: (1) community outreach centers, which are similar to traditional public health clinics: (2) institutional-based centers following the mission of a large institution, such as a hospital or university: (3) wellness/health promotion centers, which offer screening, education, counseling, triage, and health maintenance services: and (4) independent practice. Nursing centers are a concept of services provided by nurses in practice arrangements in a community. Nursing centers offer a variety of services, ranging from primary care provided by advanced practice nurses with medical acute management and nursing care to the more traditional education, health promotion, screening wellness and coordination services. Some services, such as the care provided by advanced practice nurses are reimbursed under various insurance plan in some instances and states, where as others, such as preventive and educational services, are not. Thus, lack of reimbursement has threatened the survival of some centers. Licensing of nursing centers varies by state and program and accreditation of nursing centers is also limited. 52% of centers are affiliated with another facility and 48% are freestanding centers. The number of registered nurse at the nursing centers ranges from just one to 115, with a mean of eight RNs peragency and a median of three. Nursing centers avail ability varies: 14% are open 24 hours, 27% have variable short hours, 23% are open 6-7 days per week, and 36% are open Monday- Friday. As the result of my visiting three health centers in Seattle and San Francisco, the women's primary care nurse practitioners focus on a systematic and comprehensive assessment of the health status of women and diagnosis and management of common physical and psychosocial health concerns of women in ambulatory settings. Therapeutic nursing strategies are directed toward self-care, risk reoduction, health surveillance, stress reduction, healthy nutrition, social support, healthy coping, psychological well-being, and pharmacological therapy. They function as primary care providers for the well ness and illness care of women from adolescence through the older adult years and pregnant families. 2. In Korea a nurse-midwife practices independently for pregnant women's health including childbearing family at her own clinic in community. Her services are reimbursed under national health insurance but they are not paid on a fee-for-service schedule covering items. Analyzing the nursing centers in America, I suggest that nurse-midwifery clinics offer primary care for women and home care for chronic ill patients. The health law and health insurance policy should be reovised in order to expand nurse-midwife's and home care nurse's roles at nurse-midwifery clinic.

• The Journal of the Korea Contents Association
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• v.15 no.1
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• pp.350-356
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• 2015

The purpose of this study is effect factors of Pre-Hospital Medication in the Patients with Bee-Sting. This study is to identify the necessity of using epinephrine in prehospital stage from the perspective of early management of anaphylaxis following a bee sting. Methods: Patients suffering from a bee sting who used the 119 rescue between 2013 from 119 center data were included. Age, sex, month of injury, time factors, vital signs, medication, signs, distance factors, presence of cardiac arrest, AVPU triage by EMT were extracted. The severity of bee sting injury was divided into mild, moderate, and severe according to the presenting symptoms and signs. Results: The severe patients treated by using oxygen, IV, ECG, Medication. Anaphylaxis is a serious allergic reaction of rapid onset that may lead to death. One of Anaphylaxis patients lived by using epinephrine. Most patients collapsed at the scene of mount. Bee sting injuries occurred primarily during summer to the farmer. Nine patients collapsed at the scene. Bee sting injuries occurred primarily from June to October. Conclusion: The primary treatment for anaphylaxis is epinephrine. Epinephrine in pre-hospital stage is factors of essential for patients. Also epinephrine will permit to be equipped in the EMT-P and use of epinephrine by law.

• Journal of Korea Entertainment Industry Association
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• v.15 no.1
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• pp.207-220
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• 2021

The purpose of the study is to investigate the application and utility of emergency rescue education and derive limitations, improvements and development directions of university education based on the field experience of 119 emergency medical technician(EMT)s. The research subjects were six new 119 emergency medical technician(EMT)s within three years of starting their first-aid service in the field. After conducting in-depth narrative interviews, the analysis was performed using Colaizzi method. The 82 formulated meanings were derived from significant statements. From formulated meanings, 23 themes, 4 theme clusters, 2 categories were identified. The four theme clusters were 'The effectiveness of university education', 'The limitations of university education', 'The direction of improvement in educational methodology' and 'The direction of improvement in educational contents. University education has been helpful overall, but limitations are observed at the same time, suggesting that it should be developed through the improvement of educational methodologies (i.e. problem-based learning, field case review, education through role-playing, simulation education, strengthening skill ect.) and educational content (i.e. training tailored to the field, education focused on trauma or cardiac arrest, expansion of triage education in disaster management, reinforcement of education on-site safety, education on special patients, diverse guidance and faculty for different perspectives).