• Asian Pacific Journal of Cancer Prevention
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• 제15권20호
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• pp.8647-8650
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• 2014

Background: Ovarian cancer is the most common cancer cause of gynecologic cancer deaths. In order to increase the likelihood of patient survival through primary operation by gyneco-oncologists, an appropriate algorithm for referral is considered here. Materials and Methods: Suspicious adnexal mass cases including ovarian malignancy probability score-1 (OMPS1) scores between 2.3-3.65 are re-evaluated by OMPS2. Sensitivity and specificity of each score were determined. Results: Sensitivity and specificity with a 3.82 score of OMPS2 in the studied subgroup (OMPS1 scores between 2.3-3.65) were 64% and 76.9% respectively. Conclusions: Management of OMPS1 scores of below 2.3 with sensitivity of 100% and above 3.65 with specificity of 72.9% is clear. In the subgroup of cases with OMPS1 score between 2.3-3.65, OMPS2 is helpful for triage with a cutoff score of 3.82.

• 한국병원경영학회지
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• 제25권3호
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• pp.38-52
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• 2020

Purpose: The purpose of the study is to suggest the main functions and implications of public hospitals to effectively respond to the future epidemic crisis based on analyzing the accessibility to designated Coronavirus Disease 2019 (COVID-19) medical institutions of Seoul and examining the main features of the quarantine of Seoul municipal hospitals. Method: To analyze the response and function of Seoul municipal hospitals, we reviewed the Infectious Disease Control and Prevention ACT, 258 articles of Seoul Metropolitan Government press releases from January to the end of April, 48 articles of Seoul Metropolitan Government's daily newsletters, 2019 Health Bureau Budget report. We also referred to internal data of Seoul Children's Hospital, Seoul Seobuk Hospital, and Seoul Eunpyeong Hospital during the same period. Besides, the accessibility to medical institutions was analyzed by using the COVID-19 data which was announced daily basis. Results: The accessibility of COVID-19 patients living in the Southeastern part of Seoul to a medical institutions was 16.2km on a distance basis, and it was the lowest accessibility among four regions of Seoul since it took about 40 minutes by car. On the other hand, patients living in the Northeast part had the highest accessibility, as the access to medical institutions was 10.7km and 27 minutes by car. Also, the main functions of the municipal hospital of Seoul against COVID-19 were to shift the public hospital function to COVID-19 patients only hospitals, to perform the epidemiological investigation by medical doctors, and to support the operation of self-isolation facilities, community treatment centers and triage rooms of community health centers. Conclusion: Through the experience of COVID-19, we suggested that the functions of public hospitals will be reorganized as the reinforcement of infectious disease treatment and mental health for quarantined patients, cooperation with private hospitals, supporting for strengthening community health capacity and preparation for another epidemic.

• 간호행정학회지
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• 제4권2호
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• pp.419-437
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• 1998

Nurses use a nursing process. that is a scientific approach method. in order to understand the clients' condition and to solve their problems. Professional nurses have accepted the nursing process as a standard framework for nursing activities, and the first step of the nursing process is nursing assessment. The purpose of this study was to develop a nursing assessment tool for emergency patients. Assessment is a first step in the nursing process, and scientific assessment helps to better understand the patients. Thus the development of an assessment tool for emergency patients will improve of nursing quality and advance to efficacy of emergency room(ER) management. The study involved the development of a conceptual framework, preliminary tool, content validity verification process. and reliability verification process. The conceptual framework was developed through a review of the literature. and preliminary tool was developed from the conceptual framework that based on care flow sheet' developed James A. Haley. The preliminary tool was evaluated for validity and reliability by seven experts, one ER nurse manager, two ER head nurses, two emergency medicine doctors. and two ER charge nurses and by ten nurses with one to five year careers in ER nursing. The results of this study was as follows 1. The conceptual framework which was developed was composed of three parts. They were triage criteria, first assessment and secondary assessment. 2. The preliminary tool which was developed had 31 items based on the conceptual framework. 3. To test expert validity a 4-point scale was used. items which had gained 3-4 points from six persons of the seven experts were selected. All 31 items from the preliminary tool were selected. 4. The reliability test was done by ten nurses educated in the use of the assessment tool. Two pairs of nurses simultaneously assessed the same patients. A total agreement percentile was calculated and result was 87.3% agreement. 5. After the validity and reliability testing. the final emergency patient nursing assessment tool was finalized with 31 items. and a check-list for the responses. This study concludes that the tool which was developed is both valid and reliable will advance quality care for emergency patients. This emergency nursing assessment tool was also found to be an adequate tool for assessment of emergency patients.

• Clinical and Experimental Emergency Medicine
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• 제5권4호
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• pp.256-263
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• 2018

Objective We conducted a study to validate the effectiveness of the Korean criteria for trauma team activation (TTA) and compared its results with a two-tiered system. Methods This observational study was based on data from the Korean Trauma Data Bank. Within the study period, 1,628 trauma patients visited our emergency department, and 739 satisfied the criteria for TTA. The rates of overtriage and undertriage in the Korean one-tiered system were compared with the two-tiered system recommended by the American College of Surgery-Committee on Trauma. Results Most of the patient's physiologic factors reflected trauma severity levels, but anatomical factors and mechanism of injury did not show consistent results. In addition, while the rate of overtriage (64.4%) was above the recommended range according to the Korean criteria, the rate of undertriage (4.0%) was within the recommended range. In the simulated two-tiered system, the rate of overtriage was reduced by 5.5%, while undertriage was increased by 1.8% compared to the Korean activation system. Conclusion The Korean criteria for TTA showed higher rates of overtriage and similar undertriage rates compared to the simulated two-tier system. Modification of the current criteria to a twotier system with special considerations would be more effective for providing optimum patient care and medical resource utilization.

• 보건행정학회지
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• 제32권2호
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• pp.164-172
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• 2022

Background: The purpose of this study was to the impact of the coronavirus disease 2019 (COVID-19) outbreak on emergency departments (EDs) in patients under the age of 18 years with respiratory disease. Also, we analyzed similarities and differences in patients including revisit before and after the COVID-19 outbreak. Methods: This study population was respiratory patients under the age of 18 years who visited all 403 EDs in Korea between January 1st, 2019 and December 31st, 2020, using the National Emergency Department Information System Database. The primary outcome was the number of respiratory patients according to age, sex, the type of EDs, season, Korean Triage and Acuity Scale (KTAS) levels, the result of ED, and length of stay. The secondary outcome was the number of revisit respiratory patients within 72 hours. We calculated the risk-adjusted revisit rates according to the KTAS level using a multiple logistic regression model. Results: The number of ED visits decreased from 274,526 in 2019 to 79,007 in 2020; this number was 71.2% lower than that before COVID-19. In spring 2020, this number was 90.1% lower than during the same period in 2019. For the revisit rate in the study population, the adjusted odds ratio (95% confidence interval) was 1.22 (1.05-1.41) in 2019 and 1.39 (1.07-1.81) in 2020. Conclusion: Implementing appropriate emergency care policies in severe respiratory patients would have contributed to improving the safety of reducing in revisit rate.

• 한국군사과학기술학회지
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• 제23권3호
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• pp.277-285
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• 2020

Survivability in a battle field is the most important aspect to the warriors. To analyze the survival effectiveness of warrior platform, the simulation via war-game model is an essential step in advance to the development of platform. In this study, Army Weapon effectiveness Analysis Model(AWAM) was utilized for analysis. Several weapon parameters were adjusted to apply the characteristics of warrior platform in some cases of the defense and survival system. Especially, adjusted triage possibility, probability of kill, fatality and accuracy were employed as parameters in the simulation program to evaluate the survival effectiveness of intelligent system based on the previous researches. In the future battle field or virtual space in the AWAM, the warrior platform intelligent system could react emergency treatment on time by expoiting the bio-information of man at arms. Considering the order of supply priority, special force was selected as operating troops and battle scenario without engagement was selected to measure accurate survival effectiveness. In conclusion, the survivability of defence and survival system of the warrior platform was about 1.47 times higher than that of current system.

• 대한응급의학회지
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• 제26권1호
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• pp.29-37
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• 2015

Purpose: Stool exams are a useful tool for the early presumptive diagnosis of infectious bacterial diarrhea in the Emergency Department (ED). CT scans are often used to increase the physician's level of certainty and to facilitate patient triage by identifying the source of pain in most patients with an acute abdomen in the ED. This study was designed to investigate the correlation between stool exams and abdominal CT in patients with acute diarrhea visiting the ED. Methods: We conducted a retrospective study in the emergency department of a national university hospital from January 1, 2012 to June 30, 2013. The subjects consisted of 156 patients with acute diarrhea and abdominal pain who had stool exam results and abdominal CT findings. We divided the patients into three groups according to the stool exam results. Simultaneously, we evaluated their CT findings of the bowel and adjacent structures. Results: A total of 156 patients were enrolled. Frequency of abnormal CT findings showed statistically significant correlation with stool exams (p-value <0.001). Abnormal CT findings increased as WBCs and RBCs in stool increased (p-value <0.001). Conclusion: The stool exam was a statistically significant predictive variable in indirectly determining the severity of acute diarrhea and it showed correlation with the frequency of abnormal CT findings. It is suggested that stool exams can be used as a susceptible marker for predicting the probability of severe infectious colitis, and for making an early decision regarding close medical attention.

• Radiation Oncology Journal
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• 제37권3호
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• pp.207-214
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• 2019

Purpose: To identify the prognostic factors that could influence survival and to compare prognoses of the patients with the number of the risk factors that might assist in the adequate management of hepatocellular carcinoma (HCC) patients with bone metastases that showed a heterogeneous range of survival. Materials and Methods: A total of 41 patients, treated with radiotherapy (RT) for bone metastases from HCC from 2014 to 2017, were enrolled retrospectively. Survival was determined by the Kaplan-Meier method from the start of the RT for metastatic bone lesions. Pre-RT clinical features were evaluated and their influences on survival were analyzed. The significant factors were considered to compare survivals according to the number of prognostic factors. Results: Median follow-up was 6.0 months (range, 0.5 to 47.0 months). The median overall survival was 6.5 months, and the 1-year and 2-year survival rates were 35.5% and 13.5%, respectively. Multivariate analysis revealed that the Child-Pugh class A group, alpha-fetoprotein increased more than 30 ng/mL, and HCC size of more than 5 cm were associated with worse overall survival. The median survivals in HCC with none, 1, 2, and 3 of the aforementioned risk factors were 19.5, 9.0, 2.5, and 1.0 months, respectively (p < 0.05). Conclusion: Our results show that the overall survivals were significantly different according to the number of the risk factors among HCC patients with bone metastases who showed various lengths of survival.

• IMMUNE NETWORK
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• 제21권1호
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• pp.11.1-11.10
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• 2021

Coronavirus causes an infectious disease in various species and crosses the species barriers leading to the outbreak of zoonotic diseases. Due to the respiratory diseases are mainly caused in humans and viruses are replicated and excreted through the respiratory tract, the nasal fluid and sputum are mainly used for diagnosis. Early diagnosis of coronavirus plays an important role in preventing its spread and is essential for quarantine policies. For rapid decision and prompt triage of infected host, the immunochromatographic assay (ICA) has been widely used for point of care testing. However, when the ICA is applied to an expectorated sputum in which antigens are present, the viscosity of sputum interferes with the migration of the antigens on the test strip. To overcome this limitation, it is necessary to use a mucolytic agent without affecting the antigens. In this study, we combined known mucolytic agents to lower the viscosity of sputum and applied that to alpha and beta coronavirus, porcine epidemic diarrhea virus (PEDV) and Middle East respiratory syndrome coronavirus (MERS-CoV), respectively, spiked in sputum to find optimal pretreatment conditions. The pretreatment method using tris(2-carboxyethyl)phosphine (TCEP) and BSA was suitable for ICA diagnosis of sputum samples spiked with PEDV and MERS-CoV. This sensitive assay for the detection of coronavirus in sputum provides an useful information for the diagnosis of pathogen in low respiratory tract.

• 한국산학기술학회논문지
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• 제14권9호
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• pp.4326-4334
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• 2013

본 연구는 보훈병원에 입원한 노인환자들의 약물정보인식, 약물사용 실태 및 약물오용상태를 파악하기 위해 시도된 서술적 조사연구이다. 연구기간은 2011년 5월부터 6월까지이며 연구대상자는 전국 5개 지역 보훈병원에서 약물을 사용하고 있는 만 65세 이상된 국가유공자 220명이다. 자료분석은 SPSS Win 18.0 프로그램을 이용하였고 영역별 분석은 평균과 표준편차, t-test와 ANOVA, 다중회귀분석으로 통계적 진술하였다. 연구결과로는 대상자의 일반적 특성인 연령, 결혼유형, 교육정도, 환자분류, 건강상태가 통계적으로 유의한 수준을 나타내었다. 약물정보인식 영역에 영향력 있는 변수는 '연령'으로 나타났으며 약물오용과 약물사용 실태 요인은 '건강상태'에 영향력을 보였다. 따라서 향후에는 보훈병원 입원 노인환자와 일반 노인환자를 대상으로 한 비교 연구가 필요하며, 또한 국가적 차원에서 전액 보상되는 치료비와 진료비는 보훈병원 입원 노인환자들의 약물의존도를 부추기는 경향으로 일부 작용하므로 보훈병원 입원 노인환자들에게 보훈의료제도의 합리적 지원방안에 관한 연구와 보훈의료 서비스의 질적인 향상을 위한 연구가 이루어져야 한다.