• Journal of Korean Neurosurgical Society
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• 제56권1호
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• pp.42-47
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• 2014

Objective : Helicopter ambulance transport (HAT) is a highly resource-intensive facility that is a well-established part of the trauma transport system in many developed countries. Here, we review the benefit of HAT for neurosurgical patients in Korea. Methods : This retrospective study followed neurotrauma patients who were transferred by HAT to a single emergency trauma center over a period of 2 years. The clinical benefits of HAT were measured according to the necessity of emergency surgical intervention and the differences in the time taken to transport patients by ground ambulance transport (GAT) and HAT. Results : Ninety-nine patients were transferred to a single university hospital using HAT, of whom 32 were taken to the neurosurgery department. Of these 32 patients, 10 (31.3%) needed neurosurgical intervention, 14 (43.8%) needed non-neurosurgical intervention, 3 (9.4%) required both, and 11 (34.4%) did not require any intervention. The transfer time was faster using HAT than the estimated time needed for GAT, although for a relatively close distance (<50 km) without ground obstacles (mountain or sea) HAT did not improve transfer time. The cost comparison showed that HAT was more expensive than GAT (3,292,000 vs. 84,000 KRW, p<0.001). Conclusion : In this Korean-based study, we found that HAT has a clinical benefit for neurotrauma cases involving a transfer from a distant site or an isolated area. A more precise triage for using HAT should be considered to prevent overuse of this expensive transport method.

• 정보보호학회논문지
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• 제23권1호
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• pp.57-67
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• 2013

침해사고는 시스템 해킹, 바이러스 및 웜, 홈페이지 변조, 자료 유출 등 그 유형이 다양하고, 단순한 바이러스나 웜 등의 유포가 아닌 개인정보 및 기업기밀 정보를 취득하거나 금전적 이득을 취하기 위한 목적으로, 공격자가 사용하는공격 기법이 고의적인 데이터의 삭제나 변경 등 고도의 은닉 기법을 활용하여 흔적을 남기지 않기 때문에, 정확한 자료를 수집하기가 쉽지 않다. 침해사고 초기 대응시 초동 대응자는 신속한 조사를 수행해야할 필요가 있는 침해위협 또는 범죄와 관련 현장 정보를 취급한다, 이때 체계적인 증거 수집을 위하여 침해사고의 식별에 적합한 디지털 포렌식 프로세스 방법론의 적용이 요구된다. 본 논문에서는 초동 대응자가 효과적인 초기 대응을 위하여, 윈도우 시스템 환경에서의 디지털 포렌식 측면에서 CFFTPM 포렌식 프로세스 모델을 적용하여 사용자 사용 정보, 타임라인 정보, 인터넷 정보 등 증거 수집 기본정보를 분석하고 이에 따라 클라이언트/서버 모델로 증거수집 응용시스템을 설계하고 이를 구현하였다.

• 한국융합학회논문지
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• 제12권1호
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• pp.283-292
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• 2021

본 연구는 간호학생을 대상으로 재난간호 지식, 중증도 분류 지식 및 재난간호 준비도를 파악하고 재난간호 준비도에 미치는 영향요인을 파악하기 위한 서술적 조사연구이다. 자료수집은 2017년 6월 12일부터 10월 16일까지 B시와 G도의 간호학과 5곳의 3,4학년 간호학생 403명을 대상으로 실시하였다. 자가 보고식 설문지를 사용하였으며, IBM SPSS 25.0을 이용하여 기술통계, t-test, ANOVA, Scheffé test, Pearson's correlation coefficients, multiple regression으로 분석하였다. 연구결과 대상자의 재난간호 지식은 12.04±3.56점, 중증도 분류 지식은 6.24±2.64점, 재난간호 준비도는 79.98±12.16점이었다. 대상자의 재난간호 준비도에 영향을 미치는 요인은 낮은 재난간호 자신감(β=-.22, p<.001)과 재난간호 지식(β=.15, p=002)으로 확인되었으며, 모형의 설명력은 10.2%이었다. 그러므로, 간호학생들의 재난간호 준비도를 향상시키기 위해서는 재난간호에 대한 자신감을 향상시키고, 체계적이고 실용적인 재난간호 교육과정이 개발되어야 할 것이다.

• 한국산업정보학회논문지
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• 제26권4호
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• pp.1-9
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• 2021

본 연구는 서남해안 해양경찰이 이송하는 응급환자 유형과 이와 관련된 교육 및 원격의료지도의 필요성, 통신수단으로서 스마트글래스에 대한 인식과 태도를 알아보고자 31명의 해양경찰을 대상으로 수행되었다. 응급환자 유형은 출혈, 자상, 복통에서 상대적으로 높은 빈도와 훈련요구도가 확인되었다. 반면에 약물사용과 중증도 분류에 대한 원격의료지도 요구가 높았으며, 통신도구로서 스마트글래스의 활용에 대한 인지된 유용성과 태도점수는 각각 3.76±0.61점, 3.64±0.45점이었다. 스마트글래스에 대한 인지된 유용성과 태도 간 중간 정도의 상관관계가 확인되었다(r=.630, p<.01). 기술의 발전과 함께 해양경찰의 응급구조 활동의 효율성과 안전성을 높이기 위해 스마트글래스와 같은 새로운 장비의 적극적 도입과 다양한 노력이 필요한 시점이다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권14호
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• pp.5879-5882
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• 2014

High-risk (HR) human papillomavirus (HPV) testing is important in cervical cancer screening for triage colposcopy. The objective of the study was to evaluate the prevalence of HR HPV infection with different cervical cytological features among women undergoing health examination. A total of 2,897 women were retrospectively evaluated between May 2011 to December 2011. DNA was extracted from residual specimens collected during routine liquid-based cytology tests at the National Cancer Institute. Overall, HR HPV prevalence was 9.3% including 1.6% of HPV-16 and 0.4% of HPV-18. Of all 270 HPV positive samples, 211 (78.1% were HR-HPV non 16/18; 47 (17.4%) were HPV-16 and 12 (4.4%) were HPV-18. The prevalence of HPV infection was similar in all age groups, although a higher rate was observed in women age 31-40 years. Among women with normal cytology, HR HPV positive were found in 6.7%. In abnormal cytology, HR HPV were found 46.7% in atypical squamous cells (ASC), 54.8% in low-grade squamous intraepithelial lesions (LSIL) and 80.0% in high-grade squamous intraepithelial lesions (HSIL). HPV-16 was detected in 8.6%, 6.4% and 12.0% of ASC, LSIL and HSIL, respectively. The results of this study provide baseline information on the HPV type distribution, which may be useful for clinicians to decide who should be monitored or treated more aggressively.

• Annals of Laboratory Medicine
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• 제38권6호
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• pp.524-529
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• 2018

Background: An increase in neutrophil gelatinase-associated lipocalin (NGAL) indicates tubular injury. Diabetic nephropathy causes typical changes in the kidney, characterized by glomerulosclerosis and eventual tubular damage. We validated the usefulness of plasma NGAL (pNGAL) as a biomarker of tubular damage in patients with diabetic nephropathy. Methods: We included 376 patients with diabetes mellitus (260 patients with chronic renal insufficiency who had not received hemodialysis and 116 hemodialyzed due to diabetic nephropathy) and 24 healthy controls. Patients with chronic renal insufficiency were divided into three groups according to urinary albumin excretion (UAE) levels. pNGAL levels were measured using the Triage NGAL test (Alere, San Diego, CA, USA) and were compared between groups. We also examined whether pNGAL level was related to the degree of albuminuria and cystatin C-based glomerular filtration rate (GFR). Results: Mean pNGAL levels of the healthy controls, chronic renal insufficiency patients with diabetes mellitus, and hemodialyzed patients were $61.9{\pm}5.3ng/mL$, $93.4{\pm}71.8ng/mL$, and $1,536.9{\pm}554.9ng/mL$, respectively. pNGAL level increased significantly in patients with severe albuminuria (P <0.001) and had a moderate correlation with the degree of albuminuria (r=0.467; P <0.001) and GFR (r=0.519; P <0.001). Multivariate regression analysis showed that the pNGAL level was associated with tubular damage independent of patient age, sex, and GFR. Conclusions: pNGAL level independently reflects the degree of tubular damage in patients with diabetic nephropathy. Measurement of pNGAL, combined with UAE, would enable simultaneous, highly reliable assessments of tubular damage for such patients.

• 보건행정학회지
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• 제19권3호
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• pp.27-44
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• 2009

The length of stay in emergency departments has been used as a quality indicator to reflect the overall efficiency of emergency care. Identifying characteristics associated with length of stay is critical to monitor overcrowding and improve efficient throughput function of emergency departments. This study examined the level of waiting time for initial assessment by physician and length of stay in emergency departments. Furthermore, we investigated the characteristics of patients' attendance associated with length of stay. An observational study was performed for a sample of 1,526 patients visiting ten nation-wide emergency departments. A structured form was designed to collect information about patients' demographics, route of admission, time and mode of arrival, triage level, cause of attendance, initial assessment time by physician, departure time, and disposition. Multiple regression analysis was performed to determine factors associated with length of stay. The average length of stay was 209.4 minutes (95% confidence interval [CI]=197.1-221.7), with a mean waiting time for initial assessment of 5.9 minutes (95% CI=5.1-6.7). After controlling for emergency department characteristics, increasing age, longer waiting times, attendance due to diseases, higher acuity, multiple diagnoses($\geq$2) and requiring admission or transfer to other health care facilities were positively associated with length of stay in emergency departments. The findings suggest that both patients' characteristics and the flow between emergency departments and parent hospitals should be taken into account in predicting length of stay in emergency departments.

• 대한간호학회지
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• 제44권2호
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• pp.228-236
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• 2014

Purpose: Common conditions, such as dehydration or respiratory infection can aggravate hypoxia and are associated with interstage mortality in infants who have undergone palliative surgery for congenital heart diseases. This study was done to evaluate the efficacy of a home monitoring program (HMP) in decreasing infant mortality. Methods: Since its inception in May 2010, all infants who have undergone palliative surgery have been enrolled in HMP. This study was a prospective observational study and infant outcomes during HMP were compared with those of previous comparison groups. Parents were trained to measure oxygen saturation, body weight and feeding volume and to contact the hospital through the hotline for emergency situations. Telephone counseling was conducted by clinical nurse specialists every week post discharge. Results: Forty-one infants were enrolled in HMP. Nine hundred telephone counseling sessions were conducted. Seventy-three infants required telephone triage with the most common conditions being gastrointestinal (50.7%) and respiratory symptoms (32.9%). With HMP intervention, interstage mortality decreased from 18.6% (8/43) to 9.8% (4/41) (${\chi}^2$=1.15, p=.283). Conclusion: Results indicate that active measures and treatments using the HMP decrease mortality rates, however further investigation is required to identify various factors that contribute to hemodynamic complications during the interstage period.

• 임상간호연구
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• 제18권2호
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• pp.317-328
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• 2012

Purpose: This study was done to provide oncology nurses systemic guidelines designed to perform telephone counseling in outpatient settings treating patients with chemotherapy. Methods: Symptoms which are frequently questioned were identified through case reports recorded by 4 clinical nurse specialists from January 4 to December 31. 2010. Fifteen clinical experts and two hemato-oncologists reviewed the developed draft. Their opinions were synthesized to arrive at consensus on the ideal guidelines. This process confirmed content validity. The two hemato-oncologists also verified the face validity. Results: The six symptoms which were most frequently asked about were identified through 4,644 case reports and concerned pain, fever, skin alteration, nausea/vomiting, stomatitis and diarrhea. Evidence-based telephone triage guidelines for the 6 major symptoms in patients receiving chemotherapy were developed. Conclusion: These guidelines will help oncology nurses from novice to expert incorporate evidence-based telenursing into their practice.

• 동의생리병리학회지
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• 제28권2호
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• pp.243-250
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• 2014

This study examined the knowledge and understanding of integrative medicine in Korea, specifically conflicts between western and oriental medicine within Parallel (Dual) health care systems. Qualitative methodology using grounded theory guided semi-structured, in-depth interviews with Western Medical Doctors (W.M.D., n = 6), Oriental Medical Doctors (O.M.D., n = 5) and Traditional Chinese Medicine Practitioners (T.C.M.P., n = 4). Thematic analysis was used to determine broad themes from the interviews. 15 professionals (W.M.D. (40%), O.M.D. (33%), T.C.M.P. (27%), 10 males (67%) and 5 females (33%), mean age 45) were interviewed, recorded, and transcribed. Thematic analysis revealed three key themes: systematic conflicts, integration and future directions. Subthemes of systematic conflicts included: credibility of Oriental Medicine, commercial imperatives, maintaining social standing of O.M.D., professional qualifications and lack structures supporting collaborative practice. Integration subthemes included lack of academic linkage and clarity for appropriate triage, opposing medical paradigms and limited social imperative. Future directions should include: social justification, guarantee of oriental medicine legitimacy, role of government and understanding of scientific evidence. To successfully integrate dual medical systems there is a need to address differences in social-environmental factors and perceptions of scientific understanding, as well as developing strong academic links in clinical practice.