• Journal of Korean Neurosurgical Society
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• v.29 no.10
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• pp.1365-1371
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• 2000

Objectives : Spinal cord compression is a rare presentation of non-Hodgkin's lymphoma(NHL), occurring in 0.1% to 10.2% of patients. Primary spinal extradural NHL, i.e. occurring in the absence of any detectable extraspinal lymphoproliferative disorder, has a potentially favourable outcome if diagnosed and treated early. The authors describe two patients with a clinical picture of acute spinal cord compression as the first presentation of NHL. Methods : The patients were 48-year-old female and 27-year-old female. Both presented with back pain followed by acute paraparesis and voiding difficulty. One patient was diabetic. Plain radiographs of the spine were not specific. Thoracic spine magnetic resonance imaging(MRI) revealed evidence of extradural soft tissue mass extending multiple vertebral segments. Results : The patients underwent emergency laminectomy for decompression and tissue diagnosis. Histological and immunohistochemical study revealed B-cell lymphoma, intermediate grade in both patients. Postoperative staging did not reveal any additional lesions other than extradural manifestation of the malignant lymphoma. Surgery with additional chemotherapy and radiotherapy allowed the clinical improvement of both patients. Conclusion : The authors report two patients with a clinical picture of acute spinal cord compression as the first presentation of NHL, and stress that primary spinal epidural NHL should be a diagnostic consideration in the patient without prior history of malignancy who presents with a prodrome of back pain followed by a rapid neurological deterioration.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.12 no.1
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• pp.318-326
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• 2011

The purpose of this study is to investigate whether standardized patient(SP) can be used as a reliable examiner in Objective Structured Clinical Examination(OSCE). 4 SPs and 4 faculties who have more than 2 years experience of OSCE scoring were selected. For 1 assignment 2 members of faculty and 2 SPs were designated as raters. SPs were educated for assessing 2 technical skills, male Foley catheter insertion and wound dressing, for 8 hours (4 hours / day, each topic). The definition, method, cautions and complications for each of procedural skills were covered in the education. Theoretical lectures, video learning, faculty demonstration and practical training on mannequins were employed. The 8 raters were standardized for an hour with simulated OSCE scoring using previous videos on the day before the OSCE. Each assessment was composed of 14 checklists and 1 global rate. The allotted time for each assignment was 5minutes and for evaluation time 2 minutes per student. The evaluation from the faculty and SPs were compared and analyzed with the GENOVA program. The overall generalizability coefficient (G coefficient) was 0.839 from two cases of OASTS. The reliability of the raters was high, 0.946. The inter-rater agreement between faculty group and SP group was 0.949 for checklist and 0.908 for global rating. Therefore SPs can play a role of raters in OSCE for procedural skills, if they are given the appropriate training.

• Quality Improvement in Health Care
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• v.20 no.1
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• pp.42-57
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• 2014

Objective: The objective of this research was to develop a guideline for more effective use of physical restraint on patients in the intensive care unit and training the nurses on it and applying it on clinical practice to assess its effectiveness. Method: This research analyzed the before and after effect of the development of a guideline for physical restraint by dividing the category into nurse and patient. In the case of nurse, a comparison of knowledge and nursing service regarding the use of physical restraint from before the training on physical restraint guideline(Jan. 2011) and after the training on physical restraint guideline(Dec. 2011) was made. In the case of patient, a comparison of physical restraint usage rate and average usage time, the number of unplanned extubation cases were compared from before the use of physical restraint (Jan.~Apr. 2011) and after the use of physical restraint (Sep.~Dec. 2011) were made. Result: After the training on the physical restraint guideline, the knowledge of the nurse and the nursing practice showed notable improvement by (p<0.000) and (p<0.048) respectively and in patient, physical restraint usage rate and average time of usage decreased by (p<0.001) and (p<0.001) respectively. And despite the decrease in the number of cases in which the physical restraint was used, the number of unplanned extubation cases remained the same. Conclusion: Physical restraint guideline training and guideline usage can be stated to have brought out positive effect in both the nurse and patient. In order to maintain such positive effects, continuous training is necessary and continuous revaluation is necessary, regarding knowledge and nursing practices.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.2
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• pp.465-469
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• 2015

Background: Orostachys japonicus A. Berger (A. Berger) is commonly used as a folk remedy for cancer therapy. However, the mechanisms of its anti-cancer activity are poorly investigated in human cancer cells. In this study, we investigated whether flavonoids extracted from Orostachys japonicus A. Berger (FEOJ) might have anticancer effects in human leukemia cells, focusing on cell death mechanisms. Materials and Methods: U937 human leukemic cancer cells were used. Results: FEOJ induced apoptosis in a dose-dependent manner in human U937 cancer cells. Flow cytometry revealed significant accumulation of cells with sub-G1 DNA content at the concentrations of $200{\mu}g/mL$ and $400{\mu}g/mL$. FEOJ-induced apoptosis was caspase-dependent through loss of mitochondrial membrane potential (MMP, ${\Delta}{\Psi}m$) in human U937 cancer cells, which might be associated with suppression of Bcl-2 and XIAP proteins. FEOJ induced the p38 MAPK signaling pathway, playing at least in part an important role in FEOJ-induced apoptosis. Conclusions: This study suggested that FEOJ may induce caspase-dependent apoptosis in human leukemic cells by regulating MMP (${\Delta}{\Psi}m$) through suppressing Bcl-2 and X-IAP. In addition, the results indicated that upstream p38 MAPK signaling regulates the apoptotic effect of FEOJ. This study provides evidence that FEOJ might have anti-cancer potential for human leukemic cells.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.3
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• pp.1427-1431
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• 2016

Background: Potential disadvantages of blood transfusion during curative gastrectomy for gastric cancer have been reported, and the role of peri-operative transfusions remains to be ascertained. Thus, the aim of our study was to survey its impact in patients with gastric cancer undergoinging gastrectomy. Materials and Methods: Clinical data of patients receiving curative gastrectomy at Far Eastern Memorial Hospital were obtained. Findings for pre-operative anemia states, pre-, peri- and post-operative transfusion of red blood cell (RBC) products as well as post-operative complication events were collected for univariate analysis. Results: A total of 116 patients with gastric cancer received gastrectomy at Far Eastern Memorial Hospital from 2011 to 2014. Both pre-operative and intra- and post-operative transfusion of RBC products were markedly associated with post-operative infectious events (OR: 3.70, 95% CI: 1.43-9.58, P=0.002; OR: 8.20, 95% CI: 3.11-22.62, P<0.001, respectively). In addition, peri- and post-operative RBC transfusion was significantly associated with prolonged hospital stay from admission to discharge (OR: 8.66, 95% CI: 1.73-83.00, P=0.002) and post-operative acute renal failure (OR: 19.69, 95% CI: 2.66-854.56, P<0.001). Also, the overall survival was seemingly decreased by peri-operative RBC transfusion in our gastric cancer cases (P=0.078). Conclusions: Our survey indicated that peri-operative RBC transfusion could increase the risk of infectious events and acute renal failure post curative gastrectomy as well as worsen the overall survival in gastric cancer cases. Hence, unnecessary blood transfusion before, during and after curative gastrectomy should be avoided in patients with gastric cancer.

• Korean Journal of Occupational Health Nursing
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• v.10 no.2
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• pp.174-182
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• 2001

This study was performed to find out the differences between noise levels of hospital wards and the nurses efforts for noise management in some general hospitals. The hospital wards selected were the intensive care unit(ICU), the emergency room(ER), the nursery room(NR), the internal medicine(IM), the general surgery(GS) among the 5 general hospitals located in Seoul. The data were collected from August 3 to September 13, 1999 through questionnaire survey and noise measurement in each nursing station of hospital wards. Data analysis was done by SPSS 8.0 package among the 305 questionnaires and 24 hours monitored noise levels. Frequency, Chi-square and ANOVA test were used. The study results were as belows: 1. The noise level measured by 24 hours monitoring survey were exceeded on the standard limit in all the hospital wards. Data also showed that noise levels were significantly different in each ward among the three shifts working duties. 2. The subjects were all female nurses. They were mostly working in the ICU ward(28.9%). They were 26~30 years old (43.9%), junior college graduates(57.0%), working for 1~5 years(55.1%) as staff-nurse(85.6%). There were no significant differences between hospital wards and general characteristics of nurses. 3. The noise levels perceived by nurses were regarded as 'Highly noisy'(56.4%), especially during the 11:30 and 15:30 (30.2%) o'clock. Data also showed that noise education was not ever given to nurses(89.9%). Nurses also responded that they hardly put an effort to reduce noise level(54.8%). However, there were significant differences between wards and noisy working time, experience of noise education and level of effort for noise reduction. 4. Nurses also perceived the ventilator alarm and EKG-alarm as the most disturbing sounds in the ICU, human voice and telephone ringing in the ER, human voice and EKG-alarming in the NR, human voices and telephone ringing in IM and GS both wards respectively in order. There were significant differences between hospital wards and noise making factors. 5. Nurses were shown that they regarded highly 'Sound reduction of the human voice', 'Careful handling on medical instruments', and 'Immediate appliances on alarming materials' as the practical method for noise management. There were significant differences between hospital wards and behavioral practical efforts for noise management. According to that results, the statistical differences were shown in the 24 hour monitored noise levels in each ward. Also, nurses perceived the noise severity differently and they approached variously on the practical efforts for noise reduction in each ward. Thus, author thinks that concrete and systematic endeavor will be necessary for noise reduction and management in hospitals for better working and healing environment for both of patients and staffs.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.15 no.5
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• pp.2914-2922
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• 2014

To study the risk factors and effect of gastric cancer screening, case-control study was conducted. From June 2007 to December 2011, 580 newly diagnosed gastric cancer (342 advanced gastric cancer, 171 early gastric cancer) patients were enrolled at the department of general surgery in a university hospital. History of gastric examinations and possible risk factors were collected through interviews with structured questionnaire and reviewed medical chart. Comparing advanced cancer and early gastric cancer were analysed by chi-square test and logistic regression. The results showed that aged 70 and over (OR 2.393; 95%CI 1.329-4.310), Ex-smoker (OR 1.612; 95%CI 0.970-2.680), blood type A (OR 1.784; 95%CI 1.035-3.075), and H. pylori infection (OR 1.699; 95%CI 0.905-3.191) were important risk factors for advanced gastric cancer compared to early gastric cancer. Weight loss (OR 2.752; 95%CI 1.333-5.684) and indigestion (OR 1.574; 95%CI 1.069-2.319) were also important sign and symptom. Although the results cannot find effect of screening, national policies on early cancer detection must conduct.

• Journal of Biomedical Engineering Research
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• v.40 no.5
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• pp.197-205
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• 2019

The existing Extracorporeal membrane oxygenation(ECMO) and Cardiopulmonary bypass system(CPB) have been developed and applied to various devices according to their respective indications. However, due to the complicated configuration and difficult usage method, it causes inconvenience to users and there is a risk of an accident. Therefore, smart all-in-one cardiopulmonary circulation device is being developed recently. The smart all-in-one cardiopulmonary assist device consists of a blood pump for cardiopulmonary bypass, a blood oxidizer for cardiopulmonary bypass, a blood circuit for cardiopulmonary bypass, and an artificial cardiopulmonary device. It is an integrated cardiopulmonary bypass device that can be used for a variety of purposes such as emergency, intraoperative, post-operative intensive care, and long-term cardiopulmonary assist, combined with CPB used in open heart surgery and ECMO used when patient's cardiopulmonary function does not work normally. The smart all-in-one cardiopulmonary assist device does not exist as a standard and international standard applicable to advanced medical devices. Therefore, in this study, we will refer to the International Standard for Blood Components, the International Standard for Blood, the Guideline for Blood Products, and prepare applicable performance and safety guidelines to help quality control of medical devices, and contribute to the improvement of the health of people. The guideline, which is the result of conducted a survey of the method of safety and performance test, is based on the principle of all-in-one cardiopulmonary aiding device, related domestic foreign standards, the status of domestic and foreign patents, related literature, blood pump(ISO 18242), blood oxygenator (ISO 7199), and blood circuit (ISO 15676) for cardiopulmonary bypass.The items on blood safety are as follows: American Society for Testing and Materials ASTM F1841-97R17), and in the 2010 Food and Drug Administration's Safety Assessment Guidelines for Medical Assisted Circulatory Devices. In addition, after reviewing the guidelines drawn up through expert consultation bodies including manufacturers / importers, testing inspectors, academia, etc. the final guideline was established through revision and supplementation process. Therefore, we propose guidelines for evaluating the safety and performance of smart all-in-one cardiopulmonary assist devices in line with growing technology.

• Journal of the Korea Convergence Society
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• v.10 no.1
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• pp.339-351
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• 2019

This study was conducted to identify the factors associated with the ruptured intracranial aneurysm (RIA) among demographic, admission to hospital, clinical, aneurysym itself and lifestyle characteristics. Medical records of RIA patients and un-RIA patients which had been admitted to undergo treatment including surgery (From January to December 2016) were included into data analysis. Multiple logistic regression showed that two and more than warning signs (14.14 (CI: 1.25-159.40)) indicated the greatest odds ratio with RIA, was followed by headache more than 3 scores (13.95 (CI: 3.68-52.83)), the admission via emergency room (13.62 (CI: 4.85-38.26)), single marital status (9.72 (CI: 2.22-42.49)), 1 mmHg increased systolic blood pressure (1.04 (CI: 1.01-1.08)), 1 score increased GCS (0.58 (CI: 0.37-0.90)), arrythmia finding in electrocardiogram (3.70 (CI: 1.22-11.22)) and increased age (0.95 (CI: 0.91-0.99)). The risk groups having factors associated with RIA were identified. Preventive activities including routine assessment should be done before developing the rupture and urgent care should be needed after developing the rupture for risk groups.

• The Korean Society of Law and Medicine
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• v.24 no.1
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• pp.67-98
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• 2023

In the early stages of the COVID-19 pandemic, Korea took the lead in implementing "social distancing" policies more strongly than other countries. In addition to making it mandatory to wear a mask according to the policy, all patients using medical institutions are tested for COVID-19 to prevent Healthcare-Associated Infections, and only those patients who test negative have been regulated to receive face-to-face medical treatment. In this process, situations such as the disabled, who have difficulty wearing masks, were not taken into account, and emergency patients did not receive timely treatment or surgery from medical personnel. In response, the National Human Rights Commission of Korea has decided that forcing everyone to wear a mask and restricting access to medical institutions constitutes discrimination against the disabled. Therefore, the purposes this study has that, the first is to review cases of human rights discrimination against persons with disabilities due to measures to prevent the transmission of infectious diseases that did not consider the characteristics of persons with disabilities in the COVID-19 situation and issues regarding the decisions of the National Human Rights Commission of Korea, the second is to find a reasonable plan and the need for measures to prevent refusal of treatment by medical institutions for the disabled who have difficulty wearing masks.