• 기록학연구
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• 제63호
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• pp.269-299
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• 2020

2014년 11월에 개정된 공공기록물법 시행령 제30조(보존장소)로 인해 영구기록물관리기관(국가기록원)의 장이 지정한 기록물은 기록관(특수기록관)에서도 계속 보존·관리할 수 있게 되었다. 이러한 변경 조치가 이루어질 경우 해당 기록관들은 보존기간 30년 이상 기록물의 보존 대책을 마련하고, 관리에 관한 제반 업무를 추가적으로 수행하여야 하는 등 기존과는 다른 운영 및 보존관리체계를 구축하여야만 한다. 하지만 보존장소 변경에 관한 대상선정 기준(사료적 가치)이 다소 모호하고, 지정 절차가 마련되어 있지 않으며, 기록관의 변화를 지원할 수 있는 법적 근거도 부재한 상황이어서 추가 개선이 요구된다. 이에 본고에서는 국가기록원의 보존장소 변경 조치 현황과 해당 기록관들의 운영 실태를 살펴보고, 공공기록물법령을 중심으로 보완 및 개선사항들에 대하여 제안해 보고자 한다.

• Journal of Korean Biological Nursing Science
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• 제19권2호
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• pp.60-68
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• 2017

Purpose: The purpose of this study was to analyze the relationship between lower urinary tract symptoms and urodynamic parameters to investigate the characteristics of mixed urinary incontinence (MUI) and stress urinary incontinence (SUI). Methods: The subjects were 318 women with MUI and 128 women with SUI. Data were collected retrospectively from electronic medical records including Bristol Female Lower Urinary Tract Symptoms-Scored Form (BFLUTS-SF), Incontinence Quality of Life Instrument (I-QOL), voiding diaries, and urodynamic parameters. Results: Compared with the SUI group, the MUI group was older and showed lower I-QOL and more severe urinary tract symptoms. The MUI group had more urinary frequency, more nocturia, and a higher urgency score than the SUI group. In the correlation analysis, the greatest difference between the two groups was that urgency was associated with Qmax, maximal cystometric capacity, and detrusor overactivity only in the MUI group (r = -.175, p= .004; r = -.281, p< .001; r= .232, p< .001, respectively). Conclusion: As a result of this study, we propose that a customized management program that emphasizes the control of urgency for the MUI group, and one that effectively strengthens the weak pelvic floor for the SUI group.

• 대한간호학회지
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• 제45권4호
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• pp.523-532
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• 2015

Purpose: The usability, user satisfaction, and impact of electronic nursing record (ENR) systems were investigated. Methods: This mixed-method research was performed as a time-motion (TM) study and a survey which were carried out at six hospitals between August and November 2013. The TM study involved 108 nurses from medical, surgical, and intensive care units at each hospital, plus an additional 48 nurses who served as nonparticipating observers. In the survey, 1879 volunteer nurses completed the Impact of ENR Systems Scale, the System Usability Scale, and a global satisfaction scale. Qualitative and quantitative analyses were performed. Results: The mean scores for the ENR impact, system usability, and satisfaction were 4.28 (out of 6), 58.62 (out of 100), and 74.31 (out of 100), respectively, and they differed significantly between hospitals (F=43.43, p<.001, F=53.08 and p<.001, and F=29.13 and p<.001, respectively). A workflow fragmentation assessment revealed different patterns of ENR system use among the included hospitals. Three user characteristics-educational background, practice period, and experience of using paper records-significantly affected the system usability and satisfaction scores. Conclusion: The system quality varied widely among the ENR systems. The generally low-to-moderate levels of system usability and user satisfaction suggest many opportunities for improvement.

• Journal of Chest Surgery
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• 제26권11호
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• pp.861-865
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• 1993

The lung cancer in patients under 40 years old is rare and reported to be more rapidly fatal than in older persons. We reviewed the records of 18 cases who younger than 40 years with histologically proven lung cancer between 1959 and 1992 at department of Thoracic Surgery in National Medical Center. There were 12 male and 6 female patients. Two male and all female patients had never smoked. The 17 cases had respiratory symptoms for a mean duration of 3 months. The squamous carcinoma was found in 7 cases[38.9%], small cell carcinoma in 4 cases[22.2%], mixed cell carcinoma in 4 cases[22.2%], adenocarcinoma in 2 cases[11.1%] and bronchoalveolar cell carcinoma in 1 case. Among the 6 resected tumors, one case was stage I, two cases were stage II and three cases were stage IIIa. The operation was considered complete and curative in 6 patients and noncurative in 6 pations because of an exploratory thoracotomy. We conclude that lung cancer in young persons is virulent and that diagnosis is frequently delayed.

• 대한임상독성학회지
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• 제6권2호
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• pp.110-116
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• 2008

Purpose: Acute toxic hepatitis is a common cause of acute liver failure (ALF). We investigated the causes, clinical manifestation, and outcomes of ALF patients who underwent liver transplantation due to acute toxic hepatitis caused by herbal medicines and preparations. Methods: Between January 1992 and May 2008, we retrospectively reviewed the medical records of 24 patients who were transplanted due to acute toxic hepatitis caused by herbal medicines and preparations. We applied the RUCAM score to patients with acute toxic hepatitis and assessed the relationship between herbal preparations and liver injury. We studied the patients' medication history, liver function tests, and clinical outcomes. Results: The type of liver injury was divided into three groups: hepatocellular type, 14 patients (58.3%); cholestatic type, 4 patients (16.7%); and mixed type, 6 patients (25%). Polygonum multiflorum Thunberg (3 cases) was the most common cause of acute toxic hepatitis, followed by Acanthopanax senticosus (2 cases), pumpkin juice (2 cases), Dictamnus dasycarpus Turcz (2 cases), Hovenia dulcis (1 case), Phellinus linteus (1 case), and Artemisia capillaries (1 case). One year survival after liver transplantation was 76%. Conclusion: We identified the herbal preparations leading to acute liver failure. Many patients consider herbal remedies to be completely free of unwanted side effects. However, we found that many herbal products have biological activities that can lead to severe hepatotoxicity.

• Clinical and Experimental Pediatrics
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• 제60권5호
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• pp.151-157
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• 2017

Purpose: Macrolide resistance rate of Mycoplasma pneumoniae has rapidly increased in children. Studies on the clinical features between macrolide susceptible-M. pneumoniae (MSMP) and macrolide resistant-M. pneumoniae (MRMP) are lacking. The aim of this study was to identify the macrolide resistance rate of M. pneumoniae in Korean children with M. pneumoniae penupmonia in 2015 and compare manifestations between MSMP and MRMP. Methods: Among 122 children (0-18 years old) diagnosed with M. pneumoniae pneumonia, 95 children with the results of macrolide sensitivity test were included in this study. Clinical manifestations were acquired using retrospective medical records. Results: The macrolide resistant rate of M. pneumoniae was 87.2% (82 of 94 patients) in children with M. pneumoniae pneumonia. One patient showed a mixed type of wild type and A2063G mutation in 23S rRNA of M. pneumoniae. There were no significant differences in clinical, laboratory, and radiologic findings between the MSMP and MRMP groups at the first visit to our hospital. The time interval between initiation of macrolide and defervescence was significantly longer in the MRMP group ($4.9{\pm}3.3$ vs. $2.8{\pm}3.1days$, P=0.039). Conclusion: The macrolide resistant rate of M. pneumoniae is very high in children with M. pneumoniae pneumonia in Korea. The clinical manifestations of MRMP are similar to MSMP except for the defervescence period after administration of macrolide. Continuous monitoring of the occurrence and antimicrobial susceptibility of MRMP is required to control its spread and establish strategies for treating second-line antibiotic resistant M. pneumoniae infection.

• 임상간호연구
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• 제21권3호
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• pp.377-388
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• 2015

Purpose: To identify user requirements for electronic nursing record (ENR) systems so as to ensure system usability. Methods: A mixed methods approach were applied in three steps : (i) task and workflow analysis with literature review of nursing documentation, (ii) literature reviews of system usability, and (iii) Use Case idenfication and consensus-based validation. We analyzed the nursing activity logs collected from a time-motion investigation of six hospitals. The Use Cases were validated by eight clinical experts from different hospitals and two experts from academia in a sequential Delphi survey. Consensus was achieved for the significance score and agreement among the panel. Results: Eight task groups and patterns of task flow were observed, which were translated into nine Use Cases. The specification of Use Cases was derived from principles, guidelines, and recommendations on nursing documentation and electronic health record systems, which was organized into three requirements of each Use Case: functionality, information, and design characteristics. Each Use Case achieved an agreement of 50~70%, and significance scores of 4 or 5 on a 5-point Likert scale. Conclusion: The nine Use Case identified were considered to be important and adequate in terms of both clinical and informatics contexts.

• Clinical and Experimental Pediatrics
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• 제63권4호
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• pp.135-140
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• 2020

Background: Breastfeeding reportedly reduces the overall frequency of infections. Respiratory syncytial virus (RSV), the most common respiratory pathogen in infants, involves recurrent wheezing and has a pathogenic mechanism related to airway structural damage. Purpose: This study aimed to investigate whether breastfeeding has a beneficial effect against RSV-induced respiratory infection compared to formula feeding among infants in Korea. Methods: We retrospectively reviewed the medical records of infants under 1 year of age who were admitted with RSV infection between January 2016 and February 2018 at the department of pediatrics of 4 hospitals. We investigated the differences in clinical parameters such as cyanosis, chest retraction, combined infection, fever duration, oxygen use, oxygen therapy duration, intensive care unit (ICU) admission, and corticosteroid treatment of exclusive breast milk feeding (BMF), artificial milk formula fed (AMF), and mixed feeding (MF) groups. Results: Among the 411 infants included in our study, 94, 161, and 156 were included in the BMF, MF, and AMF groups, respectively. The rates of oxygen therapy were significantly different among the BMF (4.3%), MF (8.1%), and AMF (13.5 %) groups (P=0.042). The odds ratios (ORs) for oxygen therapy was significantly higher in the AMF group than in the BMF group (adjusted OR, 3.807; 95% confidence interval, 1.22-11.90; P=0.021). The ICU admission rate of the BMF group (1.1%) was lower than that of the MF (3.5%) and AMF (4.5%) groups; however, the dissimilarity was not statistically significant (P=0.338). Conclusion: The severity of RSV infection requiring oxygen therapy was lower in the BMF than the AMF group. This protective role of human milk on RSV infection might decrease the need for oxygen therapy suggesting less airway damage.

• 동의신경정신과학회지
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• 제21권4호
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• pp.137-149
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• 2010

Objectives : The aim of this study was to describe the clinical aspects in dementia outpatients who visited oriental neuropsychiatry clinic and to analyze the efficacy of herbal medicine. Methods: We analysed medical records of dementia outpatients who visited oriental neuropsychiatry clinic of K medical center from August. 2000 to July, 2010 and matched our criteria. Results: Ninety-two subjects were selected for analysis and consisted of 77.3% dementia of Alzheimer type. 13.0% vascular dementia. and 9.8% mixed type of dementia. Herbal medicine prescribed mainly were Jowjseungchung-tang(Tiaowejshengqing-tang). Kunneo-tang(Jjannao-tang) and Chenwangbosim-dan(Tianwangbuxin-dan) for dementia of Alzheimer type, and Sunghyangjungki-san(Xjngxjangzhengqi-san) and Upung-dan (Yufeng-dan) for vascular dementia. Scores of K-DRS were not changed for some subs cales and decreased but less than natural decline of Alzheimer disease. Score on the Memory subscale in group of Kunneo-tang(Jjannao-tang) increased significantly. Conclusions : These results suggest that the herbal medicine may be effective for dementia. More prospective studies are needed to assess the efficacy and prognosis of herbal medicine for dementia. Clinical guideline is needed for systematic data accumulation.

• Advances in pediatric surgery
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• 제16권2호
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• pp.134-142
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• 2010

Malignant ovarian tumors in children are very rare, and consist of about 1 % of all childhood malignant tumors. The purpose of this study is to examine the clinical characteristics, treatment, and prognosis for children with malignant ovarian tumors. We retrospectively reviewed the medical records of children under 15 years of age with malignant ovarian tumors who had been treated surgically at Asan Medical Center between 1989 and March 2009. There were 32 patients, ranged in age at surgery from 2 to 15 years (mean; 10.4 years). The median follow-up period was 64.7 months (from 1 month to 188 months). Pathologic diagnosis were; immature teratoma (n=10), mixed germ cell tumor (n=10), and dysgerminoma (n=6). Tumor stage was classified by the staging system of the International Federation of Gynecology and Obstetrics (FIGO). The number of patients in stage I, II, III, and IV were 24 (75 %), 2 (6.2 %), 4 (12.5 %), and 2 (6.1 %), respectively. The tumor recurred in 4 patients. Seven patients of group 1 did not receive postoperative adjuvant chemotherapy, and in three of them, the tumor recurred. Twenty-five patients (group 2) underwent postoperative adjuvant chemotherapy, and there was only one recurrence. One patient who did not receive postoperative adjuvant chemotherapy and expired 10 months after operation because of tumor recurrence and distant metastasis. The overall 5-year event free survival (EFS) was 84.2 %: group 1 in 44.4 %, and group 2 in 95.7 %. Tumor recurrence was related to the postoperative adjuvant chemotherapy (p=0.004). In conclusion, proper surgical procedures with relevant postoperative adjuvant chemotherapy might improve clinical results in children with malignant ovarian tumors.