• Journal of Korea Entertainment Industry Association
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• v.15 no.1
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• pp.131-142
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• 2021

Purpose: Clinical practicums via non-face-to-face methods were inevitable due to the COVID-19 pandemic. We developed an online program for emergency nursing care and identified the feasibility of the program and the learning achievements of students. Methods: This was a methodological study. The program was developed by three professors who taught theory and clinical practicum for adult nursing care and clinical experts. Students received four hours of video content and two task activities every week in four-week program. Real-time interactive video conferences were included. Qualitative and qualitative data were collected. Results: A total of 96 students participated in the program. The mean score for overall satisfaction with the online program was 4.72(±1.02) out of 6. Subjects that generally had high learning achievement scores were basic life support care, fall prevention, nursing documentation, infection control, and anaphylaxis care. As a result of a content analysis of 77 reflective logs on the advantages of this program, students reported that "experience in applying nursing process," "case-based learning and teaching method," and "No time and space constraints" were the program's best features. Conclusion: Collaboration between hospitals and universities for nursing is more important than ever to develop online content for effective clinical practicum.

• Journal of Gastric Cancer
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• v.8 no.3
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• pp.160-165
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• 2008

Purpose: With the introduction of H. pylori eradication and proton pump inhibitor, the operative treatments for the acute or chronic complications of peptic ulcer, such as perforation, bleeding and stricture, have decreased. Also owing to the development of non-operative treatment such as interventional endoscopic treatment, the surgical approach to the acute complications, like perforation and bleeding, has diminished. The non-operative treatments for the stricture and obstruction of chronic peptic ulcer in part related to discontinuation of medication have not been satisfactory. We analyzed the clinical outcomes of the patients who underwent operative treatment for outlet obstruction with peptic ulcer. Materials of Methods: From January 1994 to December 2007, we reviewed 31 patients who had been operated on at the National Medical Center for peptic ulcer obstruction. We excluded the cases of adhesive obstructions that were caused by a former ulcer operation and also the cases of obstructions found during emergency operations for treating perforation and bleeding. We classified the surgical treatment group into the bypass operation group and the surgical resection group. We evaluated the effects of the operations by the Visick score. The recurrences were confirmed only by the endoscopic observation of peptic ulcer. Results: The number of patients in the bypass operation group was 6 (19.4%) and that of resection group was 25 (80.6%). The mean age was 57.5 (25~81) years. The number of male patients was 29 (93.5%) and the number of females was 2 (6.5%). The mean symptom duration was 29.6 months. There were 19 smokers (61.3%), 6 NSAID users (19.4%) and 7 H. pylori positive patients (22.6%). Two patients underwent endoscopic balloon dilatation with no success. The locations of lesion were the stomach, the duodenum and both in 9, 20 and 2 cases, respectively. There were operative complications in 13 cases (41.9%), recurrent ulcers in 2 cases (6.5%), and reoperations in 4 cases. The mean Visick score was 1.8 (1~4). There were no statistically significant clinicopathologic differences between the bypass operation group and the resection group. The two groups had 1 case each of recurrence. Although the bypass group had a greater complication rate (83.3%) than the resection group (32%), this was not statistically meaningful (P=0.175). The mean Visick score was 3.0 in the bypass group and 1.6 in the resection group, so the resection group was better (P=0.001). Conclusion: For a case of chronic peptic ulcer with outlet obstruction, even though it has been reported that endoscopic balloon dilatation worked well, surgery is still regarded as an important treatment. If you consider the patients' satisfaction and the difficulty of diagnosing malignant ulcers, surgical resection should be recommended more often than a bypass operation.

• Radiation Oncology Journal
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• v.14 no.4
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• pp.299-306
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• 1996

Purpose : Respiratory symptoms related with malignant airway disease have been the main causes of lowered qualify of life and also sometimes may be life-threatening if not properly managed. The authors report the short-term experiences of endobronchial brachytherapy for symptomatic malignant airway obstruction using high dose rate after-loading brachytherapy unit. Materials and Methdos : Twenty-five Patients with symptomatic malignant airway obstruction were treated with endobronchial brachytherapy between the period of December 1994 and March 1996 at Department of Radiation Oncology of Samsung Medical Center Twenty-one ($84\%$) were patients with non-small cell lung cancer, three with tracheal malignancies, and one with recurrence of esophageal cancer. Twenty Patients were given elective external beam radiation therapy, while six were given endobronchial laser evaporation therapy on emergency bases in addition to endobronchial brachytherapy. Three procedures for each patient were planned and total of 70 procedures were completed. Results : Improvement rates of major respiratory symptoms after endobronchial brachytherapy procedures were $88\%$(22/25). $96\%$(22/23), $100\%$ (15/15), and $100\%$(9/9) for cough, dyspnea, hemoptysis and obstructive pneumonia, respectively. ECOG performance scores were improved in $56\%$ of total patients group, while there was no case with worsened ECOG score. Fifteen patients died and the median interval from the start of treatment to death was 4 months (range: $1\~17$ months), while that of ten survivors was 9 months (range $5\~19$ months). There were five patients with controlled intrathoracic disease, who have survived over one rear. All deaths were associated with uncontrolled local and/or distant disease. Four Patients died of massive fatal hemoptysis, three of who received emergency endobronchial laser evaporation therapy before the start of endobronchial brachytherapy. Conclusion : Endobronchial brachytherapy has been confirmed as an excellent palliative treatment modality improving respiratory symptoms as well as patients' general performance status. Based on the current observations, use of endobronchial brachytherapy in curative setting as a boost technique may be warranted.

• The Korean Society of Law and Medicine
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• v.18 no.2
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• pp.163-194
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• 2017

Coronary artery disease has increased in Korea as the country enters the aged society. It is well known that the incidence of coronary artery disease is related to aging, hypertension, diabetes, hyperlipidemia, and dietary habit. For effective treatment of significant coronary stenosis, close coordination between cardiac surgery and cardiology team is essential. Especially cardiologists' decision whether to do the stent placement or CABG is very important because the cardiologists usually start to consult the patients for their treatment. Recently, non-surgical interventions(that is stent placement) in cardiology field have dramatically increased as the national insurance system removed the limitation of the number of stents deployed. However, accidents are often caused by inappropriate use of stents, especially in patients with triple coronary disease or left main disease with heavy coronary calcifications. Another aspect of stent placement is to cope with an emergency case in the event of coronary rupture or pericardial tamponade during coronary interventions without cardiac surgeons. In the past two years, the Korea Consumer Agency (Consumer Dispute Coordination Committee) analyzed eight cases of medical dispute settlement. Only two hospitals were manned with both cardiologists and cardiac surgeons. Seven patients died of procedures of stenting and five patients died on the day of the procedure. Among the 8 cases, 5 cases showed 3 vessel disease and the rest of the cases had either severe calcification, complete occlusion or poor coronary antomies for stenting According to a 2017 national data registry of coronary stenting, less than 3 drug-eluting stents were implanted in 98% of all patients. In 2015, the number of stent procedures was 38,922, and approximately in 800 (2%) cases, more than four stents were used per patient. We emphasize that it is necessary to seriously consider the cost-benefit analysis between stent and CABG. The patient has the right to choose the right procedure by asking the liability of 'instruction explanation obligation'. He should be well informed of the pros and cons of both procedures to avoid overuse of stent. It can be solved by intimate discussion of individual cases with the cardiac surgeon and the patient. Unilateral dialogue with the patient, forceful restriction on the number of stenting, lack of surgeon's backup in difficult cases should all be avoided. It is also necessary to solve the problem not only at the hospital level, such as multidisciplinary integrated medical care, but also a nationwide solution such as expanding cardiac surgeons as essential personnel to public officials.

• Korean Journal of Heritage: History & Science
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• v.56 no.4
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• pp.230-246
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• 2023

The wooden fence(木柵), which began to appear in the Bronze Age and is presumed to be the oldest defense facility in human history, was used as a fortress for the purpose of further strengthening military defense functions until after the Japanese Invasion of Korea in 1592 in the Joseon Dynasty(壬辰倭亂). As it was established as the concept of a fortress or a fence installed outside a fence castle(城柵) or barracks fence(營柵), its importance as an essential facility for defense was further highlighted. This study is the result of exploring wooden fence that were used as official facilities during the Joseon Dynasty, focusing on literature surveys such as 『Annals of the Joseon Dynasty』 and 『New Jeungdonggukyeojiseungram』 In this study, in particular, the conclusion of this study is as follows, focusing on the use and function of Nokgakseong(鹿角城), underwater wooden fence, installation methods, and materials of wooden fences, is as follows. The conclusions of this study, which focused on the materials of the wooden fence, are as follows. First, as invasions by foreign enemies became more frequent in the late Goryeo and early Joseon Dynasty, wooden fences played a major role as a major out-of-castle defense facility((防禦施設). In addition, wooden fences were modified and installed into various types such as wooden fences(木柵城), Nokgakseong, a fence made up of large branches in the shape of a deer antler, and underwater wooden fences(水中木柵) according to the circumstances of the times, government policy, and location environment. Second, wooden fences were installed in strategic locations in defense facilities for military purposes, such as mountain fortress(山城), fortresses(營), camps(鎭), forts(堡), and castles(邑城) in strategic locations, and were used for defense in case of emergency. According to the urgency of farming, it was installed in accordance with the non-farming season, when it is easy to mobilize manpower to avoid the busy farming season. The size of the wooden fence of the Joseon Dynasty, which are confirmed through literature records, was converted into Pobaekchuk(布帛尺), and the circumference was very diverse from 4,428chuk(2,066m) to 55chuk(25m). Third, Nokgakseong is an efficient combat support facility that is more aggressive than a general wooden fence, and the records of Nokgakseong in the Annals of the Joseon Dynasty appeared during the King Sejong period the record was 20 times, the most. By region, it was found that it was mainly installed in coastal rugged areas such as Pyeongan and Hamgildo(12), which are the 6-jin areas of the 4th Army. Fourth, in the early 15th century, as the royal court established a maritime defense strategy for the coastal area of the southern coast, after the Sampo Invasion(三浦倭亂), riots by Japanese settlers in Sampo in 1510, major military posts including eupseong(邑城), camps, and forts were established. The installation of underwater barriers around various government facilities rapidly increased as a defense facility to block the warships of Japanese pirates around various government facilities. Fifth, between the 15th and 17th centuries before and after the Japanese Invasion of Korea in Sampo, underwater fences were installed in the Southern coast and Ganghwa Island. In particular, in the 15th century, underwater fences were intensively installed in coastal areas of Gyeongsangnam-do, such as Jepo. Pine trees and Oaks are the main materials used for underwater fences, but other materials such as Oldham's meliosma, Loose-flower hornbeam and The vines of arrowroots were also used as materials for wooden fences.