• Pediatric Infection and Vaccine
• /
• v.30 no.2
• /
• pp.73-83
• /
• 2023

Purpose: This study aimed to investigate the viral load dynamics in children with underlying malignancies diagnosed with symptomatic coronavirus disease 2019 (COVID-19). Methods: This was a retrospective longitudinal cohort study of patients <19 years old with underlying hemato-oncologic malignancies that were diagnosed with their first symptomatic severe acute respiratory syndrome coronavirus 2 polymerase chain reaction (PCR)-confirmed COVID-19 infection during March 1 to August 30, 2022. Review of electronic medical records and telephone surveys were undertaken to assess the clinical presentations and transmission route of the patients. Thresholds of negligible likelihood of infectious virus was defined as E gene reverse transcription (RT)-PCR cycle threshold (Ct) value ≥25. Results: During the 6-month study period, a total of 43 children with 44 episodes of COVID-19 were included. Of the 44 episodes, the median age of the patients included was 8 years old (interquartile range [IQR], 4.9-10.5), and the most common underlying disease was acute lymphoid leukemia (n=30, 68.2%), followed by patients post-hematopoietic stem cell transplantation (n=8, 18.2%). Majority of the patients had mild COVID-19 (n=32, 72.7%), and three patients (7.0%) had severe/critical COVID-19. Furthermore, 2.3% (n=1) died of COVID-19 associated acute respiratory distress syndrome. The largest percentage of the patients showed E gene RT-PCR Ct value ≥25 between 15-21 days (n=13, 39.4%), followed by 22-28 days (n=10, 30.3%). In 15.2% (n=5), E gene RT-PCR Ct value remained <25 beyond 28 days after initial positive PCR. Refractory malignancy status (β, 67.0; 95% confidence interval, 7.0-17.0; P=0.030) was significantly associated with prolonged duration of E gene RT-PCR <25. A patient with prolonged duration of E gene RT-PCR Ct value <25 was suspected to have infectivity shown by the transmission of the virus to his mother at day 86 after his initial positive test. Conclusions: Children that acquire symptomatic COVID-19 during refractory malignancy state are at a high risk for prolonged shedding warranting PCR-based transmission precautions in this cohort of patients.

• Journal of the Korean Society of Radiology
• /
• v.17 no.3
• /
• pp.297-303
• /
• 2023

Pediatric Computed Tomography (CT) examinations can often result in exam failures or the need for frequent retests due to the difficulty of cooperation from young patients. Deep Learning Image Reconstruction (DLIR) methods offer the potential to obtain diagnostically valuable images while reducing the retest rate in CT examinations of pediatric patients with high radiation sensitivity. In this study, we investigated the possibility of applying DLIR to reduce artifacts caused by respiration or motion and obtain clinically useful images in pediatric chest CT examinations. Retrospective analysis was conducted on chest CT examination data of 43 children under the age of 7 from P Hospital in Gyeongsangnam-do. The images reconstructed using Filtered Back Projection (FBP), Adaptive Statistical Iterative Reconstruction (ASIR-50), and the deep learning algorithm TrueFidelity-Middle (TF-M) were compared. Regions of interest (ROI) were drawn on the right ascending aorta (AA) and back muscle (BM) in contrast-enhanced chest images, and noise (standard deviation, SD) was measured using Hounsfield units (HU) in each image. Statistical analysis was performed using SPSS (ver. 22.0), analyzing the mean values of the three measurements with one-way analysis of variance (ANOVA). The results showed that the SD values for AA were FBP=25.65±3.75, ASIR-50=19.08±3.93, and TF-M=17.05±4.45 (F=66.72, p=0.00), while the SD values for BM were FBP=26.64±3.81, ASIR-50=19.19±3.37, and TF-M=19.87±4.25 (F=49.54, p=0.00). Post-hoc tests revealed significant differences among the three groups. DLIR using TF-M demonstrated significantly lower noise values compared to conventional reconstruction methods. Therefore, the application of the deep learning algorithm TrueFidelity-Middle (TF-M) is expected to be clinically valuable in pediatric chest CT examinations by reducing the degradation of image quality caused by respiration or motion.

• KSCE Journal of Civil and Environmental Engineering Research
• /
• v.29 no.4B
• /
• pp.385-396
• /
• 2009

Non-household unit water use for each type of business are estimated in this study. The business types are subdivided into forty based on nine categories by the national industrial standard classification, such as office, commerce, public bathing, public water use etc. Correlation analysis and analysis of variance (ANOVA) are applied to obtain statistical characteristics between industrial water use data, surveyed in six cities including Nonsan, Seosan and the National Statistical Bureau and site area, employees number etc. for each detailed business area. As the proposed non-household unit water uses are compared with five surveyed data in USA, it is shown that almost of water uses per unit area are less than those in USA. Non-household unit water uses of 25% cumulative probability water use recommended as efficiency benchmarks among surveyed data in Korea are also less than those in USA. Especially, in the case of water use in school, the average and the range are similar results showing water use range between 0.4 and 6.2 ($l/m^2/day$) as liter per capita day per an unit area, also water use range between 11.9 to 64.0 (l/student/day) as liter per capita day per a person. From the result of correlation analysis with internal and exogenous affecting factors on non-household water use, it can be concluded that a unit area is most appropriate factor as a standard of non-household unit water use. In case of water use in educational business, the number of students including staffs is more correlated than site ares with water use for the settled water consumption tendency. Although the increase and decrease of educational institutes, retail/wholesale store and restaurants are shown remarkable by the temperature as a representative factor, low correlations are shown in water use fluctuation in lodging house and hospital.

• 한국노년학
• /
• v.31 no.4
• /
• pp.1155-1167
• /
• 2011

The purpose of this study was to investigate the frequency of falls, fear of falling, perceived health status, and number of disease according to cognitive function in community-dwelling the elderly women. This study utilized a descriptive survey design. Data were collected for six months with 311 elderly women who visited in public health center at S city. After obtaining Institutional Review Board(IRB) approval, a face-to-face, and private interview was conducted with each participant who was eligible and agreed to participate in this study by trained graduate-level nursing students. The questionnaires consisted of MoCA-K, K-MMSE, Fall Efficacy Scale, PHS scale. The collected data were analyzed with SPSS/WIN 17.0 program, which was used descriptive statistics, Chi-Square test and t-test, Correlation. The major findings of this study were as follows; 1) The average age of the subjects was 71.68±5.13 and cognitive function score was 22.14±4.32. approximately 35% of participants had fallen within one year. 2) there were significant differences in perceived health status according to cognitive function. 3) fear of fall and cognitive function, perceived health status and cognitive function were significant correlation. In conclusion, this study will contribute to establish strategies for preventing fall. Interventions for fall prevention and fear of fall enhancement should be developed with the consideration of the level of cognitive function in the elderly. Reducing the fear of falling through the comprehensive nursing intervention will ultimately improve the quality of life in the elderly.

• Therapeutic Science for Rehabilitation
• /
• v.13 no.1
• /
• pp.9-21
• /
• 2024

Objective : The purpose of this study was to confirm the characteristics and quality of a single-subject research that conducted interventions to improve activities of daily living (ADL) in stroke patients. Methods : 'Stroke,' 'activities of daily living,' and 'single-subject studies' were searched as keywords among papers published in the last 15 years between 2009 and 2023 among Research Information Sharing Service, DBpia, and e-articles. A total of nine papers were examined for the characteristics and quality before analysis. Results : The independent variables applied to improve ADL included constraint-induced therapy, mental practice for performing functional activities, virtual reality-based task training, subjective postural vertical training without visual feedback, bilateral upper limb movement, core stability training program, traditional occupational therapy and neurocognitive rehabilitation, smooth pursuit eye movement, neck muscle vibration, and occupation-based community rehabilitation. Assessment of Motor and Process Skills was the most common evaluation tool for measuring dependent variables, with four articles, and Modified Barthel Index and Canadian Occupational Performance Measure were two articles each. As a result of confirming the qualitative level of the analyzed papers, out of a total of nine studies, seven studies were at a high level, two at a moderate level, and none were at a low level. Conclusion : Various types of rehabilitation treatments have been actively applied as intervention methods to improve the daily life activities of stroke patients; the quality level of single-subject studies applying ADL interventions was reliable.

• Journal of Korean Dental Hygiene Science
• /
• v.6 no.2
• /
• pp.115-127
• /
• 2023

Background: This study was conducted to determine the level of job satisfaction and patient safety cultural activities for dental hygienists and to determine the relationship between job satisfaction and patient safety cultural activities. Methods: A survey was conducted on 214 dental hygienists, and data from the final 180 were analyzed. Job satisfaction consisted of a total of 20 questions, and patient safety cultural activities included a total of 25 questions. The survey was conducted on a 5-point scale. Results: The average job satisfaction score of the study subjects was 3.44 points. Among patient safety cultural activities, infection control had the highest average score (4.12 points) and radiation safety management had the lowest average score (3.10 points). Patients with less than 3 years of clinical experience (4.01 points) had higher patient safety culture activity scores than those with 3 to 10 years of clinical experience (3.72 points) and those with more than 10 years of clinical experience (3.69 points). The level of patient safety cultural activities was statistically significantly higher as age, less clinical experience, and job satisfaction increased (p<0.05). Conclusion: In the case of dental hygienists, patient safety cultural activities must be carried out throughout the entire work, so an active will to practice patient safety cultural activities is necessary. In order to improve the performance of patient safety cultural activities, it is necessary to adjust the workload of dental hygienists to improve job satisfaction and create a work environment in which they can focus on patient safety cultural activities.

• Journal of Oral Medicine and Pain
• /
• v.32 no.1
• /
• pp.9-33
• /
• 2007

In the field of dentistry, there existed relatively few emergency patients or patients who need intensive care and thus had low medical dispute rates. However, these days, there is a general tendency of increased medical disputes. Although many medical disputes are caused by medical accidents of the dentists, because dental assistants are also lawfully involved in practicing dentistry, there is a possibility of medical disputes or medical accidents caused by dental assistants. Therefore, the role of the dental assistants cannot be ignored. This study consists of a survey given to dental hygienists currently working in general hospitals, dental hospitals and private dental clinics. Following is the results of the analysis of 275 respondents' backgrounds, medical disputes rates including patients' complaints, their understanding of medical regulations and their general understanding of overall dental practice and medical disputes. 1. 251 of 274(91.6%) respondents doubted the risk of medical accident and dispute. 2. 81(29.5%) dental hygienist experienced complaint from patients. They have been working in the private dental clinic, the rate of this experience was high. 3. 349 case of 1805(19.3%) the complaints by patients, highest percentage among its category, were those regarding dental fees and poor service. 4. 129 case of 1805(7.1%) patients' complaints, highest percentage among it's subcategory, were those regarding the absence of explanations of precautions or request of agreements before dental treatment. 5. 252 of 267 (94.4%) dental hygienists chart after a scaling treatment. However, only 55(20.7%) dental hygienists chart the fact of explaining the precautions. 6. 6(2.2%) dental hygienists do not inspect patients' medical history, if patients don't mention it. 7. 104 of 274(38.0%) dental hygienists responded to be capable of administering first aid treatment. 8. 115(41.8%) dental hygienists have a first aid kit and equipment. 9. In case of medical dispute, 268(97.8%) dental hygienists respond that, charting plays a big role in resolving the dispute. 10. In case of medical dispute, 272(93.3%) dental hygienists respond that, explanation and agreement before treatment have an important role in settlement of dispute 11. Only 160(58.4%) dental hygienists responded correct answer that the duration of keeping medical records is 10 years. 12. 124(45.3%) respondents thought that it is legal for a dental hygienist to take a panoramic dental X-ray, 71(25.9%) respondents thought that it is legal practice cervical resin treatment by dental hygienist, and 37(13.5%) respondents thought that it is legal extract primary teeth by dental hygienist. 13. 24(18.76%) respondents thought that it doesn't matter to tell patient's state to others 14. 272(99.27%) responded that receiving education for the prevention of medical disputes was needed and of them, 61.0% thought it was urgent. 15. 186(64.2%) has never had classes regarding the prevention of medical disputes while in school and 212(77.4%) has not had the same type of classes after graduating from school. 16. 256(93.4%) responded that there will be even more of an increased number of medical disputes. Among them, 83.3% of respondents though that due to the increased opportunity of acquiring information through the internet and mass media. The study shows that 29.5 percentage of dental hygienists have experienced the medical disputes and complaints and they are lack of recognition of medical regulations and dental hygienist's official duty. So, there is a big potential of the percentage to increase. Therefore, the correct understanding of explaining precautions and requesting agreement before dental treatments and performing them are mandatory. Moreover, classes regarding the prevention and counterplans of medical disputes need to be widely offered.

• The Korean Journal of Nuclear Medicine Technology
• /
• v.19 no.2
• /
• pp.74-80
• /
• 2015

Purpose Breast lymphoscintigraphy is an important technique to present for body surface precisely, which shows a lymph node metastasis of malignant tumors at an early stage and is performed before and after surgery in patients with breast cancer. In this study, we evaluated several methods of body outline imaging to present exact location of lesions, as well as compared respective exposure doses. Materials and Methods RANDO phantom and SYMBIA T-16 were used for obtaining imaging. A lesion and an injection site were created by inserting a point source of 0.11 MBq on the axillary sentinel lymph node and 37 MBq on the right breast, respectively. The first method for acquiring the image was used by drawing the body surface of phantom for 30 sec using $Na^{99m}TcO_4$ as a point source. The second, the image was acquired with $^{57}Co$ flood source for 30 seconds on the rear side and the left side of the phantom, the image as the third method was obtained using a syringe filled with 37 MBq of $Na^{99m}TcO_4$ in 10 ml of saline, and as the fourth, we used a photon energy and scatter energy of $^{99m}Tc$ emitting from phantom without any addition radiation exposure. Finally, the image was fused the scout image and the basal image of SPECT/CT using MATLAB$^{(R)}$ program. Anterior and lateral images were acquired for 3 min, and radiation exposure was measured by the personal exposure dosimeter. We conducted preference of 10 images from nuclear medicine doctors by the survey. Results TBR values of anterior and right image in the first to fifth method were 334.9 and 117.2 ($1^{st}$), 266.1 and 124.4 ($2^{nd}$), 117.4 and 99.6 ($3^{rd}$), 3.2 and 7.6 ($4^{th}$), and 565.6 and 141.8 ($5^{th}$). And also exposure doses of these method were 2, 2, 2, 0, and $30{\mu}Sv$, respectively. Among five methods, the fifth method showed the highest TBR value as well as exposure dose, where as the fourth method showed the lowest TBR value and exposure dose. As a result, the last method ($5^{th}$) is the best method and the fourth method is the worst method in this study. Conclusion Scout method of SPECT/CT can be useful that provides the best values of TBR and the best score of survey result. Even though personal exposure dose when patients take scout of SPECT/CT was higher than another scan, it was slight level comparison to 1 mSv as the dose limit to non-radiation workers. If the scout is possible to less than 80 kV, exposure dose can be reduced, and also useful lesion localization provided.

• Journal of Chest Surgery
• /
• v.36 no.12
• /
• pp.929-936
• /
• 2003

We analysed the surgical outcomes of immediate reoperations after mitral valve repair. Material and Method: Eighteen patients who underwent immediate reoperation for failed mitral valve repair from April 1995 through July 2001 were reviewed retrospectively. There were 13 female patients. The mitral valve disease was regurgitation (MR) in 12 patients, stenosis (MS) in 3, and mixed lesion in 3. The etiologies of the valve disease were rheumatic in 9 patients, degenerative in 8, and endocarditis in 1. The causes of reoperation was residual MR in 13 patients, residual MS in 4, and rupture of left ventricle in 1. Fourteen patients had rerepair for residual mitral lesions (77.8%) and four underwent replacement. Result: There was no early death. After mean follow-vp of 33 months, there was one late death. Echocardiography revealed no or grade 1 of MR (64.3%) in 9 patients and no or mild MS in 11 patients (78,6%). Reoperation was done in one patient. The cumulative survival and freedom from valve-related reoperation at 6 years were 94% and 90%, respectively. The cumulative freedom from recurrent MR and MS at 4 years were 56% and 44%, respectively. Conclusion: This study suggests that immediate reoperation for failed mitral valve repair offers good early and intermediate survival, and mitral valve rerepair can be successfully performed in most of patients. However, because mitral rerepair have high failure rate, especially in rheumatic valve disease, adequate selections of valvuloplasty technique and indication are important to reduce the failure rate of mitral rerepair.

• Journal of Chest Surgery
• /
• v.31 no.10
• /
• pp.939-944
• /
• 1998

Background: The sugical results of the Cox-Maze procedure (CMP) for lone atrial fibrillation(AF) have proven to be exellent. However, those for AF associated with mitral valve(MV) disease have been reported to be a little inferior. Materials and methods: To assess the efficacy and safety of the CMP as a combined procedure with MV operation, we studied retrospectively our experiences. Between April 1994 and October 1997, we experienced 70 (23 males, 47 females) cases of CMP concomitantly with MV operation. Results: The etiologies of MV disease were rheumatic in 67 and degenerative in 3 cases. The mean duration of AF before sugery was 66$\pm$70 months. Fifteen patients had the past medical history of thromboembolic complications, and left atrial thrombi were identified at operation in 24 patients. Twelve cases were reoperations. Aortic cross clamp (ACC) time was mean 151$\pm$44 minutes, and cardiopulmonary bypass (CPB) time was mean 246$\pm$65 minutes. Concomitant procedures were mitral valve replacement (MVR) in 19, MVR and aortic valve replacement (AVR) in 14, MVR and tricupid annuloplasty (TAP) in 8, MVR with AV repair in 3, MV repair in 11, MVR and coronary artery bypass grafting (CABG) in 2, MVR and AVR and CABG in 1, redo-MVR in 10, redo-MVR and redo-AVR in 2 patients. The rate of hospital mortality was 1.4%(1/70). Perioperative recurrence of AF was seen in 44(62.9%), and atrial tachyarrhythmias in 10(14.3%), low cardiac output syndrome in 4(5.7%), postoperative bleeding that required mediastinal exploration in 4(5.7%) patients. Other complications were acute renal failure in 2, aggravation of preoperative hemiplegia in 1, and transient delirium in 1 patient. We followed up all the survivors for 16.4 months(3-44months) on an average. Sinus rhythm has been restored in 65(94.2%) patients. AF has been controlled by operation alone in 73.9% and operation plus medication in 20.3%. Two patients needed permanent pacemaker implantation; one with sick sinus syndrome, and the other with tachycardia- bradycardia syndrome. Only two patients remained in AF. We followed up our patients with transthoracic echocardiography to assess the atrial contractilities and other cardiac functions. Right atrial contractility could be demonstrated in 92% and left atrial contractility in 53%.We compared our non-redo cases with redo cases. Although the duration of AF was significantly longer in redo cases, there was no differences in ACC time, CPB time, postoperative bleeding amount and sinus conversion rate. Conclusions: In conclusion, the CMP concomitant with MV operation demonstrated a high sinus conversion rate under the acceptable operative risk even in case of reoperation.